TY 2015 Form 990

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

MIAMI COUNTY YOUNG MEN'S CHRISTIAN
ASSOCIATION INC

Employer identification number

35-0893512

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....	1,563,481	1,054,288	787,284	761,005	751,397	4,917,455
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	1,563,481	1,054,288	787,284	761,005	751,397	4,917,455
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.						4,917,455

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..	1,563,481	1,054,288	787,284	761,005	751,397	4,917,455
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	3,745	10,686	66,105	42,852	-6,957	116,431
9	Net income from unrelated business activities, whether or not the business is regularly carried on..		800	3,816	3,509	4,406	12,531
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	643,792	710,573	661,616	664,175	671,392	3,351,548
11	Total support. Add lines 7 through 10.						8,397,965

Gross receipts from related activities, etc. (see instructions) ..................

660,621

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

58.560 %

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

63.100 %

16a

33 1/3% support test—2015. 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 ....................... right arrow

33 1/3% support test—2014. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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 ....... right arrow

33 1/3% support tests—2014. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART II, LINE 10	OTHER INCOME 3,351,548

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

MIAMI COUNTY YOUNG MEN'S CHRISTIAN
ASSOCIATION INC

Employer identification number

35-0893512

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization MIAMI COUNTY YOUNG MEN'S CHRISTIAN ASSOCIATION INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization MIAMI COUNTY YOUNG MEN'S CHRISTIAN ASSOCIATION INC		Employer identification number 35-0893512

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization MIAMI COUNTY YOUNG MEN'S CHRISTIAN ASSOCIATION INC			Employer identification number 35-0893512
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MIAMI COUNTY YOUNG MEN'S CHRISTIAN
ASSOCIATION INC

Employer identification number

35-0893512

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	482,456	467,300	424,752	404,527	400,969
b	Contributions ...				100
c	Net investment earnings, gains, and losses	-14,208	33,018	57,467	33,089	15,060
d	Grants or scholarships ...	16,677	17,862	14,919	12,964	11,502
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	451,571	482,456	467,300	424,752	404,527

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

42.500 %

Permanent endowment SchDMd Bullet

57.500 %

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

Yes

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	281,891		281,891
b	Buildings	2,572,868	1,918,401	654,467
c	Leasehold improvements
d	Equipment ...	1,173,388	974,339	199,049
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,135,407

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)ENDOWMENT FUNDS	451,571	F
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	451,571

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1	1,393,311
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3	1,393,311
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	1,393,311

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	1,475,615
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b	1,391
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e	1,391
3	Subtract line 2e from line 1...................			3	1,474,224
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	1,474,224

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

SCHEDULE D, PAGE 2, PART V, LINE 4

THE PURPOSE OF THESE FUNDS IS TO PROVIDE SUPPORT TO THE MIAMI COUNTY YMCA TO CARRY OUT ITS ROLE AND MISSION. BOARD DESIGNATED FUNDS ALLOW FOR PRINCIPAL AND EARNINGS TO BE DISTRIBUTED AT THE ORGANIZATION'S DISCRETION. PERMANENT FUNDS ONLY ALLOW FOR THE ORGANIZATION TO USE THE ANNUAL SPENDABLE DISTRIBUTIONS, WHICH ARE BASED OFF THE HISTORICAL BALANCE OF EACH FUND OVER A FIVE-YEAR PERIOD, FOR THE STATED PURPOSE OF EACH FUND.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
MIAMI COUNTY YOUNG MEN'S CHRISTIAN
ASSOCIATION INC

Employer identification number

35-0893512

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 FUNDRAISER (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	22,470	22,470
2	Less: Contributions . . . .
3	Gross income (line 1 minus line 2) . . . . . .	22,470	22,470

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	17,718	17,718
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		17,718
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		4,752

