Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Doing business as
ACHIEVE
 
Number and street (or P.O. box if mail is not delivered to street address)
125 CUTLER POND ROAD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
BINGHAMTON, NY13905
D Employer identification number

15-0619307
E Telephone number

G Gross receipts $ 20,843,165
F Name and address of principal officer:
DANIEL K BALLARD
125 CUTLER POND ROAD
BINGHAMTON,NY13905
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ACHIEVENY.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet1256
K Form of organization:
 
L Year of formation: 1949
M State of legal domicile: NY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: NYSARC WAS FOUNDED IN 1949 TO MEET A CRITICAL MISSION -- TO IMPROVE THE QUALITY OF LIFE FOR PEOPLE WITH INTELLECTUAL AND OTHER DEVELOPMENTAL DISABILITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 162
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 162
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 468
6 Total number of volunteers (estimate if necessary) ............. 6 22
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,023,196 671,287
9 Program service revenue (Part VIII, line 2g) ......... 19,147,057 20,130,642
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,232 1,293
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 20,171,485 20,803,222
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 12,925,439 13,315,626
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 6,398,401 10,439,749
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 19,323,840 23,755,375
19 Revenue less expenses. Subtract line 18 from line 12....... 847,645 -2,952,153
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 10,782,366 6,996,748
21 Total liabilities (Part X, line 26)............. 3,735,627 2,902,162
22 Net assets or fund balances. Subtract line 21 from line 20..... 7,046,739 4,094,586
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO PROVIDE LEADERSHIP, ADVOCACY AND OPPORTUNITIES WHICH ENABLE PERSONS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO ENHANCE THE QUALITY OF THEIR LIVES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 7,589,864 including grants of $   ) (Revenue $ 8,050,912 )
RESIDENTIAL SERVICES: ACHIEVE OPERATED SUPERVISED AND SUPPORTIVE INDIVIDUAL RESIDENTIAL ALTERNATIVES FOR 117 INDIVIDUALS. EACH TYPE OF RESIDENCE PROVIDES A HOME FOR INDIVIDUALS WHO HAVE INTELLECTUAL AND OTHER DEVELOPMENTAL DISABILITIES. INDIVIDUALS LIVING IN A RESIDENCE HAVE THE OPPORTUNITY TO IMPROVE AND ENHANCE THEIR LEVEL OF INDEPENDENCE AS WELL AS INTEGRATE INTO THE COMMUNITY. EACH RESIDENCE IS LICENSED BY THE NYS OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES. IN ADDITION, 17 INDIVIDUALS RECEIVED INDIVIDUAL SUPPORT SERVICES ALLOWING THEM MORE CHOICE IN WHERE THEY LIVE AND THE SERVICES THEY RECEIVE. THE RESPITE BED PROGRAM PROVIDED TEMPORARY PLACEMENT FOR 23 INDIVIDUALS LIVING AT HOME AND ALLOWED FOR CAREGIVER RESPITE.
4b (Code:   ) (Expenses $ 8,274,619 including grants of $   ) (Revenue $ 9,443,884 )
VOCATIONAL SERVICES- THE PRE-VOCATIONAL PROGRAM IS DESIGNED TO IMPROVE AND ENHANCE VOCATIONAL AND PRE-VOCATIONAL OPPORTUNITIES, INCREASE PRODUCTIVITY AND EARNING POTENTIAL, AND PROMOTE INDEPENDENCE AND IDENTITY AS A VALUED MEMBER OF THE WORK FORCE AND COMMUNITY. SERVICES PROVIDED TO APPROXIMATELY 328 INDIVIDUALS INCLUDING PRE-VOCATIONAL TRAINING, BEHAVIORAL MANAGEMENT, WORK ADJUSTMENT/ASSIMILATION, AND OTHER WORK SKILLS TRAINING. SERVICES PROVIDED TO 149 CONSUMERS THROUGH OUR DAY HABILITATION PROGRAM INCLUDE: ACTIVITIES OF DAILY LIVING SKILLS, COGNITIVE SKILL DEVELOPMENT, RECREATION, COMMUNICATION DEVELOPMENT, OCCUPATIONAL, PHYSICAL AND SPEECH THERAPY, AND COMPREHENSIVE NURSING SERVICES. SUPPORTED EMPLOYMENT PROVIDED SERVICES TO 500 CONSUMERS WORKING TOWARD PLACING THOSE INDIVIDUALS IN AN OUTSIDE WORK ENVIRONMENT.
4c (Code:   ) (Expenses $ 1,035,582 including grants of $   ) (Revenue $ 1,017,687 )
FAMILY SUPPORT SERVICES- OUR FAMILY SUPPORT PROGRAM PROVIDES A VARIETY OF SERVICES. FAMILY EMPOWERMENT ASSISTS FAMILIES BY PROVIDING REIMBURSEMENTS FOR IN-HOME RESPITE SERVICES. RESPITE PROVIDES TEMPORARY RELIEF FROM THE DEMANDS OF CARE GIVING, WHICH HELPS REDUCE OVERALL FAMILY STRESS. THE RECREATION/RESPITE SERVICE PROVIDES RECREATIONAL AND SOCIAL ACTIVITIES TO BOTH TEENS AND ADULTS. PARTY NIGHT OCCURS EIGHT TIMES A YEAR AND PROVIDES A SOCIAL OUTING FOR INDIVIDUALS AS WELL AS RESPITE FOR FAMILIES. OUR SIBLING SUPPORT WORKSHOPS ARE DESIGNED TO PROVIDE ACTIVITIES AND SUPPORTS TO SIBLINGS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. COMMUNITY HABILITATION SERVICES ARE INDIVIDUALLY TAILORED SUPPORTS THAT ASSIST WITH SKILLS RELATED TO LIVING IN THE COMMUNITY. COMMUNITY HABILITATION SERVIES ARE PROVIDED TO INDIVIDUALS WHO LIVE INDEPENDENTLY OR WITH THEIR FAMILY. THE FAMILY SUPPORT PROGRAM SERVED OVER 328 INDIVIDUALS THROUGHOUT 2014.
(Code:   ) (Expenses $ 566,290 including grants of $   ) (Revenue $ 789,495 )
MEDICAID SERVICE COORDINATION
(Code:   ) (Expenses $ 73,633 including grants of $   ) (Revenue $ 63,642 )
SUMMER PROGRAM
(Code:   ) (Expenses $ 758,382 including grants of $   ) (Revenue $ 757,074 )
TRANSPORTATION
(Code:   ) (Expenses $ 164,169 including grants of $   ) (Revenue $ 2,620 )
CHAPTER FUNDS
(Code:   ) (Expenses $ 3,569,515 including grants of $   ) (Revenue $   )
FUNDRAISING AND DEVELOPMENT
(Code:   ) (Expenses $   including grants of $   ) (Revenue $ 5,328 )
ADMINISTRATIVE EXPENSES
4d Other program services (Describe in Schedule O.)
(Expenses $ 5,131,989 including grants of $   ) (Revenue $ 1,618,159 )
4e Total program service expensesMediumBullet22,032,054
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) .... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
368
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
468
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
162
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
162
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletAMY OSTERHOUT

