Form990-EZ
Click to see attachment
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except private foundation)
bullet Do not enter Social Security numbers on this form as it may be made public. By law, the
IRS generally cannot redact the information on the form.
bullet Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
OMB No. 1545-1150
2013
Open to Public
Inspection
A
For the 2013 calendar year, or tax year beginning 01-01-2013, and ending 12-31-2013
B
Check if applicable:
C Name of organization
HUMANE SOCIETY OF LAKE NORMAN
 
Number and street (or P. O. box, if mail is not delivered to street address)7711 TROTTER ROAD
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code CHARLOTTE, NC28216
D Employer identification number

27-2946088
E Telephone number

F Group Exemption
Number. . bullet  
G Accounting Method: Other (specify) bullet   H Check bulletI Website:bulletN/AJ Tax-exempt status(check only one)?Click to see attachment(   ) bullet(insert no.) or
K Form of organization:  
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . bullet $ 22,091
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I)Check if the organization used Schedule O to respond to any question in this Part I...................
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received............... 1 22,091
2 Program service revenue including government fees and contracts ............ 2  
3 Membership dues and assessments...................... 3  
4 Investment income........................... 4  
5a Gross amount from sale of assets other than inventory........ 5a  
b Less: cost or other basis and sales expenses........... 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ...... 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) . 6a  
b Gross income from fundraising events (not including $   of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000) 6b  
c Less: direct expenses from gaming and fundraising events....... 6c  
d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances........ 7a  
b Less: cost of goods sold................. 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ......... 7c  
8 Other revenue (describe in Schedule O) ..................... 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8.............. Bullet 9 22,091
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) ................. 10  
11 Benefits paid to or for members........................ 11  
12 Salaries, other compensation, and employee benefits................ 12  
13 Professional fees and other payments to independent contractors............ 13 75
14 Occupancy, rent, utilities, and maintenance................... 14  
15 Printing, publications, postage, and shipping................... 15  
16 Other expenses (describe in Schedule O) .................... 16 22,159
17 Total expenses. Add lines 10 through 16 ................. Bullet 17 22,234
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9)............ 18 -143
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return)................ 19 344
20 Other changes in net assets or fund balances (explain in Schedule O) .......... 20  
21 Net assets or fund balances at end of year. Combine lines 18 through 20.........Bullet 21 201
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2013)
Form 990-EZ (2013)
Page 2
Part IIBalance Sheets (see the instructions for Part II)Check if the organization used Schedule O to respond to any question in this Part II.................

(A) Beginning of year(B) End of year
22Cash, savings, and investments................
344
22
201
23Land and buildings....................
 
23
 
24Other assets (describe in Schedule O) ..........
 
24
 
25Total assets......................
344
25
201
26
Total liabilities (describe in Schedule O) .............
 
