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
THE ASSISTANCE FUND INC
Employer identification number
27-0270731
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.") ....
20,630,025
21,389,658
41,208,735
70,764,572
63,651,633
217,644,623
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
20,630,025
21,389,658
41,208,735
70,764,572
63,651,633
217,644,623
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)..
178,754,840
6
Public support. Subtract line 5 from line 4.
38,889,783
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..
20,630,025
21,389,658
41,208,735
70,764,572
63,651,633
217,644,623
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
11,495
81,852
82,349
119,345
95,048
390,089
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.)..
-14,973
-14,973
11
Total support (Add lines 7 through 10).
218,019,739
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
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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
THE ASSISTANCE FUND INC
Employer identification number
27-0270731
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2
JEFFREY P. SPAFFORD AND EDWARD H. HENSLEY ARE BOTH 50% OWNERS OF ASSIST RX,INC., AN S CORP. THAT PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11
THE BOARD OF DIRECTORS IS PROVIDED WITH A COPY OF THE COMPLETED FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE SECRETARY OF THE CORPORATION SHALL DISTRIBUTE ANNUALLY TO ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES (AS IDENTIFIED BY THE CORPORATION), A FORM SOLICITING THE DISCLOSURE OF ALL CONFLICTS OF INTEREST, INCLUDING SPECIFIC INFORMATION CONCERNING THE TERMS OF ANY CONTRACT OR TRANSACTION WITH THE CORPORATION AND WHETHER THE PROCESS FOR APPROVAL SET FORTH IN THIS POLICY WAS USED. SUCH DISCLOSURE FORM MAY REQUIRE DISCLOSURE OF OTHER RELATIONSHIPS THAT MAY NOT CONSTITUTE AN ACTUAL CONFLICT OF INTEREST, BUT WHICH ARE REQUIRED TO BE DISCLOSED IN ORDER FOR THE CORPORATION TO COMPLY WITH ITS ANNUAL REPORTING REQUIREMENTS. AN EMPLOYEE OF THE CORPORATION WITH A POTENTIAL CONFLICT OF INTEREST IN A PARTICULAR MATTER SHALL PROMPTLY AND FULLY DISCLOSE THE POTENTIAL CONFLICT TO HIS SUPERVISOR. THE EMPLOYEE SHALL THEREAFTER REFRAIN FROM PARTICIPATING IN DELIBERATIONS AND DISCUSSION, AS WELL AS ANY DECISIONS, RELATING TO THE MATTER AND FOLLOW THE DIRECTION OF THE SUPERVISOR AS TO HOW THE CORPORATION DECISIONS WHICH ARE THE SUBJECT OF THE CONFLICT WILL BE DETERMINED. THE BOARD CHAIR SHALL BE RESPONSIBLE FOR DETERMINING THE PROPER WAY FOR THE CORPORATION TO HANDLE CORPORATION DECISIONS WHICH INVOLVE UNRESOLVED EMPLOYEE CONFLICTS OF INTEREST. IN MAKING SUCH DETERMINATIONS, THE BOARD CHAIR MAY CONSULT WITH LEGAL COUNSEL. THE BOARD CHAIR SHALL REPORT TO THE BOARD AT LEAST ANNUALLY CONCERNING EMPLOYEE CONFLICTS OF INTEREST WHICH HAVE BEEN DISCLOSED AND CONTRACTS AND TRANSACTIONS INVOLVING EMPLOYEE CONFLICTS WHICH THE BOARD CHAIR HAS APPROVED.
