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
FAMILY LIVES ON FOUNDATION
Employer identification number
23-2929922
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.") ....
188,500
189,279
202,402
179,605
131,078
890,864
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
188,500
189,279
202,402
179,605
131,078
890,864
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)..
228,516
6
Public support. Subtract line 5 from line 4.
662,348
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..
188,500
189,279
202,402
179,605
131,078
890,864
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
2,699
1,297
1,197
725
5,918
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).
896,782
12
Gross receipts from related activities, etc. (see instructions)
..................
12
280,771
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
73.860 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
73.360 %
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
FAMILY LIVES ON FOUNDATION
Employer identification number
23-2929922
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
FAMILY LIVES ON FOUNDATION'S MISSION IS TO SUPPORT THE LIFELONG EMOTIONAL WELLBEING OF CHILDREN WHOSE MOTHER OR FATHER HAS DIED. THE DEATH OF A PARENT IS ONE OF THE MOST TRAUMATIC LIFE EVENTS A CHILD CAN EXPERIENCE. MORE THAN TWO MILLION CHILDREN AND TEENS IN THE US ARE GRIEVING THE DEATHS OF THEIR MOMS OR DADS. FAMILY LIVES ON FOUNDATION'S GROUNDBREAKING TRADITION PROGRAM ADDRESSES THREE CRITICAL, AND OFTENTIMES UNMET, NEEDS IN CHILD AND FAMILY BEREAVEMENT SUPPORT. GRIEVING FAMILIES NEED INTRA-FAMILY CONNECTION AND COMMUNICATION, ONGOING SUPPORT, AND CONTINUING EMOTIONAL BOND WITH THEIR DECEASED PARENT. THE TRADITION PROGRAM PROVIDES OPPORTUNITIES FOR INTENTIONAL REMEMBERING, A SAFE HAVEN FOR GRIEF, COMMUNICATION AND CELEBRATION.
FORM 990, PAGE 2, PART III, LINE 2
SINCE JANUARY 2014, WE HAVE BEGUN AN ACCELERATED NATIONAL OUTREACH AND AWARENESS INITIATIVE TO SERVE MORE FAMILIES GRIEVING THE DEATH OF A MOTHER OR FATHER. GIVEN THE TREMENDOUS NEED FOR SUPPORT, OUR GOAL IS TO INCREASE OUR REACH TO ENGAGE AND ASSIST MORE GRIEVING CHILDREN AND SURVIVING CAREGIVERS. OUR TARGETED APPROACH IS DESIGNED TO BE SCALABLE AND REMOVE LOGISTICAL, CULTURAL AND SOCIOECONOMIC BARRIERS.
FORM 990, PAGE 2, PART III, LINE 3
WE HAVE RECENTLY MADE SEVERAL INNOVATIVE CHANGES TO OUR TRADITION PROGRAM SO THAT WE CAN FULFILL EVEN MORE TRADITIONS FOR GRIEVING CHILDREN. USING TECHNOLOGY WE ARE ABLE TO INCREASE OUR REACH AND PRODUCTIVITY TO REMOVE PHYSICAL AND PSYCHOLOGICAL BARRIERS TO OUR SERVICE. PRIOR TO STREAMLINING, FAMILY MEETINGS REQUIRED IN-HOME VISITS AND THE MANAGEMENT AND SCHEDULING LOGISTICS WERE TIME CONSUMING. WITH THE USE OF SKYPE WE ARE ABLE TO SERVE MORE FAMILIES IN LESS TIME AND CHILDREN FEEL SAFER SHARING THEIR FEELINGS WITH A SCREEN BARRIER IN PLACE. THROUGH NEW SOFTWARE, WE HAVE SIMPLIFIED CUMBERSOME SCHEDULING TASKS. AS A RESULT, WE HAVE EXPERIENCED RECORD- BREAKING ENROLLMENT ONE MONTH AFTER IMPLEMENTING ONLINE, MOBILE-READY ENROLLMENT FORMS.
FORM 990, PAGE 2, PART III, LINE 4A
COMFORTABLE ENVIRONMENT TO HELP MOVE A CHILD THROUGH GRIEF INTO HEALING. THE AVERAGE CHILD REMAINS IN THE PROGRAM FOR 7.2 YEARS SO THE LONGEVITY AND CONTINUITY NURTURES AND SUSTAINS FAMILY CONNECTIONS THROUGHOUT THE CHILD'S DEVELOPMENT, ASSISTING THEM TO ADAPT TO THE DEATH OF THEIR PARENT. TRAINED VOLUNTEERS WORK WITH CHILDREN TO IDENTIFY A TRADITION THEY SHARED WITH THEIR MOTHER OR FATHER, AND THAT THEY WANT TO CONTINUE. VOLUNTEERS ENGAGE THE CHILD AND FAMILY IN A CHILD-FOCUSED MANNER. EACH ELIGIBLE CHILD, INCLUDING MULTIPLE SIBLINGS IN A SINGLE FAMILY, IS ENCOURAGED TO ARTICULATE HIS OR HER OWN TRADITION. CURRENTLY SERVED CHILDREN HAVE CHOSEN ACTIVITIES SUCH AS GOING TO THE ZOO, MOVIE THEATER OR TO VISIT GRANDMA; BAKING COOKIES, MUFFINS AND CAKES; BACK-TO-SCHOOL SHOPPING; AND PLANTING FLOWERS. FAMILY LIVES ON THEN PROVIDES THE LOGISTICAL AND FINANCIAL RESOURCES FOR THE FAMILY AND CHILD'S ANNUAL PARTICIPATION IN THE REQUESTED TRADITION EACH YEAR UNTIL THE CHILD REACHES THE AGE OF 18.
FORM 990, PAGE 6, PART VI, LINE 11B
BOTH MEMBERS OF THE ORGANIZATION'S MANAGEMENT AND BOARD OF DIRECTORS REVIEW AND APPROVE FORM 990 BEFORE IT IS SUBMITTED.
FORM 990, PAGE 6, PART VI, LINE 12C
CONFLICT OF INTEREST DISCLOSURE FORMS ARE SIGNED YEARLY BY THE BOARD AND THE ORGANIZATION STAFF AND POTENTIAL CONFLICTS MADE KNOWN TO ALL BOARD MEMBERS. BOARD MEMBERS ABSTAIN FROM ANY VOTES FOR WHICH A CONFLICT MAY EXIST.
FORM 990, PAGE 6, PART VI, LINE 15A
THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AFTER RESEARCHING EXECUTIVE DIRECTOR COMPENSATION FOR THE INDUSTRY, SET COMPENSATION FOR THE EXECUTIVE DIRECTOR. THE COMPENSATION WAS THEN APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15B
THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AFTER RESEARCHING KEY EMPLOYEE COMPENSATION FOR THE INDUSTRY, SET COMPENSATION FOR THE KEY EMPLOYEES. THE COMPENSATION WAS THEN APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS FOR THE ORGANIZATION ARE ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE.
FORM 990, PART XI, LINE 9
REIMBURSEMENT OF OFFICE EXPENSE 1,958 REIMBURSEMENT OF OFFICE EXPENE -1,958 ROUNDING -1
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.