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.) .... | 1,172,700 | 1,227,820 | 1,173,869 | 1,890,021 | 1,345,163 | 6,809,573 |
| 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 | 1,172,700 | 1,227,820 | 1,173,869 | 1,890,021 | 1,345,163 | 6,809,573 |
| 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).. | 997,256 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 5,812,317 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,172,700 | 1,227,820 | 1,173,869 | 1,890,021 | 1,345,163 | 6,809,573 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 157,485 | 141,325 | 131,449 | 321,429 | 289,730 | 1,041,418 |
| 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.).. | 9,498 | 4,197 | 4,435 | 11,491 | 6,583 | 36,204 |
| 11 | Total support. Add lines 7 through 10. | 7,887,195 | |||||
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 |
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| Return Reference | Explanation |
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| 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 |
|---|---|
| SCHEDULE R | OPTIMIST INTERNATIONAL FOUNDATION (THE FOUNDATION) IS AFFILIATED WITH OPTIMIST INTERNATIONAL (THE ORGANIZATION), WHICH IS A SEPARATE 501(C)(4) ENTITY. THE FOUNDATION AND THE ORGANIZATION HAVE SEPARATE GOVERNING BODIES AND SEPARATE OFFICERS. HOWEVER, THE FOUNDATION WAS ESTABLISHED IN PRIOR YEARS TO COLLECT CONTRIBUTIONS FROM THE GENERAL PUBLIC AND ESTABLISH PROGRAM SERVICES THAT FURTHER EXECUTE THE ORGANIZATION'S CHARITABLE AND LITERARY ACTIVITIES. THE FOUNDATION UTILIZES THE ORGANIZATION TO PROCESS PAYROLL TRANSACTIONS ON ITS BEHALF. WHILE THE FOUNDATION DOES EMPLOY four INDIVIDUALS (INCLUDING THE EXECUTIVE DIRECTOR OF THE FOUNDATION), ALL REQUIRED PAYROLL FILINGS (W-2, W-3, 941) ARE FILED BY THE ORGANIZATION UNDER THE ORGANIZATION'S FEDERAL EMPLOYER IDENTIFICATION NUMBER. THE FOUNDATION REIMBURSES THE ORGANIZATION FOR 100% OF THE PAYROLL COSTS INCURRED FOR THESE Four EMPLOYEES, WHICH AMOUNTED TO $253,033 FOR THE YEAR ENDED SEPTEMBER 30, 2016. Two OF THE FOUNDATIONS FORMER EMPLOYEES ARE PARTICIPANTS IN A DEFINED BENEFIT PENSION PLAN SPONSORED BY THE ORGANIZATION. ONE OF THE FORMER EMPLOYEES, WHO WAS THE FORMER EXECUTIVE DIRECTOR OF THE FOUNDATION, IS CURRENTLY RECEIVING BENEFIT PAYMENTS FROM THE PLAN (THE FREQUENCY AND AMOUNT OF WHICH ARE DETERMINED ACCORDING TO THE PLAN DOCUMENT). ON AN ANNUAL BASIS, THE FOUNDATION MAKES A PAYMENT TO THE ORGANIZATION RELATED TO THE PLAN. HOWEVER FOR THE YEAR ENDED SEPTEMBER 30, 2016 NO REIMBURSEMENT PAYMENT WAS MADE. THE FOUNDATION HOLDS A LONG TERM NOTE RECEIVABLE FROM THE ORGANIZATION. DURING THE CURRENT FISCAL YEAR, TOTAL REPAYMENTS OF INTEREST AND PRINCIPAL ON THE LOAN FROM THE ORGANIZATION TO THE FOUNDATION AMOUNTED TO $56,965. ON A PERIODIC BASIS, THE ORGANIZATION ADVANCES OPERATING FUNDS TO THE FOUNDATION. |