26
 
27Net assets or fund balances (line 27 of column (B) must agree with line 21)..
344
27
201
Part IIIStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? THE FOSTER HOME THIS PROGRAM WILL ALLOW THE RESCUE OF AND PROVIDE THE CARE AND SHELTER FOR ADOPTABLE STRAY AND HOMELESS ANIMALS, OWNER SURRENDERED ANIMALS AND ANIMALS SCHEDULED FOR EUTHANASIA AT VARIOUS COUNTY OPERATED ANIMAL SHELTERS. THE ANIMALS WILL BE FOSTERED AT EITHER A PRIVATE RESIDENCE OR A MANAGED SHELTER ESTABLISHED BY THE HSLN AND CARED FOR UNTIL AN APPROVED PERMANENT HOME CAN BE FOUND AND THE ADOPTION PROCESS COMPLETED. THE SANCTUARY PROGRAM THIS PROGRAM WILL PROVIDE CARE AND SHELTER FOR ANIMALS DEEMED UNADOPTABLE AFTER RESCUE DUE TO UNFORESEEN PROBLEMS OR PROBLEMS THAT DEVELOP AFTER RESCUE, WHEN EUTHANASIA OF THE PARTICULAR ANIMAL IS NOT NECESSARY. FOSTER ANIMALS DECLARED UNADOPTABLE WILL BE MAINTAINED BY THE HSLN AS A SANCTUARY RESCUE UNTIL NATURAL DEATH OCCURS OR UNTIL EUTHANIZE CANNOT BE AVOIDED.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 SPAY/NEUTER VOUCHER PROGRAM FOR COMPANION PETS THIS PROGRAM WILL ASSIST THE PUBLIC WITH THE COST OF S/N AND RABIES VACCINATIONS FOR THEIR COMPANION PETS. VOUCHERS WILL ASSIGN PETS IN NEED TO LOCAL SPAY/NEUTER CLINICS AND/OR LOCAL PARTICIPATING VETERINARIANS FOR EITHER FREE OR DISCOUNTED SPAY AND/OR NEUTER AND RABIES SERVICES. PARTICIPATING CLINICS WILL ACCEPT THE VOUCHER AND BILL THE HSLN FOR THE COST ON A MONTHLY BASIS. THE STRAY AND FERAL CAT PROGRAM (S.A.F. CAT PROGRAM) THIS PROGRAM WILL PROVIDE SPAY/NEUTER AND RABIES VACCINATION TO UNADOPTABLE STRAY AND FERAL CATS BY UTILIZING THE TNR (TRAP/NEUTER/RETURN) PHILOSOPHY. CATS FITTING INTO THE CATEGORY OF UNADOPTABLE AND FERAL WILL BE TRAPPED, SPAYED OR NEUTERED WITH EAR TIPPINGS INCLUDED, VACCINATED AND RETURNED TO THE SAME OR DIFFERENT SAFE AREA UNDER THE SUPERVISION OF AN APPROVED COLONY MANAGER. DUTIES OF THE COLONY MANAGER WILL BE TO ASSURE ANY NEW CATS(S) ARRIVING AT THE COLONY ARE ALTERED AND VACCINATED, ASSURING THERE IS STURDY AND SECURE SHELTERS WITH PROPER BEDDING FOR ALL THE CATS, ASSURING THE CATS ARE FED AND WATERED ON A DAILY BASIS AND RE-TRAPPING ANY SICK OR INJURED CAT THAT REQUIRES MEDICAL ATTENTION. THE PUBLIC ASSISTANCE PROGRAM THIS PROGRAM WILL PROVIDE FOOD, SHELTERS, SPAYS, NEUTERS, VACCINATIONS, ANTIBIOTICS, DE-WORMERS, ETC AND MEDICAL ATTENTION TO ANIMALS IN NEED WHEN THEIR OWNERS CANNOT AFFORD TO DO SO THEMSELVES. THE PRIMARY PURPOSE OF THIS PROGRAM WILL BE TO ENABLE OWNERS TO KEEP THEIR PETS THROUGH FINANCIALLY HARD TIMES, RATHER THAN BE FORCED TO SURRENDER THEM TO ANIMAL CONTROL. THE GOOD SAMARITAN PROGRAM THIS PROGRAM WILL PROVIDE ASSISTANCE TO AN INDIVIDUAL(S) UPON FINDING A STRAY AND/OR INJURED ANIMAL. MEDICAL ATTENTION, SPAYS OR NEUTERS, VACCINATIONS, FOOD, SHELTER, ETC WILL BE OFFERED TO HELP THE INDIVIDUAL IN THEIR EFFORTS TO RESCUE AND RE-HOME THE ANIMAL WITHOUT OBLIGATING THE HSLN TO ENTER