Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 3,277,057 | 2,544,117 | 2,193,144 | 2,163,297 | 4,323,794 | 14,501,409 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 3,277,057 | 2,544,117 | 2,193,144 | 2,163,297 | 4,323,794 | 14,501,409 |
| 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).. | 3,404,402 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 11,097,007 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,277,057 | 2,544,117 | 2,193,144 | 2,163,297 | 4,323,794 | 14,501,409 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,065,498 | 1,050,246 | 1,269,551 | 1,517,812 | 1,278,364 | 6,181,471 |
| 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. | 20,682,880 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | PART III, LINE 1: THE MISSION OF THE COMMUNITY FOUNDATION: BY BRINGING CARING PEOPLE AND CHARITABLE ENDEAVORS TOGETHER, WE MAKE DONOR DREAMS SHINE FOR THE GOOD OF OUR COMMUNITY. WE DO THIS BY: 1) SERVING AS THE VEHICLE FOR DONORS' CHARITABLE DREAMS, 2) AWARDING GRANTS TO CHARITABLE PROJECTS AND ORGANIZATIONS, 3) ADDRESSING COMMUNITY NEEDS AS A CATALYST AND CONVENER. |
| FORM 990, PAGE 6, PART VI, LINE 1A | DESCRIPTION OF DELEGATION OF AUTHORITY TO EXECUTIVE COMMITTEE: BYLAWS OF THE COMMUNITY FOUNDATION AS AMENDED NOVEMBER 10, 2014 STATE THE FOLLOWING: SECTION 4.01. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL CONSIST OF THE PRESIDENT, VICE PRESIDENT, SECRETARY AND TREASURER OF THE BOARD OF DIRECTORS, THE EXECUTIVE DIRECTOR OF THE FOUNDATION, AND THE CHAIRS OF THE PUBLIC RELATIONS, FINANCE AND INVESTMENT, GRANT AND SCHOLARSHIP, DONOR RELATIONS, AND GOVERNANCE COMMITTEES (ALL MEMBERS OF THE BOARD OF DIRECTORS). SECTION 4.02. POWERS OF THE EXECUTIVE COMMITTEE. DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, AND SUBJECT TO SUCH LIMITATIONS AS MAY BE REQUIRED BY LAW OR BY RESOLUTION OF THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL OF THE AUTHORITY OF THE BOARD OF DIRECTORS, EXCEPT THAT THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY TO AMEND THE BY-LAWS. |
| FORM 990, PAGE 6, PART VI, LINE 4 | BYLAWS OF THE COMMUNITY FOUNDATION AS AMENDED NOVEMBER 10, 2014 STATE THE FOLLOWING: SECTION 4.01. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL CONSIST OF THE PRESIDENT, VICE PRESIDENT, SECRETARY AND TREASURER OF THE BOARD OF DIRECTORS, THE EXECUTIVE DIRECTOR OF THE FOUNDATION, AND THE CHAIRS OF THE PUBLIC RELATIONS, FINANCE AND INVESTMENT, GRANT AND SCHOLARSHIP, DONOR RELATIONS, AND GOVERNANCE COMMITTEES (ALL MEMBERS OF THE BOARD OF DIRECTORS). |
| FORM 990, PAGE 6, PART VI, LINE 11B | UPON COMPLETION OF THE FORM 990, AN ELECTRONIC VERSION OF THE RETURN IS DISTRIBUTED TO ALL BOARD MEMBERS AT LEAST THREE DAYS BEFORE THE SECOND MONDAY OF NOVEMBER. AT THE NOVEMBER BOARD MEETING, WHICH TAKES PLACE ON THE SECOND MONDAY, THE BOARD TREASURER PRESENTS THE FORM 990 FOR ACCEPTANCE. THE BOARD VOTES TO ACCEPT OR NOT ACCEPT THE FORM 990 AS PRESENTED. IF ACCEPTED, THE FORM 990 IS THEN SUBMITTED TO THE IRS. IF NOT ACCEPTED, THE FORM 990 WILL BE REVISED UNTIL ACCEPTED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE COMMUNITY FOUNDATION REQUIRES A SIGNED CONFLICT OF INTEREST DISCLOSURE FORM FROM ALL BOARD MEMBERS AND FROM ANY COMMITTEE MEMBER WHO IS IN A POSITION TO RECOMMEND GRANT DISTRIBUTIONS. DISCLOSURE FORMS ARE RENEWED AND RE-SIGNED ANNUALLY