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	17,718	17,718

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

MIAMI COUNTY YOUNG MEN'S CHRISTIAN
ASSOCIATION INC

Employer identification number

35-0893512

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	THE MIAMI COUNTY YMCA IS A CHARITABLE, COMMUNITY SERVICE ORGANIZATION THAT INCLUDES MEN, WOMEN, AND CHILDREN OF ALL AGES, ABILITIES, INCOMES, RACES, AND RELIGIONS. WE ARE DEDICATED TO BUILDING STRONG KIDS, FAMILIES AND COMMUNITIES BY PUTTING CHRISTIAN PRINCIPLES INTO PRACTICE THROUGH PROGRAMS THAT PROMOTE HEALTHY LIFESTYLES, STRONG VALUES, LEADERSHIP DEVELOPMENT, AND COMMUNITY INTERACTION. EVERYONE IS WELCOME AT OUR YMCA, REGARDLESS OF THE ABILITY TO PAY-ALL WHO ARE IN NEED CAN RECEIVE FINANCIAL ASSISTANCE FOR MEMBERSHIPS AND PROGRAMS. OUR YMCA IS FOUNDED AND LED BY VOLUNTEERS FROM OUR COMMUNITY. VOLUNTEERS ALSO SERVE AS MENTORS, COACHES, PROGRAM LEADERS, AND INSTRUCTORS AND MORE. THE YMCA BELIEVES WE ALL NEED TO BELONG-A PLACE WHERE WE GENUINELY CARE ABOUT ONE ANOTHER; WHERE WE PULL TOGETHER FOR A COMMON CAUSE; WHERE WE TREAT EACH OTHER WITH LOVING KINDNESS, OPEN COMMUNICATION, AND SUPPORT; WHERE WE SHARE IN DECISIONS. THE YMCA NURTURES CHILDREN, SUPPORTS FAMILIES, AND STRENGTHENS SOCIETY. IT'S A FORCE FOR HOPE. OUR YMCA GOALS INCLUDE BUILDING SELF-ESTEEM AND NURTURING A SENSE OF ACCOMPLISHMENT. WE ALSO STRIVE TO DEMONSTRATE, MODEL, AND TEACH OUR CHARACTER DEVELOPMENT CORE VALUES OF CARING,HONESTY, RESPECT, AND RESPONSIBILITY TO ALL WHO ENTER THE YMCA, FOCUSING ON YOUTH AND ADOLESCENTS. WE UPHOLD THE GOAL OF PROMOTING FAMILIES AND SUPPORT PEOPLE OF ALL KINDS IN THEIR EFFORTS TO BE RESPONSIBLE PARENTS WHO ARE CONCERNED WITH THE PHYSICAL, EMOTIONAL, AND SPIRITUAL HEALTH OF THEIR CHILDREN. THROUGH COMMUNITY-BASED EXERCISE, SPORTS, AND EDUCATION PROGRAMS, THE YMCA PROMOTES GOOD HEALTH FOR PEOPLE OF ALL AGES, ALL ABILITIES, AND ALL INCOMES. DIVERSITY IS A SOURCE OF STRENGTH. EVERY PERSON HAS AN INHERENT WORTH AND HAS SOMETHING TO CONTRIBUTE TO THE LARGER COMMUNITY. THE YMCA FOSTERS AN ENVIRONMENT WHERE DIVERSITY IS CELEBRATED AND WHERE MEMBERS, VOLUNTEERS, AND STAFF MEMBERS CAN REACH THEIR FULLEST POTENTIAL. OUR YMCA VISION IS TO BUILD STRONG KIDS BY: FOCUSING ON CHARACTER DEVELOPMENT IN ALL PROGRAMS EMPHASIZING THE VALUES OF CARING, HONESTY, RESPECT AND RESPONSIBILITY...BUILDING ASSETS IN YOUTH THROUGH A WIDE VARIETY OF PROGRAMS...TEACHING KIDS TO SWIM, AND TO PLAY AND ENJOY SPORTS...PROVIDING GOOD ROLE MODELS, AND BEING A SAFE