47 RIVERSIDE DRIVE
JOHNSON CITY,NY13790 (607) 723-8361
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) ROBERT SALANKIEWICZ........................................................................
ASSISTANT TREASURER
 2.00
.......................0.60 		X   X       0 0 0
(2) DR CAMELIA LAWRENCE........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(3) ELLEN FELDMAN........................................................................
PRESIDENT
 10.00
.......................0.60 		X   X       0 0 0
(4) GARY SHAY........................................................................
1ST VICE PRESIDENT
 2.00
.......................0.60 		X   X       0 0 0
(5) MICHAEL METZGER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(6) THOMAS J TALBETT JR........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(7) JERRY ISAACS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(8) AL TURK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(9) IDA RIOS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(10) RAPHAEL SMITH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(11) DR TODD JACOBSON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(12) SUSAN POST........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(13) RICHARD SISSON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(14) DR JAMES ASHE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(15) JILL ABDALLAH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(16) RUTH VITALE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(17) MERRILEE HAMLIN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MARY SKILLAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(19) MARY ANNE VANDENBURGH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(20) DOROTHY WHEELER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(21) ROSE MARY CELLA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(22) DONALD GEER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(23) MARK METZGER ESQ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(24) WENDY BEEMAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(25) SHELLEY WINTERS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(26) ROBERT KLEPPANG........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(27) JUDY SCHELLE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(28) CANDIE POCOCK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(29) RONALD GEORGE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(30) CHERYL ENGLERT........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(31) MARCY VANZANDT........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(32) RANDY SCHAAL ESQ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(33) DAWN DESMOND........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(34) JOEL KAPLAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(35) SALLY ROMANO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(36) PAUL A GIORDANO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(37) SAUNDRA M GUMEROVE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(38) HARRIET TRAVERSA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(39) RADY BRUELL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(40) DR MELVIN GERTNER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(41) DONALD SMITH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(42) DR JOHN KOWALCZYK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(43) RUTH RIDGWAY........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(44) JOYCE CARMEN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(45) GORDON EYER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(46) JOSEPH M BOGNANNO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(47) JOANNA GRECO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(48) JOANNE GRANT........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(49) JAMES CANNON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(50) REV KEN DEGNAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(51) MARLENE HILL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(52) MARY ANN BARBARINO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(53) DEBORAH WILBUR........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(54) WALTER HOGAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(55) LAURA DODGE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(56) HEATHER STRICKLAND........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(57) SUSAN LUCAS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(58) EDIE HALL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(59) RICHARD RIMA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(60) DIANE DEARBORN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(61) EDWARD RAUSH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(62) SONIA CRANNAGE ESQ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(63) RICHARD SIROTA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(64) GISELA SCHMIDT........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(65) AUDREY TARANTINO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(66) KAREN FEINSTEIN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(67) PATRICIA CAMPANELLA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(68) DR LAWRENCE FEIN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(69) ROBERT DESIO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(70) ROBERT CLEMENTE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(71) BARBARA ROESER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(72) JOHN DESANTO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(73) HAROLD HOFFMEIER JR........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(74) MARCIA KASPRZYK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(75) JOHN BECKER II........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(76) ROSE PALMEIERI........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(77) PAUL GREENFIELD........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(78) ARTHUR STILWELL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(79) JOSEPH DEL BROCCOLO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(80) JAMES MCENEANEY........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(81) FRED SALZBERG........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(82) KENNETH WALKER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(83) IRENE KIRTACK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(84) STEVEN DROBYSH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(85) ROBERT BOENING........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(86) THOMAS HITCHCOCK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(87) DANIEL MARTINDALE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(88) ANNE MARIE LOCKHART........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(89) CAROL KENYON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(90) DIAN CIFUNI........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(91) NELVA TUREK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(92) ANTHONY ASSALONE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(93) ANGELO DEFELIPPO III........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(94) SHERYL R FRISHMAN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(95) MARY ELLEN MURPHY........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(96) ELLEN OWENS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(97) GREG BOOTH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(98) MISCHELLE K SHATTUCK........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(99) HOWARD JURIST........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(100) REV DIANE PRENTICE........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(101) MARY OTTER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(102) JAMES SAVAGE........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(103) KATHY SHEEHAN........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(104) DAVID ALAMO........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(105) CAROLYN NYTCH........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(106) JOHN MACH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(107) LORI MARTINDALE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(108) SHARON BOYD........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(109) EDWARD LEAHY........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(110) SARAH BEISHEIM........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(111) CYNTHIA LACKI........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(112) JOHN STEVENS........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(113) JAMES HAYES ESQ........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(114) COLLEEN FRIENDS........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(115) DAVE SEBASTIANELLI........................................................................
2ND VICE PRESIDENT
 2.00
.......................0.60 		X   X       0 0 0
(116) ALSON MCKENNA........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(117) LISA DOLPHIN........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(118) JULIE ERB........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(119) KELLY EURILLO........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(120) DOROLLO NIXON........................................................................
BOARD MEMBER
 2.00
.......................0.60 		X           0 0 0
(121) NICKI FRENCH........................................................................
SECRETARY
 2.00
.......................0.60 		X   X       0 0 0
(122) DANIEL BALLARD........................................................................
TREASURER
 2.00
.......................0.60 		X   X       0 0 0
(123) DEBRA THOMPSON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(124) MARYANN BRUNER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(125) KIM PARKER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(126) GILBERT DUKEN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(127) JAMES WARREN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(128) RINALDO ESPOSITO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(129) DAVE MILLER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(130) DEBRAH FISCHER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(131) DAVID LISCOMB........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(132) CHUCK STEVENS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(133) HALLIE GREENE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(134) DAVID MATHIS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(135) DEBORAH MCGRATH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(136) JOSEPH BRILL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(137) ANNE TOWNSEND........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(138) ROBERT BARNETT........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(139) DAVID WICKERHAM........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(140) FRANCES DEMPSEY........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(141) SCOTT LANG........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(142) DR SEVERIN CARLSON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(143) BERNIE KROOKS........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(144) ABBY REUBEN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(145) JAMES BLACKBURN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(146) LISA LEE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(147) BARBARA STEWART........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(148) BRIAN ATTEA ESQ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(149) SHANNON PATCH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(150) DMITRY FELD........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(151) JEAN SCHULTZ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(152) STEPHANIE DYER........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(153) JOANNE RHODE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(154) MARY BETH IRISH........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(155) ANNE GORDON........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(156) NANCY PETRINO........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(157) SHARYN VAN REEPINGHEN........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(158) ZAIDA MORELL........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(159) GREG HURD........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(160) NICHOLAS LANZA........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(161) STACEY OSBORNE........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(162) ROSA RODRIGUEZ........................................................................
BOARD OF GOV. REP.
 0.50
.......................   		X           0 0 0
(163) MARY JO THORN........................................................................
CHIEF EXECUTIVE OFFICER
 40.00
.......................1.00 		    X       151,676 0 11,913
(164) SANDRA RADZIWON........................................................................
CHIEF FINANCIAL OFFICER
 40.00
.......................1.00 		    X       35,743 0 4,940
(165) ANTHONY MARZOLINO........................................................................
CHIEF FINANCIAL OFFICER
 40.00
.......................1.00 		    X       41,494 0 2,209
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 228,913 0 19,062
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
ANDREW R MANCINI