THE ANIMAL INTO THE FOSTER HOME PROGRAM. EDUCATIONAL INFORMATION ON PET HEALTH CARE AND OWNERSHIP WILL BE PROVIDED TO THE RESCUER TO MAKE THE TEMPORARY FOSTER TIME A SUCCESS AND INFORMATION ON HOW TO PERFORM AN INTERVIEW ON A POTENTIAL NEW OWNER WILL ALSO BE OFFERED. THE ANIMAL TRANSPORT PROGRAM THROUGH AGENCIES SUCH AS BUT NOT LIMITED TO THE NORTH SHORE ANIMAL LEAGUE, LAST CHANCE HIGHWAY AND THE PETSMART RESCUE WAGON, THE ANIMAL TRANSPORT PROGRAM WILL ASSIST OTHER ESTABLISHED ANIMAL TRANSPORT ORGANIZATIONS IN THE RESCUE AND TEMPORARY FOSTERING OF UNWANTED ANIMALS UNTIL THEY CAN BE TRANSPORTED TO NEIGHBORING STATES AND PLACED FOR ADOPTION. DURING THIS TEMPORARY FOSTER TIME OF APPROX 10 TO 14 DAYS BASIC SERVICES SUCH AS FOOD, MEDICAL ATTENTION AND HEALTH CERTIFICATES WILL BE PROVIDED TO THE DOGS, CATS, PUPPIES AND KITTENS CHOSEN FOR THE TRANSPORT. ON TRANSPORT DAY THE ANIMALS WILL BE PRESENTED TO THE PARTNERING ORGANIZATION FOR THE TRIP. THIS PROGRAM WILL ALSO PROVIDE PHYSICAL TRANSPORTATION SERVICES WHEN AN ANIMAL(S) ARE IN NEED TRANSPORT FROM POINT A TO POINT B AND WILL ALSO SUPPORT OTHER GROUPS WITH THE COST OF GASOLINE. THE SHELTER ALLIANCE PROGRAM THIS PROGRAM WILL PROVIDE FOOD, GROOMING, BLANKETS, VACCINATIONS, MEDICAL ATTENTION, ETC TO THE ANIMALS HELD AT LOCAL SHELTERS AND TO OTHER NON- PROFIT SHELTERS OR NON SHELTER 501 C 3 ORGANIZATIONS WHEN THEIR ALLOTTED FUNDS CANNOT PROVIDE THESE ITEMS FOR THE ANIMALS IN THEIR CARE. THE PURPOSE OF THIS PROGRAM WILL BE TO MAKE THE SHELTER ANIMALS MORE ADOPTABLE AND APPEALING TO THE PUBLIC TO INCREASE ADOPTIONS, AND TO REDUCE THE NUMBER OF ANIMALS EUTHANIZED FOR ILLNESS AND INJURY THAT BASIC MEDICAL ATTENTION COULD CURE. THE FOSTER HOME THIS PROGRAM WILL ALLOW THE RESCUE OF AND PROVIDE THE CARE AND SHELTER FOR ADOPTABLE STRAY AND HOMELESS ANIMALS, OWNER SURRENDERED ANIMALS AND ANIMALS SCHEDULED FOR EUTHANASIA AT VARIOUS COUNTY OPERATED ANIMAL SHELTERS. THE ANIMALS WILL BE FOSTERED AT EITHER A PRIVATE RESIDENCE OR A MANAGED SHELTER ESTABLISHED BY THE HSLN AND CARED FOR UNTIL AN APPROVED PERMANENT HOME CAN BE FOUND AND THE ADOPTION PROCESS COMPLETED. THE SANCTUARY PROGRAM THIS PROGRAM WILL PROVIDE CARE AND SHELTER FOR ANIMALS DEEMED UNADOPTABLE AFTER RESCUE DUE TO UNFORESEEN PROBLEMS OR PROBLEMS THAT DEVELOP AFTER RESCUE, WHEN EUTHANASIA OF THE PARTICULAR ANIMAL IS NOT NECESSARY. FOSTER ANIMALS DECLARED UNADOPTABLE WILL BE MAINTAINED BY THE HSLN AS A SANCTUARY RESCUE UNTIL NATURAL DEATH OCCURS OR UNTIL EUTHANIZE CANNOT BE AVOIDED. THE PET ADOPTION PROGRAM THIS PROGRAM WILL WORK TO SECURE APPROVED AND PERMANENT HOMES FOR HSLN FOSTER ANIMALS AT ANY ACCEPTABLE AND WILLING ESTABLISHMENT, INCLUDING BUT NOT LIMITED TO PETSMART, PETCO, PETFINDER.COM, CHARLOTTE.COM AND LOCAL AREA NEWSPAPERS. TAG/MICROCHIP PROGRAM THIS PROGRAM WILL WORK TO PROVIDE NAME TAGS AND MICROCHIPS FOR COMPANION ANIMALS AND HSLN FOSTER ANIMALS. HSLN VOLUNTEERS WILL PROVIDE THE SERVICE