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.) .... | 41,208,735 | 70,764,572 | 63,651,633 | 79,339,210 | 92,048,788 | 347,012,938 |
| 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 | 41,208,735 | 70,764,572 | 63,651,633 | 79,339,210 | 92,048,788 | 347,012,938 |
| 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).. | 259,984,458 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 87,028,480 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 41,208,735 | 70,764,572 | 63,651,633 | 79,339,210 | 92,048,788 | 347,012,938 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 82,349 | 119,345 | 95,048 | 171,417 | 846,651 | 1,314,810 |
| 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. | 348,327,748 | |||||
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) |
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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): |
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| 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) |
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| 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 |
|---|---|
| PART II, SECTION C, LINE 17A, FACTS AND CIRCUMSTANCES TEST: | THE ASSISTANCE FUND CONTINUES TO QUALIFY AS A PUBLIC CHARITY UNDER THE FACTS AND CIRCUMSTANCES TEST BY AFFIRMING THE FOLLOWING: SUPPORT FROM THE GENERAL PUBLIC IS WELL ABOVE THE 10% THRESHOLD AND IS CURRENTLY AT 24.98%. THE ORGANIZATION WORKS DILIGENTLY TO EXPAND THE GENERAL PUBLIC DONOR BASE BY WORKING TO ATTRACT NEW MAJOR DONORS AND EXPAND INDIVIDUAL GIVING THROUGH EMAIL AND MAIL CAMPAIGNS, CONDUCTING SPECIAL EVENTS, SOCIAL MEDIA CAMPAIGNS, AND PROMOTING PLANNED GIVING OPPORTUNITIES. TAF IS LED BY AN INDEPENDENT GOVERNING BOARD COMPRISED OF INDIVIDUALS WITH VARYING BACKGROUNDS WHO ADVOCATE FOR THE ORGANIZATION. TAF CONTINUALLY PROVIDES SUPPORT TO THE GENERAL PUBLIC DIAGNOSED WITH A CHRONIC OR CRITICAL DISEASES WHO NEED HELP PAYING FOR THEIR PRESCRIPTION MEDICATION COPAYS, DEDUCTIBLES, HEALTH INSURANCE PREMIUMS AND ANCILLARY MEDICAL EXPENSES. BASED ON THE AFOREMENTIONED, THE ORGANIZATION IS MEETING THE FACTS-AND-CIRCUMSTANCES TEST. |
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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 I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: | VISION IS TO SEE THE DAY WHEN NO PERSON GOES WITHOUT MEDICATION DUE TO AN INABILITY TO PAY. UNTIL THEN, WE EXIST SO THAT PATIENTS (LIKE YOU) DON'T HAVE TO MISS TAKING YOUR MEDICATION BECAUSE OF COSTS. |
| FORM 990, PART III, LINE 4A: | each of which covers the FDA-approved medications that treat a specific disease. Since our founding in 2009, The Assistance Fund has handled more than 100,000 calls providing reference and eligibility processing, as well as sharing educational information that may benefit callers in managing their chronic condition. |
| FORM 990, PART VI, SECTION A, LINE 2: | ADA DE LA OSA IS THE SISTER-IN-LAW OF VINCENT SCREIBER. |
| FORM 990, PART VI, SECTION B, LINE 11: | THE BOARD OF DIRECTORS IS PROVIDED WITH A COPY OF THE COMPLETED FORM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C: | The Secretary of the corporation shall distribute annually to all directors, officers and key employees (as identified by the corporation), a form soliciting the disclosure of all conflicts of interest, including specific information concerning the terms of any contract or transaction with the corporation and whether the process for approval set forth in this policy was used. Such disclosure form may require disclosure of other relationships that may not constitute an actual conflict of interest, but which are required to be disclosed in order for the corporation to comply with its annual reporting requirements. An employee of the corporation with a potential conflict of interest in a particular matter shall promptly and fully disclose the potential conflict to his supervisor. The employee shall thereafter refrain from participating in deliberations and discussion, as well as any decisions, relating to the matter and follow the direction of the supervisor as to how the corporation decisions which are the subject of the conflict will be determined. The board chair shall be responsible for determining the proper way for the corporation to handle corporation decisions which involve unresolved employee conflicts of interest. In making such determinations, the board Chair may consult with legal counsel. The board chair shall report to the board at least annually concerning employee conflicts of interest which have been disclosed and contracts and transactions involving employee conflicts which the board chair has approved. |
| FORM 990, PART VI, SECTION B, LINE 15: | It is the policy of the corporation to pay no more than reasonable compensation for personal services rendered to the corporation by officers and employees. The directors of the corporation shall not receive compensation for fulfilling their duties as directors, although directors may be reimbursed for actual out-of-pocket expenses which they incur in order to fulfill their duties as directors. Expenses of spouses will not be reimbursed by the corporation unless the expenses are necessary to achieve a corporation purpose. The board of directors must approve in advance the amount of all compensation for officers of the corporation. Before approving the compensation of an officer, the board shall determine that the total compensation to be provided by the corporation to the officer is reasonable in amount in light of the position, responsibility and qualification of the officer for the position held, including the result of an evaluation of the officer's prior performance for the corporation, if applicable. In making the determination, the board shall consider total compensation to include the salary and the value of all benefits provided by the corporation to the individual in payment for services. At the time of the discussion and decision concerning an officer's compensation, the officer should not be present in the meeting. The board shall obtain and consider appropriate data concerning comparable compensation paid to similar officers in like circumstances. The board shall set forth the basis for its decisions with respect to compensation in the minutes of the meeting at which the decisions are made, including the conclusions of the evaluation and the basis for determining that the individual's compensation was reasonable in light of the evaluation and the comparability data. For other key employees, compensation is determined by the executive director after review of comparability data, including a salary survey. The information gathered and factors considered in arriving at the compensation is documented in the employees' personnel file. This process is performed on an annual basis. process is performed on an annual basis. |
| FORM 990, PART VI, SECTION C, LINE 19: | There shall be kept at the office of the corporation: (1) correct and complete books and records of account; (2) minutes of the proceedings of the board of directors and the executive committee; (3) a current list of the directors and officers of the corporation and their residence addresses; (4) a copy of these by-laws; (5) a copy of the corporation's application for recognition of exemption with the internal revenue service; and (6) copies of the past three (3) years' information returns to the internal revenue service. Any of the books, minutes and records of the corporation may be in written form or in any other form capable of being converted into written form within a reasonable time. The organization's governing documents and financial statements are available to the public upon request. |
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