Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 2,494,622 | 2,790,859 | 2,899,082 | 2,140,332 | 2,342,510 | 12,667,405 |
| 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 | 2,494,622 | 2,790,859 | 2,899,082 | 2,140,332 | 2,342,510 | 12,667,405 |
| 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).. | 4,037,895 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 8,629,510 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 2,494,622 | 2,790,859 | 2,899,082 | 2,140,332 | 2,342,510 | 12,667,405 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 25,924 | 6,034 | 3,726 | 3,034 | 649 | 39,367 |
| 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 VI.).. | 8,931 | 10,840 | 5,052 | 7,594 | 12,716 | 45,133 |
| 11 | Total support Add lines 7 through 10. | 12,751,905 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 14000265 |
| Software Version: | 2014v5.0 |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Client Note 1 | Client Note 1 - FORM 990PART II, LINE 42-DEPRECIATION EXPENSEPART IV, LINE 57a & 57b-FIXED ASSETS AND ACCUMULATED DEPRECIATIONDEPRECIATION IS COMPUTED ON THE STRAIGHT LINE BASIS OVER THE ESTIMATEDUSEFUL LIFES OF THE ASSETS, GENERALLY 3-5 YEARS. |
| Form 990, Part III, Line 4d: Other Program Services Description | OTHER PROGRAM SERVICES 4: ADVOCACY-THE DMRF PROVIDES THE STAFF AND ADMINISTRATIVE SUPPORT FOR the DYSTONIA ADVOCACY NETWORK, A COLLABORATION OF FIVE DYSTONIA ORGANIZATIONS WORKING TO MEET THE POLICY NEEDS OF THE DYSTONIA COMMUNITY. FOR THE PAST eight YEARS,THE DYSTONIA ADVOCACY NETWORK HAS BEEN INSTRUMENTAL IN EDUCATING CONGRESS ABOUT THE BENEFITS OF LISTING DYSTONIA AS A CONDITION ELIGIBLE FOR STUDY ON THE DEPARTMENT OF DEFENSE (DOD) PEER-REVIEWED MEDICAL RESEARCH PROGRAM, RESULTING IN THEM MAKING THE CONDITION ELIGIBLE FOR INVESTIGATORS TO COMPETE FOR RESEARCH FUNDING. ON BEHALF OF THE FIVE DYSTONIA ADVOCACY NETWORK ORGANIZATIONS, THE DMRF UTILIZES A LEGISLATIVE CONSULTANT TO TRACK LEGISLATIVE ACTIVITIES ON CAPITOL HILL, MAINTAINS AN ADVOCACY WEBSITE, AND ELECTRONICALLY DISSEMINATES ACTION ALERTS TO STAY CONNECTED WITH KEY LEGISLATORS. THE DMRF ALSO SUPPORTS A NATIONWIDE NETWORK OF VOLUNTEER ADVOCATES WHO CONTINUALLY WORK TO EDUCATE MEMBERS OF CONGRESS ABOUT DYSTONIA AND ADVANCE THE COMMUNITY'S LEGISLATIVE AGENDA. VOLUNTEERS MEET WITH POLICYMAKERS DURING THE ANNUAL ADVOCACY DAY AND AS NEEDED THROUGHOUT THE YEAR TO ADVOCATE ON BEHALF OF THE DYSTONIA COMMUNITY ON ISSUES SUCH AS INCREASED RESEARCH FUNDING FOR THE NATIONAL INSTITUTES OF HEALTH, ACCESS TO HEALTHCARE, and appropriate, AFFORDABLE REIMBURSEMENT for dystonia treatments. |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | SAMUEL BELZBERG IS THE SPOUSE OF FRANCES BELZBERG.FRANCES BELZBERG IS THE SPOUSE OF SAMUEL BELZBERG.ART KESSLER IS THE SON OF DENNIS AND BARBARA KESSLER.DENNIS KESSLER IS THE SPOUSE OF BARBARA KESSLER AND FATHER OF ART KESSLER.BARBARA KESSLER IS THE SPOUSE OF DENNIS KESSLER AND MOTHER OF ART KESSLER.ROSALIE LEWIS IS THE SPOUSE OF RICHARD LEWIS.RICHARD LEWIS IS THE SPOUSE OF ROSALIE LEWIS.MARK RUDOLPH IS THE SPOUSE OF DIANE RUDOLPH.DIANE RUDOLPH IS THE SPOUSE OF MARK RUDOLPH.JOHN SYMONDS IS THE SPOUSE OF KAREN ROSS.KAREN ROSS IS THE SPOUSE OF JOHN SYMONDS. |