ON A WEEKLY OR MONTHLY BASIS AND ASSIST PET OWNERS IN THE PROPER REGISTRATION OF THE PET(S). THE PURPOSE OF THIS PROGRAM IS TO INCREASE THE RETURN OF LOST PETS TO THEIR OWNERS AND TO PREVENT THE NEEDLESS EUTHANASIA OF A PET IF AND WHEN ITS LOST AND/OR COLLECTED BY ANIMAL CONTROL. SPONSORSHIP PROGRAM THE HSLN UNDERSTANDS THERE ARE MANY CARING PEOPLE DESIRING TO HELP WITH ANIMAL RESCUE, BUT JUST DO NOT HAVE THE TIME TO DO SO. THE HSLN MEMBERSHIP PROGRAM WILL ALLOW SINGLE INDIVIDUALS, FAMILIES, WORK GROUPS AND EVEN CHILDREN AND STUDENTS OF ANY AGE, ETC TO BECOME HSLN SPONSORS BY DONATING AN ANNUAL SPONSORSHIP FEE TO THE HSLN. SPONSORS WILL RECEIVE A BUMPER STICKER, MEMBERSHIP CARD(S) AND A PEEL OFF STICKER FOR THEIR BOOK BAGS, BRIEF CASES, REAR VIEW MIRROWS, ETC THAT REFLECTS THEIR SUPPORT FOR THE HSLN AND VERIFIES THEIR MEMBERSHIP FOR 1 YEAR. SPONSORSHIP PROGRAMS WILL INCLUDE A STUDENT SPONSORSHIP AT 12.00 PER YEAR, INDIVIDUAL SPONSORSHIP AT 24.00 PER YEAR, FAMILY SPONSORSHIP AT 35.00 PER YEAR AND WORK GROUPS AT 50.00 PER YEAR. SHELTER PET SPONSORSHIP PROGRAM THIS PROGRAM WILL ALLOW AN INDIVIDUAL(S) TO BE PART OF A RESCUED PETS LIFE WHEN CIRCUMSTANCES PREVENT THEM FROM ACTUALLY OWNING A PET OR BEING ABLE TO VOLUNTEER THEIR TIME AND SERVICES. A SET FEE OF APPROX 18.00 PER MONTH PER PET WILL BE DONATED BY THE INDIVIDUAL(S) WHICH DESIGNATES THEM AS A SHELTER PET SPONSOR AND THE FEE DONATED WILL BE USED TO PROVIDE FOOD, VITAMIN SUPPLEMENTS IF NEEDED, FLEA/TICK/HEARTWORM MEDS, LITTER FOR THE FELINES, WARM BLANKETS, TOYS AND CHEWIES FOR THE PET. THE DONOR WILL PICK THE PET THEY WISH TO SPONSOR AND WILL BE GIVEN PROGRESS REPORTS AND UPDATES ON A REGULAR BASIS, INCLUDING A NOTE AND PICTURE OF THE PET WITH HIS/HER NEW FAMILY WHEN ADOPTED.
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet		 28a 21,352
29
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet 		29a
30
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet 		30a
31 Other program services (describe in Schedule O)
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a).......... bullet 32 21,352
Part IV
List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated — see the instructions for Part IV)Check if the organization used Schedule O to respond to any question in this Part IV............
(a) Name and title (b) Average
hours per week
devoted to position		 (c)Reportable compensation
(Forms W-2/1099-MISC) (if not paid, enter -0-) 		(d) Health benefits, contributions to employee benefit plans,
and deferred compensation		 (e) Estimated amount
of other compensation
GAYLE HOUSERClick to see attachmentPRESIDENT/TR 10.00 0    
Form 990-EZ (2013)
Form 990-EZ (2013)
Page 3
Part V
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V.......
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ...................
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the changeon Schedule O (see instructions) ..........................
34
 
