Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MID-NEBRASKA COMMUNITY FOUNDATION INC
Employer identification number
47-0604965
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
654,669
726,714
1,000,109
1,124,238
1,783,710
5,289,440
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
654,669
726,714
1,000,109
1,124,238
1,783,710
5,289,440
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)..
1,157,918
6
Public support. Subtract line 5 from line 4.
4,131,522
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
654,669
726,714
1,000,109
1,124,238
1,783,710
5,289,440
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
-158,419
400,749
558,577
729,367
773,485
2,303,759
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
20,284
25,806
27,950
30,317
35,160
139,517
11
Total support (Add lines 7 through 10).
7,732,716
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
53.430 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
61.570 %
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
13000170
Software Version:
2013v4.0
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MID-NEBRASKA COMMUNITY FOUNDATION INC
Employer identification number
47-0604965
Return Reference
Explanation
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et
THE FOLLOWING MID-NEBRASKA COMMUNITY FOUNDATION DIRECTORS:GARY BYRNE WAS A PRINCIPAL OF SCOTT ABSTRACT AND TITLE SERVICES OF THE PLAINS.OLIVIA CONRAD, WHO RESIGNED AS A DIRECTOR IN OCTOBER 2013, WAS AN EMPLOYEE OF FIRST NATIONAL BANK.DIANA DIFFENDAFFER WAS AN OWNER OF A CLOTHING STORE IN NORTH PLATTE.ALAN ERICKSON WAS A DIRECTOR OF NEBRASKALAND NATIONAL BANK, AS WELL AS REAL ESTATE INVESTMENTS.MARY LYNN HORST WAS AN EMPLOYEE OF NORTH PLATTE PUBLIC SCHOOLS.J. PATRICK KEENAN HAD INVESTMENTS IN LOCAL MOTELS AND OTHER REAL ESTATE.JIM MCCLYMONT WAS A PRACTICING ATTORNEY.DR. MARK NIELSEN WAS A PRACTICING PHYSICIAN.JOHN PATTERSON HAD REAL ESTATE INVESTMENTS.CHARLENE SCHNEIDER WAS AN EMPLOYEE OF U.S. BANK.BOB SPADY WAS A PRINCIPAL OF BOB SPADY BUICK-GMC.KIMBERLY STEGER WAS AN EMPLOYEE OF EQUITABLE BANK.LARRY STOBBS WAS A PRINCIPAL OF ROSENBERG INSURANCE CO.GLENN VAN VELSON WAS A PRACTICING ATTORNEY.EXECUTIVE DIRECTOR ERIC SEACREST WAS AN OWNER OF SKYLINE LIQUOR AND WINFIELD COFFEE.THE ABOVE LISTED INDIVIDUALS, IN THE NORMAL COURSE OF BUSINESS MIGHT HAVE DEALINGS WITH INDIVIDUALS WHO ALSO WERE MNCF OFFICERS, DIRECTORS AND KEY EMPLOYEES.
Form 990, Part VI, Line 11b: Form 990 Review Process
MID-NEBRASKA COMMUNITY FOUNDATION ASSIGNED PRIMARY RESPONSIBILITY FOR PREPARING AND REVIEWING FORM 990 TO MNCF STAFF MEMBERS AND TO ITS INDEPENDENT ACCOUNTING FIRM, MCPHERRON, SKILES & LOOP CPAS PC OF NORTH PLATTE, NEBRASKA, WHO HELPED PREPARE REGULAR FINANCIAL STATEMENTS FOR MANAGEMENT PURPOSES.INDEPENDENT ACCOUNTANT PATRICIA BRUNZ CPA OF MCPHERRON, SKILES & LOOP CPA PC AND MNCF EXECUTIVE DIRECTOR ERIC SEACREST REVIEWED FORM 990 PREPARATION AND CONTENT.THE FORM 990 WAS SHARED WITH EACH MEMBER OF THE MNCF BOARD OF DIRECTORS AND FEEDBACK WAS INVITED.COPIES OF THE FILED FORM 990 WILL BE AVAILABLE FOR REVIEW BY THE PUBLIC AND THE MID-NEBRASKA COMMUNITY FOUNDATION OFFICE, 120 N DEWEY STREET, NORTH PLATTE, NE.COPIES OF THE FILED FORM 990 TYPICALLY HAVE BEEN MADE AVAILABLE ON THE WEB SITES OF ORGANIZATIONS THAT MONITOR NON-PROFIT ORGANIZATIONS IN THE U.S. SUCH AS GUIDESTAR.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