FORM 990, PART VI, SECTION B, LINE 15
IT IS THE POLICY OF THE CORPORATION TO PAY NO MORE THAN REASONABLE COMPENSATION FOR PERSONAL SERVICES RENDERED TO THE CORPORATION BY OFFICERS AND EMPLOYEES. THE DIRECTORS OF THE CORPORATION SHALL NOT RECEIVE COMPENSATION FOR FULFILLING THEIR DUTIES AS DIRECTORS, ALTHOUGH DIRECTORS MAY BE REIMBURSED FOR ACTUAL OUT-OF-POCKET EXPENSES WHICH THEY INCUR IN ORDER TO FULFILL THEIR DUTIES AS DIRECTORS. EXPENSES OF SPOUSES WILL NOT BE REIMBURSED BY THE CORPORATION UNLESS THE EXPENSES ARE NECESSARY TO ACHIEVE A CORPORATION PURPOSE. THE BOARD OF DIRECTORS MUST APPROVE IN ADVANCE THE AMOUNT OF ALL COMPENSATION FOR OFFICERS OF THE CORPORATION. BEFORE APPROVING THE COMPENSATION OF AN OFFICER, THE BOARD SHALL DETERMINE THAT THE TOTAL COMPENSATION TO BE PROVIDED BY THE CORPORATION TO THE OFFICER IS REASONABLE IN AMOUNT IN LIGHT OF THE POSITION, RESPONSIBILITY AND QUALIFICATION OF THE OFFICER FOR THE POSITION HELD, INCLUDING THE RESULT OF AN EVALUATION OF THE OFFICER'S PRIOR PERFORMANCE FOR THE CORPORATION, IF APPLICABLE. IN MAKING THE DETERMINATION, THE BOARD SHALL CONSIDER TOTAL COMPENSATION TO INCLUDE THE SALARY AND THE VALUE OF ALL BENEFITS PROVIDED BY THE CORPORATION TO THE INDIVIDUAL IN PAYMENT FOR SERVICES. AT THE TIME OF THE DISCUSSION AND DECISION CONCERNING AN OFFICER'S COMPENSATION, THE OFFICER SHOULD NOT BE PRESENT IN THE MEETING. THE BOARD SHALL OBTAIN AND CONSIDER APPROPRIATE DATA CONCERNING COMPARABLE COMPENSATION PAID TO SIMILAR OFFICERS IN LIKE CIRCUMSTANCES. THE BOARD SHALL SET FORTH THE BASIS FOR ITS DECISIONS WITH RESPECT TO COMPENSATION IN THE MINUTES OF THE MEETING AT WHICH THE DECISIONS ARE MADE, INCLUDING THE CONCLUSIONS OF THE EVALUATION AND THE BASIS FOR DETERMINING THAT THE INDIVIDUAL'S COMPENSATION WAS REASONABLE IN LIGHT OF THE EVALUATION AND THE COMPARABILITY DATA. FOR OTHER KEY EMPLOYEES, COMPENSATION IS DETERMINED BY THE EXECUTIVE DIRECTOR AFTER REVIEW OF COMPARABILITY DATA, INCLUDING A SALARY SURVEY. THE INFORMATION GATHERED AND FACTORS CONSIDERED IN ARRIVING AT THE COMPENSATION IS DOCUMENTED IN THE EMPLOYEES' PERSONNEL FILE. THIS PROCESS IS PERFORMED ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19
THERE SHALL BE KEPT AT THE OFFICE OF THE CORPORATION: (1) CORRECT AND COMPLETE BOOKS AND RECORDS OF ACCOUNT; (2) MINUTES OF THE PROCEEDINGS OF THE BOARD OF DIRECTORS AND THE EXECUTIVE COMMITTEE; (3) A CURRENT LIST OF THE DIRECTORS AND OFFICERS OF THE CORPORATION AND THEIR RESIDENCE ADDRESSES; (4) A COPY OF THESE BY-LAWS; (5) A COPY OF THE CORPORATION'S APPLICATION FOR RECOGNITION OF EXEMPTION WITH THE INTERNAL REVENUE SERVICE; AND (6) COPIES OF THE PAST THREE (3) YEARS' INFORMATION RETURNS TO THE INTERNAL REVENUE SERVICE. ANY OF THE BOOKS, MINUTES AND RECORDS OF THE CORPORATION MAY BE IN WRITTEN FORM OR IN ANY OTHER FORM CAPABLE OF BEING CONVERTED INTO WRITTEN FORM WITHIN A REASONABLE TIME. THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART XII, LINE 2C
THE BOARD OF DIRECTORS SELECTED 3 MEMBERS TO SERVE AS THE AUDIT COMMITTEE. THESE INDIVIDUALS WERE RESPONSIBLE FOR SELECTING THE INDEPENDENT ACCOUNTANTS TO PERFORM THE AUDIT OF THE FINANCIAL STATEMENTS.
PART IV, LINE 11B
THE POPULATION SERVED BY THE ASSISTANCE FUND INCLUDES PATIENTS SUFFERING FROM BOTH CRITICAL AND CHRONIC ILLNESSES THAT REQUIRE SPECIALTY PHARMACEUTICALS TO MANAGE DISEASE SYMPTOMS OR MAINTAIN LIFE ITSELF. IN ORDER TO ENSURE CONTINUITY OF CARE FOR THE PATIENTS ENROLLED WITHIN ALL OF ITS PROGRAMS, THE ORGANIZATION MAINTAINS A RESERVE OF FUNDS.
PART V, LINE 7 G AND H
THESE QUESTIONS HAVE BEEN ANSWERED NO BECAUSE THE ORGANIZATION DID NOT HAVE ANY CONTRIBUTIONS OF THESE TYPES THAT WOULD REQUIRE THIS REPORTING.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.