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
Mission Lazarus Inc
Employer identification number
75-3151070
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.") ....
1,450,893
1,555,929
2,810,766
2,489,925
2,629,338
10,936,851
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
1,450,893
1,555,929
2,810,766
2,489,925
2,629,338
10,936,851
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)..
0
6
Public support. Subtract line 5 from line 4.
10,936,851
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..
1,450,893
1,555,929
2,810,766
2,489,925
2,629,338
10,936,851
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
17,565
980
86
688
2,171
21,490
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.)..
2,953
8,056
5,597
3,049
2,303
21,958
11
Total support (Add lines 7 through 10).
10,980,299
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,496,870
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
99.600 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.580 %
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.") .
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
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:
13000170
Software Version:
2013v3.1
-
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
Mission Lazarus Inc
Employer identification number
75-3151070
Return Reference
Explanation
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: Various program services including health services, mission groups, agriculture, rebuilding homes for earthquake victims and special projects.
Form 990, Part VI, Line 11b: Form 990 Review Process
The treasurer submits Form 990 to the executive committee for review, then it is filed.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
The directors are required to complete a conflict of interest disclosure statement each year, and fully disclose any interest each director has that will be considered self-dealing or a conflict of interest.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
An executive compensation committee ("ECC"), consisting of three directors of the corporation, will meet annually prior to the beginning of the organization's fiscal year. The ECC will gather compensation survey results from an outside firm. In conducting this survey, comparative data is to be gathered from non-profit organizations of similar size.Using the survey results, the ECC will propose annual salary ranges for all employees. The corporation's board of directors will review and approve the salary ranges for the top ten most highly compensated organization employees. These approved salary ranges will be used in conjunction with the employee performance appraisals to determine the specific compensation level for each individual.The ECC will set the compensation level for the president/chief executive officer. The president/chief executive officer will set the compensation levels for all other organization employees. In this practice, the ECC will also review the president/chief executive officer established compensation levels for the remaining nine most highly compensated employees.Then, in executive session with the president/chief executive officer present, the board of directors will review the compensation levels and comparison data for the president/chief executive officer and the other nine positions. This report to the full board will occur after the annual compensation process has taken place and is implemented. The data will be presented for informational purposes only; no action will be required by the board.The actions taken by the ECC will enable the organization to receive the rebuttable presumption of reasonableness for purposes of Internal Revenue Code Section 4958 with respect to the total compensation of certain members of the senior management team including the president/chief executive officer and the next nine most highly compensated employees. The three factors which must be satisfied in order to receive the rebuttable resumption fo reasonableness are the following:1) The compensation arrangement is approved in advance by an "authorized body" of the applicable tax-exempt organization which is composed entirely of individuals who do not have a "conflict of interest" with respect to the compensation agreement.2) The authorized body obtained and relied upon "appropriate data as to comparability" prior to making its determination; and3) The authorized body "adequately documented the basis for its determination" concurrently with making that determination.The actions outlined above with respect to the committee and the establishment of the rebuttable presumption of reasonableness applies to certain individuals disclosed in this Form 990, including the president/chief executive officer and the next nine most highly compensated employees. The compensation and benefits of the other individuals contained in this Form 990 is reviewed annually by the president/chief executive officer with assistance from the ECC in conjuntion with the individual's job performance during the year and is based upon other objective factors designed to ensure that reasonable and fair market value compensation is paid by the organization. Other objective factors include market survey data for comparable positions, individual goals and objectives, personnel reviews, evaluations, self-evaluations and performance feedback meetings.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Financial information is available on our web site and all other governing documents and policies are available upon request.
Form 990, Part IX, Line 24e: Other Expenses
Clothing: Column (A) - Total = $5715; Column (B) - Program Services = $5715; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Fuel and Oil: Column (A) - Total = $110296; Column (B) - Program Services = $110296; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Giving: Column (A) - Total = $39381; Column (B) - Program Services = $39381; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Medical: Column (A) - Total = $44880; Column (B) - Program Services = $44880; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Miscellaneous Fundraising: Column (A) - Total = $27; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $27
Form 990, Part IX, Line 24e: Other Expenses
Miscellaneous: Column (A) - Total = $89165; Column (B) - Program Services = $89165; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Postage and Shipping: Column (A) - Total = $33706; Column (B) - Program Services = $17159; Column (C) - Management & General = $0; Column (D) - Fundraising = $16547
Form 990, Part IX, Line 24e: Other Expenses
Printing and Publications: Column (A) - Total = $11596; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $11596
Form 990, Part IX, Line 24e: Other Expenses
Rental Expenses: Column (A) - Total = $50985; Column (B) - Program Services = $12917; Column (C) - Management & General = $38068; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Taxes: Column (A) - Total = $514; Column (B) - Program Services = $514; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Utilities: Column (A) - Total = $73898; Column (B) - Program Services = $73898; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses
Video Production: Column (A) - Total = $386; Column (B) - Program Services = $0; Column (C) - Management & General = $0; Column (D) - Fundraising = $386
Form 990, Part IX, Line 24e: Other Expenses
Website Expense: Column (A) - Total = $8452; Column (B) - Program Services = $0; Column (C) - Management & General = $8268; Column (D) - Fundraising = $184
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.