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
HEALTHED CONNECT INC
Employer identification number
27-1115162
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.") .
94,143
141,488
206,286
224,173
666,090
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..
9,703
9,703
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.
103,846
141,488
206,286
224,173
675,793
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
46,324
48,784
110,212
62,032
267,352
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..
46,324
48,784
110,212
62,032
267,352
8
Public support (Subtract line 7c from line 6.)
408,441
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...
103,846
141,488
206,286
224,173
675,793
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
255
8,903
6,677
15,835
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
255
8,903
6,677
15,835
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.)..
104,101
141,488
215,189
230,850
691,628
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
59.060 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
53.450 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
2.000 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
2.000 %
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
HEALTHED CONNECT INC
Employer identification number
27-1115162
Return Reference
Explanation
FORM 990, PAGE 1, PART I, LINE 6
BOARD MEMBERS AND OFFICERS ARE ALL VOLUNTEERS. VOLUNTEERS HAVE PROVIDED CONSULTING SERVICES IN A NUMBER OF AREAS, INCLUDING LEGAL, FINANCIAL, GRANT WRITING, TRAINING COURSE DEVELOPMENT, DESIGN, TRAVELING TO AFRICA AS TRAINERS AND TEACHERS, AND PREPARATION OF MEALS FOR CHILDREN.
FORM 990, PAGE 6, PART VI, LINE 2
JAC KIRKPATRICK SHERRI KIRKPATRICK BD MEMBER BD MEMBER MARRIED JAC & SHERRI KIRKPATRICK KRISTI KIRKPATRICK BD MEMBERS BD MEMBER PARENTS
FORM 990, PAGE 6, PART VI, LINE 4
ARTICLE II DIRECTORS BY-LAWS CHANGE FROM: SECTION2:NUMBER, APPOINTMENT AND TERM. THE NUMBER OF DIRECTORS OF THE CORPORATION SHALL BE NOT FEWER THAN TWELVE NOR MORE THAN FIFTEEN; THE NUMBER TO BE ESTABLISHED FROM TIME TO TIME BY THE BOARD OF DIRECTORS. THE INITIAL DIRECTORS SHALL BE APPOINTED FOR ONE, TWO, OR THREE YEAR TERMS BY THE INCORPORATOR, WITH SUCH APPOINTMENT BEING SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF GRACELAND UNIVERSITY. THEREAFTER, DIRECTORS SHALL BE NOMINATED AND ELECTED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF GRACELAND UNIVERSITY, FOR THREE YEAR TERMS; PROVIDED THAT NO DIRECTOR MAY SERVE FOR MORE THAN THREE CONSECUTIVE TERMS. EACH DIRECTOR SHALL HOLD OFFICE UNTIL HIS OR HER SUCCESSOR HAS BEEN APPOINTED, OR SUCH DIRECTORS EARLIER REMOVAL, RESIGNATION OR INCAPACITY, PROVIDED, HOWEVER, THAT ANY DIRECTOR WHO HAS SERVED FOR THREE CONSECUTIVE TERMS SHALL AUTOMATICALLY CEASE TO BE A DIRECTOR. TO: SECTION2:NUMBER, APPOINTMENT AND TERM. THE NUMBER OF DIRECTORS OF THE CORPORATION SHALL BE NOT FEWER THAN TWELVE NOR MORE THAN FIFTEEN; THE NUMBER TO BE ESTABLISHED FROM TIME TO TIME BY THE BOARD OF DIRECTORS. THE INITIAL DIRECTORS SHALL BE APPOINTED FOR ONE, TWO, OR THREE YEAR