PLACE FOR KIDS TO GROW. OUR VISION INCLUDES BUILDING STRONG FAMILIES BY: OFFERING QUALITY AFTER-SCHOOL AND SCHOOL'S OUT PROGRAMS WHICH ALLOW PARENTS TO WORK WITH THE SECURITY THAT THEIR CHILDREN ARE SAFE...GIVING CHILDREN AND PARENTS OR CARE GIVERS ACTIVITIES TO DO TOGETHER...PROVIDING FINANCIAL ASSISTANCE TO LOW-INCOME FAMILIES FOR Y PROGRAMS...PROMOTING HEALTHY LIFESTYLE PROGRAMS...CONDUCTING FAMILY PROGRAMS AND DISTRIBUTING INFORMATION FOR PARENTS...AND BY HELPING FAMILIES IN NEED. AND OUR VISION INCLUDES BUILDING STRONG COMMUNITIES BY: COLLABORATING WITH SCHOOLS, CHURCHES, HOSPITALS, CHAMBER OF COMMERCE, AND OTHER ORGANIZATIONS TO BETTER SERVICE THE COMMUNITY...INVOLVING COMMUNITY LEADERS AS BOARD AND COMMITTEE MEMBERS TO HELP GUIDE THE ORGANIZATION TO MEET COMMUNITY NEEDS...INVOLVING HUNDREDS OF VOLUNTEERS EACH YEAR AND EMPLOYING 50-100 STAFF WITH HIGH CONCENTRATION OF TEENAGERS...AND BY BUILDING LEADERS FOR THE FUTURE. IN SUMMARY, OUR PURPOSE IS TO EXIST TO MAKE A DIFFERENCE FOR GENERATIONS TO COME.
FORM 990, PAGE 1, PART I, LINE 6	VOLUNTEERS PROVIDE THEIR SERVICES FOR ALL THE VARIOUS PROGRAMS OFFERED BY THE ORGANIZATION. INCLUDED BUT NOT LIMITED TO: YOUTH SPORT COACHES, AQUATICS, DAY CARE, PHYSICAL FITNESS ROUTINES, FRONT DESK HELP, ETC.
FORM 990, PAGE 2, PART III, LINE 4B	IN ADDITION, WE PROVIDE AID TO FAMILIES WHO NEED HELP DUE TO FAMILY VIOLENCE, SUBSTANCE ABUSE, ETC. BY COLLABORATING WITH OTHER SOCIAL SERVICE AGENCIES. WE ALSO PROVIDE A VARIETY OF ACTIVITIES THAT EMPHASIZE PARENT EDUCATION AND HELP PARENTS LEARN MORE ABOUT HOW TO RAISE HEALTHY, HAPPY CHILDREN WHO DEVELOP SELF-ESTEEM AND MORAL AND ETHICAL VALUES. LAST YEAR, CHILD CARE SCHOLARSHIP UNITS WERE GIVEN THROUGHOUT THE SCHOOL YEAR AND SUMMER. SEVENTY PERCENT OF OUR SCHOOL AGE CHILD CARE PROGRAM PARTICIPANTS ARE HELPED WITH FINANCIAL ASSISTANCE.
FORM 990, PAGE 2, PART III, LINE 4C	MEMBERS ALSO ARE ASKED TO CONTRIBUTE FINANCIALLY TO THE YMCA. EACH YEAR, WE STRIVE TO RAISE FUNDS THROUGH ANNUAL PARTNERS OF YOUTH/STRONG KIDS PROGRAMS TO HELP OFFSET THE COST OF MEMBERSHIPS AND PROGRAMS TO THOSE IN OUR COMMUNITY THAT DO NOT HAVE THE ABILITY TO PAY FULL MEMBERSHIP FEES. IN SUPPORT OF OUR EXEMPTION, THE YMCA IS COMMITTED TO PROVIDING MEMBERSHIPS TO THOSE WHO CANNOT AFFORD TO PAY. THIS IS IN SHARP CONTRAST TO THOSE WHO PROVIDE FITNESS SERVICES IN PRIVATE, FOR-PROFIT ORGANIZATIONS. LAST YEAR, WE PROVIDED FINANCIAL ASSISTANCE TO INDIVIDUALS, AWARDING OVER 55,000 IN MEMBERSHIP ASSISTANCE. WE HAVE A MEMBERSHIP BASE OF APPROXIMATELY 3,800 