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? ............
35a
 
No
b
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
35b
 
 
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III
35c
 
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes," complete applicable parts of Schedule N ................
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
 
b
Did the organization file Form 1120-POL for this year?...................
37b
 
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?..
38a
 
No
b
If “Yes," complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9.......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities.....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet   ; section 4912 bullet   ; section 4955 bullet  
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefittransaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I ......
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958...bullet  
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization...........................bullet  
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T ......................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42aThe organization's books are in care of bulletGAYLE HOUSER Telephone no. bullet (704) 992-0061
Located at bullet7711 TROTTER ROADCHARLOTTE,NC ZIP + 4bullet28216
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes," enter the name of the foreign country: bullet
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
 
No
If “Yes," enter the name of the foreign country: bullet
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year....bullet43
 
Yes
No
44a
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ................................
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completedinstead of Form 990-EZ.............................
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year?.........
44c
 
No
d
If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an
explanation in Schedule O ............................
44d
 
 
45a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?.........
45a
 
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions)......................
45b
 
No
Form 990-EZ (2013)
Form 990-EZ (2013)
Page 4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition tocandidates for public office? If “Yes," complete Schedule C, Part I. ..............
46
 
No
Part VI
Section 501(c)(3) organizations only All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51 Check if the organization used Schedule O to respond to any question in this Part VI ................
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................
47
 
No
48
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?......
49a
 
No
b
If "Yes," was the related organization a section 527 organization?................
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and title of each employee (b) Average
hours per week
devoted to position		 (c) Reportable compensation
(Forms W-2/1099-MISC) 		(d) Health benefits, contributions to employee benefit plans, and deferred compensation (e) Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000 .................bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and business address of each independent contractor (b) Type of service (c) Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000..........bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ...............bullet
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name bullet

Firm's EIN bullet
Firm's address bullet



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2013)


Form 990-EZ, Special Condition Description:
Special Condition Description

Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow 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
HUMANE SOCIETY OF LAKE NORMAN
 
Employer identification number

27-2946088
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
f
g
(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) right arrow (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) right arrow (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
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.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
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) right arrow (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.") .         22,091 22,091
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.         22,091 22,091
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.) 22,091
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...         22,091 22,091
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.)..         22,091 22,091
14
Section C. Computation of Public Support Percentage
15
15
100.000 %
16
16
 
Section D. Computation of Investment Income Percentage
17
17
0 %
18
18
 
19a
b
20
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:  
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.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet 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
HUMANE SOCIETY OF LAKE NORMAN
 