129 ODELL AVE
ENDICOTT,NY13760 		CONSTRUCTION 468,152
EMPLOYMENT SOLUTIONS

PO BOX 601959
CHARLOTTE,NC28260 		CONTRACT LABOR 398,443
DONSON TRANSPORTATION INC

3000 WAYNE STREET
ENDWELL,NY13760 		CLIENT TRANSPORTATION 162,583
BROOME COUNTY DEPARTMENT OF TRANSPORTATI

413 OLD MILL ROAD
VESTAL,NY13850 		CLIENT TRANSPORTATION 109,742
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b 3,131
c Fundraising events....1c 14,622
d Related organizations...1d  
e Government grants (contributions)1e 170,179
f All other contributions, gifts, grants, and
similar amounts not included above1f 		483,355
g Noncash contributions included in lines
1a-1f:$ 		180
h Total. Add lines 1a-1f.......MediumBullet 671,287
Program Service RevenueAmt Business Code
2a VOCATIONAL 624310 9,443,884 9,443,884    
b RESIDENTIAL 623990 8,050,912 8,050,912    
c FAMILY SUPPORT SERVICES 624100 1,017,687 1,017,687    
d MEDICAID SERVICE COORDINATION 900099 789,495 789,495    
e TRANSPORTATION 480000 757,074 757,074    
f All other program service revenue . 71,590 71,590    
g Total. Add lines 2a–2f........MediumBullet 20,130,642
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,293     1,293
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$ 14,622
of contributions reported on line 1c). See Part IV, line 18 ..
a 39,943
b Less: direct expenses ...b 39,943
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See Instructions......MediumBullet 20,803,222 20,130,642 0 1,293
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 223,138   223,138  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 9,640,108 8,857,676 782,432  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 102,706 94,847 7,859  
9 Other employee benefits ....... 2,616,298 2,389,078 227,220  
10 Payroll taxes ........... 733,376 676,632 56,744  
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....        
12 Advertising and promotion ....        
13 Office expenses ....... 166,733 63,191 103,542  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 339,275 320,343 18,932  
17 Travel ............ 889,702 871,975 17,727  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 19,083 18,314 769  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 491,935 452,184 39,751  
23 Insurance .............. 89,693 76,852 12,841  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a CONTRIBUTION AND GRANT 3,484,012 3,484,012    
b CONSUMER WAGES 868,760 868,760    
c LEASE/RENTAL EXPENSE 774,863 754,223 20,640  
d CONSULTANTS/TEMPORARY S 621,834 610,375 11,459  
e All other expenses 2,693,859 2,493,592 200,267  
25 Total functional expenses. Add lines 1 through 24e 23,755,375 22,032,054 1,723,321 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing .............   1  
2 Savings and temporary cash investments ......... 1,955,335 2 1,500,222
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 3,274,042 4 3,483,128
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 67,430 8 42,267
9 Prepaid expenses and deferred charges .......... 110,382 9 44,585
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 8,280,062
b Less: accumulated depreciation ..... 10b 6,510,197 5,216,334 10c 1,769,865
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 158,843 15 156,681
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 10,782,366 16 6,996,748
Liabilities 17 Accounts payable and accrued expenses ......... 1,376,625 17 1,094,343
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 158,843 21 156,681
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties .. 652,249 23 391,926
24 Unsecured notes and loans payable to unrelated third parties .... 880,499 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 667,411 25 1,259,212
26 Total liabilities. Add lines 17 through 25......... 3,735,627 26 2,902,162
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 6,038,687 27 3,606,794
28 Temporarily restricted net assets ........... 1,008,052 28 487,792
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 7,046,739 33 4,094,586
34 Total liabilities and net assets/fund balances ........ 10,782,366 34 6,996,748
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
20,803,222
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
23,755,375
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,952,153
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
7,046,739
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
4,094,586
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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.") .... 303,880 641,279 1,369,495 1,023,196 671,287 4,009,137
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 3 303,880 641,279 1,369,495 1,023,196 671,287 4,009,137
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. 4,009,137
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4.. 303,880 641,279 1,369,495 1,023,196 671,287 4,009,137
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 6,996 4,727 1,931 1,232 1,293 16,179
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.)..            
11 Total support Add lines 7 through 10. 4,025,316
12
12
93,753,227
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
99.600 %
15
15
98.490 %
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
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)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
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 		 
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)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
  		Employer identification number

