Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
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 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
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.") . | 268,759 | 268,759 | ||||
| 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. | 268,759 | 268,759 | ||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 268,759 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 268,759 | 268,759 | ||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2 | 2 | ||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2 | 2 | ||||
| 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.) .. | 60 | 60 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 268,821 | 268,821 | ||||
| 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 | ||||
| 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....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | REFUNDS - 2015 AMOUNT: $ 60. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD SHALL HAVE ALL POWERS CONFERRED ON BOARDS OF NOT-FOR-PROFIT CORPORATIONS PURSUANT TO NEW YORK STATE LAW, OR ANY OTHER LAW THAT IS APPLICABLE TO THE CORPORATION. ALL OFFICERS OF THE CORPORATION SHALL BE ELECTED AT THE ANNUAL MEETING OF THE BOARD OF DIRECTORS. ADDITIONAL OFFICERS MAY BE SELECTED FOR SUCH PERIOD, HAVE SUCH AUTHORITY AND PERFORM SUCH DUTIES, EITHER IN AN ADMINISTRATIVE OR SUBORDINATE CAPACITY, AS THE BOARD OF DIRECTORS MAY FROM TIME TO TIME DETERMINE. ANY DIRECTOR MAY BE REMOVED FOR NEGLECT OF DUTY OR MISCONDUCT IN OFFICE, OR MAY BE REMOVED PURSUANT TO ANY OTHER PROVISION OF NEW YORK LAW, BY VOTE OF A 2/3 OF THE ENTIRE BOARD OF DIRECTORS. IN THE EVENT OF A REMOVAL OF ANY SUCH DIRECTOR, THE BOARD OF DIRECTORS SHALL SELECT AND RECOMMEND TO THE APPOINTMENT BODY A SUCCESSOR DIRECTOR TO SERVE THE REMAINING TERM OF THE REMOVED DIRECTOR HE OR SHE REPLACES. ANY DIRECTOR WHO PARTICIPATES IN LESS THAN 65 PERCENT OF THE BOARD MEETINGS OVER HIS/HER TERM ON AN ANNUAL BASIS SHALL BE AUTOMATICALLY REMOVED UNLESS THE DIRECTOR PROVIDES DOCUMENTED MEDICAL REASONS FOR NON-PARTICIPATION. IN THE EVENT OF REMOVAL FOR NON-PARTICIPATION, THE BOARD OF DIRECTORS SHALL ELECT AND RECOMMEND TO THE APPOINTMENT BODY A SUCCESSOR DIRECTOR WITHIN NINETY DAYS TO SERVE THE REMAINING TERM OF THE REMOVED DIRECTOR HE OR SHE REPLACES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION USES A DIFFERENT CPA FIRM TO ASSIST IN GATHERING THE INFORMATION REPORTED ON FORM 990. A DRAFT IS THEN PROVIDED TO THE BOARD FOR THEIR REVIEW PRIOR TO FINALIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | 1. EACH NEWLY-ELECTED DIRECTOR, PRIOR TO TAKING HIS/HER POSITION ON THE BOARD, AND ALL PRESENT DIRECTORS AS SOON AS PRACTICABLE AFTER THE ADOPTION OF THIS POLICY, SHALL DISCLOSE, IN WRITING, ON THE DISCLOSURE STATEMENT, WHICH IS ATTACHED, TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS, THE NATURE OF ANY EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER INTEREST AS A DIRECTOR. SUCH CONFLICT OF INTEREST INCLUDES, BUT IS NOT LIMITED TO, DIRECTORSHIP, MANAGEMENT, CONSULTATION, OR MATERIAL BUSINESS WITH THE LAND BANK, OR WHERE THERE IS GREAT LIKELIHOOD THAT SUCH CONCERN WILL BE DOING BUSINESS WITH THE LAND BANK. SUCH CONFLICT OF INTEREST ALSO INCLUDES FINANCIAL