Employer identification number

27-2946088
Return Reference Explanation
FORM 990-EZ, PART I, LINE 16 EXPENSES TRAVEL 220 MEDICAL EXPENSES 10,539 SHELTER/SANCTUARY EXPENSE 8,870 BANK SERVICE CHARGES 119 LICENSES, FEES, PERMITS 320 OFFICE & POSTAGE EXPENSE 148 SUPPLIES 1,943 TOTAL 22,159
FORM 990-EZ, PART III THE FOSTER HOME THIS PROGRAM WILL ALLOW THE RESCUE OF AND PROVIDE THE CARE AND SHELTER FOR ADOPTABLE STRAY AND HOMELESS ANIMALS, OWNER SURRENDERED ANIMALS AND ANIMALS SCHEDULED FOR EUTHANASIA AT VARIOUS COUNTY OPERATED ANIMAL SHELTERS. THE ANIMALS WILL BE FOSTERED AT EITHER A PRIVATE RESIDENCE OR A MANAGED SHELTER ESTABLISHED BY THE HSLN AND CARED FOR UNTIL AN APPROVED PERMANENT HOME CAN BE FOUND AND THE ADOPTION PROCESS COMPLETED. THE SANCTUARY PROGRAM THIS PROGRAM WILL PROVIDE CARE AND SHELTER FOR ANIMALS DEEMED UNADOPTABLE AFTER RESCUE DUE TO UNFORESEEN PROBLEMS OR PROBLEMS THAT DEVELOP AFTER RESCUE, WHEN EUTHANASIA OF THE PARTICULAR ANIMAL IS NOT NECESSARY. FOSTER ANIMALS DECLARED UNADOPTABLE WILL BE MAINTAINED BY THE HSLN AS A SANCTUARY RESCUE UNTIL NATURAL DEATH OCCURS OR UNTIL EUTHANIZE CANNOT BE AVOIDED.
FORM 990-EZ, PART III, LINE 28 SPAY/NEUTER VOUCHER PROGRAM FOR COMPANION PETS THIS PROGRAM WILL ASSIST THE PUBLIC WITH THE COST OF S/N AND RABIES VACCINATIONS FOR THEIR COMPANION PETS. VOUCHERS WILL ASSIGN PETS IN NEED TO LOCAL SPAY/NEUTER CLINICS AND/OR LOCAL PARTICIPATING VETERINARIANS FOR EITHER FREE OR DISCOUNTED SPAY AND/OR NEUTER AND RABIES SERVICES. PARTICIPATING CLINICS WILL ACCEPT THE VOUCHER AND BILL THE HSLN FOR THE COST ON A MONTHLY BASIS. THE STRAY AND FERAL CAT PROGRAM (S.A.F. CAT PROGRAM) THIS PROGRAM WILL PROVIDE SPAY/NEUTER AND RABIES VACCINATION TO UNADOPTABLE STRAY AND FERAL CATS BY UTILIZING THE TNR (TRAP/NEUTER/RETURN) PHILOSOPHY. CATS FITTING INTO THE CATEGORY OF UNADOPTABLE AND FERAL WILL BE TRAPPED, SPAYED OR NEUTERED WITH EAR TIPPINGS INCLUDED, VACCINATED AND RETURNED TO THE SAME OR DIFFERENT SAFE AREA UNDER THE SUPERVISION OF AN APPROVED COLONY MANAGER. DUTIES OF THE COLONY MANAGER WILL BE TO ASSURE ANY NEW CATS(S) ARRIVING AT THE COLONY ARE ALTERED AND VACCINATED, ASSURING THERE IS STURDY AND SECURE SHELTERS WITH PROPER BEDDING FOR ALL THE CATS, ASSURING THE CATS ARE FED AND WATERED ON A DAILY BASIS AND RE-TRAPPING ANY SICK OR INJURED CAT THAT REQUIRES MEDICAL ATTENTION. THE PUBLIC ASSISTANCE PROGRAM THIS PROGRAM WILL PROVIDE FOOD, SHELTERS, SPAYS, NEUTERS, VACCINATIONS, ANTIBIOTICS, DE-WORMERS, ETC AND MEDICAL ATTENTION TO ANIMALS IN NEED WHEN THEIR OWNERS CANNOT AFFORD TO DO SO THEMSELVES. THE PRIMARY PURPOSE OF THIS PROGRAM WILL BE TO ENABLE OWNERS TO KEEP THEIR