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
MIDDLEBURY LAND TRUST INC
Employer identification number
23-7050688
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.") ....
32,800
10,824
8,536
20,438
20,525
93,123
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
32,800
10,824
8,536
20,438
20,525
93,123
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.
93,123
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..
32,800
10,824
8,536
20,438
20,525
93,123
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
48,819
55,845
62,890
62,783
76,339
306,676
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).
399,799
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
23.290 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
27.670 %
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
THIS IS THE FIRST YEAR THE ORGANIZATION HAS NOT SATISFIED THE 33 1/3 PERCENT PUBLIC SUPPORT TEST IN EITHER THE CURRENT YEAR OR THE IMMEDIATELY PRECEDING YEAR. HOWEVER, THE ORGANIZATION STILL SATISFIES THE PUBLIC SUPPORT TEST UNDER TREASURY REGULATION 1.170A-9(F)(3). THE ORGANIZATION EXCEEDS THE 10 PERCENT THRESHOLD OF PUBLIC SUPPORT SET BY THE TREASURY REGULATION WITH 23.29% PUBLIC SUPPORT RECEIVED DURING THE CURRENT YEAR. FURTHERMORE, THE ORGANIZATION SOLICITS CONTRIBUTIONS AND MEMBERSHIPS THROUGH ITS WEBSITE, AND ALSO SOLICITS MEMBERSHIPS THROUGH DIRECT MAIL. THE ORGANIZATION ALSO RECEIVES CONTRIBUTIONS OF LAND AND EASEMENTS. THERE IS CONSIDERABLE FLEXIBILITY ON THE PART OF MIDDLEBURY LAND TRUST IN ACCOMMODATING THE REQUIREMENTS OF THE DONOR WITH RESPECT TO THE TYPE OF INTEREST THE DONOR MAY WISH TO GIVE. THUS, IN ADDITION TO AN OUT-RIGHT CONVEYANCE OF LAND, A DONOR MAY CONVEY PARTIAL INTERESTS IN LAND OVER A PERIOD OF YEARS (FOR EXAMPLE, AN UNDIVIDED ONE-TENTH PER YEAR), OR RESERVE THE RIGHT TO LIVE ON OR USE THE LAND FOR THE REMAINDER OF HIS OR HER LIFE, OR MAY CONVEY A CONSERVATION EASEMENT. IN GRANTING A CONSERVATION EASEMENT, THE DONOR GIVES UP ONLY HIS OR HER DEVELOPMENT RIGHTS IN THE LAND. THE DONOR RETAINS ALL OTHER PROPERTY RIGHTS, INCLUDING THE FREEDOM TO USE THE LAND AND ENJOY IT IN ANY WAY THAT IS CONSISTENT WITH ITS OPEN AND NATURAL CHARACTER. HOWEVER, ONCE ALL THE RESTRICTIONS ON THE GIFTS HAVE BEEN SATISFIED, THE DONOR OR THE DONOR'S HEIRS HAVE NO MORE CONTROL OVER THE USE OF THE LAND THAN ANY OF MEMBER OF ORGANIZATION, THOUGH THEY MAY BE ELECTED TO THE BOARD BY THE ORGANIZATION'S MEMBERS. THE ORGANIZATION PROVIDES FACILITIES FOR THE BENEFIT OF THE GENERAL PUBLIC ENSURING ITS HOLDINGS OF LAND AND EASEMENTS ARE AVAILABLE FOR PUBLIC USE, PROTECTION OF NATURAL HABITATS, AND THE PRESERVATION OF OPEN SPACE. THE MIDDLEBURY LAND TRUST MAINTAINS ITS AREAS SO THAT THE NATURAL CHARACTER OF THE LAND ENDURES. ALL MIDDLEBURY LAND TRUST