INDIVIDUALS. LAST YEAR MORE THAN 60% OF OUR MEMBERSHIP BASE RECEIVED SOME FORM OF FINANCIAL HELP FOR MEMBERSHIP AND PROGRAMS, TOUCHING LIVES OF THOSE AFFECTED AND MAKING A DIFFERENCE FOR GENERATIONS TO COME. HELPING PEOPLE OF ALL AGES AND ABILITIES DEVELOP HEALTH IN SPIRIT, MIND AND BODY IS THE CORE OF THE YMCA MOVEMENT. OUR PROGRAMS ARE DESIGNED TO HELP PEOPLE CREATE REALISTIC GOALS FOR SELF-IMPROVEMENT AND EMPHASIZE DISEASE PREVENTION THROUGH REGULAR EXERCISE, PROPER NUTRITION, STRESS MANAGEMENT, AND HEALTH EDUCATION. SPORTS PROGRAMS FOR YOUTH, ADULTS, AND SENIORS ARE AN IMPORTANT ASPECT OF THE YMCA'S MISSION TO THE COMMUNITY. OUR CARRIAGE CLUB IS A PROGRAM THAT KEEPS SENIORS ACTIVE AND FLEXIBLE; AND FAMILY SWIM TIME GIVES ADULTS AND CHILDREN SHARED TIME IN THE POOL TO APPRECIATE ONE ANOTHER AND TO PROMOTE INTERGENERATIONAL RELATIONSHIPS. OUR SERVICES ARE OFFERED AT AFFORDABLE FEES FOR THE COMMUNITY AT LARGE, WITH REASONABLE ACCOMMODATIONS FOR THOSE WITH SPECIAL NEEDS, AND WITH FINANCIAL ASSISTANCE AVAILABLE FOR THOSE WHO CANNOT AFFORD FULL FEES. MEMBERS CAN PARTICIPATE IN MOST ADULT HEALTH AND WELLNESS PROGRAMS. OUR YMCA OFFERS PROGRAMS DESIGNED TO PROMOTE TOTAL WELLNESS OF INDIVIDUALS, THROUGH GROUP SUPPORT AND INCENTIVES, THAT WILL GIVE THEM THE TOOLS NEEDED TO MAKE PERMANENT LIFESTYLE CHANGES FOR THE BETTER. THESE PROGRAMS TEAM UP MEMBERS AND PARTICIPANTS WITH OTHERS TO GIVE THEM ADDITIONAL SUPPORT AND ENCOURAGEMENT. IN LIGHT OF THE RISING OBESITY RATES IN THIS COUNTRY, OUR YMCA PARTICIPATES IN THE ACTIVATE AMERICA INITIATIVE, IN SHAPE INDIANA AND THE MAYOR'S WELLNESS COUNCIL, AND ENGAGES IN A VARIETY OF EVENTS AND COMMUNITY ACTIVITIES DESIGNED TO HELP THE AT RISK POPULATION DEVELOP HABITS AND RELATIONSHIPS THAT LEAD TO MORE ACTIVE LIFESTYLES. ONE SUCH EVENT IS THE HEALTHY KIDS DAY/KIDS FAIR/BIKE RODEO, A FREE EVENT FOR THE COMMUNITY, COLLABORATING WITH MANY COMMUNITY HEALTH ORGANIZATIONS TO PROVIDE INFORMATION, SCREENINGS, AND ACTIVITIES THAT WILL IMPROVE THE HEALTH OF OUR FAMILIES. THIS PROGRAM SERVES OVER 1,000 FAMILIES ANNUALLY. HEALTH AND WELLNESS PROGRAMS SERVE A TOTAL OF 5,000 PARTICIPANTS EACH YEAR.
FORM 990, PAGE 6, PART VI, LINE 11B	FINANCE COMMITTEE MEMBERS ARE PROVIDED A DRAFT COPY TO REVIEW BEFORE SERVICE PROVIDER FILES WITH TAXING AUTHORITIES.
FORM 990, PAGE 6, PART VI, LINE 12C	ALL KEY STAFF AND BOARD ARE REQUIRED TO READ AND SIGN THE WRITTEN POLICY.
