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
SET OF COLORADO SPRINGS
Employer identification number
84-1183335
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.") ....
614,544
1,027,196
317,410
563,663
431,444
2,954,257
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
614,544
1,027,196
317,410
563,663
431,444
2,954,257
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)..
546,245
6
Public support. Subtract line 5 from line 4.
2,408,012
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..
614,544
1,027,196
317,410
563,663
431,444
2,954,257
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
29,941
15,351
13,382
13,213
12,972
84,859
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.)..
0
0
0
15,449
12,009
27,458
11
Total support (Add lines 7 through 10).
3,066,574
12
Gross receipts from related activities, etc. (see instructions)
..................
12
67,976
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
78.520 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
85.360 %
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:
13000248
Software Version:
2013v3.1
-
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
SET OF COLORADO SPRINGS
Employer identification number
84-1183335
Return Reference
Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS
S.E.T. PROVIDES BASIC MEDICAL SERVICS AND HOLISTIC HEALTH PROGRAMS TO UNINSURED, UNDERINSURED AND LOW INCOME PEOPLE WITHOUT DISCRIMINATION. S.E.T.'S PHILOSOPHY DEFINES HOLISTIC HEALTH AS CARING FOR THE ENTIRE PERSON (BODY, MIND AND SPIRIT). THIS PHILOSOPHY FOCUSES ON THE PREMISE THAT INDIVIDUALS CAN HEAL THEMSELVES BY THE DEVELOPMENT OF HEALTHY ATTITUDES, PATTERNS OF BEHAVIOR, AND MAINTENANCE OF A HEALTHY BALANCE IN THEIR LIVES. S.E.T.'S GOAL IS TO SERVE, EMPOWER AND TRANSFORM OUR CLIENTS TO ACTIVELY PARTICIPATE IN THEIR CARE AND TAKE RESPONSIBILITY FOR THEIR TOTAL WELL BEING. SERVICE IS PROVIDED THROUGH HEALTHCARE, EMPOWERMENT IS ACHEIVED THROUGH HEALTH AND WELLNESS EDUCATION AND TRANSFORMATION IS REALIZED THROUGH INCREASED HUMAN DIGNITY AND COMMUNITY CONNECTIONS.
Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders
THE SOLE MEMBER OF THE CORPORATION SHALL BE CHI COLORADO ("CHIC"). CHIC IS A TAX-EXEMPT COLORADO CORPORATION (THE "CORPORATE MEMBER"). CATHOLIC HEALTH INITIATIVES ("CHI") IS THE SOLE CORPORATE MEMBER OF CHIC AND IS ALSO A TAX-EXEMPT COLORADO CORPORATION.
Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body
CHI COLORADO ("CHIC"), A COLORADO NON-PROFIT CORPORATION, IS DESCRIBED IN SET OF COLORADO SPRING'S BYLAWS AS THE "CORPORATE MEMBER." THE CORPORATE MEMBER HAS THE POWER TO APPOINT, REMOVE OR REPLACE THE MEMBERS OF THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders
"THE ORGANIZATION'S CORPORATE MEMBER IS SET OF COLORADO SPRINGS. PURSUANT TO THE ORGANIZATION'S BYLAWS, BOTH SET OF COLORADO SPRINGS AND CATHOLIC HEALTH INITIATIVES ("CHI") (SET OF COLORADO SPRINGS' SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE SET OF COLORADO SPRINGS BOARD: *APPROVE MEMBERS OF THE SET OF COLORADO SPRINGS BOARD *AMENDMENT OF THE CORPORATE DOCUMENTS OF THE SET OF COLORADO SPRINGS *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE SET OF COLORADO SPRINGS *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR THE SET OF COLORADO SPRINGS THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE SET OF COLORADO SPRINGS *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE SET OF COLORADO SPRINGS *APPROVAL OF ISSUANCE OF DEBT BY SET OF COLORADO SPRINGS *APPROVAL OF PARTICIPATION OF SET OF COLORADO SPRINGS IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY SET OF COLORADO SPRINGS *APPROVAL OF A MERGER INVOLVING THE SET OF COLORADO SPRINGS *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE SET OF COLORADO SPRINGS *TO REQUIRE THE TRANSFER OF ASSETS BY THE SET OF COLORADO SPRINGS TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO THE ORGANIZATION'S BYLAWS, SET OF COLORADO SPRINGS OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE."
Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body
THE EXECUTIVE DIRECTOR REVIEWS THE TAX RETURN IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTANTS. SUBSEQUENT TO THE REVIEW, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED FOR REVIEW. SUBSEQUENT TO E-FILING, THE FINAL FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS.
Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy
EACH BOARD MEMBER MUST ACT AT ALL TIMES IN A MANNER THAT IS CONSISTENT WITH THE ENTITY'S MISSION AND VALUES BASED SERVICE TO THE COMMUNITY AND EXERCISE CARE THAT HE OR SHE DOES NOT HAVE ANY PERSONAL INTEREST WHICH MIGHT CONFLICT WITH OR APPEAR TO CONFLICT WITH THE INTEREST OF THE ENTITY OR WHICH MIGHT INFLUENCE THEIR JUDGMENT OR ACTIONS IN PERFORMING THEIR DUTIES. AT THE BEGINNING OF EACH BOARD MEETING, MEMBERS WITH A POTENTIAL CONFLICT OF INTEREST ARE REQUIRED TO DISCLOSE THE CONFLICT. THE BOARD AS A WHOLE THEN DETERMINES IF THE MEMBER SHOULD RECUSE THEMSELVES FROM ALL DISCUSSIONS CONCERNING THE PENDING MATTER OR ABSTAIN FROM VOTING ON THE MATTER.
FORM 990, PART VI, LINE 15, PROCESS FOR DETERMING COMPENSATION
DURING THE TAX YEAR ENDED 6/30/14, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A.
Form 990, Part VI, Sec C, Line 19, Required documents available to the public
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
Form 990, Part IX, Line 11g, Other Expenses
OTHER FEES FOR SERVICES - TOTAL EXPENSE: 127825, PROGRAM SERVICE EXPENSE: 126547, MANAGEMENT AND GENERAL EXPENSES: 1278, FUNDRAISING EXPENSES: ;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.