15-0619307
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   4,038,319 2,970,215 1,068,104
d Equipment ................   1,750,153 1,602,277 147,876
e Other .................   2,491,590 1,937,705 553,885
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,769,865
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DUE TO OPWDD 210,845
REFUNDABLE ADVANCES 163,760
HEALTH REIMBURSEMENT ACCOUNTS 139,344
DUE TO AFFILIATES 745,263





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,259,212
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ASC 740-10 WHICH REQUIRES ENTITIES TO DISCLOSE IN THEIR FINANCIAL STATEMENTS THE NATURE OF ANY UNCERTAINTY IN THEIR TAX POSITION. FOR TAX-EXEMPT ENTITIES, THEIR TAX-EXEMPT STATUS ITSELF IS DEEMED TO BE AN UNCERTAINTY, SINCE EVENTS COULD OCCUR TO JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE CHAPTER IMPLEMENTED FASB ASC 740-10 AND ITS CURRENT ACCOUNTING POLICY FOR EVALUATING UNCERTAIN TAX POSITIONS IS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE CHAPTER HAS NOT RECOGNIZED ANY BENEFITS FROM UNCERTAIN TAX POSITIONS IN 2014 AND BELIEVES IT HAS NO UNCERTAIN TAX POSITIONS FOR WHICH IT IS REASONABLY POSSIBLE THAT THE TOTAL AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL SIGNIFICANTLY INCREASE OR DECREASE WITHIN 12 MONTHS OF THE STATEMENTS OF FINANCIAL POSITION DATE. THE CHAPTER EVALUATED ITS TAX POSITION AND CONCLUDED THAT ALL OF THE POSITIONS TAKEN BY THE CHAPTER WOULD MORE LIKELY THAN NOT BE SUSTAINED UPON EXAMINATION, BASED ON TECHNICAL MERITS. THE INFORMATION RETURNS OF THE CHAPTER FOR 2011, 2012, AND 2013 ARE SUBJECT TO EXAMINATION BY TAX AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ
filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