FORM 990, PAGE 6, PART VI, LINE 15A	YES. THE EXECUTIVE DIRECTOR'S PAY IS SUBJECT TO ANNUAL REVIEW AND APPROVAL OF THE BOARD OF DIRECTORS. DATA RELEVENT TO THE COST OF LIVING IN THE LOCAL AREA AND COMPARABILITY ACROSS THE REGION WITH OTHER YMCA DIRECTORS' SALARY AND BENEFITS ARE FACTORED IN AS WELL.
FORM 990, PAGE 6, PART VI, LINE 19	PUBLIC, UPON REQUEST, WILL BE PROVIDED A COPY OF ANY POLICY, IRS DETERMINATION LETTER, FEDERAL OR STATE TAX FILING FORMS 990, 990-T, NP-20, IT-20NP.
FORM 990, PART XI, LINE 9	ROUNDING 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MIAMI COUNTY YMCA IS A CHARITABLE, COMMUNITY SERVICE ORGANIZATION THAT INCLUDES MEN, WOMEN, AND CHILDREN OF ALL AGES, ABILITIES, INCOMES, RACES, AND RELIGIONS. WE ARE DEDICATED TO BUILDING STRONG KIDS, FAMILIES AND COMMUNITIES BY PUTTING CHRISTIAN PRINCIPLES INTO PRACTICE THROUGH PROGRAMS THAT PROMOTE HEALTHY LIFESTYLES, STRONG VALUES, LEADERSHIP DEVELOPMENT, AND COMMUNITY INTERACTION. EVERYONE IS WELCOME AT OUR YMCA, REGARDLESS OF THE ABILITY TO PAY-ALL WHO ARE IN NEED CAN RECEIVE FINANCIAL ASSISTANCE FOR MEMBERSHIPS AND PROGRAMS. OUR YMCA IS FOUNDED AND LED BY VOLUNTEERS FROM OUR COMMUNITY. VOLUNTEERS ALSO SERVE AS MENTORS, COACHES, PROGRAM LEADERS, AND INSTRUCTORS AND MORE. THE YMCA BELIEVES WE ALL NEED TO BELONG-A PLACE WHERE WE GENUINELY CARE ABOUT ONE ANOTHER; WHERE WE PULL TOGETHER FOR A COMMON CAUSE; WHERE WE TREAT EACH OTHER WITH LOVING KINDNESS, OPEN COMMUNICATION, AND SUPPORT; WHERE WE SHARE IN DECISIONS. THE YMCA NURTURES CHILDREN, SUPPORTS FAMILIES, AND STRENGTHENS SOC
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	131
6	Total number of volunteers (estimate if necessary) .............	6	150
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,721
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	761,005	751,397
9	Program service revenue (Part VIII, line 2g) .........	664,175	638,151
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	43,102	-8,085
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	80,779	11,848
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,549,061	1,393,311
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	855,876	865,629
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 5,982
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	598,464	608,595
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,454,340	1,474,224
19	Revenue less expenses. Subtract line 18 from line 12.......	94,721	-80,913
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,787,381	1,705,280
21	Total liabilities (Part X, line 26).............	960	1,163
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,786,421	1,704,117

