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
PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT INC
Employer identification number
59-0818924
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.") ....
15,034,843
14,683,290
14,062,691
14,132,364
15,546,038
73,459,226
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..
35,000
35,000
35,000
35,000
35,000
175,000
4
Total. Add lines 1 through 3
15,069,843
14,718,290
14,097,691
14,167,364
15,581,038
73,634,226
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.
73,634,226
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..
15,069,843
14,718,290
14,097,691
14,167,364
15,581,038
73,634,226
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
180,754
168,249
184,203
170,680
167,878
871,764
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).
74,505,990
12
Gross receipts from related activities, etc. (see instructions)
..................
12
35,368,769
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
98.830 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
98.820 %
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
PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT INC
Employer identification number
59-0818924
Return Reference
Explanation
FORM 990, PART VI, SECTION B, LINE 11
THE INDEPENDENT ACCOUNTING FIRM THAT PERFORMS THE ANNUAL AUDIT ALSO ASSISTS IN PREPARING THE FORM 990. MANAGEMENT PROVIDES THE ACCOUNTING FIRM WITH THE ADDITIONAL INFORMATION NECESSARY TO COMPLETE THE FORM 990, AND REVIEWS FOR ACCURACY. THE COMPLETED FORM 990 IS THEN PRESENTED TO THE FINANCE COMMITTEE WHICH REVIEWS AND ACCEPTS AFTER ALL QUESTIONS ARE ANSWERED. THE FINANCE COMMITTEE MAKES A COPY OF THE FORM 990 AVAILABLE TO THE FULL BOARD FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE CONFLICT OF INTEREST POLICY IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF DIRECTORS. BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT MUST REVIEW AND SIGN A STATEMENT ANNUALLY DISCLOSING OR UPDATING THEIR INTEREST, AND THOSE OF THEIR FAMILY MEMBERS, THAT COULD GIVE RISE TO A CONFLICT OF INTEREST IN THE OPERATIONS OF PEACE RIVER CENTER. STAFF ISSUES ARE ADDRESSED WITH THE CHIEF EXECUTIVE OFFICER (CEO); BOARD MEMBER ISSUES ARE ADDRESSED WITH THE CEO AND BOARD CHAIR.
FORM 990, PART VI, SECTION B, LINE 15
AN EXECUTIVE COMPENSATION COMMITTEE WAS FORMED AND A CHAIR OF THE COMMITTEE WAS APPOINTED. AN EVALUATION OF THE CEO'S PERFORMANCE WAS OBTAINED AND REVIEWED, THIS WAS ACCOMPLISHED BY SURVEYING THE BOARD MEMBERS AS WELL AS EXECUTIVE TEAM/MANAGEMENT. TO UPDATE AND VALIDATE THE RANGE OF RECOMMENDED COMPENSATION FOR THE CEO POSITION, THE CHAIR OBTAINED NATIONAL SURVEY DATA FOR COMPARABLE MENTAL HEALTH AND HEALTH CARE ENTITIES. IN ADDITION TO THIS SURVEY DATA, THE COMMITTEE OBTAINED CEO COMPENSATION INFORMATION THROUGH GUIDESTAR FROM FORMS 990 FOR SELECTED FLORIDA COMMUNITY MENTAL HEALTH ENTITIES THAT THE COMMITTEE FELT WERE COMPARABLE BOTH IN BUDGET AND SCOPE OF SERVICES MANAGED. USING A COMBINATION OF THE NATIONAL SURVEY DATA AND THE FLORIDA CEO COMPENSATION FIGURES OBTAINED THROUGH GUIDESTAR, THE COMMITTEE DEVELOPED AND RECOMMENDED AN UPDATED CEO COMPENSATION RANGE FOR THE CURRENT FISCAL YEAR. THE RANGE WAS RECOMMENDED TO THE EXECUTIVE COMMITTEE WHO COMPARED TO THE CURRENT COMPENSATION FOR THE CEO AND A RECOMMENDATION WAS THEN MADE TO THE BOARD FOR ACTION TO ADJUST ACCORDINGLY. THE CEO REVIEWS THE PERFORMANCE OF THE OTHER CORPORATE OFFICERS AND PERIODICALLY REVIEWS SALARY RANGES. THE HUMAN RESOURCES DEPARTMENT COORDINATES AND CONDUCTS THE SALARY SURVEYS.
FORM 990, PART VI, SECTION C, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VII, SECTION A: COMPENSATION OF DIRECTORS
PETER GOLOTKO IS A PRINCIPAL IN A FIRM THAT MANAGES RETIREMENT PLANS. THIS FIRM HAS BEEN RETAINED BY PEACE RIVER CENTER TO MANAGE THE 401K AND 403B PLANS AND IS A CO-FIDUCIARY IN THE ADMINISTRATION OF THE PLANS. THE FIRM RECEIVES COMPENSATION FROM THE PLAN PARTICIPANTS. THE FIRM WAS SELECTED THROUGH A COMPETITIVE BID PROCESS. SOZON VATIKIOTIS IS THE CEO OF AN INSURANCE BROKERAGE FIRM THAT PROVIDES SERVICES RELATED TO THE PEACE RIVER CENTER HEALTH AND WELFARE BENEFIT PLANS. THE FIRM RECEIVES COMPENSATION FROM THE INSURANCE COMPANIES HIRED TO PROCESS CLAIMS AND PROVIDE STOP-LOSS COVERAGE. THE FIRM WAS SELECTED THROUGH A COMPETITIVE BID PROCESS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.