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
TEAMMATES MENTORING PROGRAM
Employer identification number
90-0311108
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.") ....
1,056,617
1,478,336
1,150,112
1,398,011
1,689,134
6,772,210
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
1,056,617
1,478,336
1,150,112
1,398,011
1,689,134
6,772,210
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)..
394,132
6
Public support. Subtract line 5 from line 4.
6,378,078
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..
1,056,617
1,478,336
1,150,112
1,398,011
1,689,134
6,772,210
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
22,307
21,958
20,057
24,004
33,503
121,829
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.)..
13,379
24,522
13,337
22,428
56,981
130,647
11
Total support (Add lines 7 through 10).
7,024,686
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
90.800 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
94.050 %
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
TEAMMATES MENTORING PROGRAM
Employer identification number
90-0311108
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2
THE EXECUTIVE DIRECTOR'S PARENTS ARE BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11
THE FINANCE COMMITTEE IS PROVIDED A COPY OF FORM 990 FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12C
CONFLICT OF INTEREST FORMS ARE DISTRIBUTED & ANY CONFLICTS ARE DISCLOSED TO THE BOARD FOR REVIEW AND A VOTE ON APPROVAL/DENIAL.
FORM 990, PART VI, SECTION B, LINE 15
COMPENSATION IS DETERMINED BY A REVIEW AND APPROVAL OF INDEPENDENT PERSONS, COMPARABILITY DATA, AND PERFORMANCE REVIEWS.
FORM 990, PART VI, SECTION C, LINE 19
AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:
THE PROCESS HAS NOT CHANGED.
FORM 990, LINE H(B):
20-0277213 TEAMMATES OF FREMONT PUBLIC SCHOOLS 20-0278189 TEAMMATES OF SUTTON 20-0278406 TEAMMATES OF BOX BUTTE COUNTY 20-0455876 TEAMMATES OF PALMYRA BENNETT DOUGLAS 20-1228770 CENTRAL CITY TEAMMATES 20-1243792 TEAMMATES OF PLAINVIEW 20-1395116 TEAMMATES OF MCCOOK 20-1448745 TEAMMATES OF KIMBALL 20-1831084 TEAMMATES OF BLAIR 20-2460879 TEAMMATES OF RED CLOUD 20-3772724 TEAMMATES OF THAYER COUNTY 20-4449109 TEAMMATES OF GRETNA 20-5313485 TEAMMATES OF W POINT BEEMER BANCROFT 20-5347922 TEAMMATES OF COZAD 20-5348143 TEAMMATES OF ELWOOD 20-5498785 TEAMMATES OF HOLT COUNTY 20-5772883 TEAMMATES OF SUPERIOR 20-5819669 TEAMMATES OF LAWRENCE-NELSON 20-8158561 TEAMMATES OF SOUTH SIOUX CITY 20-8380817 TEAMMATES OF SCOTTS BLUFF COUNTY 26-0572250 TEAMMATES OF CHADRON 26-0734201 TEAMMATES OF HOWARD COUNTY 26-0834825 TEAMMATES OF STANTON 26-1144533 TEAMMATES OF DONIPHAN-TRUMBALL 26-1261937 TEAMMATES OF WOOD RIVER 26-1278850 TEAMMATES OF NORRIS 26-1310199 TEAMMATES OF HYANNIS 26-1375465 TEAMMATES OF WOODBINE IA 26-1458854 TEAMMATES OF HOLDREGE 26-1584051 TEAMMATES OF ARAPAHOE 26-1604623 TEAMMATES OF COUNCIL BLUFFS IA 26-1700653 TEAMMATES OF ELKHORN