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 383,740 including grants of $ 310,574 ) (Revenue $ 31,550 )
	PUBLIC MASS TRANSIT PROGRAM: PROVIDES A MASS TRANSIT SYSTEM FOR THE ELDERLY AND CITIZENS OF THE CITY OF PERU AND MIAMI COUNTY. THE ORGANIZATION PROVIDES RIDES FOR CITIZENS THAT INCLUDE MEDICAL APPOINTMENTS, GROCERY SHOPPING, WORK, VISITATION WITH FRIENDS AND RELATIVES IN SENIOR CENTERS, NURSING FACILITIES, AND LONG-TERM CARE, AND ANY OTHER TRANSPORTS REQUESTED FROM CITIZENS NEEDING A DEPENDABLE TRANSPORTATION SYSTEM.

4b	(Code: ) (Expenses $ 149,711 including grants of $ 25,551 ) (Revenue $ 117,172 )
	CHILD CARE/FAMILY: OUR YMCA PROVIDES HIGH QUALITY CHILD CARE AND DAY CAMP BY PROVIDING COMPREHENSIVE ACTIVITIES FOR SCHOOL AGE CHILDREN DRAWING ON DIVERSE MEMBERS OF THE COMMUNITY. WE PROVIDE BOTH FULL AND PART TIME OPTIONS TO SERVE A WIDE RANGE OF FAMILY SCHEDULING NEEDS. WOVEN INTO THE FABRIC OF THE YMCA MISSION IS A COMMITMENT TO STRENGTHENING FAMILIES. YMCA CHILD CARE AND DAY CAMP PROGRAMS RELIEVE THE BURDEN OF BALANCING WORK AND FAMILY AND MAKE IT POSSIBLE FOR PARENTS OF CHILDREN IN OUR CARE TO REMAIN GAINFULLY EMPLOYED, KNOWING THAT THEIR CHILDREN ARE THRIVING IN A SAFE, DEVELOPMENTALLY SOUND ENVIRONMENT. THE YMCA PROVIDES TUITION ASSISTANCE FOR CHILD CARE AND OTHER PROGRAMS. OVER 39,000 WAS AWARDED TO FAMILIES TO DEFRAY THEIR FEES THIS PAST YEAR. IN ADDITION, WE PROVIDE AID TO FAMILIES WHO NEED HELP DUE TO FAMILY VIOLENCE, SUBSTANCE ABUSE, ETC. BY COLLABORATING WITH OTHER SOCIAL SERVICE AGENCIES. WE ALSO PROVIDE A VARIETY OF ACTIVITIES THAT EMPHASIZE PARENT EDUCATION AND HELP PARENTS LEARN MORE ABOUT HOW TO RAISE HEALTHY, HAPPY CHILDREN WHO DEVELOP SELF-ESTEEM AND MORAL AND ETHICAL VALUES. LAST YEAR, CHILD CARE SCHOLARSHIP UNITS WERE GIVEN THROUGHOUT THE SCHOOL YEAR AND SUMMER. SEVENTY PERCENT OF OUR SCHOOL AGE CHILD CARE PROGRAM PARTICIPANTS ARE HELPED WITH FINANCIAL ASSISTANCE.