OR EACH TIME THEY (BOARD MEMBERS) SERVE ON A GRANT OR SCHOLARSHIP COMMITTEE. THE EXECUTIVE DIRECTOR COLLECTS AND REVIEWS THE DISCLOSURE FORMS AS THEY ARE RETURNED AND MAKES SURE THAT ALL WHO ARE REQUIRED TO COMPLETE A DISCLOSURE FORM HAVE DONE SO. WHEN AN INDIVIDUAL REPORTS AN ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST, THE COMMUNITY FOUNDATION FOLLOWS THE PROCEDURES OUTLINED IN ITS POLICY FOR DISCLOSURE OF CONFLICTS TO THE APPLICABLE BODY OF DECISION-MAKERS AND RECUSAL OF INDIVIDUAL(S) WITH CONFLICTS FROM THE DECISION-MAKING PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE FOLLOWING PROCESS WAS UNDERTAKEN IN FISCAL YEAR 2013/2014, WITH RESPECT TO COMPENSATION PAID TO THE EXECUTIVE DIRECTOR IN FISCAL YEAR 2014/2015. THE BOARD PRESIDENT AND THE EXECUTIVE DIRECTOR COMPLETE A FORMAL REVIEW INSTRUMENT INDEPENDENTLY AND THEN REVIEW RESULTS. THE BOARD PRESIDENT MEETS WITH THE EXECUTIVE COMMITTEE; THE EXECUTIVE DIRECTOR DOES NOT ATTEND. THE EXECUTIVE COMMITTEE REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE IN THE AREAS OF BOARD RELATIONS; STAFF PLANNING AND SUPERVISION; GRANTS AND PROGRAM MANAGEMENT; AND PUBLIC RELATIONS AND RESOURCE DEVELOPMENT. THE EXECUTIVE COMMITTEE THEN DETERMINES CONTINUED EMPLOYMENT, THE STRENGTHS AND POSSIBLE AREAS OF IMPROVEMENT AND COMPENSATION. THIS INFORMATION IS THEN SHARED WITH THE EXECUTIVE DIRECTOR. IN PREPARATION FOR THE EXECUTIVE DIRECTOR EVALUATION, THE COMMUNITY FOUNDATION PRESIDENT (AS CHAIR OF THE EXECUTIVE COMMITTEE) IS PROVIDED A COMPILATION OF THE COUNCIL ON FOUNDATIONS' NATIONWIDE SALARY INFORMATION. THE PRESIDENT IS ALSO PROVIDED WITH COMMUNITY FOUNDATION SALARY INFORMATION FOR THE STATE OF INDIANA AND ALSO FOR THE NORTHEAST REGION OF INDIANA. MINUTES OF THE EXECUTIVE COMMITTEE'S COMPENSATION DELIBERATIONS AND DECISIONS ARE PREPARED NO LATER THAN THE NEXT MEETING OF THE EXECUTIVE COMMITTEE, OR SIXTY DAYS AFTER THE DATE OF THE MEETING AT WHICH THE COMPENSATION IS APPROVED, WHICHEVER IS LATER. LINE 15B) N/A-THE COMMUNITY FOUNDATION HAS NO "OTHER OFFICERS OR KEY EMPLOYEES" TO REPORT ON. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE COMMUNITY FOUNDATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE FOR PUBLIC REVIEW IN OUR PUBLIC REVIEW FILE. THIS FILE IS KEPT IN A BINDER IN A PUBLIC AREA OF THE COMMUNITY FOUNDATION OFFICES, AND IS AVAILABLE FOR INSPECTION UPON REQUEST. THE FILE CONTAINS FORM 1023, ARTICLES OF INCORPORATION, BY-LAWS, IRS DETERMINATION LETTER, STATE SALES TAX EXEMPTION CERTIFICATE, RESOLUTIONS, A LIST OF BOARD AND STAFF MEMBERS, IRS FORM 990'S FROM THE MOST RECENT 5 YEARS, POLICIES (SUCH AS OUR POLICY ON DONATIONS, INVESTMENT POLICY, CONFLICT OF INTEREST POLICY, WHISTLEBLOWER POLICY, ETC.), COPIES OF OUR GRANT AND SCHOLARSHIP APPLICATIONS, OUR MOST RECENT AUDITED FINANCIAL STATEMENTS AND SAMPLE FUND AGREEMENTS. |
| FORM 990, PAGE 7, PART VII | ESTIMATE OF THE AVERAGE HOURS PER WEEK FOR A RELATED ORGANIZATION: SUZANNE LIGHT SERVED APPROXIMATELY 0.88 PER WEEK VOLUNTEER HOURS ON THE BOARD OF DIRECTORS FOR ORTHOPEDICS CAPITAL FOUNDATION, INC., A RELATED ORGANIZATION AND SUPPORTING ORGANIZATION OF THE KOSCIUSKO COUNTY COMMUNITY FOUNDATION. |
| FORM 990, PART XI, LINE 9 | ANNUITY PAYMENTS/SPLIT INTEREST CHANGE -90,321 AGENCY FUND REVENUES 19,413 AGENCY FUND EXPENSES 87,106 |
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