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
COMMUNITY GALLERY INC DBA AVA GALLERY
Employer identification number
23-7394706
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.") ....
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
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.
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..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
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
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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.") .
207,835
240,238
240,305
317,158
807,511
1,813,047
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......
255,150
237,197
256,933
232,908
234,474
1,216,662
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.
462,985
477,435
497,238
550,066
1,041,985
3,029,709
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
98,279
136,501
234,780
c
Add lines 7a and 7b..
98,279
136,501
234,780
8
Public support (Subtract line 7c from line 6.)
2,794,929
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...
462,985
477,435
497,238
550,066
1,041,985
3,029,709
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
12,977
10,285
14,922
14,305
8,550
61,039
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
610
1,684
5,732
8,026
c
Add lines 10a and 10b.
12,977
10,285
15,532
15,989
14,282
69,065
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.)
..
50,851
53,022
44,674
55,860
61,529
265,936
13
Total support. (Add lines 9, 10c, 11, and 12.)..
526,813
540,742
557,444
621,915
1,117,796
3,364,710
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
83.070 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
86.160 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
2.050 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
2.040 %
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
COMMUNITY GALLERY INC DBA AVA GALLERY
Employer identification number
23-7394706
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 3
THE 11 BANK STREET PROPERTY IS IN CARE OF THOMAS BUESCHEL, NORTHERN EQUITIES, 42 RIVERSIDE DRIVE, LEBANON, NH 03766 FOR PROPERTY MANAGEMENT.
FORM 990, PART VI, SECTION A, LINE 6
THE MEMBERS OF THE GALLERY SHALL CONSIST OF NO LESS THAN TEN MEMBERS BUT NOT MORE THAN TWENTY AND MUST ALWAYS HAVBE AT LEAST FOUR ARTISTS ON THE BOARD.
FORM 990, PART VI, SECTION A, LINE 7A
BOARD MEMBERS VOTE TO APPROVE NEW OFFICERS.
FORM 990, PART VI, SECTION B, LINE 11
THE ORGANIZATION'S CHAIR, TREASURER, AND EXECUTIVE DIRECTOR REVIEW THE FORM 990 BEFORE IT IS SUBMITTED TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING BOARD MEMBERS TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. INDIVIDUAL BOARD MEMBERS MAY ALSO EXCUSE THEMSELVES IN THE COURSE OF BOARD MEETINGS SHOULD ISSUES BE DISCUSSED THAT COULD GIVE RISE TO CONFLICTS. SUCH INSTANCES ARE RECORDED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT ITS ANNUAL MEETING, AND UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE ON THE GUIDESTAR WEBSITE.
FORM 990, PART IX, LINE 24E
COST OF ART SOLD: PROGRAM SERVICE EXPENSES 32,761. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,761. INTERNS: PROGRAM SERVICE EXPENSES 9,634. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,634. EXHIBITIONS: PROGRAM SERVICE EXPENSES 8,825. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,825. BANK FEES: PROGRAM SERVICE EXPENSES 37. MANAGEMENT AND GENERAL EXPENSES 6,333. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,370. COMMUNITY OUTREACH: PROGRAM SERVICE EXPENSES 6,076. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,076. SPECIAL EVENTS: PROGRAM SERVICE EXPENSES 5,937. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,937. GALLERY SUPPLIES: PROGRAM SERVICE EXPENSES 5,753. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,753. GALLERY OPENINGS: PROGRAM SERVICE EXPENSES 4,783. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,783. PAYROLL FEES: PROGRAM SERVICE EXPENSES 1,927. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,927. CONSULTING: PROGRAM SERVICE EXPENSES 1,906. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,906. MISC: PROGRAM SERVICE EXPENSES 1,202. MANAGEMENT AND GENERAL EXPENSES 141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,343. MILEAGE: PROGRAM SERVICE EXPENSES 1,120. MANAGEMENT AND GENERAL EXPENSES 9. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,129. DUES AND PUBLICATIONS: PROGRAM SERVICE EXPENSES 902. MANAGEMENT AND GENERAL EXPENSES 67. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 969.
FORM 990, PART XI, LINE 9:
FUNDRAISING EXPENSE 8,386. ROUNDING -1.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.