PETS THROUGH FINANCIALLY HARD TIMES, RATHER THAN BE FORCED TO SURRENDER THEM TO ANIMAL CONTROL. THE GOOD SAMARITAN PROGRAM THIS PROGRAM WILL PROVIDE ASSISTANCE TO AN INDIVIDUAL(S) UPON FINDING A STRAY AND/OR INJURED ANIMAL. MEDICAL ATTENTION, SPAYS OR NEUTERS, VACCINATIONS, FOOD, SHELTER, ETC WILL BE OFFERED TO HELP THE INDIVIDUAL IN THEIR EFFORTS TO RESCUE AND RE-HOME THE ANIMAL WITHOUT OBLIGATING THE HSLN TO ENTER THE ANIMAL INTO THE FOSTER HOME PROGRAM. EDUCATIONAL INFORMATION ON PET HEALTH CARE AND OWNERSHIP WILL BE PROVIDED TO THE RESCUER TO MAKE THE TEMPORARY FOSTER TIME A SUCCESS AND INFORMATION ON HOW TO PERFORM AN INTERVIEW ON A POTENTIAL NEW OWNER WILL ALSO BE OFFERED. THE ANIMAL TRANSPORT PROGRAM THROUGH AGENCIES SUCH AS BUT NOT LIMITED TO THE NORTH SHORE ANIMAL LEAGUE, LAST CHANCE HIGHWAY AND THE PETSMART RESCUE WAGON, THE ANIMAL TRANSPORT PROGRAM WILL ASSIST OTHER ESTABLISHED ANIMAL TRANSPORT ORGANIZATIONS IN THE RESCUE AND TEMPORARY FOSTERING OF UNWANTED ANIMALS UNTIL THEY CAN BE TRANSPORTED TO NEIGHBORING STATES AND PLACED FOR ADOPTION. DURING THIS TEMPORARY FOSTER TIME OF APPROX 10 TO 14 DAYS BASIC SERVICES SUCH AS FOOD, MEDICAL ATTENTION AND HEALTH CERTIFICATES WILL BE PROVIDED TO THE DOGS, CATS, PUPPIES AND KITTENS CHOSEN FOR THE TRANSPORT. ON TRANSPORT DAY THE ANIMALS WILL BE PRESENTED TO THE PARTNERING ORGANIZATION FOR THE TRIP. THIS PROGRAM WILL ALSO PROVIDE PHYSICAL TRANSPORTATION SERVICES WHEN AN ANIMAL(S) ARE IN NEED TRANSPORT FROM POINT A TO POINT B AND WILL ALSO SUPPORT OTHER GROUPS WITH THE COST OF GASOLINE. THE SHELTER ALLIANCE PROGRAM THIS PROGRAM WILL PROVIDE FOOD, GROOMING, BLANKETS, VACCINATIONS, MEDICAL ATTENTION, ETC TO THE ANIMALS HELD AT LOCAL SHELTERS AND TO OTHER NON- PROFIT SHELTERS OR NON SHELTER 501 C 3 ORGANIZATIONS WHEN THEIR ALLOTTED FUNDS CANNOT PROVIDE THESE ITEMS FOR THE ANIMALS IN THEIR CARE. THE PURPOSE OF THIS PROGRAM WILL BE TO MAKE THE SHELTER ANIMALS MORE ADOPTABLE AND APPEALING TO THE PUBLIC TO INCREASE ADOPTIONS, AND TO REDUCE THE NUMBER OF ANIMALS EUTHANIZED FOR ILLNESS AND INJURY THAT BASIC MEDICAL ATTENTION COULD CURE. THE FOSTER HOME THIS PROGRAM WILL ALLOW THE RESCUE OF AND PROVIDE THE CARE AND SHELTER FOR ADOPTABLE STRAY AND HOMELESS ANIMALS, OWNER SURRENDERED ANIMALS AND ANIMALS SCHEDULED FOR EUTHANASIA AT VARIOUS COUNTY OPERATED ANIMAL SHELTERS. THE ANIMALS WILL BE FOSTERED AT EITHER A PRIVATE RESIDENCE OR A MANAGED SHELTER ESTABLISHED BY THE HSLN AND CARED FOR UNTIL AN APPROVED PERMANENT HOME CAN BE FOUND AND THE ADOPTION PROCESS COMPLETED. THE SANCTUARY PROGRAM THIS PROGRAM WILL PROVIDE CARE AND SHELTER FOR ANIMALS DEEMED UNADOPTABLE