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
DOMESTIC & SEXUAL VIOLENCE CRISIS CENTER (PHONEX PLACE)
Employer identification number
91-1018890
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.") ....
853,675
933,953
964,091
834,851
990,061
4,576,631
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
853,675
933,953
964,091
834,851
990,061
4,576,631
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.
4,576,631
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..
853,675
933,953
964,091
834,851
990,061
4,576,631
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
58
52
30
30
22
192
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).
4,576,823
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
100.000 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.990 %
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:
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
DOMESTIC & SEXUAL VIOLENCE CRISIS CENTER (PHONEX PLACE)
Employer identification number
91-1018890
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
MISSION STATEMENT: EDUCATE, ADVOCATE AND EMPOWER TO END VIOLENCE. VALUES STATEMENT: WE BELIEVE IN: THE BASIC HUMAN RIGHT TO BE RESPECTED AND THE INHERENT CAPACITY TO RESPECT OTHERS. A SAFE, CONFIDENTIAL, NON JUDGMENTAL AND NON DISCRIMINATORY ENVIRONMENT. A BELIEF IN COMPASSION FOR ALL INDIVIDUALS PUTTING COMPASSION INTO ACTION THROUGH CONSCIOUS EMPATHY. A COMMITMENT TO ERADICATING INJUSTICES TO HUMANITY. INTEGRITY THAT IS GOUNDED IN THE PRINCIPALS OF SOCIAL CHANGE, EMPOWERMENT AND SAFE OPTIONS FOR CLIENTS. VISION STATEMENT: DSV CRISIS CENTER ENVISIONS COMMUNITIES WITHOUT VIOLENCE WHERE ALL CAN LIVE SAFELY WITH DIGNITY AND RESPECT.
FORM 990, PAGE 1, PART I, LINE 6
VOLUNTEERS WORK ON THE BOARD OF DIRECTORS, PROVIDE LABOR FOR THE 24 HOUR CRISIS LINE, HELP WITH LEGAL AND MEDICAL COUNCELING, AND WITH FUNDRAISERS THAT DSV CONDUCTS. DSV RECEIVES DONATED SERVICES FROM A VARIETY OF UNPAID VOLUNTEERS ASSISTING DSV IN PROVIDING SERVICES TO VICTIMS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT AMOUNTING TO 5,779 HOURS FOR THE FISCAL YEAR ENDING JUNE 30, 2012. AT A CONSERVATION ESTIMATION OF 22.69 PER HOUR THIS AMOUNTS TO DONATED SERVICES WORTH 131,122.
FORM 990, PAGE 2, PART III, LINE 4A
CRISIS INTERVENTION: 2065 SERVICES TO 220 NEW. 3158 SERVICES TO 412 SURVIVORS OF SEXUAL ASSSULT. 3383 SERVICES TO 570 CHILD VICTIMS. 3432 SERVICES TO 479 ADULT VICTIMS. SEXUAL ASSAULT DEMOGRAPHICS: 32% OF ALL SERVICES WERE TO ADULTS, 41% OF ALL SERVICES WERE TO CHILD VICTIMS, 27% OF ALL SERVICES WERE TO ADULTS WHO WERE ABUSED AS CHILDREN. 664 PREVENTION ACTIVITIES TO 10,417 INDIVIDUALS. 952 COMMUNITY AWARENESS PRESENTATIONS TO 13,855 INDIVIDUALS. 704 SYSTEM COORDINATION ACTIVIES TO 10,601 INDIVIDUALS. 272 TRAINING & EDUACATION ACTIVITIES TO 8429 INDIVIDUALS.693 HOURS OF THERAPY TO 74 INDIVIDUALS. CRIME VICTIMS SERVICES-LEGAL, MEDICAL AND SOCIAL ADVOCACY, SUPPORT GROUPS, 24 HOUR CRISIS INTERVENTION.1169 HOURS VICTUMS OF CRIME DEMOGRAPHICS: 59% CAUCASION, 35% HISPANIC, 4% NATIVE AMERICAN, 3% BLACK. 24% FEMALE, 76% MALE CLIENTS.AGE: 17 AND UNDER 31%, 18-24 4%, 25-59 53% AND 60 AND UP 3%. ADULTS 69% CHILD UNDER 18 31%. 1155SERVICES TO 161 NEW AND UNDUPLICATED CLIENTS. 30 TRAINING EVENTS TO 241 INDIVIDUALS. 240 OUTREACH EVENTS TO 4222 INDIVIDUALS. 209 PRESENTATIONS TO 3503 INDIVIDUALS. CONFIDENTIAL EMERGENCY SHELTER SERVICES- LEGAL, MEDICAL AND SOCIAL ADVOCACY, SUPPORT GROUPS, 24 HOUR CRISIS INTERVENTION. 3940 SERVICES 47% MOMS 53% CHILDREN. 1559 ADULT BED NIGHTS, 2381 BED NIGHTS TO KIDS. AVERAGE STAY 42 DAYS.
FORM 990, PAGE 2, PART III, LINE 4D
VOLUNTEER BOARD, CRISIS LINE VOLUNTEERS, & STAFF TRAINING & OUTREACH PROGRAMS.
FORM 990, PAGE 6, PART VI, LINE 11B
THE GOVERNING BOARD WAS PROVIDED A COPY OF THE FORM 990 AND WAS ABALE TO ASK QUESTIONS AND REVIEW IT WITH THE TAX PREPARER. THE FORM 990 WAS APPROVED FOR FILING.
FORM 990, PAGE 6, PART VI, LINE 12C
DSV DOES HAVE A WRITTEN CONFLICT OF INTEREST POLICY THAT IS REVIEWED ANNUALY AND ENFORCED AS NEEDED. THERE HAS NOT BEEN NEED TO ENFORCE IT AT THIS TIME.
FORM 990, PAGE 6, PART VI, LINE 15A
DSV DOES DO A COMPARABLE STUDY OR REVIEWS STUDIES AVAILABLE FOR THE EXECUTIVE DIRECTOR, WHO IS THE TOP MANAGMENT OFFICIAL, AT THE ANNUAL REVIEW OF THE EXECUTIVE DIRECTOR.
FORM 990, PAGE 6, PART VI, LINE 19
FINANCIAL STATEMENTS, FORM 990, AND THE FORM 1023 ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE WENATCHEE OFFICE OF DOMESTIC VIOLENCE SEXUAL ASSAULT VICTIMS OF CRIME CRISIS CENTER. CONFILCT OF INTEREST AND OTHER GOVERNING POLICIES ARE AVAILABLE AT REQUEST IN THE OFFICE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.