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
NOTAH BEGAY III FOUNDATION
Employer identification number
20-1870330
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.") ....
4,736,205
3,032,275
2,008,231
2,783,794
3,309,767
15,870,272
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
4,736,205
3,032,275
2,008,231
2,783,794
3,309,767
15,870,272
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)..
2,402,634
6
Public support. Subtract line 5 from line 4.
13,467,638
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..
4,736,205
3,032,275
2,008,231
2,783,794
3,309,767
15,870,272
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
13,261
41,485
26,963
24,606
28,357
134,672
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.)..
351,449
185,860
281,947
18,960
13,901
852,117
11
Total support (Add lines 7 through 10).
16,857,061
12
Gross receipts from related activities, etc. (see instructions)
..................
12
103,203
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
79.890 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
86.140 %
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
NOTAH BEGAY III FOUNDATION
Employer identification number
20-1870330
Return Reference
Explanation
FORM 990, PART III, LINE 2
IN 2013, NB3 FOUNDATION LAUNCHED AN UNPRECEDENTED NATIONAL INITIATIVE, "NATIVE STRONG: HEALTHY KIDS, HEALTHY FUTURES," TO BUILD A NATIONAL FRAMEWORK DESIGNED TO REDUCE NATIVE AMERICAN CHILDHOOD OBESITY AND TYPE 2 DIABETES. NATIVE STRONG IS FRAMED TO REVERSE CHILDHOOD OBESITY AND DIABETES TRENDS THROUGH FOUR KEY FUNCTIONS - GRANTMAKING, COLLABORATION, KNOWLEDGE BUILDING AND CAPACITY BUILDING. CRITICAL TO AND INTEGRATED ACROSS EACH OF THESE CORE FUNCTIONS ARE SUPPORTING IMPACT SERVICES - RESEARCH AND EVALUATION, POLICY, RESOURCE DEVELOPMENT AND COMMUNICATIONS. IN THE LAST FISCAL YEAR, NATIVE STRONG AWARDED 20 GRANTS TOTALING $584,430 TO 19 TRIBES AND NATIVE NONPROFIT ORGANIZATIONS IN 7 STATES. GRANTS SUPPORT NATIVE-LED, STRATEGIC, EMERGING AND PROMISING PROGRAM MODELS PROGRAMS CONDUCTED BY TRIBAL GOVERNMENTS AND NATIVE NONPROFITS THAT EMPOWER TRIBAL COMMUNITIES TO INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOOD, NUTRITION EDUCATION AND PHYSICAL ACTIVITY AS WELL AS SUPPORT POLICY DEVELOPMENT TO IMPROVE HEALTH OUTCOMES OF NATIVE CHILDREN.
FORM 990, PART III, LINE 3
HEALTH EDUCATION WAS ROLLED INTO THE SAN FELIPE PLACED BASED PROGRAM. THE SOCCER PROGRAM WAS ROLLED INTO THE NATIVE STRONG PROGRAM.
FORM 990, PART VI, SECTION B, LINE 11
PRIOR TO FILING BOARD MEMBERS ARE PROVIDED A COPY OF FORM 990. A BOARD MEETING IS HELD TO REVIEW AND APPROVE FORM 990.
FORM 990, PART VI, SECTION B, LINE 15
COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS DETERMINED BY AN EXTERNAL ORGANIZATION THAT ASSISTS IN EXECUTIVE SEARCHES FOR NOT-FOR-PROFIT ORGANIZATIONS.
FORM 990, PART VI, SECTION C, LINE 19
THE FOUNDATION RETAINS COPIES OF FORMS 990 AND AUDIT INFORMATION IN THE FOUNDATION'S PHYSICAL OFFICE; THESE RECORDS ARE AVAILABLE FOR PUBLIC INSPECTION DURING REGULAR OFFICE HOURS. THE FOUNDATION'S POLICIES AND PROCEDURES AND FISCAL POLICIES ARE KEY DOCUMENTS THAT CONTAIN DETAIL ON THE FOUNDATION'S CONFLICT OF INTEREST AND OTHER POLICIES AND ARE ALSO AVAILABLE FOR PUBLIC INSPECTION ON SITE AND BY REQUEST FROM THE FOUNDATION.
FORM 990, PART IX, LINE 11G
CONSULTING: PROGRAM SERVICE EXPENSES 239,003. MANAGEMENT AND GENERAL EXPENSES 12,811. FUNDRAISING EXPENSES 83,461. TOTAL EXPENSES 335,275. EVALUATION & RESEARCH: PROGRAM SERVICE EXPENSES 68,216. MANAGEMENT AND GENERAL EXPENSES 3,656. FUNDRAISING EXPENSES 23,821. TOTAL EXPENSES 95,693. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 133,333. MANAGEMENT AND GENERAL EXPENSES 7,147. FUNDRAISING EXPENSES 46,560. TOTAL EXPENSES 187,040. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 133,989. MANAGEMENT AND GENERAL EXPENSES 7,182. FUNDRAISING EXPENSES 46,790. TOTAL EXPENSES 187,961. OTHER RESEARCH SERVICES: PROGRAM SERVICE EXPENSES 12,631. MANAGEMENT AND GENERAL EXPENSES 677. FUNDRAISING EXPENSES 4,411. TOTAL EXPENSES 17,719.
FORM 990, PAGE 5, QUESTIONS 7G AND H
THE ORGANIZATION DID NOT RECEIVE THE TYPES OF CONTRIBUTIONS LISTED AND, THEREFORE, DOES NOT HAVE EITHER A FORM 8899 OR A FORM 1098-C FILING REQUIREMENT. THEREFORE, THESE QUESTIONS ARE LEFT BLANK BECAUSE THEY ARE NOT APPLICABLE AND THE ANSWER IS NEITHER YES OR NO.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.