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
MESA COMMUNITY ACTION NETWORK INC
Employer identification number
86-0558407
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.") ....
3,920,640
3,825,322
3,711,118
3,150,556
113,118
14,720,754
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
3,920,640
3,825,322
3,711,118
3,150,556
113,118
14,720,754
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.
14,720,754
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..
3,920,640
3,825,322
3,711,118
3,150,556
113,118
14,720,754
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
8
12
13
11
281
325
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
328,873
328,873
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
35,019
17,886
6,861
6,284
66,050
11
Total support (Add lines 7 through 10).
15,116,002
12
Gross receipts from related activities, etc. (see instructions)
..................
12
2,287,099
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
97.390 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.260 %
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
MESA COMMUNITY ACTION NETWORK INC
Employer identification number
86-0558407
Return Reference
Explanation
FORM 990, PART III, LINE 2
A NEW PERSONAL INVESTMENT CENTER THAT INCLUDES FINANCIAL, EDUCATIONAL AND EMPLOYMENT COACHING.
FORM 990, PART VI, SECTION A, LINE 4
THE ORGANIZATION MADE THE FOLLOWING CHANGES TO THEIR ORGANIZATION DOCUMENTS: - ADDED THE CORPORATIONS SOLE MEMBER: A NEW LEAF, INC. - CHANGED NUMBER OF DIRECTORS TO NOT LESS THAN NINE AND NOT MORE THAN FIFTEEN. - ADDED SECTION ON HOW TO SEEK REPRESENTATION ON THE MESACAN BOARD - QUORUM CRITERIA CHANGED TO 51%
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER IS A NEW LEAF, INC., AND ARIZONA NON-PROFIT CORPORATION EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3).
FORM 990, PART VI, SECTION A, LINE 7A
THE MEMBER APPROVES THE BOARD MEMBERS ELECTED BY THE BOARD OF DIRECTORS OTHER THAN THE MEMBERS, REPRESENTING NOT FEWER THAN ONE-THIRD OF THE DIRECTORS, THE BOARD ELECTS IN ACCORDANCE WITH DEMOCRATIC SELECTION PROCEDURES ADMINISTERED BY THE ORGANIZATION ADEQUATE TO ASSURE THAT THE MEMBERS ARE REPRESENTATIVE OF LOW-INCOME INDIVIDUALS AND FAMILIES IN THE NEIGHBORHOOD SERVED AND IF THEY REPRESENT A SPECIFIC NEIGHBORHOOD, THAT THEY LIVE IN THAT NEIGHBORHOOD.
FORM 990, PART VI, SECTION A, LINE 7B
THE MEMBER HAS THE RIGHT TO APPROVE THE APPOINTMENT OR REMOVAL OF ANY DIRECTORS OTHER THAN THE DIRECTORS OVER WHICH THEY DO NOT, AS DESCRIBED IN THE RESPONSE TO LINE 7A. THE MEMBER MUST ALSO APPROVE ANY AMENDMENT OR REPEAL OF THE ORGANIZATION'S ARTICLES OF INCORPORATION OR BYLAWS OR THE ADOPTION OF NEW ARTICLES OF INCORPORATION OR BYLAWS, THE APPOINTMENT OR REMOVAL OF ANY OFFICER OF THE ORGANIZATION, THE FIXING OF COMPENSATION OF THE DIRECTORS FOR SERVING ON THE BOARD OF DIRECTORS OR ON ANY COMMITTEE OF THE BOARD OF DIRECTOR, THE EXECUTION OF ANY CONTRACT FOR GOODS, SERVICES OR FACILITIES, THE BORROWING OR LENDING OF MONEY AND THE LIQUIDATION OR DISSOLUTION OF THE CORPORATION, OF THE TRANSFER, DISPOSITION, OR ENCUMBRANCE OF THE PROPERTIES OR ASSETS OF THE ORGANIZATION OTHER THAN IN THE ORDINARY COURSE OF THE ORGANIZATION'S BUSINESS.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTANT. THE 990 IS THEN REVIEWED BY THE PRESIDENT AND CEO PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
ALL MEMBERS OF THE BOARD OF DIRECTORS AND KEY LEADERSHIP STAFF COMPLETE CONFLICT OF INTEREST FORMS AS REQUIRED UNDER A NEW LEAF, INC.'S CONFLICT OF INTEREST POLICY. THE ORGANIZATION'S MANAGEMENT TEAM MONITORS COMPLIANCE WITH POLICIES AND USE OF VENDORS, AGENCIES, PROFESSIONALS OR OTHER OUTSIDE ORGANIZATIONS TO ENSURE COMPLIANCE WITH POLICIES. BOARD MEMBERS RESCUE THEMSELVES FROM DISCUSSIONS OR VOTES WHEN POTENTIAL CONFLICTS OF INTEREST ARISE. BOARD MEMBERS ANNUALLY COMPLETE A DISCLOSURE OF CONFLICT OF INTEREST STATEMENT WHICH IS MAINTAINED BY THE GOVERNANCE COMMITTEE AND THE CEO AND FORWARDED TO ANY GOVERNMENTAL AGENCIES WHICH REQUIRE SUCH DISCLOSURE.
FORM 990, PART VI, SECTION B, LINE 15
MESA COMMUNITY ACTION NETWORK (MESACAN) IS MANAGED BY A NEW LEAF, INC. AND MESACAN REIMBURSES THEM FOR SALARIES. SEVERAL MEMBERS OF THE TRI-PARTITE BOARD ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS OF A NEW LEAF. THE BOARD OF DIRECTORS APPROVES THE SALARIES OF KEY EMPLOYEES AND OTHER OFFICERS IN THE BUDGET APPROVAL PROCESS FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19
A PUBLIC COPY OF THE FORM 990, FORM 1023, THE CONFLICT OF INTEREST POLICY AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATION OFFICE DURING REGULAR BUSINESS HOURS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.