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
ANIMAL CARE AND ASSISTANCE FUND
Employer identification number
20-8667061
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.") ....
119,857
164,215
196,087
206,816
195,766
882,741
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
119,857
164,215
196,087
206,816
195,766
882,741
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)..
269,984
6
Public support. Subtract line 5 from line 4.
612,757
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..
119,857
164,215
196,087
206,816
195,766
882,741
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
3,328
3,655
-787
7,843
3,569
17,608
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.)..
38,876
38,876
11
Total support (Add lines 7 through 10).
939,225
12
Gross receipts from related activities, etc. (see instructions)
..................
12
56,246
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
65.240 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
68.340 %
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
ANIMAL CARE AND ASSISTANCE FUND
Employer identification number
20-8667061
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
FOR ANIMALS TO EXPERIENCE A LIFE OF RESPECT AND BE FREE FROM UNNECESSARY SUFFERING. OUR OBJECTIVE IS TO OFFER PET OWNERS IN FINANCIAL CRISIS AN ALTERNATIVE TO EUTHANASIA WHEN THEIR PET FACES A TREATABLE, YET LIFE- THREATENING CONDITION. COMPANION PETS ARE VITAL MEMBERS OF THE FAMILY... WE WANT TO RESTORE THE QUALITY OF LIFE FOR PETS AS WELL AS THEIR OWNER.
FORM 990, PAGE 2, PART III, LINE 2
IN 2013 THE ANIMAL CARE AND ASSISTANCE FUND (ACAF) BEGAN TO OPERATE THE ROGAN REXFORD ANIMAL BLOOD BANK. SEE PART III 4B FOR A DETAILED DESCRIPTION OF THE PROGRAM. SEE ALSO THE DESCRIPTION BELOW AND ON SCHEDULE L FOR A MORE DETAILED DESCRIPTION OF SIGNIFICANT PROGRAM SERVICES PROVIDED CURRENTLY AND IN THE PAST.
FORM 990, PAGE 2, PART III, LINE 4A
THE ASSISTANCE PAYMENTS ARE GRANTED TO THE OWNERS OF THE PETS IN NEED BUT ARE PAID DIRECTLY TO THE DEPARTMENTS OF THE PITTSBURGH VETERINARY SPECIALTY AND EMERGENCY CLINIC (PVSEC) ON BEHALF OF THE PET OWNERS. THE "EMERGENCY ASSISTANCE FUND"; "CANCER CARE FUND (ASTA'S ANGEL FUND)"; AND "EYE CARE FUND (MAGGIE'S FUND)" REQUIRES THAT THE PET OWNERS PROVIDE AT LEAST 50% OF THE COST OF CARE IN ORDER TO RECEIVE AID FROM THE "EMERGENCY ASSISTANCE FUND". VETERINARY EMERGENCY CLINIC (VEC) ONE OF THE DEPARTMENTS OF PVSEC, VEC IS MAJORITY OWNED BY ACAF'S BOARD CHAIR DR. KENTON REXFORD. FOR FURTHER INFORMATION ON THE RELATIONSHIP OF VEC AND ACAF PLEASE ALSO SEE SCHEDULE L. IN 2013 VEC RECEIVED 35,403 IN PAYMENTS FOR SERVICES PERFORMED ON BEHALF OF THE PETS OF OWNERS SERVICED BY ACAF.
FORM 990, PAGE 2, PART III, LINE 4B
THE ROGAN REXFORD ANIMAL BLOOD BANK ALLOWS VETERINARIANS TO TREAT THEIR PATIENTS QUICKLY AND SAFELY WITH BLOOD COLLECTED FROM VOLUNTEERS. ACAF'S GOAL IS TO GROW AND OPERATE THE BLOOD BANK TO SERVICE THE ENTIRE PITTSBURGH REGION. THE BLOOD BANK IS OPERATED ON BEHALF OF ACAF BY THE PITTSBURGH VETERINARY SPECIALTY AND EMERGENCY CLINIC (PVSEC). IN 2013 THE VETERINARY EMERGENCY CLINIC (VEC) WHICH IS MAJORITY OWNED BY ACAF'S BOARD CHAIR DR. KENTON REXFORD, WAS THE SOLE PURCHASER OF BLOOD UNITS FROM THE BLOOD BANK. FOR FURTHER INFORMATION ON THE RELATIONSHIP OF VEC AND ACAF PLEASE ALSO SEE SCHEDULE L . IN 2013 PVSEC, VEC AND OTHER DEPARTMENTS WITHIN PVSEC, PROVIDED A SUBSTANTIAL AMOUNT OF THE SUPPORT OF THE OPERATIONS OF THE BLOOD BANK IN 2013.
FORM 990, PAGE 6, PART VI, LINE 2
CHARLES AFTOSMIS LAURA AFTOSMIS HUSBAND AND WIFE
FORM 990, PAGE 6, PART VI, LINE 11B
THE FORM 990 IS REVIEWED BY THE BOARD CHAIR AND THE TREASURER OF ACAF PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 15B
THE BOARD OF ACAF REVIEWED AND APPROVED THE COST PAID TO VETERINARY MANAGEMENT, LLC., TO LEASE THE SERVICES OF PROGRAM DIRECTOR JESSICA BALOGH. VETERINARY MANAGEMENT, LLC., IS A MANAGEMENT COMPANY THAT THE BOARD CHAIR DR. KENTON REXFORD HAS PARTIAL OWNERSHIP IN.
FORM 990, PAGE 6, PART VI, LINE 19
THE ACAF'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.