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 SUPPORT NETWORK OF SENC
Employer identification number
58-1868436
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.") ....
53,804
29,906
48,170
25,014
33,674
190,568
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
53,804
29,906
48,170
25,014
33,674
190,568
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.
190,568
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..
53,804
29,906
48,170
25,014
33,674
190,568
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
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).
190,568
12
Gross receipts from related activities, etc. (see instructions)
..................
12
44,250
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
100.000 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
100.000 %
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 SUPPORT NETWORK OF SENC
Employer identification number
58-1868436
Return Reference
Explanation
FORM 990-EZ, PART I, LINE 16
EXPENSES OFFICE SUPPLIES & EXPENSE 740 TRAVEL 4,687 DUES & SUBSCRIPTIONS 45 INSURANCE 1,577 PARENT/COMMUNITY TRAINING 1,370 WORKER'S COMPENSATION INS 590 SERVICE-RELATED SUPPLIES 236 EQUIPMENT RENTAL 2,020 FLOWERS 60 TOTAL 11,325
FORM 990-EZ, PART II, LINE 24
OFFICE EQUIPMENT 6,934 6,934 LESS ACCUMULATED DEPRECIATION 6,934 6,934 ACCUMULATED DEPRECIATION 0 0 TOTAL 0 0
FORM 990-EZ, PART II, LINE 26
PAYROLL LIABILITIES 0 1,628
FORM 990-EZ, PART III
WE PROVIDE FAMILIIES OF CHILDREN WITH SPECIAL NEEDS EMOTIONAL AND EDUCATIONAL SUPPORT, ASSISTANCE IN ACCESSING COMMUNITY SERVICES, AND PROMOTE FAMILY CENTERED PRACTICES IN BRUNSWICK, COLUMBUS, DUPLIN, NEW HANOVER AND PENDER COUNTIES.
FORM 990-EZ, PART III, LINE 28
NEW HANOVER COUNTY SCHOOLS EXCEPTIONAL CHILDREN PROJECT (NHCS/EC) THIS PROJECT RAN FROM JULY 1, 2013 TO JUNE 30, 2014. WITH THESE FUNDS, THE TAXPAYER ORGANIZED AND HOSTED A 'COMING TOGETHER CONFERENCE' WHICH OVER 200 PEOPLE ATTENDED. THE TAXPAYER ALSO HOSTED THREE BASIC TRAINING WORKSHOPS TO HELP PARENTS BETTER UNDERSTAND THE INDIVIDUAL EDUCATION PLAN PROCESS, THE FEDERAL SPECIAL EDUCATION LAW, AS WELL AS HOW THEY AS PARENTS CAN BE EQUAL TEAM MEMEBERS IN THIS PROCESS. ONE STAFF MEMBER IS FUNDED IN THIS CONTRACT TO WORK WITH NEW HANOVER COUNTY NC FAMILIES ONE-ON-ONE TO BETTER UNDERSTAND THEIR CHILD'S EVALUATIONS, SPECIALIZED INSTRUCTION PLAN, AND IS ALSO AVAILABLE TO ATTEND SCHOOL MEETINGS WITH THE FAMILIES. NINETY FAMILIES WERE SERVED UNDER THIS PROJECT.
FORM 990-EZ, PART III, LINE 29
FOSTER FAMILIES GRANTS (DSS CF & DSS NH) THIS PROJECT RAN FROM AUGUST 1, 2013 TO JUNE 30, 2014 THIS FUNDING COMES FROM THE NC DEPARTMENT OF SOCIAL SERVICES TO THE FAMILY SUPPORT PROGRAM AT THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL. THE TAXPAYER WRITES GRANT PROPOSALS AND ENTERS INTO SUB-CONTRACT AGREEMENTS FOR THESE FUNDS. WITH THESE FUNDS, THE TAXPAYER ENGAGES IN COLLABORATIVE ACTIVITIES WITH ORGANIZATIONS AND AGENCIES IN THEIR COMMUNITY OF NEW HANOVER, BLADEN, BRUSWICK, PENDER, ROBESON, DUPLIN, CUMBERLAND, SAMPSON AND COLUMBUS COUNTIES. THEY ATTEND LOCAL INTERAGENCY COORDINATING COUNCIL MEETINGS IN EACH COUNTY, AS WELL AS SERVING AS CHAIR AND TREASURER FOR NEW HANOVER COUNTY. THEY PROVIDED 30 FAMILY MEMBERS WITH INFORMATION ABOUT LOCAL RESOURCES AND/OR DISABLILTY-RELATED ISSUES. THEY PROVIDED TRAINING WORKSHOPS FOR FAMILY MEMBERS WHO HAVE CHILDREN WITH SPECIAL NEEDS IN THE NEONATAL INTENSIVE CARE UNIT OF NEW HANOVER COUNTY REGIONAL MEDICAL CENTER. THEY PROVEDED 5 BABIES EASY SAFE SLEEP TRAINING WORKSHOPS WHICH FOCUS ON HELPING PARENTS UNDERSTAND WHY THEY MUST PLACE BABIES ON THEIR BACKS TO SLEEP AND OTHER SAFETY CONSIDERATIONS TO PREVENT SIDS. THEY ALSO PROVEDED PARENT TO PARENT CONNECTIONS TO PARENTS WHO WANT TO TALK TO OTHER PARENTS WHO ALSO HAVE A CHILD WITH A DEVELOPMENTAL DISABILITY.
FORM 990-EZ, PART III, LINE 30
EARLY INTERVENTION COLLABORATIVE PROJECT (EICP) THIS PROJECT RAN FROM OCTOBER 15, 2013 TO JUNE 30, 2014. THIS IS A CONTRACT WITH THE NEW HANOVER COUNTY HEALTH DEPARTMENT AND THE TAXPAYER DIRECTLY. THE FUNDS ARE FROM THE CAPE FEAR MEMORIAL FOUNDATION FOR THIS PROJECT. THIS PROJECT INCLUDES 1 LICENSED COUNSELOR FROM THE NEW HANOVER COUNTY HEALTH DEPARTMENT AND 1 CERTIFIED INFANT/TODDLER SPECIALIST FROM THE TAXPAYER. IN THIS PROJECT, THE TAXPAYER PROVIDED INTENSIVE IN HOME SERVICES TO PARENTS WHO HAVE A CHILD AGES BIRTH TO FIVE DIAGNOSED WITH A SPECIAL NEED OR BEHAVIORAL ISSUE. THIS IS A COLLABORATION BETWEEN THE HEALTH DEPARTMENT'S CARE COORDINATION 4 CHILDREN PROJECT AND THE TAXPAYER IN ORDER TO PROVIDE MORE FAMILIES SUPPORT THAN THEY WOULD OTHERWISE RECEIVE. REFERRALS FOR THIS PROJECT HAVE COME FROM A VARIETY OF COMMUNITY AGENCIES LIKE THE SCHOOL SYSTEM, NEW HANOVER DEPARTMENT OF SOCIAL SERVICES, LOCAL THERAPISTS AND FROM OTHER DEPARTMENTS WITHIN THE HEALTH DEPARTMENT. THE TAXPAYER SAW 8 FAMILIES IN THIS PROJECT AND PROVIDED ONE-ON-ONE SUPPORT IN THE CHILDS' HOMES.
FORM 990-EZ, PART III, LINE 31
OTHER GENERAL SUPPORT SERVICES FOR FAMILIES WITH SPECIAL NEEDS CHILDREN.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.