| form 990, part iv, questions 14, 15 and 16 | THE FOUNDATION HAS A RELATIONSHIP WITH AN ORGANIZATION BASED IN CANADA - THE OPTIMIST INTERNATIONAL FOUNDATION OF CANADA (CANADIAN FOUNDATION). THE CANADIAN FOUNDATION IS A SEPARATE LEGAL ENTITY, AND HAS A SEPARATE BOARD OF DIRECTORS. THERE ARE NO COMMON BOARD MEMBERS BETWEEN THE FOUNDATION AND THE CANADIAN FOUNDATION. SEVERAL YEARS AGO, THE FOUNDATION ADVANCED FUNDS TO THE CANADIAN FOUNDATION TO COVER CERTAIN OPERATING COSTS. THIS AMOUNT HAS BEEN RECORDED ON THE FOUNDATION'S FINANCIAL STATEMENTS AS A RECEIVABLE. NO FORMAL REPAYMENT AGREEMENT EXISTS, HOWEVER THE CANADIAN FOUNDATION HAS BEEN MAKING PAYMENTS TO THE FOUNDATION ON A PERIODIC BASIS TO REDUCE THE AMOUNT OF THE ADVANCE. THE CANADIAN FOUNDATION PAID OFF THE BALANCE BY SEPTEMBER 30, 2016. |
| Form 990, Part VI, Section A, line 3 | THE FOUNDATION HAS OUTSOURCED THE ACCOUNTING FUNCTION TO OPTIMIST INTERNATIONAL, WHICH IS A SEPARATE EXEMPT ORGANIZATION. THE FOUNDATION'S ACCOUNTING ACTIVITIES ARE PERFORMED BY CONNIE PELLOCK and michelle hayes AT OPTIMIST INTERNATIONAL. UTILIZING INFORMATION PREPARED BY OPTIMIST INTERNATIONAL, THE FOUNDATION'S EXECUTIVE DIRECTOR AND THE BOARD OF DIRECTORS MONITOR THE ACCOUNTING ACTIVITY AND FINANCIAL PERFORMANCE OF THE FOUNDATION ON A PERIODIC BASIS. |
| Form 990, Part VI, Section A, line 8b | THE ORGANIZATION DOES NOT CURRENTLY HAVE ANY FORMAL COMMITTEES OF THE BOARD OF DIRECTORS THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. |
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS REVIEWED BY MANAGEMENT AND PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL AT A REGULARLY SCHEDULED MONTHLY BOARD MEETING. AFTER REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS, THE FORM 990 IS FILED WITH THE IRS BY MANAGEMENT. |
| Form 990, Part VI, Section B, line 12c | BOARD MEMBERS ANNUALLY REVIEW A LIST OF VENDORS AND SUPPLIERS TO DETERMINE CONFLICTS OF INTEREST. |
| Form 990, Part VI, Section B, line 15a | THE BOARD OF DIRECTORS APPROVED THE SALARY OF THE FOUNDATION'S CURRENT EXECUTIVE DIRECTOR BASED ON COMPARISONS FOR SIMILAR POSITIONS IN SIMILAR NOT-FOR-PROFIT ORGANIZATIONS. THE COMPARATIVE INFORMATION WAS ACCUMULATED BY THE FOUNDATION DURING THE SEARCH FOR A NEW EXECUTIVE DIRECTOR IN A PRIOR YEAR. ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE TO DETERMINE IF A CHANGE IN COMPENSATION IS WARRANTED. THE FOUNDATION DOES NOT HAVE ANY KEY EMPLOYEES OR HIGHLY COMPENSATED EMPLOYEES OTHER THAN THE EXECUTIVE DIRECTOR. |
| Form 990, Part VI, Section C, line 19 | THE VARIOUS DOCUMENTS ARE AVAILABLE UPON WRITTEN REQUEST ADDRESSED TO THE FOUNDATION'S OFFICE. |
| Form 990, Part XI, line 9: | CHANGE IN VALUE OF CHARITABLE GIFT ANNUITIES AND SPLIT INTEREST AGREEMENTS 8,570. |
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