AFTER RESCUE DUE TO UNFORESEEN PROBLEMS OR PROBLEMS THAT DEVELOP AFTER RESCUE, WHEN EUTHANASIA OF THE PARTICULAR ANIMAL IS NOT NECESSARY. FOSTER ANIMALS DECLARED UNADOPTABLE WILL BE MAINTAINED BY THE HSLN AS A SANCTUARY RESCUE UNTIL NATURAL DEATH OCCURS OR UNTIL EUTHANIZE CANNOT BE AVOIDED. THE PET ADOPTION PROGRAM THIS PROGRAM WILL WORK TO SECURE APPROVED AND PERMANENT HOMES FOR HSLN FOSTER ANIMALS AT ANY ACCEPTABLE AND WILLING ESTABLISHMENT, INCLUDING BUT NOT LIMITED TO PETSMART, PETCO, PETFINDER.COM, CHARLOTTE.COM AND LOCAL AREA NEWSPAPERS. TAG/MICROCHIP PROGRAM THIS PROGRAM WILL WORK TO PROVIDE NAME TAGS AND MICROCHIPS FOR COMPANION ANIMALS AND HSLN FOSTER ANIMALS. HSLN VOLUNTEERS WILL PROVIDE THE SERVICE ON A WEEKLY OR MONTHLY BASIS AND ASSIST PET OWNERS IN THE PROPER REGISTRATION OF THE PET(S). THE PURPOSE OF THIS PROGRAM IS TO INCREASE THE RETURN OF LOST PETS TO THEIR OWNERS AND TO PREVENT THE NEEDLESS EUTHANASIA OF A PET IF AND WHEN ITS LOST AND/OR COLLECTED BY ANIMAL CONTROL. SPONSORSHIP PROGRAM THE HSLN UNDERSTANDS THERE ARE MANY CARING PEOPLE DESIRING TO HELP WITH ANIMAL RESCUE, BUT JUST DO NOT HAVE THE TIME TO DO SO. THE HSLN MEMBERSHIP PROGRAM WILL ALLOW SINGLE INDIVIDUALS, FAMILIES, WORK GROUPS AND EVEN CHILDREN AND STUDENTS OF ANY AGE, ETC TO BECOME HSLN SPONSORS BY DONATING AN ANNUAL SPONSORSHIP FEE TO THE HSLN. SPONSORS WILL RECEIVE A BUMPER STICKER, MEMBERSHIP CARD(S) AND A PEEL OFF STICKER FOR THEIR BOOK BAGS, BRIEF CASES, REAR VIEW MIRROWS, ETC THAT REFLECTS THEIR SUPPORT FOR THE HSLN AND VERIFIES THEIR MEMBERSHIP FOR 1 YEAR. SPONSORSHIP PROGRAMS WILL INCLUDE A STUDENT SPONSORSHIP AT 12.00 PER YEAR, INDIVIDUAL SPONSORSHIP AT 24.00 PER YEAR, FAMILY SPONSORSHIP AT 35.00 PER YEAR AND WORK GROUPS AT 50.00 PER YEAR. SHELTER PET SPONSORSHIP PROGRAM THIS PROGRAM WILL ALLOW AN INDIVIDUAL(S) TO BE PART OF A RESCUED PETS LIFE WHEN CIRCUMSTANCES PREVENT THEM FROM ACTUALLY OWNING A PET OR BEING ABLE TO VOLUNTEER THEIR TIME AND SERVICES. A SET FEE OF APPROX 18.00 PER MONTH PER PET WILL BE DONATED BY THE INDIVIDUAL(S) WHICH DESIGNATES THEM AS A SHELTER PET SPONSOR AND THE FEE DONATED WILL BE USED TO PROVIDE FOOD, VITAMIN SUPPLEMENTS IF NEEDED, FLEA/TICK/HEARTWORM MEDS, LITTER FOR THE FELINES, WARM BLANKETS, TOYS AND CHEWIES FOR THE PET. THE DONOR WILL PICK THE PET THEY WISH TO SPONSOR AND WILL BE GIVEN PROGRESS REPORTS AND UPDATES ON A REGULAR BASIS, INCLUDING A NOTE AND PICTURE OF THE PET WITH HIS/HER NEW FAMILY WHEN ADOPTED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  

TY 2013 CompensationExplanation
Name:
HUMANE SOCIETY OF LAKE NORMAN
EIN: 27-2946088
Person Name Explanation
GAYLE HOUSER