WINE PAIRING
(event type) 		(b) Event #2

BOWLING TOURNAMENT
(event type) 		(c) Other events

3
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 14,007 14,492 26,066 54,565
2 Less: Contributions . . 1,512 10,882 2,228 14,622
3 Gross income (line 1
minus line 2) . . . 		12,495 3,610 23,838 39,943
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . .   1,472   1,472
7 Food and beverages .        
8 Entertainment . . .        
9 Other direct expenses . 12,495 2,138 23,838 38,471
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 39,943
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 0
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2014
Schedule G (Form 990 or 990-EZ) 2014
Page 3
11
Does the organization conduct gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activities conducted in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $  
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2014
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1MARY JO THORNCHIEF EXECUTIVE OFFICER (i)
(ii)		 151,676
...............................
0 		0
...............................
0 		0
...............................
0 		2,319
...............................
0 		9,594
...............................
0 		163,589
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JAMES HAYES BOARD MEMBER OF ACHIEVE AND PARTNER @ HINMAN, HOWARD & KATTELL LAW FIRM 9,108 LEGAL FEES   No
(2) DAVE SEBASTIANELLI BOARD MEMBER OF ACHIEVE AND EMPLOYEE OF BROWN AND BROWN INSURANCE 1,080,311 INSURANCE PREMIUM   No
(3) DAN BALLARD BOARD MEMBER OF ACHIEVE AND EMPLOYEE OF SERAFINI TRANSPORTATION 21,662 TRANSPORTATION SERVICES   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 NYSARC, INC. IS A UNITARY CORPORATION CONSISTING OF ITS 55 CHAPTERS. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER IS ONE DIVISION OF THE CORPORATION. THE CORPORATION AND CHAPTER'S GOVERNING BODY IS THE BOARD OF GOVERNORS REPRESENTING THE INDIVIDUAL MEMBERSHIP IN EACH CHAPTER'S JURISDICTION. EACH CHAPTER HAS FROM 1 TO 6 GOVERNORS BASED ON MEMBERSHIP. THE CORPORATION THROUGH ITS BYLAWS DELEGATES DAY-TO-DAY OPERATING AUTHORITY TO THE CHAPTER'S BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE OF THE BOARD OF GOVERNORS (SEE PART VI, LINE 7A BELOW) COMPRISES THE CORPORATION'S ELECTED OFFICERS AND EXCERCISES ALL POWERS OF THE BOARD OF GOVERNORS BETWEEN PLANARY MEETINGS OF THE GOVERNORS.
FORM 990, PART VI, SECTION A, LINE 7A THE DELEGATION ASSEMBLY, WHICH REPRESENTS NYSARC'S 100,000 MEMBERS, ELECTS THE CORPORATION PRESIDENT, SECRETARY,TREASURER AND ASSISTANT TREASURER TO 1-YEAR TERMS. DELEGATES ELECT REGIONAL VICE PRESIDENTS TO 1-YEAR TERMS FROM THEIR RESPECTIVE REGIONS. THE BOARD OF GOVERNORS ELECTS ONE SENIOR VICE PRESIDENT. THE BROOME-TIOGA COUNTY CHAPTER ELECTION PROCEDURE IS AS FOLLOWS: CHAPTER MEMBERS ARE NOTIFIED PRIOR TO THE DATE OF THE ANNUAL MEETING WITH THE NAMES OF CHAPTER OFFICERS, DIRECTORS AND NOMINATING COMMITTEE MEMBER NOMINEES. VOTING TAKES PLACE AT THE ANNUAL MEETING IN PERSON OR BY PROXY. DIRECTORS SHALL BE ELECTED FOR A TERM OF THREE YEARS. OFFICERS, CONSISTING OF PRESIDENT, VICE PRESIDENT, SECOND VICE PRESIDENT, SECRETARY, TREASURER, ASSISTANT TREASURER AND SUCH OTHER OFFICERS AS THE BOARD DEEMS NECESSARY SHALL BE ELECTED FOR A TERM OF ONE YEAR. EACH MEMBER OF THE NOMINATING COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR.
FORM 990, PART VI, SECTION A, LINE 7B CHAPTER BYLAW AMENDMENTS ARE SUBJECT TO BOARD OF GOVERNOR APPROVAL. ANY ACTION OF THE BOARD OF GOVERNORS MAY BE REVIEWED AT THE SUCCEEDING DELEGATE ASSEMBLY. NO ACTION OF THE GOVERNORS THAT AFFECTS THE IRREVOCABLE RIGHTS OF THIRD PARTIES MAY BE RESCINDED. CORPORATE BYLAW AMENDMENTS ARE SUBJECT TO APPROVAL BY A MAJORITY OF CHAPTERS.
FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF GOVERNORS DOES NOT REVIEW THE CHAPTER'S FORM 990'S BEFORE THEY ARE FILED. EACH INDIVIDUAL CHAPTER SUBMITS A COPY OF ITS FORM 990 TO THE CORPORATIONS BOARD OF GOVERNORS WHEN THE FORM 990 IS FILED BY THE CHAPTER. EACH CHAPTER MUST HAVE A POLICY AND PROCEDURE PROCESS FOR ITS BOARD OF DIRECTORS TO REVIEW THE CHAPTER'S FORM 990. THE POLICY OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER, WILL BE, ON AN ANNUAL BASIS, TO HAVE THE BUDGET AND FINANCE COMMITTEE REVIEW AND RECOMMEND APPROVAL OF THE FEDERAL FORM 990 TO THE FULL BOARD OF DIRECTORS AND THE BOARD WILL BE REQUIRED TO APPROVE THE FORM 990. THE TREASURER OR, ANY OFFICER IF THE TREASURER IS UNAVAILABLE, WILL PROVIDE THE SIGNATURE REQUIRED ON THE FEDERAL FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. THIS POLICY WILL SATISFY THE NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER'S RESPONSIBILITY FOR COMPLIANCE WITH THE INTERNAL REVENUE SERVICE REQUIRMENT FOR PRIOR BOARD REVIEW AND APPROVAL OF THE FEDERAL FORM 990 ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 12C AT TIME OF HIRE AND EACH YEAR THEREAFTER, ALL STAFF ARE PROVIDED WITH A CONFLICT OF INTEREST POLICY TO REVIEW, SIGN IN AGREEMENT AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. IF DURING ANY BUSINESS TRANSACTION IT APPEARS THERE MAY BE A CONFLICT, IT IS INVESTIGATED AND RESOLVED AT THAT TIME.
