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
NORTHERN VALLEY CATHOLIC SOCIAL SERVICE INC
Employer identification number
20-0984601
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.") ....
684,460
618,292
4,810,464
5,205,293
5,734,126
17,052,635
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
684,460
618,292
4,810,464
5,205,293
5,734,126
17,052,635
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)..
0
6
Public support. Subtract line 5 from line 4.
17,052,635
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..
684,460
618,292
4,810,464
5,205,293
5,734,126
17,052,635
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
4,431
56,081
1,548
777
3,264
66,101
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
-52,517
-50,744
-111,577
-67,814
-68,914
-351,566
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
16,767,170
12
Gross receipts from related activities, etc. (see instructions)
..................
12
29,506,737
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
100.000 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
100.000 %
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:
13000170
Software Version:
2013v4.0
-
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
NORTHERN VALLEY CATHOLIC SOCIAL SERVICE INC
Employer identification number
20-0984601
Return Reference
Explanation
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: Community Supportive Services and Programs This area of service covers a wide spectrum including resource centers offering nutritional education and food distribution, clothing programs, educational support programs, foster youth assistance, community-based multicultural programs, senior programs, and homeless assistance. The Organization strives to assist individuals and families to enhance their lives and strengthen the families within our communities. OTHER PROGRAM SERVICES 5: Court Appointed Special Advocates (CASA) The Organization operates CASA programs in Butte, Glenn and Shasta counties. Volunteers are recruited and attend extensive training to become a CASA. Once sworn in by the court, the CASA is assigned a child in the dependency court that can benefit from a CASA. The CASAs role is to advocate on behalf of that child, attend all court dates, and submit written reports to the court that represent the voice for that child. The CASA will remain assigned to that child until the child has been returned home, adopted, or has a permanent placement. The funding for this worthy program is from the Administration of the Courts (AOC) and has recently been reduced. CASA requires a commitment on the part of the agency to raise the additional funds necessary through donations, fundraisers, etc. OTHER PROGRAM SERVICES 6: OTHER - Other programs not categorized include Kohl's Cares for Kids, Adopt-a-Family, Washington Plaza, and Vehicle Donation. These programs, with the exception of Adopt-a-Family and Washington Plaza, are designed to bring in revenue to support the short fall of other programs along with the different fundraisers. Adopt-a-Family is a program that provides struggling families with the best possible holiday through generous donation from the community.
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
NVCSS CORPORATION SHALL HAVE TWO MEMBERS: THE ROMAN CATHOLIC BISHOP OF SACRAMENTO, A CORPORATION SOLE, AND CATHOLIC CHARITIES OF SACRAMENTO, INC., A CALIFORNIA PUBLIC BENEFIT NON-PROFIT CORPORATION.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body
THE MEMBERS SHALL APPOINT, AND MAY REMOVE, AT THEIR SOLE DISCRETION, MEMBERS OF THE BOARD OF DIRECTORS OF THIS CORPORATION.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders
ONE MEMBER VOTES WITH THE REST OF THE BOARD OF DIRECTORS REGARDING THE DUTIES AND RESPONSIBILITIES THAT GOVERN A NONPROFIT ORGANIZATION.
Form 990, Part VI, Line 11b: Form 990 Review Process
THE FULL BOARD HAS ONE WEEK TO REVIEW THE RETURN PRIOR TO SUBMISSION TO THE IRS.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
AT THE TIME OF HIRE, STAFF ARE GIVEN THE CONFLICT OF INTEREST FORM. ANY NEW BOARD MEMBERS ARE GIVEN CONFLICT OF INTEREST FORMS AS WELL. ONCE A YEAR, A COMMITTEE REVIEWS ALL FORMS. IN ADDITION, THE FORM IS ALWAYS AVAILABLE IF CHANGES NEED TO BE MADE.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
ANNUALLY, THE COMPENSATION OF THE CFO AND EXECUTIVE DIRECTOR ARE REVIEWED BY THE EXECUTIVE COMMITTEE AND RATIFIED BY THE BOARD OF DIRECTORS. THE SOURCE IS THE COMPENSATION AND BENEFITS SURVEY CONDUCTED BY THE CENTER FOR NONPROFIT MANAGEMENT. SALARY COMPARISON TAKES INTO CONSIDERATION INDUSTRY, SIZE OF BUDGET, AND GEOGRAPHIC LOCATION AND PROVIDES A BENCHMARK FOR THESE TWO POSITIONS.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
ANNUALLY, THE BOARD REVIEWS AND APPROVES SALARY RANGES FOR KEY STAFF. NO COMPENSATION IS OFFERED TO BOARD MEMBERS.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
THE APPLICATION AND RETURN ARE AVAILABLE IN HARD COPY OR IN ELECTRONIC VERSION UPON REQUEST. GOVERNING AND ORGANIZING DOCUMENTS ARE AVAILABLE TO THE PUBLIC IN HARD COPY ON SITE. THE CONFLICT OF INTEREST POLICY IS AVAILABLE VIA E-MAIL OR HARD COPY UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.