CONFLICT OF INTEREST POLICIES ARE DESCRIBED IN ARTICLE IV - SECTION 9 OF MNCF BY-LAWS:(a) SIGNIFICANT INVOLVEMENT: IN CONSIDERING FOUNDATION MATTERS, DIRECTORS AND OTHER COMMITTEE MEMBERS WILL ANNOUNCE AND DISCLOSE SIGNIFICANT INVOLVEMENT WITH INSTITUTIONS OR GRANTEES UNDER DISCUSSION. "SIGNIFICANT INVOLVEMENT" IS DEFINED AS: (i)SERVING AS AN ELECTED OR APPOINTED MEMBER OF A GOVERNING BOARD OR MAJOR COMMITTEE, (ii)RECEIVING COMPENSATION AS AN EMPLOYEE OR CONSULTANT, OR (iii) BEING RELATED TO AN INDIVIDUAL GRANTEE OR TO A STAFF MEMBER OF A GRANTEE INSTITUTION.(b) INDIRECT INTEREST: A DIRECTOR HAS AN INDIRECT INTEREST IN A TRANSACTION IF ANOTHER ENTITY IN WHICH THE DIRECTOR HAS A MATERIAL INTEREST OR IN WHICH THE DIRECTOR IS A GENERAL PARTNER IS A PARTY TO THE TRANSACTION,OR ANOTHER ENTITY OF WHICH THE DIRECTOR IS A DIRECTOR, OFFICER, OR TRUSTEE IS A PARTY TO THE TRANSACTION.(c) CONFLICT OF INTEREST: A CONFLICT OF INTEREST EXISTS WHEN A DIRECTOR HAS A DIRECT OR INDIRECT INTEREST IN A TRANSACTION. A CONFLICT OF INTEREST TRANSACTION IS NOT VOIDABLE OR THE BASIS FOR IMPOSING LIABILITY ON THE DIRECTOR IF THE TRANSACTION WAS FAIR AT THE TIME IT WAS ENTERED INTO OR IS APPROVED AS SET FORTH HEREIN. A TRANSACTION IN WHICH A DIRECTOR HAS A CONFLICT OF INTEREST MAY BE APPROVED IN ADVANCE BY THE VOTE OF THE BOARD OF DIRECTORS OR A COMMITTEE IF THE MATERIAL FACTS OF THE TRANSACTION AND THE DIRECTOR'S INTEREST ARE DISCLOSED OR KNOWN TO THE BOARD OR COMMITTEE, AND THE DIRECTORS APPROVING THE TRANSACTION IN GOOD FAITH REASONABLY BELIEVE THAT THE TRANSACTION IS FAIR TO THE FOUNDATION.(d) RATIFICATION: A CONFLICT OF INTEREST TRANSACTION IS AUTHORIZED, APPROVED, OR RATIFIED IF IT RECEIVES THE AFFIRMATION VOTE OF A MAJORITY OF THE DIRECTORS OR COMMITTEE MEMBERS WHO HAVE NO DIRECT INTEREST IN THE TRANSACTION. A CONFLICT OF INTEREST TRANSACTION MAY NOT BE AUTHORIZED, APPROVED, OR RATIFIED BY A SINGLE DIRECTOR. IF A MAJORITY OF THE DIRECTORS WHO HAVE NO DIRECT OR INDIRECT INTEREST IN THE TRANSACTION VOTE TO AUTHORIZE, APPROVE, OR RATIFY THE TRANSACTION, A QUORUM IS PRESENT FOR THE PURPOSE OF TAKING ACTION ON THE CONFLICT OF INTEREST TRANSACTION. THE PRESENCE OF, OR A VOTE CAST BY, A DIRECTOR WITH A DIRECT OR INDIRECT INTEREST IN THE TRANSACTION DOES NOT AFFECT THE VALIDITY OF ANY ACTION TAKEN BY THE DIRECTORS IF THE CONFLICT OF INTEREST TRANSACTION IS OTHERWISE APPROVED AS SET FORTH HEREIN.REMINDER ABOUT CONFLICTS OR DUALITY AT MEETINGS: AT VIRTUALLY ALL MNCF BOARD OF DIRECTORS MEETINGS, THE AGENDA OF THE MEETING INCLUDES A NOTICE TO PARTICIPANTS THAT IF THE BOARD OR COMMITTEE CONSIDERS A MATTER THAT MIGHT CONSTITUTE A CONFLICT OF INTEREST OR DUALITY OF INTEREST INVOLVING A PARTICIPANT, IT IS THE PARTICIPANT'S OBLIGATION TO DISCLOSE THE FACTS OF THE SITUATION AS WELL AS TO ABSTAIN FROM VOTING AND TO REFRAIN FROM ATTEMPTING TO INFLUENCE THE MATTER IN THOSE SITUATIONS WHERE A CONFLICT OF INTEREST OR DUALITY OF INTEREST EXISTS.ABSTENTIONS IN VOTING ARE RECORDED IN THE MINUTES OF BOARD OF DIRECTORS AND COMMITTEES MEETINGS.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
THE PRESIDENT OF MID-NEBRASKA COMMUNITY FOUNDATION APPOINTS AN EXECUTIVE EVALUATION COMMITTEE MADE UP OF OFFICERS AND DIRECTORS, ALL OF WHOM ARE INDEPENDENT. THE EVALUATION COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS AFTER CONSIDERING: 1. POSITION DESCRIPTION 2. SURVEY DATA ABOUT COMPENSATION OF COMPARABLE POSITIONS AT OTHER COMMUNITY FOUNDATIONS IN THE U.S. AND IN THE MIDWEST REGION 3. PERFORMANCE INFORMATION 4. SALARY HISTORY 5. BUDGET SITUATION OF THE ORGANIZATIONTHE BOARD OF DIRECTORS DISCUSSES RECOMMENDATIONS AND RELEVANT INFORMATION AND THEN TAKES ACTION ON COMPENSATION OF EXECUTIVE DIRECTOR. RECOMMENDATIONS OF EXECUTIVE EVALUATION COMMITTEE ALONG WITH ACTIONS OF BOARD OF DIRECTORS ARE RECORDED IN THE MINUTES OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
MID-NEBRASKA COMMUNITY FOUNDATION MAKES COPIES OF ITS ARTICLES OF INCORPORATION, BY-LAWS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT ITS OFFICE AT 120 NORTH DEWEY STREET, NORTH PLATTE, NE 69101.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.