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 or IRC section (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 3,650,862 | 9,295,915 | 3,758,078 | 2,224,731 | 18,929,586 | |
| 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.. | 244,569 | 201,763 | 84,068 | 530,400 | ||
| 4 | Total. Add lines 1 through 3 | 3,895,431 | 9,497,678 | 3,842,146 | 2,224,731 | 19,459,986 | |
| 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. | 19,459,986 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 3,895,431 | 9,497,678 | 3,842,146 | 2,224,731 | 19,459,986 | |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,183 | 4,884 | 2,835 | 8,902 | ||
| 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.).. | 4,856 | 5,925 | 10,781 | |||
| 11 | Total support Add lines 7 through 10. | 19,486,169 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| 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 2014 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-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS INCOME - 2013 AMOUNT: $ 4,856. 2014 AMOUNT: $ 5,925. |
| SCHEDULE A, PART II, COLUMN (E), EXPLANATION FOR SHORT YEAR: | AMOUNTS FOR THE ORGANIZATION'S SHORT YEAR (1/1/13 - 6/30/13) HAVE BEEN INCLUDED IN THE 2013 COLUMN OF SCHEDULE A, PART II ALONG WITH AMOUNTS FOR THE ORGANIZATION'S FISCAL YEAR (7/1/13 - 6/30/14). |
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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 III, LINE 3 | THE CHALLENGE GRANT PROGRAM SERVICE CEASED. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER IS COMMUNITY CARE OF NORTH CAROLINA, INC. THE MEMBER ACTS THROUGH ITS BOARD OF DIRECTORS AND IS ENTITLED TO VOTE ON ALL MATTERS RESERVED TO THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS IS ELECTED/APPOINTED BY THE ORGANIZATION'S SOLE CORPORATE MEMBER. PROCESSES FOR TERMS, NOMINATION, APPROVAL, ELECTION AND REMOVAL ARE SET BY AND ARE RESERVED TO THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS, PROVIDED THOSE ACTIONS HAVE BEEN PREVIOUSLY APPROVED BY NC HIE'S BOARD OF DIRECTORS: A) APPROVAL OF ANNUAL OPERATING AND CAPITAL BUDGETS, AND ANY MATERIAL VARIANCES THEREFROM, AND APPROVAL OF LONG-RANGE FINANCIAL PLANS B) APPROVAL OF THE INCURRENCE OF ANY INDEBTEDNESS IN EXCESS OF THE AMOUNTS DETERMINED FROM TIME TO TIME BY RESOLUTION OF THIS CORPORATION'S CORPORATE MEMBER C) APPROVAL OF MERGERS OR CONSOLIDATIONS WITH ANY DOMESTIC OR FOREIGN CORPORATION D) THE SALE, TRANSFER, ENCUMBRANCE OR OTHER DISPOSITION OF ASSETS WITH A FAIR MARKET VALUE IN EXCESS OF AN AMOUNT DETERMINED FROM TIME TO TIME BY THIS CORPORATION'S CORPORATE MEMBER OTHER THAN IN THE ORDINARY COURSE OF BUSINESS E) APPOINTMENT OR REMOVAL OF THE PRESIDENT F) APPOINTMENT OR REMOVAL OF A DIRECTOR G) AMENDMENTS TO THE ARTICLES OF INCORPORATION AND/OR BYLAWS H) VOLUNTARY DISSOLUTION I) APPROVAL OF VENDOR AGREEMENTS INVOLVING TWENTY PERCENT OR MORE OF THE CORPORATION'S OPERATING EXPENSE J) ESTABLISHMENT OF LONG RANGE PLANS AND STRATEGIES FOR THIS CORPORATION, INCLUDING ISSUES RELATING TO MARKETING, STRATEGIC DIRECTION, AND ONGOING OPERATIONS K) DEVELOPMENT OF POLICIES REGARDING THE IMPLEMENTATION OF ANY OF THE RESERVED POWERS DESCRIBED ABOVE |
| FORM 990, PART VI, SECTION B, LINE 11 | FINANCIAL MANAGEMENT, THE MANAGER OF ACCOUNTING AND THE CFO, WILL REVIEW AND APPROVE THE 990 TAX RETURN. ONCE APPROVED, FINANCIAL MANAGEMENT WILL REVIEW THE 990 WITH THE ACTING PRESIDENT OF THE NCHIE TO OBTAIN HIS APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | PRIOR TO TAKING HIS OR HER POSITION ON THE BOARD OF DIRECTORS, AND ANNUALLY THEREAFTER, EACH DIRECTOR SHALL COMPLETE AND SUBMIT TO THE SECRETARY OF THE BOARD OF DIRECTORS A CONFLICT OF INTEREST STATEMENT AS REQUIRED BY NC HIE'S CONFLICT OF INTEREST POLICY. THE BOARD OF DIRECTORS SHALL BECOME FAMILIAR WITH THE STATEMENTS OF ALL DIRECTORS IN ORDER TO GUIDE THE CONDUCT OF THE BOARD OF DIRECTORS SHOULD SUCH A CONFLICT ARISE AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD OF DIRECTORS WHICH INVOLVES OR MAY INVOLVE A CONFLICT OF INTEREST, THE AFFECTED DIRECTOR SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY HIS OR HER WRITTEN STATEMENT OR NOT. SUCH DIRECTOR SHALL ANSWER ANY QUESTIONS THAT MIGHT BE ASKED OF HIM OR HER AND SHALL DISCLOSE ALL MATERIAL FACTS. SUCH DIRECTOR SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION, IF ANY, OF ALL OFFICERS AND AGENTS OF THE CORPORATION SHALL BE FIXED BY THE SOLE CORPORATE MEMBER. PRESIDENT COMPENSATION IS COMMUNICATED WITHIN A CONTRACT AND IS AN AT WILL POSITION. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII | DAVID WELKER II - 12324 CANOLDER STREET, RALEIGH, NC 27614. LYDIA NEWMAN - 1314 REGATTA DRIVE, WILMINGTON, NC 28405. |
| FORM 990, PART IX, LINE 11G | CONSULTING SERVICES : PROGRAM SERVICE EXPENSES 188,819. MANAGEMENT AND GENERAL EXPENSES 14,201. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 203,020. OTHER CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 347,942. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 347,942. TRAINING : PROGRAM SERVICE EXPENSES 72,443. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,443. |
| FORM 990, PART XII, LINE 2C: | NC HIE HAS NOT CHANGED THEIR OVERSIGHT PROCESS OF THE AUDIT NOR THEIR SELECTION PROCESS FOR THEIR INDEPENDENT AUDITOR FROM PRIOR YEARS. |
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