VALLEY 26-2409984 TEAMMATES OF CAMBRIDGE 26-2610856 TEAMMATES OF OSCEOLA 26-2921705 TEAMMATES OF HERSHEY 26-2922062 TEAMMATES OF MEDICINE VALLEY 26-3251043 TEAMMATES OF VALENTINE 26-3305503 TEAMMATES OF CENTENNIAL 26-3342492 TEAMMATES OF OGALLALA 26-3363167 TEAMMATES OF MISSOURI VALLEY 26-3609203 TEAMMATES OF AK-SAR-BEN 26-3736187 TEAMMATES OF MILFORD 26-3781312 TEAMMATES OF FAIRBURY 26-3832730 TEAMMATES OF DIST 29 26-3978400 TEAMMATES OF OMAHA CATHOLIC SCHOOLS 27-0738214 TEAMMATES OF BRUNING DAVENPORT 27-0818692 TEAMMATES OF SCHUYLER 27-0819249 TEAMMATES OF BOYER VALLEY 27-0938834 TEAMMATES OF BRIDGEPORT 27-1069260 TEAMMATES OF SUTHERLAND 27-1220981 TEAMMATES OF WATERLOO IA 27-1404644 TEAMMATES OF MAYWOOD 27-1406837 TEAMMATES OF MULLEN 27-2262434 TEAMMATES OF OAKLAND-CRAIG 27-2868555 TEAMMATES OF NISHNABOTNA 27-3072253 TEAMMATES OF SAN DIEGO NORTH COAST 27-3208706 TEAMMATES OF LOUISVILLE 27-3717816 TEAMMATES OF SIDNEY IOWA 27-4724200 TEAMMATES OF ANSELMO MERNA 43-1971332 TEAMMATES OF NORTH PLATTE 45-2017124 TEAMMATES OF ARLINGTON 45-2738248 TEAMMATES OF SIDNEY 45-2884084 TEAMMATES OF STORM LAKE IOWA 45-3028679 TEAMMATES OF HARLAN IOWA 45-3158607 TEAMMATES OF SPENCER IOWA 45-4919072 TEAMMATES OF ARNOLD 45-5107999 TEAMMATES OF FORT CALHOUN 45-5206945 TEAMMATES OF A-H-S-T COMM SCHL DIST 45-5308908 TEAMMATES OF MILLARD 45-5319119 TEAMMATES OF PAPILLION LA VISTA 90-0057375 TEAMMATES OF GRAND ISLAND 90-0057377 TEAMMATES OF SEWARD 90-0057379 TEAMMATES OF WAYNE 90-0057382 TEAMMATES OF COLUMBUS 90-0057385 TEAMMATES OF SAUNDERS COUNTY 90-0057386 TEAMMATES OF HASTINGS 90-0057387 TEAMMATES OF PIERCE 90-0057388 TEAMMATES OF BOONE CENTRAL 90-0057535 TEAMMATES OF BEATRICE 90-0057567 TEAMMATES OF NORFOLK 90-0057569 TEAMMATES OF SANDY CREEK 90-0057572 TEAMMATES OF FRANKLIN COUNTY 90-0057574 TEAMMATES OF AURORA 90-0057575 TEAMMATES OF KEARNEY 90-0057577 TEAMMATES OF WAUSA 90-0057579 TEAMMATES OF YORK 90-0057580 TEAMMATES OF FILLMORE COUNTY 90-0057584 TEAMMATES OF ELMWOOD-MURDOCK 90-0057587 TEAMMATES OF NEBRASKA CITY 90-0057589 TEAMMATES OF LAUREL-CONCORD-COLERIDGE 90-0057590 TEAMMATES OF GARDEN COUNTY 90-0057593 TEAMMATES OF MINDEN 90-0057595 TEAMMATES OF LEXINGTON 90-0057596 TEAMMATES OF CRETE 90-0057597 TEAMMATES OF FULLERTON 90-0057598 TEAMMATES OF LINCOLN PUBLIC SCHOOLS 90-0057599 TEAMMATES OF WISNER-PILGER 90-0057600 TEAMMATES OF PLATTSMOUTH 90-0057601 TEAMMATES OF RANDOLPH 90-0057604 TEAMMATES OF NELIGH-OAKDALE 90-0057607 TEAMMATES OF GOTHENBURG 90-0057608 TEAMMATES OF ORD 90-0057614 TEAMMATES OF METRO OMAHA 46-0953229 TEAMMATES OF BELLEVUE 45-4112454 TEAMMATES OF BURWELL 46-1293800 TEAMMATES OF FREEMAN 46-1741512 TEAMMATES OF LEWIS CENTRAL 46-0607623 TEAMMATES OF LOOMIS 46-1394632 TEAMMATES OF RALSTON
FORM 990, PART V, LINE 2A:
EMPLOYEES REPORTED ON FORM W-3 INCLUDES ALL W-3S ISSUED UNDER MULIPLE ID NUMBERS FOR CHAPTERS INCLUDED UNDER GROUP EXEMPTION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.