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
VAN OTTERLOO FAMILY FOUNDATION
Employer identification number
04-6827450
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)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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
(A)
PERKINS SCHOOL FOR THE BLIND
042103616
501C3
No
Yes
Yes
900
(B)
CATHOLIC SCHOOLS FOUNDATION
222485502
501C3
No
Yes
Yes
30,000
(C)
RAWARTWORKS
222854850
501C3
No
Yes
Yes
152,800
(D)
LAKES REGION COMMUNITY SERVICES
020329795
501C3
No
Yes
Yes
500
(E)
THE PLUMMER HOME FOR BOYS
042104844
501C3
No
Yes
Yes
30,000
(F)
EPIPHANY
043391788
501C3
No
Yes
Yes
15,000
(G)
LESLEY UNIVERSITY
042103589
501C3
No
Yes
Yes
80,000
(H)
NASHOBA LEARNING GROUP
010672424
501C3
No
Yes
Yes
53,000
(I)
BEVERLY SCHOOL FOR THE DEAF
042103886
501C3
No
Yes
Yes
50,000
(J)
WHOLE VILLAGE FAMILY RESOURCE CENTER
020467706
501C3
No
Yes
Yes
1,000
(K)
BELLESINI ACADEMY
043585445
501C3
No
Yes
Yes
36,000
(L)
ENDICOTT COLLEGE
042103567
501C3
No
Yes
Yes
100
(M)
OPERATION BOOTSTRAP INC
042679573
501C3
No
Yes
Yes
50,000
(N)
NORTH SHORE COMMUNITY ACTION PROGRAMS INC
042385280
501C3
No
Yes
Yes
25,000
(O)
SHORE COUNTRY DAY SCHOOL
042104926
501C3
No
Yes
Yes
1,000
(P)
ST LUKE'S FOUNDATION
237099149
501C3
No
Yes
Yes
5,000
(Q)
SALEM MISSION
204539306
501C3
No
Yes
Yes
15,000
(R)
HOLDERNESS SCHOOL
020147630
501C3
No
Yes
Yes
1,750
(S)
TOPELA HIGH SCHOOL
481250380
501C3
No
Yes
Yes
100
(T)
PEABODY ESSEX MUSEUM
043157815
501C3
No
Yes
Yes
100
(U)
UNIVERSITY OF NEW ENGLAND
010211810
501C3
No
Yes
Yes
200
(V)
ARTIS-NAPLES INC
592322926
501C3
No
Yes
Yes
35,000
(W)
BOSTON BALLET
042312734
501C3
No
Yes
Yes
20,000
(X)
BRIDGEWELL
042296940
501C3
No
Yes
Yes
25,000
(Y)
BROOKE CHARTER SCHOOL
300015324
501C3
No
Yes
Yes
50,000
(Z)
CONSERVANCY OF SW FLORIDA
591157084
501C3
No
Yes
Yes
75,000
(AA)
ESPERANZA ACADEMY
731722348
501C3
No
Yes
Yes
94,000
(AB)
FUTURECHEFS
042261109
501C3
No
Yes
Yes
20,000
(AC)
HUNTINGTON THEATRE
222659560
501C3
No
Yes
Yes
10,000
(AD)
NEXT STEP
043579298
501C3
No
Yes
Yes
25,000
(AE)
NORTHSHORE COMMUNITY COLLEGE
222485476
501C3
No
Yes
Yes
31,000
(AF)
STEPPING STONE FOUNDATION
043086666
501C3
No
Yes
Yes
10,000
(AG)
THE HAVEN PROJECT
453797693
501C3
No
Yes
Yes
10,000
(AH)
THE KLINGENSTEIN CENTER
131624202
501C3
No
Yes
Yes
120,000
(AI)
UNIVERSITY OF KANSAS
480547734
501C3
No
Yes
Yes
500
(AJ)
THE LIBRARY FOUNDATION
480956441
501C3
No
Yes
Yes
250
(AK)
PEMI-BAKER LITERACY
272966716
501C3
No
Yes
Yes
100
(AL)
BEACON ACADEMY
731710051
501C3
No
Yes
Yes
25,000
(AM)
GIRLS INC
042104250
501C3
No
Yes
Yes
50,000
(AN)
GUADALUPE CENTER IMMOKALEE
592617151
501C3
No
Yes
Yes
60,000
(AO)
SOUNDART
133132697
501C3
No
Yes
Yes
15,000
(AP)
TENACITY
043452763
501C3
No
Yes
Yes
150,000
(AQ)
BROCKTON SPORTS FOUNDATION
043319019
501C3
No
Yes
Yes
25,000
(AR)
COMMONLIT
042103886
501C3
No
Yes
Yes
707
Total
1,399,007
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.") ....
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
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.
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..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
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).
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
VAN OTTERLOO FAMILY FOUNDATION
Employer identification number
04-6827450
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 8B
THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD. THE FOUNDATION ONLY HAS A BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11
TRUSTEE, ROSE MARIE VAN OTTERLOO, RECEIVES THE 990, SHE REVIEWS THE INFORMATION.
FORM 990, PART VI, SECTION B, LINE 15A
ERIN VAN OTTERLOO'S COMPENSATION AS EXECUTIVE DIRECTOR WAS DETERMINED BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19
UPON REQUEST
FORM 990, PART VII
ROSE MARIE VAN OTTERLOO - C/O VOFF 18 SEWALL STREET, MARBLEHEAD, MA 01945. PETER WOODWARD - C/O VOFF 18 SEWALL STREET, MARBLEHEAD, MA 01945. LAWRENCE GRIFFIN - C/O VOFF 18 SEWALL STREET, MARBLEHEAD, MA 01945.
FORM 990, PART XI, LINE 9:
DIFFERENCE BETWEEN BOOK AND TAX CAPITAL GAIN/LOSSES 2,990,220.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.