Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 162,275 | 174,025 | 181,530 | 192,924 | 209,685 | 920,439 |
| 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...... | 28,389 | 31,100 | 29,869 | 26,098 | 30,100 | 145,556 |
| 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. | 190,664 | 205,125 | 211,399 | 219,022 | 239,785 | 1,065,995 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 7,585 | 6,900 | 7,450 | 5,735 | 22,485 | 50,155 |
| 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.. | 7,585 | 6,900 | 7,450 | 5,735 | 22,485 | 50,155 |
| 8 | Public support (Subtract line 7c from line 6.) | 1,015,840 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 190,664 | 205,125 | 211,399 | 219,022 | 239,785 | 1,065,995 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 25,278 | 24,456 | 21,022 | 24,007 | 14,631 | 109,394 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 25,278 | 24,456 | 21,022 | 24,007 | 14,631 | 109,394 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 8,589 | 9,566 | 4,831 | 22,986 | ||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 224,531 | 239,147 | 237,252 | 243,029 | 254,416 | 1,198,375 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SUPPLEMENTAL INFORMATION | RENTAL OF STORAGE UNIT FROM BOARD MEMBER'S BUSINESS AT CURRENT MARKET RATE. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 | SPECIAL EVENTS TO RAISE FUNDS BUT ARE ALSO HEALTH RELATED - RUN AND GOLF. INTERNATIONAL RUNNER AT RACE TO LECTURE RUNNERS AND OTHER ATTENDEES. ORANIZATION PROVIDES EDUCATIONAL INFORMATION- CHOLESTEROL, BLOOD PRESSURE CELIAC DISEASE AND HEPATITIS C. TOTAL NUMBER OF PEOPLE SERVED DURING 2013 2,286 AT 178 ACTIVITIES. |
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS FOR SPECIFIC EVENTS - RUN - FLAG, REGISTER, DISTRIBUTE PACKETS, PROVIDE WATER, DO CHILDREN'S ACTIVITIES SCHOOL SPORTS PHYSICALS - DO EXAMS, MAN 13 HEALTH STATIONS, TESTING, REGISTRATION, TRAFFIC MONITORS, MAN REFRESHMENT STATEMENT MAILINGS FOR CLASSES, MEDICAL EDUCATION LECTURES, FUND RAISING APPEALS SCHOLARSHIP COMMITTEE - REVIEW 171 APPLICATIONS, MEETINGS BOARD MEMBERS - MANAGEMENT, FINANCE, PROGRAMS, PROJECTS SCREENINGS AND HEALTH EVENTS - BLOOD PRESSURES - NURSES |
| FORM 990, PAGE 2, PART III, LINE 4D | CONTINUING MEDICAL EDUCATION LECTURES FOR 362 HEALTH CARE PROFESSIONALS FOR AMERICAN MEDICAL ASSOCIATION CREDIT. 6 LECTURES. INDIRECT EXPENSES FOR ALL PROGRAMS - PRIMARILY STAFF AND FACILITY COST. COMMUNITY PROGRAMS ON HEALTH TOPICS. INDIRECT EXPENSES FOR ALL PROGRAMS INCLUDEED IN EXPENSE FIGURE. |
| FORM 990, PAGE 6, PART VI, LINE 7A | ALL BOARD MEMBERS ARE ELECTED BY MAJORITY VOTE OF THE EXISTING BOARD MEMBERS AT THE ANNUAL MEETING. UNUSUAL RESIGNATIONS AND ELECTIONS ARE ACTED ON AT A REGULAR BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 7B | BOARD MEMBERS AT REGULAR MEETINGS APPROVE THE BUDGET, ELECT BOARD MEMBERS AND OFFICERS, APPROVE BYLAW CHANGES, APPROVE EVENTS, PROGRAMS AND ACTIVITIES. MAKE POLICY FOR PRESERVATION OF ASSETS AND ACCEPTANCE OF TANGIBLE ASSETS. APPROVE ALL CHANGES AND ADOPTION OF POLICIES OF GOVERNANCE. |