FORM 990, PART VI, SECTION B, LINE 15 AS IT RELATES TO THE CHIEF EXECUTIVE OFFICER'S COMPENSATION REVIEW, THE EXECUTIVE COMMITTEE WILL BE GUIDED BY THE FOLLOWING: 1. REVIEWS AND DETERMINES, BASED ON THE PERFORMANCE EVALUATION, THE COMPENSATION AND BENEFITS OF THE CEO AND RECOMMENDS THEM TO THE FULL BOARD. 2. RETAINS, AS NECESSARY, CONSULTANT AND/OR DATA AND INFORMATION TO ASSIST THE COMMITTEE IN THE EVALUATION OF THE COMPENSATION OF THE CEO. THIS EVALUATION MUST BE ADEQUATE IN SCOPE TO SATISFY THE INTERNAL REVENUE SERVICE REQUIRMENTS REGARDING EXCESS COMPENSATION IN ITS INTERMEDIATE SANCTION REGULATIONS. 3. A REVIEW OF EXECUTIVE COMPENSATION PLANS TO THE EXTENT REQUIRED BY FEDERAL AND STATE LAWS AND REGULATIONS. THE EXECUTIVE COMMITTEE UTILIZES A COMPENSATION AND REVIEW PROCESS THAT ENSURES DUE DILIGENCE,WHICH MAY INCLUDE ANALYSIS OF SALARIES FOR COMPARABLE POSITIONS (990 FORMS FROM OTHER LIKE AGENCIES,SURVEY INFORMATION, ETC.), BUDGET CONSIDERATION, AND A REVIEW OF INTERNAL EQUITY CONSIDERATIONS. THE PERFORMANCE EVALUATION WILL BE A KEY FACTOR IN THE COMPENSATION RECOMMENDATIONS. PRIOR TO FORMALIZING ANY COMPENSATION PLAN, OR PLAN REVISION, THE CHAIRPERSON MAY REVIEW THE PLAN WITH THE CHIEF FINANCIAL OFFICER TO ENSURE COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS AS WELL AS TO ENSURE FEASIBILITY OF ADMINISTRATION OF THE PLAN WITHIN THE STRUCTURE AND POLICIES OF THE AGENCY. THE EXECUTIVE COMMITTEE WILL REVIEW AS REQUIRED THE CONTRACT FOR THE CEO AND PROVIDE RECOMMENDATIONS REGARDING CHANGE THERE TO. ANY CHANGES REGARDING THESE BENEFITS ARE REFLECTED IN THE CEO CONTRACT. A COPY OF THE CONTRACT WILL BE KEPT IN THE CEO'S PERSONNEL FILE. THE CHAIRPERSON OF THE COMMITTEE SHALL REPORT TO THE BOARD THE DELIBERATIONS, ACTIONS, AND RECOMMENDATIONS OF THE COMMITTEE. THE CHAIRPERSON (OR DESIGNEE) WILL MEET WITH THE CEO TO INFORM HIM/HER OF CHANGES IN THE CONTRACT AND IN COMPENSATION AND BENEFITS AGREED UPON BY THE BOARD. KEY EXECUTIVE MANAGEMENT STAFF ARE EVALUATED ANNUALLY BY THE CEO. ANY CHANGES IN COMPENSATION ARE MADE BASED ON COMPARATIVE MARKET ANALYSIS AND AGENCY BUDGET COMPARATIVE DATA.
FORM 990, PART VI, SECTION C, LINE 19 UNDER REGULATIONS THAT BECAME EFFECTIVE IN 1999, NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER IS SUBJECT TO FEDERAL REQUIREMENTS TO MAKE THE FOLLOWING FORMS "WIDELY AVAILABLE" TO ALL MEMBERS OF THE GENERAL PUBLIC: 1. THE THREE MOST RECENT ANNUAL INFORMATION RETURNS (FORM 990), EXCLUDING THE LIST OF SIGNIFICANT DONORS (SCHEDULE B) THAT IS ATTACHED TO THE FORM 990, BUT INCLUDING ANY OTHER ACCOMPANYING SCHEDULES AS REQUIRED. 2. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER'S ORIGINAL APPLICATION FOR RECOGNITION OF ITS TAX-EXEMPT STATUS (FORM 1023), FILED WITH IRS AND ALL ACCOMPANYING SCHEDULES AND ATTACHMENTS. IT IS THE POLICY OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER TO ADHERE TO THE FOLLOWING GUIDELINES IN ORDER TO COMPLY WITH THE PRECEDING PUBLIC DISCLOSURE REQUIRMENTS: 1. ANYONE APPEARING IN PERSON AT THE OFFICES OF NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER DURING NORMAL WORKING HOURS MAKING A REQUEST TO INSPECT THE FORMS WILL BE GRANTED ACCESS TO A FILE COPY OF THE FORMS. THE CONTROLLER SHALL BE RESPONSIBILE FOR MAINTAINING THIS COPY OF EACH FORM AND FOR MAKING IT AVAILABLE TO ALL REQUESTERS. 2. FOR ALL WRITTEN REQUESTS FOR COPIES OF FORMS RECEIVED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER , THE ORGANIZATION SHALL REQUIRE PRE-PAYMENT OF ALL COPYING AND SHIPPING CHARGES. FOR REQUESTS FOR COPIES THAT ARE RECEIVED WITHOUT PREPAYMENT, NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER WILL NOTIFY THE REQUESTER OF THIS POLICY VIA PHONE CALL OR BY LETTER WITHIN 7 DAYS OF RECEIPT OF THE ORIGINAL REQUEST. 3. THE COPYING COST CHARGED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER FOR PROVIDING COPIES OF REQUESTED FORMS SHALL BE $1.00 FOR THE FIRST PAGE COPIES AND $0.15 FOR EACH SUBSEQUENT PAGE. ALL COPIES SHALL BE SHIPPED TO REQUESTERS VIA REGULAR FIRST CLASS MAIL, THUS, SHIPPING CHARGES WILL BE A STANDARD $3.00 PER SHIPMENT. 4. AFTER PAYMENT IS RECEIVED BY NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER, ALL REQUESTED COPIES SHALL BE SHIPPED TO REQUESTERS WITHIN 30 DAYS. MAKING ALL COPIES AND SHIPPING WITHIN THE 30-DAY TIME PERIOD SHALL BE THE RESPONSIBILITY OF THE BUSINESS OFFICE. 5. FOR REQUESTS FOR COPIES MADE IN PERSON DURING NORMAL BUSINESS HOURS, COPIES SHALL BE PROVIDED WHILE THE REQUESTER WAITS. 6. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER SHALL ACCEPT CERIFIED CHECKS AND MONEY ORDERS FOR REQUESTS FOR COPIES MADE IN PERSON. NYSARC, INC., BROOME-TIOGA COUNTY CHAPTER SHALL ACCEPT CERTIFIED CHECKS, MONEY ORDERS AND CREDIT CARDS AS PAYMENT FOR COPIES OF FORMS REQUESTED IN WRITING.