INTERESTS, DEFINED AS ANY PERSON HAVING DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT, OR FAMILY: A) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE LAND BANK HAVE A TRANSACTION OR ARRANGEMENT, OR B) A COMPENSATION ARRANGEMENT WITH THE LAND BANK OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE ORGANIZATION HAS A TRANSACTION OR ARRANGEMENT, OR C) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE LAND BANK IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. OTHER AREAS REQUIRING DISCLOSURE INCLUDE THE PURCHASE OR SALE OF PROPERTY OR PROPERTY RIGHTS AND INTERESTS POTENTIALLY IN COMPETITION WITH THE LAND BANK, AND/OR THE INVOLVEMENT WITH ORGANIZATIONS PROVIDING SERVICES SIMILAR TO THE LAND BANK. 2. WHENEVER A DIRECTOR ASSUMES NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE AS A DIRECTOR OF THE LAND BANK, SUCH INDIVIDUAL WILL DISCLOSE, IN WRITING, THE NATURE OF SUCH EXTERNAL INTERESTS TO THE AUDIT COMMITTEE. 3. QUESTIONS RELATING TO THE POSSIBLE EXISTENCE OF A CONFLICT OF INTEREST MAY BE DIRECTED TO THE LAND BANK'S LEGAL CONSULTANT FOR HIS/HER REVIEW AND DETERMINATION. 4. WHENEVER A MATTER BEING DELIBERATED BY THE BOARD OF DIRECTORS, OR ANY COMMITTEE OR SUBCOMMITTEE OF THE BOARD, CREATES A POTENTIAL CONFLICT OF INTEREST FOR ANY DIRECTOR, SUCH DIRECTOR WILL NEITHER VOTE NOR INFLUENCE THE DECISION OF THE BOARD OR COMMITTEE, NOR BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE FOREGOING WILL NOT BE CONSTRUED AS PREVENTING ANY DIRECTOR FROM STATING HIS POSITION ON ANY BOARD MATTER, NOR FROM PROVIDING INFORMATION TO OTHER DIRECTORS ON ANY BOARD MATTER. IT IS EXPECTED THAT FOLLOWING A DIRECTOR'S STATEMENT OF HIS POSITION ON A GIVEN ISSUE, THAT HE/SHE WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. THE MINUTES OF THE MEETING WILL RECORD THE NAME OF THE PERSON(S) WHO DISCLOSED CONFLICTING INTERESTS, THE NATURE OF THE CONFLICTING INTERESTS AND NOTE THEIR ABSTENTIA FROM THE DISCUSSION AND VOTE. THE MINUTES OF THE MEETING WILL ALSO REFLECT THE JUSTIFICATION FOR DETERMINING THE QUORUM. 5. IF THE AUDIT COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE DIRECTOR OF THE BASIS FOR SUCH BELIEF AND AFFORD THE DIRECTOR AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. 6. IF, AFTER HEARING THE RESPONSE OF THE DIRECTOR AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE AUDIT COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE CORRECTIVE ACTION. 7. IF THE AUDIT COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THEN THE AUDIT COMMITTEE SHALL CONSIDER WHETHER ANOTHER DISCUSSION AND/OR VOTE ON THE MATTER IS NECESSARY OR APPROPRIATE, AND MANAGEMENT/THE BOARD OF DIRECTORS SHALL REFRAIN TO THE EXTENT PRACTICAL FROM ACTING ON THE BASIS OF THE INITIAL AUDIT COMMITTEE ACTION UNTIL SUCH RECONSIDERATION HAS OCCURRED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE. |
| FORM 990, PART XII,LINE 2C: | THIS IS THE ORGANIZATIONS FIRST YEAR OF EXISTENCE AND FIRST AUDIT. THE AUDIT COMMITTEE SHALL OVERSEE THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS. THE COMMITTEE SHALL ANNUALLY RETAIN AN INDEPENDENT AUDITOR TO CONDUCT THE AUDIT AND UPON THE COMPLETION THEREOF, REVIEW THE RESULTS OF THE AUDIT AND ANY RELATED MANAGEMENT LETTER WITH THE AUDITOR. |
| Software ID: | |
| Software Version: |