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.) .... | 4,041,140 | 4,252,100 | 3,047,422 | 1,939,788 | 2,483,335 | 15,763,785 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 4,041,140 | 4,252,100 | 3,047,422 | 1,939,788 | 2,483,335 | 15,763,785 |
| 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).. | 4,309,856 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 11,453,929 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 4,041,140 | 4,252,100 | 3,047,422 | 1,939,788 | 2,483,335 | 15,763,785 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,531,864 | 2,680,820 | 2,043,351 | 2,122,860 | 1,818,917 | 10,197,812 |
| 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.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10. | 25,997,372 | |||||
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.) | ||||||
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.).. | ||||||
| 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 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 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) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 15000324 |
| Software Version: | 2015v3.0 |
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, Line 6: Explanation of Classes of Members or Shareholder | The organization has a sole corporate member, Masonicare Corporation, with the right to appoint the members of the governing body and to participate in the organization's governance. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Masonicare Corporation, as sole corporate member, annually appoints the members of the governing body. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Pursuant to the certificate of incorporation of the organization, Masonicare Corporation, as the sole corporate member, has certain reserved powers to take or approve certain actions of the governing body. These powers include the prior approval of amendments to the organization's certificate of incorporation and bylaws, approval of long range plans, budgets and material changes in budgets, mission statements and policies (including investment policies) as well as sales or transfer of assets, mergers and/or dissolutions and certificate of need applications. The sole corporate member's powers also include the appointment and removal of directors, the organization's board chairman and independent audit firm. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Masonicare management and our third party accountants review the tax return for completeness and accuracy. It is reviewed by the chief executive officer and chairman of the board. The tax return is also placed on a secured website that can be accessed by all board members for their review. At a full board meeting a discussion is held regarding comments/questions from board members. The tax return is then finalized and filed. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Annually, officers, board members and senior employees are required to complete a conflict of interest disclosure. The corporate compliance officer annotates the results to determine if, and if so to what extent, a conflict of interest exists. The results of the officer and board member disclosures are first reviewed by the board chairman and then reported at the board meetings. Any officer or board member shall not make or second motions or vote(other than to abstain) on matters if a conflict of interest exists, whether or not the officer or board member had an opportunity to make a written disclosure through the formalized process. Senior employee disclosures are reported to the president and chief executive officer. The entire process is coordinated by the corporate compliance officer. All respondents are advised of their continuing duty to disclose any possible conflict of interest that may arise during the course of their service. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The compensation committee of Masonicare Corporation, engages an independent firm to certify the reasonableness of the executive director of the organization annually. This process was completed in November 2015. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The Masonicare Corporation financial statements are publicly available through EMMA and public securities markets. The statements of Masonic Charity Foundation of CT are included in the Masonicare Corporation consolidated fnancial statements. The certificate of incorporation and related documents are on file with the Connecticut Secretary of State's Office The conflict of interest policy is available upon request. |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Actuarial loss on annuity obligations = -$227610 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Assets Released from Restriction = -$104914 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Change in FMV of perpetual interest trusts = -$171912 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Intercompany = $2888390 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Net transfers with affiliates = -$15190954 |
| Form 990, Part IV, Question 24a,TE Bond Issue | Masonic Charity Foundation of CT is a member of the Masonicare obligated group that is responsible for the repayment of the Series C and Series E bonds issued by Masonicare, Inc. in 2007 and 2011. The current outstanding bond balance is 96,082,224. |
| Form 990, Part VII, Section A, Line 1a | Hours related for volunteer trustees (column B) are the estimated hours per week that the volunteer trustees contribute to this and all other related exempt organizations, not necessarily equally but in the proportion required for which they receive no compensation. Related organizations include, Masonicare Inc, Masonicare Health Center, Masonicare at Newtown Inc, Masonicare at Ashlar Village Inc, Masonicare at Home Inc, Masonicare Home Health and Hospice Inc, Masonicare Partners Home Health and Hospice, Masonicare at Mystic Inc and Keystone Indemnity Company Inc. |
| Software ID: | 15000324 |
| Software Version: | 2015v3.0 |