FORM 990, PART VII MICHAEL METZGER - 393 DELAWARE AVENUE, DELMAR, NY 12054. THOMAS J. TALBETT, JR. - 393 DELAWARE AVENUE, DELMAR, NY 12054. JERRY ISAACS - 393 DELAWARE AVENUE, DELMAR, NY 12054. AL TURK - 393 DELAWARE AVENUE, DELMAR, NY 12054. IDA RIOS - 393 DELAWARE AVENUE, DELMAR, NY 12054. RAPHAEL SMITH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. TODD JACOBSON - 393 DELAWARE AVENUE, DELMAR, NY 12054. SUSAN POST - 393 DELAWARE AVENUE, DELMAR, NY 12054. RICHARD SISSON - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. JAMES ASHE - 393 DELAWARE AVENUE, DELMAR, NY 12054. JILL ABDALLAH - 393 DELAWARE AVENUE, DELMAR, NY 12054. RUTH VITALE - 393 DELAWARE AVENUE, DELMAR, NY 12054. MERRILEE HAMLIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY SKILLAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY ANNE VANDENBURGH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DOROTHY WHEELER - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROSE MARY CELLA - 393 DELAWARE AVENUE, DELMAR, NY 12054. DONALD GEER - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARK METZGER, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. WENDY BEEMAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHELLEY WINTERS - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT KLEPPANG - 393 DELAWARE AVENUE, DELMAR, NY 12054. JUDY SCHELLE - 393 DELAWARE AVENUE, DELMAR, NY 12054. CANDIE POCOCK - 393 DELAWARE AVENUE, DELMAR, NY 12054. RONALD GEORGE - 393 DELAWARE AVENUE, DELMAR, NY 12054. CHERYL ENGLERT - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARCY VANZANDT - 393 DELAWARE AVENUE, DELMAR, NY 12054. RANDY SCHAAL, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAWN DESMOND - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOEL KAPLAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. SALLY ROMANO - 393 DELAWARE AVENUE, DELMAR, NY 12054. PAUL A. GIORDANO - 393 DELAWARE AVENUE, DELMAR, NY 12054. SAUNDRA M. GUMEROVE - 393 DELAWARE AVENUE, DELMAR, NY 12054. HARRIET TRAVERSA - 393 DELAWARE AVENUE, DELMAR, NY 12054. RADY BRUELL - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. MELVIN GERTNER - 393 DELAWARE AVENUE, DELMAR, NY 12054. DONALD SMITH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. JOHN KOWALCZYK - 393 DELAWARE AVENUE, DELMAR, NY 12054. RUTH RIDGWAY - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOYCE CARMEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. GORDON EYER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH M. BOGNANNO - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOANNA GRECO - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOANNE GRANT - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES CANNON - 393 DELAWARE AVENUE, DELMAR, NY 12054. REV. KEN DEGNAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARLENE HILL - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY ANN BARBARINO - 393 DELAWARE AVENUE, DELMAR, NY 12054. DEBORAH WILBUR - 393 DELAWARE AVENUE, DELMAR, NY 12054. WALTER HOGAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. LAURA DODGE - 393 DELAWARE AVENUE, DELMAR, NY 12054. HEATHER STRICKLAND - 393 DELAWARE AVENUE, DELMAR, NY 12054. SUSAN LUCAS - 393 DELAWARE AVENUE, DELMAR, NY 12054. EDIE HALL - 393 DELAWARE AVENUE, DELMAR, NY 12054. RICHARD RIMA - 393 DELAWARE AVENUE, DELMAR, NY 12054. DIANE DEARBORN - 393 DELAWARE AVENUE, DELMAR, NY 12054. EDWARD RAUSH - 393 DELAWARE AVENUE, DELMAR, NY 12054. SONIA CRANNAGE, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. RICHARD SIROTA - 393 DELAWARE AVENUE, DELMAR, NY 12054. GISELA SCHMIDT - 393 DELAWARE AVENUE, DELMAR, NY 12054. AUDREY TARANTINO - 393 DELAWARE AVENUE, DELMAR, NY 12054. KAREN FEINSTEIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. PATRICIA CAMPANELLA - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. LAWRENCE FEIN - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT DESIO - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT CLEMENTE - 393 DELAWARE AVENUE, DELMAR, NY 12054. BARBARA ROESER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOHN DESANTO - 393 DELAWARE AVENUE, DELMAR, NY 12054. HAROLD HOFFMEIER, JR. - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARCIA KASPRZYK - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOHN BECKER, II - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROSE PALMEIERI - 393 DELAWARE AVENUE, DELMAR, NY 12054. PAUL GREENFIELD - 393 DELAWARE AVENUE, DELMAR, NY 12054. ARTHUR STILWELL - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH DEL BROCCOLO - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES MCENEANEY - 393 DELAWARE AVENUE, DELMAR, NY 12054. FRED SALZBERG - 393 DELAWARE AVENUE, DELMAR, NY 12054. KENNETH WALKER - 393 DELAWARE AVENUE, DELMAR, NY 12054. IRENE KIRTACK - 393 DELAWARE AVENUE, DELMAR, NY 12054. STEVEN DROBYSH - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT BOENING - 393 DELAWARE AVENUE, DELMAR, NY 12054. THOMAS HITCHCOCK - 393 DELAWARE AVENUE, DELMAR, NY 12054. DANIEL MARTINDALE - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANNE MARIE LOCKHART - 393 DELAWARE AVENUE, DELMAR, NY 12054. CAROL KENYON - 393 DELAWARE AVENUE, DELMAR, NY 12054. DIAN CIFUNI - 393 DELAWARE AVENUE, DELMAR, NY 12054. NELVA TUREK - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANTHONY ASSALONE - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANGELO DEFELIPPO, III - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHERYL R. FRISHMAN - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY ELLEN MURPHY - 393 DELAWARE AVENUE, DELMAR, NY 12054. ELLEN OWENS - 393 DELAWARE AVENUE, DELMAR, NY 12054. GREG BOOTH - 393 DELAWARE AVENUE, DELMAR, NY 12054. MISCHELLE K. SHATTUCK - 393 DELAWARE AVENUE, DELMAR, NY 12054. HOWARD