| FORM 990, PAGE 6, PART VI, LINE 9 | F STALEY HESTER, JR 912 DOUGLAS CT SALEM, VA 24153 SYDNEY H NORDT 1569 DUNROVIN LN SALEM, VA 24153 LORRAINE LANGE 1510 LONGVIEW RD ROANOKE, VA 24018 LISA ALLISON-JONES 1921 BELLEVILLE RD ROANOKE, VA 24015 BONNIE L CULKIN 5941 BUCKLAND MILL RD ROANOKE, VA 24019 PETER F DAWYOT 3128 LINKS MANOR DR SALEM, VA 24153 CHRISTIANA MAXWELL 3223 CATAWBA RD TROUTVILLE, VA 24175 CATHERINE DANIEL 100 ADAM PERRY RD VA 24151 JOHN D LUGAR 2717 LONGVIEW AVE ROANOKE, VA 24014 PAULA N MITCHELL 2320 MT VERNON RD ROANOKE, VA 24015 WENDY E ROTANZ 313 N BROAD ST SALEM, VA 24153 E BLACKFORD NOLAND 2632 RICHELIEU AVE SW ROANOKE, VA 24014 MELINDA PAYNE 722 PARAGON AVE SALEM, VA 24153 CATHIE M THOMAS P O BOX 397 GOODVIEW, VA 24095 JOSEPH C THOMAS JR 6618 CAMPBELL DR SALEM, VA 24153 G ROBERT VAUGHAN 147 BOGEY LN SALEM, VA 24153 CAROLINE A WALLACE 808 PENDLETON DR SALEM, VA 24153 VIRGINIA M SAVAGE 228 RICHFIELD AVE SALEM, VA 24153 |
| FORM 990, PAGE 6, PART VI, LINE 11B | MEMBERS OF FINANCE COMMITTEE REVIEW 990, ALL MEMBERS OF THE BOARD REVIEW AND RECEIVED COPIES OF AUDITED FINANCIAL STATEMENTS WHEN ISSUED AND FORM 990 WITHIN 20 DAYS OF FILING. 990'S ARE AVAILABLE AT FINANCE COMMITTEE AND CLOSEST BOARD MEETING TO FILING DATE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION OF CEO REVIEWED BY FINANCE COMMITTEE ANNUALLY WHEN BUDGET IS PREPARED. CEO IS COMPENSATED AT VERY LOW RATE AT CEO'S REQUEST WHO HAS A LARGE NUMBER OF VOLUNTEER HOURS. PAY IS CONSIDERABLY LOWER THAN COMPARABLE NONPROFIT CEO'S IN THE LOCAL AREA. |
| FORM 990, PAGE 6, PART VI, LINE 15B | NO OTHER OFFICER IS PAID. TWO FULL TIME KEY EMPLOYEES' PAY IS REVIEWED ANNUALLY BY THE FINANCE COMMITTEE. |
| FORM 990, PAGE 6, PART VI, LINE 18 | G ROBERT VAUGHAN TREASURER P O BOX 4692 ROANOKE VA 24015-0692 |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, WHISTLER BLOWING POLICY, AUDITED FINANCIALSTATEMENTS, WHISTLER BLOWING POLICY AND 990 ARE AVAILABLE ON REQUEST. AUDITED STATEMENTS ARE FILED WITH VIRGINIA DEPT OF CONSUMER AFFAIRS AND ARE AVAILABLE TO THE PUBLIC. 990 IS AVAILABLE ON WEBSITE OF GUIDESTAR AND ON REQUEST. |
| FORM 990, PART XI, LINE 9 | SALE OF INVESTMENT SECURITIES - FOR TAX PURPOSES USE OF 0 ORIGINAL COST, FOR FINANCIAL STATEMENTS USE FAIR MARKET 0 VALUE AS OF 12/31/13 IS USED. EXTENT ORIGINAL COST IS 0 FAIR MARKET VALUE COST IS GREATER 0 ADJUSTMENT RELATING TO CLASSIFCATION OF FUNDS 9,615 INVESTMENT ADJUSTMENT 3,250 |
| FORM 990, PART XI, LINE 9 | ADJUSTMENT -10 INVESTMENT SALES COST V FMV BASIS 9,615 |
| Software ID: | |
| Software Version: |