PROPERTIES ARE AVAILABLE FOR RESPONSIBLE USE BY LOCAL RESIDENTS, SUBJECT TO POSTED RESTRICTIONS. THESE RESTRICTIONS PROHIBIT CAMPING, HUNTING, TRAPPING, FISHING, FIRES AND THE USE OF POWER VEHICLES. PLANTS AND WILDLIFE MAY NOT BE REMOVED OR DESTROYED. THUS, NONDESTRUCTIVE USES SUCH AS HIKING, HORSEBACK RIDING AND NATURE PHOTOGRAPHY ARE PERMITTED. IN ADDITION, SCIENTIFIC RESEARCH AND OUTDOOR EDUCATIONAL PROJECTS BY LOCAL SCHOOLS, COLLEGES AND YOUTH ORGANIZATIONS ARE ENCOURAGED. MEMBERS OF THE ORGANIZATION MAY OBTAIN A PERMIT TO ALLOW THEM TO FISH ON THE ORGANIZATION'S LAKES ON A CATCH-AND-RELEASE BASIS. THE ORGANIZATION HAS A GOVERNING BODY THAT REPRESENTS THE INTERESTS OF THE GENERAL PUBLIC. A MEMBERSHIP IN THE ORGANIZATION CAN BE PURCHASED FOR AS LITTLE AS 15 FOR AN INDIVIDUAL OR 5 IF THE INDIVIDUAL IS A STUDENT, MAKING MEMBERSHIP ACCESSIBLE TO ALL. THESE MEMBERS ARE EACH ENTITLED TO VOTE IN THE ELECTION OF THE BOARD OF DIRECTORS OF THE ORGANIZATION.
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
MIDDLEBURY LAND TRUST INC
Employer identification number
23-7050688
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
"THE PRIMARY OBJECTIVE OF MIDDLEBURY LAND TRUST IS TO ACQUIRE AND PRESERVE LAND OR CONSERVATION EASEMENTS BY GIFT OR PURCHASE TO BE HELD IN PERPETUITY AS OPEN SPACE IN ORDER TO MAINTAIN AND PRESERVE A HEALTHY, ATTRACTIVE AND BALANCED ENVIRONMENT FOR LIVING IN THE TOWN OF MIDDLEBURY. IT THUS SEEKS TO PRESERVE THOSE NATURAL AREAS, INCLUDING FORESTS, MEADOWS, SWAMPS, MARSHES, PONDS AND STREAMS WHICH CONTRIBUTE TO AND ENHANCE THE RURAL NATURE OF THE TOWN. IN THIS CAPACITY IT MAKES ITSELF AVAILABLE TO THE TOWN OF MIDDLEBURY TO ASSIST IN IMPLEMENTING THE TOWN PLAN OF DEVELOPMENT." HTTP://WWW.MIDDLEBURYLANDTRUST.ORG/FAQS/INDEX.SHTML
FORM 990, PAGE 6, PART VI, LINE 6
THE CORPORATION HAS MEMBERSHIPS. MEMBERSHIP ENTITLES THE MEMBER TO VOTE FOR DIRECTORS AND RECEIVE NOTICES AND THE ANNUAL FINANCIAL STATEMENT.
FORM 990, PAGE 6, PART VI, LINE 7A
THE MEMBERSHIP VOTES FOR DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 7B
THE MEMBERSHIP MUST APPROVE BY VOTE FOR DISPOSAL OF REAL ESTATE.
FORM 990, PAGE 6, PART VI, LINE 11B
THE TREASURER REVIEWS AND SIGNS THE 990. AT THE NEXT BOARD MEETING THE GOVERNING BOARD IS MADE AWARE FO THE 990 FILING AND THE 990 FORM IS REVIEWED BY THE ENTIRE BOARD, IF SO WARRANTED.
FORM 990, PAGE 6, PART VI, LINE 12C
THE BOARD IS CONSIDERING COMMENCING THE LAND TRUST ALLIANCE ACCREDITATION PROCESS. THIS WOULD INCLUDE MODULES COVERING CONFLICTS OF INTEREST, WHISTLEBLOWER, AND DOCUMET RETENTION.
FORM 990, PAGE 6, PART VI, LINE 19
FORM 990, PART VI, SECTION C, LINE 18: THE AFOREMENTIONED DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19: THE AFOREMENTIONED DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.