4c	(Code: ) (Expenses $ 689,796 including grants of $ ) (Revenue $ 489,429 )
	MEMBERSHIPS AND PROGRAMS: THE YMCA IS A MEMBERSHIP ORGANIZATION. THE COMBINATION OF INDIVIDUALS IN A COMMON ORGANIZATION PROVIDES STRUCTURE AND STRENGTH. AS A VOLUNTEER ORGANIZATION, YMCA MEMBERS SERVE ON THE BOARD OF DIRECTORS AND RELATED COMMITTEES. MEMBERS ALSO PROVIDE VOLUNTEER PROGRAM LEADERSHIP. THROUGH THE BOARD, MEMBERS DETERMINE THE QUALITY AND QUANTITY OF THE SERVICES, FACILITIES, LEADERSHIP, AND ASSESS THEMSELVES DUES TO PROVIDE FOR THESE THINGS. THE YMCA PARTICIPATES IN A LONG RANGE PLANNING PROCESS TO DETERMINE THE DIRECTION OF ITS PROGRAMMING, AND ALL ELEMENTS OF THE PLAN ARE TESTED AGAINST THE MISSION TO DETERMINE IF THEY CONTRIBUTE TO OUR PURPOSE. THIS PLAN IS APPROVED BY THE MEMBERS OF THE BOARD OF DIRECTORS. MEMBERS ALSO ARE ASKED TO CONTRIBUTE FINANCIALLY TO THE YMCA. EACH YEAR, WE STRIVE TO RAISE FUNDS THROUGH ANNUAL PARTNERS OF YOUTH/STRONG KIDS PROGRAMS TO HELP OFFSET THE COST OF MEMBERSHIPS AND PROGRAMS TO THOSE IN OUR COMMUNITY THAT DO NOT HAVE THE ABILITY TO PAY FULL MEMBERSHIP FEES. IN SUPPORT OF OUR EXEMPTION, THE YMCA IS COMMITTED TO PROVIDING MEMBERSHIPS TO THOSE WHO CANNOT AFFORD TO PAY. THIS IS IN SHARP CONTRAST TO THOSE WHO PROVIDE FITNESS SERVICES IN PRIVATE, FOR-PROFIT ORGANIZATIONS. LAST YEAR, WE PROVIDED FINANCIAL ASSISTANCE TO INDIVIDUALS, AWARDING OVER 55,000 IN MEMBERSHIP ASSISTANCE. WE HAVE A MEMBERSHIP BASE OF APPROXIMATELY 3,800 INDIVIDUALS. LAST YEAR MORE THAN 60% OF OUR MEMBERSHIP BASE RECEIVED SOME FORM OF FINANCIAL HELP FOR MEMBERSHIP AND PROGRAMS, TOUCHING LIVES OF THOSE AFFECTED AND MAKING A DIFFERENCE FOR GENERATIONS TO COME. HELPING PEOPLE OF ALL AGES AND ABILITIES DEVELOP HEALTH IN SPIRIT, MIND AND BODY IS THE CORE OF THE YMCA MOVEMENT. OUR PROGRAMS ARE DESIGNED TO HELP PEOPLE CREATE REALISTIC GOALS FOR SELF-IMPROVEMENT AND EMPHASIZE DISEASE PREVENTION THROUGH REGULAR EXERCISE, PROPER NUTRITION, STRESS MANAGEMENT, AND HEALTH EDUCATION. SPORTS PROGRAMS FOR YOUTH, ADULTS, AND SENIORS ARE AN IMPORTANT ASPECT OF THE YMCA'S MISSION TO THE COMMUNITY. OUR CARRIAGE CLUB IS A PROGRAM THAT KEEPS SENIORS ACTIVE AND FLEXIBLE; AND FAMILY SWIM TIME GIVES ADULTS AND CHILDREN SHARED TIME IN THE POOL TO APPRECIATE ONE ANOTHER AND TO PROMOTE INTERGENERATIONAL RELATIONSHIPS. OUR SERVICES ARE OFFERED AT AFFORDABLE FEES FOR THE COMMUNITY AT LARGE, WITH REASONABLE ACCOMMODATIONS FOR THOSE WITH SPECIAL NEEDS, AND WITH FINANCIAL ASSISTANCE AVAILABLE FOR THOSE WHO CANNOT AFFORD FULL FEES. MEMBERS CAN PARTICIPATE IN MOST ADULT HEALTH AND WELLNESS PROGRAMS. OUR YMCA OFFERS PROGRAMS DESIGNED TO PROMOTE TOTAL WELLNESS OF INDIVIDUALS, THROUGH GROUP SUPPORT AND INCENTIVES, THAT WILL GIVE THEM THE TOOLS NEEDED TO MAKE PERMANENT LIFESTYLE CHANGES FOR THE BETTER. THESE PROGRAMS TEAM UP MEMBERS AND PARTICIPANTS WITH OTHERS TO GIVE THEM ADDITIONAL SUPPORT AND ENCOURAGEMENT. IN LIGHT OF THE RISING OBESITY RATES IN THIS COUNTRY, OUR YMCA PARTICIPATES IN THE ACTIVATE AMERICA INITIATIVE, IN SHAPE INDIANA AND THE MAYOR'S WELLNESS COUNCIL, AND ENGAGES IN A VARIETY OF EVENTS AND COMMUNITY ACTIVITIES DESIGNED TO HELP THE AT RISK POPULATION DEVELOP HABITS AND RELATIONSHIPS THAT LEAD TO MORE ACTIVE LIFESTYLES. ONE SUCH EVENT IS THE HEALTHY KIDS DAY/KIDS FAIR/BIKE RODEO, A FREE EVENT FOR THE COMMUNITY, COLLABORATING WITH MANY COMMUNITY HEALTH ORGANIZATIONS TO PROVIDE INFORMATION, SCREENINGS, AND ACTIVITIES THAT WILL IMPROVE THE HEALTH OF OUR FAMILIES. THIS PROGRAM SERVES OVER 1,000 FAMILIES ANNUALLY. HEALTH AND WELLNESS PROGRAMS SERVE A TOTAL OF 5,000 PARTICIPANTS EACH YEAR.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,223,247