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | The bylaws were amended to more accurately describe the roles of the MSAC and program Vice Presidents, allow for electronic voting by the Board of Directors when needed, and include the Audit Committee in standing committees. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | THE BOARD OF DIRECTORS HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE TAX REVIEW TASK FORCE WHICH IS COMPRISED OF THE PRESIDENT, TREASURER AND CHAIRPERSON OF THE AUDIT COMMITTEE. PRIOR TO THE SIGNING AND FILING OF THE FORM 990, MANAGEMENT, OUTSIDE CPA, THE TAX REVIEW TASK FORCE AND THE INDEPENDENT ACCOUNTANT WHO PREPARES THE FORM 990 MEET TO REVIEW THE ENTIRE FORM. UPON APPROVAL BY THE TAX REVIEW TASK FORCE, THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR REVIEW, AFTER WHICH IT IS SIGNED BY THE TREASURER AND IS FILED. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | ON AN ANNUAL BASIS, DMRF REQUESTS WRITTEN STATEMENT OF ANY CONFLICTS FROM MEMBERS OF THE BOARD. THE BOARD PRESIDENT, ALONG WITH EXECUTIVE DIRECTOR, MONITOR AND REPORT POTENTIAL CONFLICTS TO CHAIR OF AUDIT COMMITTEE. ANY CONFLICTS THAT ARE DETERMINED TO EXIST ARE REPORTED TO THE BOARD. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | ANNUALLY, THE DMRF BOARD PRESIDENT CONSULTS WITH THE BOARD OF DIRECTORS REGARDING THE PERFORMANCE OF THE EXECUTIVE DIRECTOR AND PREPARES A WRITTEN PERFORMANCE EVALUATION. THE BOARD PRESIDENT, AFTER CONSULTATION WITH THE BOARD, DETERMINES SALARY ACTION, IF ANY, AND MEETS WITH THE EXECUTIVE DIRECTOR TO DISCUSS THE PERFORMANCE EVALUATION. COMPARATIVE SALARY INFORMATION IS OBTAINED ABOUT ORGANIZATIONS OF SIMILAR SCOPE AND SIZE THROUGH INFORMATION FROM THE ASSOCIATION FORUM OF CHICAGOLAND AND THROUGH OTHER PUBLICLY AVAILABLE INFORMATION. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | NOT APPLICABLEFORM 990, PART VI, LINE 15A-COMPENSATION REVIEW & APPROVAL PROCESS FOR CE0, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIALANNUALLY, THE DMRF BOARD PRESIDENT CONSULTS WITH THE BOARD OF DIRECTORS REGARDING THE PERFORMANCE OF THE EXECUTIVE DIRECTOR AND PREPARES A WRITTEN PERFORMANCE EVALUATION. THE BOARD PRESIDENT, AFTER CONSULTATION WITH THE BOARD, DETERMINES SALARY ACTION, IF ANY, AND MEETS WITH THE EXECUTIVE DIRECTOR TO DISCUSS THE PERFORMANCE EVALUATION. IF DEEMED NECESSARY BY THE BOARD, COMPARATIVE SALARY INFORMATION IS OBTAINED THROUGH CONTACTS WITH MEMBER ORGANIZATIONS OF THE NATIONAL ORGANIZATION OF RATE DISORDERS (NORD). |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | FORM 990, AUDITED FINANCIAL STATEMENTS, the annual report, AND THE BOARD APPROVED ANNUAL OPERATING PLAN ARE AVAILABLE ON THE FOUNDATION'S WEBSITE. CONFLICT OF INTEREST,GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART V, LINE 2A-EMPLOYEES | THE NUMBER OF EMPLOYEES REPORTED ON FORM W-3 FOR 2014 WAS 11 WHICH TRANSLATES INTO 8 FULL TIME EQUIVALENTS. |
| FORM 990,PART VII,SECTION A-COMPENSATION | THE EXECUTIVE DIRECTOR IS OFFERED THE SAME BENEFIT PACKAGE AS ALL OTHER EMPLOYEES. CONSISTENT WITH PAST YEARS, THE EMPLOYEE BENEFITS OFFERED INCLUDE HEALTH INSURANCE, LONG-TERM DISABILITY INSURANCE, LIFE INSURANCE, PRE-TAX PARKING BENEFITS, AND 401(K) EMPLOYER MATCHING. IN ADDITION, THE FOUNDATION UNDERWRITES A MODEST DENTAL BENEFIT PLAN IN WHICH THEY REIMBURSE EMPLOYEES FOR DENTAL EXPENSES. THE COST OF PROVIDING EMPLOYEE HEALTH INSURANCE CONTINUES TO BE THE PREDOMINANT EXPENSE IN THE EMPLOYEE BENEFIT PACKAGE. OTHER COMPENSATION OF $31,691 INCLUDES $12,319 OF PRETAX CONTRIBUTIONS FOR HEALTH AND TRANSIT BENEFITS PAID BY THE EXECUTIVE DIRECTOR. |
| Software ID: | 14000265 |
| Software Version: | 2014v5.0 |