JURIST - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY OTTER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOHN MACH - 393 DELAWARE AVENUE, DELMAR, NY 12054. LORI MARTINDALE - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHARON BOYD - 393 DELAWARE AVENUE, DELMAR, NY 12054. EDWARD LEAHY - 393 DELAWARE AVENUE, DELMAR, NY 12054. SARAH BEISHEIM - 393 DELAWARE AVENUE, DELMAR, NY 12054. CYNTHIA LACKI - 393 DELAWARE AVENUE, DELMAR, NY 12054. DEBRA THOMPSON - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARYANN BRUNER - 393 DELAWARE AVENUE, DELMAR, NY 12054. KIM PARKER - 393 DELAWARE AVENUE, DELMAR, NY 12054. GILBERT DUKEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES WARREN - 393 DELAWARE AVENUE, DELMAR, NY 12054. RINALDO ESPOSITO - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAVE MILLER - 393 DELAWARE AVENUE, DELMAR, NY 12054. DEBRAH FISCHER - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAVID LISCOMB - 393 DELAWARE AVENUE, DELMAR, NY 12054. CHUCK STEVENS - 393 DELAWARE AVENUE, DELMAR, NY 12054. HALLIE GREENE - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAVID MATHIS - 393 DELAWARE AVENUE, DELMAR, NY 12054. DEBORAH MCGRATH - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOSEPH BRILL - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANNE TOWNSEND - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROBERT BARNETT - 393 DELAWARE AVENUE, DELMAR, NY 12054. DAVID WICKERHAM - 393 DELAWARE AVENUE, DELMAR, NY 12054. FRANCES DEMPSEY - 393 DELAWARE AVENUE, DELMAR, NY 12054. SCOTT LANG - 393 DELAWARE AVENUE, DELMAR, NY 12054. DR. SEVERIN CARLSON - 393 DELAWARE AVENUE, DELMAR, NY 12054. BERNIE KROOKS - 393 DELAWARE AVENUE, DELMAR, NY 12054. ABBY REUBEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. JAMES BLACKBURN - 393 DELAWARE AVENUE, DELMAR, NY 12054. LISA LEE - 393 DELAWARE AVENUE, DELMAR, NY 12054. BARBARA STEWART - 393 DELAWARE AVENUE, DELMAR, NY 12054. BRIAN ATTEA, ESQ. - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHANNON PATCH - 393 DELAWARE AVENUE, DELMAR, NY 12054. DMITRY FELD - 393 DELAWARE AVENUE, DELMAR, NY 12054. JEAN SCHULTZ - 393 DELAWARE AVENUE, DELMAR, NY 12054. STEPHANIE DYER - 393 DELAWARE AVENUE, DELMAR, NY 12054. JOANNE RHODE - 393 DELAWARE AVENUE, DELMAR, NY 12054. MARY BETH IRISH - 393 DELAWARE AVENUE, DELMAR, NY 12054. ANNE GORDON - 393 DELAWARE AVENUE, DELMAR, NY 12054. NANCY PETRINO - 393 DELAWARE AVENUE, DELMAR, NY 12054. SHARYN VAN REEPINGHEN - 393 DELAWARE AVENUE, DELMAR, NY 12054. ZAIDA MORELL - 393 DELAWARE AVENUE, DELMAR, NY 12054. GREG HURD - 393 DELAWARE AVENUE, DELMAR, NY 12054. NICHOLAS LANZA - 393 DELAWARE AVENUE, DELMAR, NY 12054. STACEY OSBORNE - 393 DELAWARE AVENUE, DELMAR, NY 12054. ROSA RODRIGUEZ - 393 DELAWARE AVENUE, DELMAR, NY 12054.
FORM 990, PART IX, LINE 24E CONTRACT MATERIAL: PROGRAM SERVICE EXPENSES 595,770. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 595,770. CONSUMER/FAMILY RELATED EXPENSES: PROGRAM SERVICE EXPENSES 578,013. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 578,013. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 348,419. MANAGEMENT AND GENERAL EXPENSES 13,927. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 362,346. FOOD: PROGRAM SERVICE EXPENSES 350,423. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 350,423. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 116,030. MANAGEMENT AND GENERAL EXPENSES 117,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 233,331. PROGRAM SUPPLIES: PROGRAM SERVICE EXPENSES 224,650. MANAGEMENT AND GENERAL EXPENSES 3,479. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 228,129. TELEPHONE: PROGRAM SERVICE EXPENSES 123,414. MANAGEMENT AND GENERAL EXPENSES 16,627. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 140,041. SMALL EQUIPMENT: PROGRAM SERVICE EXPENSES 87,699. MANAGEMENT AND GENERAL EXPENSES 27,311. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,010. MISCELLANEOUS EXPENSES: PROGRAM SERVICE EXPENSES 34,164. MANAGEMENT AND GENERAL EXPENSES 8,429. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,593. STAFF DEVELOPMENT: PROGRAM SERVICE EXPENSES 19,868. MANAGEMENT AND GENERAL EXPENSES 13,193. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,061. MARKETING: PROGRAM SERVICE EXPENSES 15,142. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,142.
FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
NYSARC INCBROOME-TIOGA COUNTY CHAPTER
 
Employer identification number

15-0619307
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) THE FOUNDATION OF THE BROOME-TIOGA ASSOCIATION FOR RETARDED CITIZENS
125 CUTLER POND ROAD

BINGHAMTON,NY13905
22-3273829 		PLANNED GIVING ACTIVITIES NY 501(C)(3) 7 N/A
Yes
 
(2) COUNTRY VALLEY INDUSTRIES INC
125 CUTLER POND ROAD

BINGHAMTON,NY13905
22-3081071 		REALTY COMPANY NY 501(C)(3) 7 N/A
Yes
 
(3) COUNTRY VALLEY COMMUNITY RESIDENCE INC
125 CUTLER POND ROAD

BINGHAMTON,NY13905
16-1082590 		REALTY COMPANY NY 501(C)(2)   N/A
Yes
 








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COUNTRY VALLEY INDUSTRIES INC

 K 403,912 COST
(2) COUNTRY VALLEY INDUSTRIES INC

 B 3,404,014 COST




Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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