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) MARK DEMCHAK...................................................................... EXEC. DIR.	50.00 .................	X		68,868	0	23,285
(2) KURT KRAUSKOPF...................................................................... TREASURER	1.00 .................	X	X	0	0	0
(3) STEVE DOBBS...................................................................... SECRETARY	1.00 .................	X	X	0	0	0
(4) DEBRA CLOSE...................................................................... PAST CHAIR	1.00 .................	X	X	0	0	0
(5) JIM YATES...................................................................... BOARD CHAIR	1.00 .................	X	X	0	0	0
(6) DENNIS KINLEY...................................................................... VICE CHAIR	................. 1.00	X	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	68,868	23,285

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..		1a	28,292
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	336,125

f	All other contributions, gifts, grants, and similar amounts not included above		1f	386,980

g	Noncash contributions included in lines 1a-1f:$ 1,139
h Total.Add lines 1a-1f.......		751,397

		Business Code
2a	MEMBERSHIP		388,339	388,339
b	PROGRAMS		74,323	74,323
c	CHILD CARE - PRESCHOOL		62,032	62,032
d	CHILD CARE - SCHOOL AGE		55,141	55,141
e	TRANSIT SERVICES		31,550	31,550
f	All other program service revenue.			26,766	26,766
g Total.Add lines 2a–2f.....			638,151

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			-6,957			-6,957
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	200
b	Less: cost or other basis and sales expenses	1,328
c	Gain or (loss)	-1,128
d	Net gain or (loss).....			-1,128	-1,128
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		22,470
b	Less: direct expenses ...b		17,718
c	Net income or (loss) from fundraising events..			4,752
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a		11,808
b	Less: cost of goods sold ..b		8,123
c	Net income or (loss) from sales of inventory..			3,685			3,685
Business Code			Miscellaneous Revenue
11a	ADVERTISING INCOME		541800	1,721		1,721
b	OTHER INCOME			1,690			1,690
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			3,411
12	Total revenue. See Instructions......			1,393,311	637,023	1,721	-1,582

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	729,091	567,047	157,706	4,338
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	37,419	30,653	6,596	170
9	Other employee benefits .......	45,153	35,825	9,094	234
10	Payroll taxes ...........	53,966	43,600	10,106	260
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	11,220	11,220
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12	Advertising and promotion ....	3,730	3,730
13	Office expenses .......	9,874	6,928	2,946
14	Information technology ......	4,274	3,419	855
15	Royalties ..
16	Occupancy ...........	101,603	85,341	16,262
17	Travel ............	1,758	284	1,474
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	5,493	988	4,505
20	Interest ...........
21	Payments to affiliates .......	19,600	14,700	3,920	980
22	Depreciation, depletion, and amortization ..	124,356	124,356
23	Insurance ...	75,773	75,773
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	BUILDING PROJECT EXPENSES	41,731	41,731
b	MAINTENANCE CONTRACTS	31,531		31,531
c	TRANSIT FUEL	31,084	31,084
d	TRANSIT REPAIRS	23,137	23,137
e	All other expenses	123,431	123,431
25	Total functional expenses. Add lines 1 through 24e	1,474,224	1,223,247	244,995	5,982
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			80,345	1	115,902
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			9,600	4	2,400
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,028,147
b	Less: accumulated depreciation	10b	2,892,740	1,213,589	10c	1,135,407
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			483,847	13	451,571
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,787,381	16	1,705,280

17	Accounts payable and accrued expenses .....	960	17	1,163
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	960	26	1,163

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	1,463,914	27	1,384,049
28	Temporarily restricted net assets ...........	42,436	28	60,272
29	Permanently restricted net assets	280,071	29	259,796
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	1,786,421	33	1,704,117
34	Total liabilities and net assets/fund balances ........	1,787,381	34	1,705,280