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
CHILDREN'S HOSPITAL & RESEARCH CNTR FNDN
Employer identification number
94-1657474
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.") ....
17,315,350
18,810,031
20,868,676
21,703,263
19,915,230
98,612,550
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
17,315,350
18,810,031
20,868,676
21,703,263
19,915,230
98,612,550
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)..
14,487,663
6
Public support. Subtract line 5 from line 4.
84,124,887
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..
17,315,350
18,810,031
20,868,676
21,703,263
19,915,230
98,612,550
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
6,690,108
6,095,934
4,280,675
3,955,220
4,126,046
25,147,983
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
31,639
31,639
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).
123,792,172
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
67.960 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
65.930 %
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:
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
CHILDREN'S HOSPITAL & RESEARCH CNTR FNDN
Employer identification number
94-1657474
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 4
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, A CALIFORNIA CONSTITUTIONAL CORPORATION ACTING ON BEHALF OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO (UCSF) BECAME THE SOLE MEMBER OF CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND (CHRCO). CHILDREN'S HOSPITAL & RESEARCH CENTER FOUNDATION (CHRCF) IS A SUBSIDIARY OF CHRCO. PURSUANT TO THE AFFILIATION AGREEMENT BETWEEN UCSF AND CHRCO, THE ARTICLES AND BYLAWS OF CHRCF WERE AMENDED AND RESTATED. FURTHER, NEW OFFICERS OF THE BOARD OF DIRECTORS OF CHRCF WERE APPOINTED AND TOOK OFFICE EFFECTIVE DECEMBER 6, 2013.
FORM 990, PART VI, SECTION A, LINE 6
THERE IS ONE VOTING MEMBER OF THE CORPORATION: CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. THE MEMBER MAY EXERCISE ITS VOTE AND ATTEND MEMBERSHIP MEETINGS OF THE CORPORATION BY RESOLUTION OF ITS BOARD OF DIRECTORS OR THROUGH THE ACTION OF ANY PERSON EXPRESSLY AUTHORIZED BY THE MEMBER'S BOARD OF DIRECTORS. THE ARTICLES OF INCORPORATION CURRENTLY STATE THAT THE SPECIFIC PURPOSES OF THE CORPORATION ARE TO RECEIVE AND MAINTAIN A FUND OR FUNDS OF REAL OR PERSONAL PROPERTY, OR BOTH, AND, SUBJECT TO THE RESTRICTIONS AND LIMITATIONS HEREINAFTER SET FORTH, TO USE AND APPLY THE WHOLE OR ANY PART OF THE INCOME THERE FROM AND THE PRINCIPAL THEREOF EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, SCIENTIFIC, LITERARY, OR EDUCATIONAL PURPOSES, BY CONTRIBUTIONS TO CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND. HENCE, THE HOSPITAL "MAY RECEIVE A SHARE OF PROFITS, EXCESS DUES, OR NET ASSETS UPON DISSOLUTION OF THE ORGANIZATION."
FORM 990, PART VI, SECTION A, LINE 7A
SEE RESPONSE TO LINE 6 ABOVE.
FORM 990, PART VI, SECTION A, LINE 7B
THE FOLLOWING ITEMS SHALL REQUIRE THE APPROVAL OF THE MEMBER: (A) THE CORPORATION'S ANNUAL BUDGET (B) THE CORPORATION'S ASSUMPTION OF ANY INDEBTEDNESS OTHER THAN INDEBTEDNESS INCURRED IN THE NORMAL COURSE OF THE CORPORATION'S BUSINESS OPERATIONS.
FORM 990, PART VI, SECTION B, LINE 11
SENIOR VICE PRESIDENT & CHIEF DEVELOPMENT OFFICER REVIEWS WITH THE CONTROLLER. THE RETURN IS THEN TAKEN TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12C
SENIOR MANAGEMENT REVIEWS ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT AS NEEDED.
FORM 990, PART VI, SECTION C, LINE 19
THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING/ORGANIZING DOCUMENTS ARE AVAILABLE TO THE PUBLIC BY INDIVIDUAL REQUESTS WITH RESPONSE VIA ELECTRONIC OR US MAIL.
FORM 990, PART XI, LINE 9:
CHANGE IN SPLIT INTEREST GIFT AGREEMENTS 2,038,236. INVESTMENT INCOME FROM K-1S 6,288. ROUNDING 6.
FORM 990, PART XII, LINE 2C
AUDIT SELECTION AND OVERSIGHT - THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
990, PART VII, SECTION A AND PART IX, STATEMENT OF FUNCTIONAL EXPENSES
EMPLOYEES COMPENSATED BY RELATED ORGANIZATION: THE OFFICERS AND EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HOSPITAL & RESEARCH CENTER OAKLAND (CHRCO). CHRCO REPORTS 100% OF THE INDIVIDUAL'S COMPENSATION ON W-2'S ISSUED BY CHRCO. SOME OF THE EMPLOYEES ARE ASSIGNED DUTIES TO OTHER RELATED ORGANIZATIONS (SEE SCHEDULE R FOR ADDITIONAL INFORMATION REGARDING THE RELATED ORGANIZATIONS). AS A RESULT OF THESE ASSIGNMENTS, WAGE AND BENEFIT COSTS ARE ALLOCATED TO RELATED ORGANIZATIONS. THE WAGE AND BENEFIT COSTS ALLOCATED TO EACH ORGANIZATION ARE REPORTED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES FOR EACH INDIVIDUAL AS BEING COMPENSATED DIRECTLY FROM THE FILING ORGANIZATION AND THE BALANCE OF COMPENSATION IS REPORTED AS COMPENSATION FROM RELATED ORGANIZATIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.