TERMS BY THE INCORPORATOR, WITH SUCH APPOINTMENT BEING SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF GRACELAND UNIVERSITY. THEREAFTER, DIRECTORS SHALL BE NOMINATED AND ELECTED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF GRACELAND UNIVERSITY, FOR THREE YEAR TERMS. EACH DIRECTOR SHALL HOLD OFFICE UNTIL HIS OR HER SUCCESSOR HAS BEEN APPOINTED, OR SUCH DIRECTORS EARLIER REMOVAL, RESIGNATION OR INCAPACITY. THERE SHALL BE NO LIMIT ON THE NUMBER OF TERMS, CONSECUTIVE OR OTHERWISE, THAT AN INDIVIDUAL DIRECTOR MAY SERVE, PROVIDED SUCH DIRECTOR HAS BEEN DULY ELECTED AND APPROVED PURSUANT TO THESE BYLAWS. APPROVED 10 11-13 BY HEALTHED CONNECT BOARD OF DIRECTORS ARTICLE X FISCAL YEAR BY-LAWS CHANGE FROM: EXCEPT AS FROM TIME TO TIME OTHERWISE PROVIDED BY THE BOARD OF DIRECTORS, THE FISCAL YEAR OF THE CORPORATION SHALL EXTEND FROM THE FIRST DAY OF JUNE TO THE LAST DAY OF MAY OF EACH YEAR, INCLUDING BOTH SUCH DATES. TO: EXCEPT AS FROM TIME TO TIME OTHERWISE PROVIDED BY THE BOARD OF DIRECTORS, THE FISCAL YEAR OF THE CORPORATION SHALL EXTEND FROM THE FIRST DAY OF JANUARY TO THE LAST DAY OF DECEMBER OF EACH YEAR, INCLUDING BOTH SUCH DATES. APPROVED 4-26-14 BY HEALTHED CONNECT BOARD OF DIRECTORS
FORM 990, PAGE 6, PART VI, LINE 9
CHERRY NEWCOM 10857 LEGACY RIDGE WAY WESTMINSTER, CO 80031 PAULETTE E(POLLY)BROWN MEHLISCH 339 TOMAHAWK DRIVE PALM DESERT, CA 92211 DENISE LEICHTER 17125 HART STREET WEST VAN NUYS, CA 91406 AMY GUTHREY 6039 OAK STREET KANSAS CITY, MO 64113 R MICHAEL (MIKE) KEEBLE 13104 HIGH DRIVE LEAWOOD, KS 66209 KRISTI KIRKPATRICK 1770 BURR OAKS DRIVE WEST DES MOINES, IA 50266 MICHAEL LEWIS 1949 ROCKFORD ROAD LOS ANGELES, CA 90039 MICHELLE MAHLIK 7880 NORTH CLUB CIRCLE MILWAUKEE, WI 53217 JEFFREY D MANUEL 1966 SOUTH LINCOLN STREET DENVER, CO 80210 RON MATHEWS 625 FOREST AVENUE PALO ALTO, CA 94301 STUART WAITE 12443 REKART LANE ST LOUIS, MO 63131 TAMMY EVERETT 203 EAST MAIN LAMONI, IA 50140 BRENDA WILLIAMS 5933 RIDGEWAY AVE KANSAS CITY, MO 64133
FORM 990, PAGE 6, PART VI, LINE 11B
HEALTHED CONNECT POLICY A-1 REVIEW OF 990 PURPOSE OF POLICY: TO ENSURE TIMELY, ACCURATE, AND TRANSPARENT INFORMATION TO THE INTERNAL REVENUE SERVICE IN THE ANNUAL FILING OF THE REQUIRED FORM 990. POLICY: A.THE TREASURER, IN CONSULTATION WITH THE EXECUTIVE DIRECTOR AND ACCOUNTANT, WILL BE RESPONSIBLE FOR FILLING OUT THE REQUIRED FORM 990. B.THE FINANCE COMMITTEE OF THE BOARD AND THE BOARD OF DIRECTORS WILL REVIEW THE ENTIRE 990, WITH THE EXCEPTION OF SCHEDULE B WHICH WILL BE WITHHELD TO PROTECT THE CONFIDENTIALITY OF DONORS, BEFORE THE FORM IS FILED. C.ANY DISCREPANCIES OR ERRORS NOTED DURING THE REVIEW WILL BE CORRECTED PRIOR TO FILING IF POSSIBLE; IF NECESSARY, A CORRECTED 990 WILL BE FILED.
FORM 990, PAGE 6, PART VI, LINE 12C
DIRECTORS & OFFICERS SIGN CONFLICT OF INTEREST DOCUMENT ANNUALLY
FORM 990, PAGE 6, PART VI, LINE 19
UPON REQUEST AND HIGHLIGHTED ON WEBSITE
FORM 990, PART XI, LINE 9
RECLASSIFICATION FOR AUDIT PURPOSES 157 RECLASSIFICATION FOR AUDIT PURPOSES -157
FORM 990, PART XI, LINE 9
ROUNDING 2
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.