Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 | |||||
| (A)
ARKANSAS CHILDREN'S HOSPITAL |
710236857 | 3 | Yes | 1,150,000 | 0 | |
| (B)
ARKANSAS CHILDREN'S RESEARCH INSTITUTE |
710694931 | 7 | No | 50,000 | 0 | |
|
Total 2
|
1,200,000 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PAGE 4, SECTION A, LINE 1 | THE ARKANSAS CHILDREN'S HOSPITAL AUXILIARY (THE AUXILIARY) WAS ORGANIZED TO RAISE FUNDS FOR AND RENDER SERVICE TO ARKANSAS CHILDREN'S HOSPITAL (THE HOSPITAL) AND ITS PATIENTS THROUGH ACTIVITIES APPROVED BY THE BOARD OF DIRECTORS OF THE HOSPITAL. THE HOSPITAL IS MENTIONED SPECIFICALLY IN THE AUXILIARY'S GOVERNING DOCUMENTS. IN ADDITION, A SMALL PORTION OF THE FUNDS RAISED BY THE AUXILIARY IS GENERALLY DESIGNATED FOR THE BENEFIT OF THE ARKANSAS CHILDREN'S RESEARCH INSTITUTE, WHICH IS NOT SPECIFICALLY MENTIONED IN THE GOVERNING DOCUMENTS, BUT WHICH WAS ORGANIZED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES TO SUPPORT ARKANSAS CHILDREN'S HOSPITAL RESEARCH AND STUDY PROGRAMS." ALL FUNDS RAISED BY THE AUXILIARY ARE TRANSFERRED TO THE HOSPITAL (OR OTHER RELATED ENTITIES, IF APPLICABLE) VIA THE ARKANSAS CHILDREN'S FOUNDATION (THE FOUNDATION), WHICH IS NOT MENTIONED SPECIFICALLY IN THE AUXILIARY'S GOVERNING DOCUMENTS AS A "BENEFICIARY" OF AUXILIARY FUNDS RAISED. HOWEVER, THE AUXILIARY'S BYLAWS DO SPECIFY COORDINATION OF FUNDRAISING EFFORTS WITH THE FOUNDATION, AND THE GOVERNANCE OF THE AUXILIARY IS TIED TO THE FOUNDATION. THE ACTIONS OF THE AUXILIARY BOARD OF DIRECTORS ARE SUBJECT TO REVIEW BY THE FOUNDATION BOARD OF DIRECTORS AND APPROVAL BY THE HOSPITAL BOARD OF DIRECTORS THROUGH THE PRESIDENT OF THE FOUNDATION. THE FUNCTION OF THE FOUNDATION IS ALSO TO RAISE FUNDS FOR THE BENEFIT OF THE ARKANSAS CHILDREN'S CONTINUUM OF CARE AND TO MANAGE AND DISTRIBUTE THOSE FUNDS TO ITS SUPPORTING ORGANIZATIONS. THE FOUNDATION TRANSFERS ALL AUXILIARY FUNDS TO THE HOSPITAL (OR RELATED PARTIES, IF APPLICABLE) ON AN ANNUAL BASIS. |
| SCHEDULE A, PAGE 5, SECTION B, LINE 1 | PER THE AUXILIARY'S BYLAWS, THE PURPOSE OF THE AUXILIARY IS "TO RAISE FUNDS FOR AND RENDER SERVICE TO ARKANSAS CHILDREN'S HOSPITAL AND ITS PATIENTS THROUGH ACTIVITIES APPROVED BY THE BOARD OF DIRECTORS OF THE HOSPITAL." ALL ACTIONS OF THE ARKANSAS CHILDREN'S HOSPITAL AUXILIARY (THE AUXILIARY) BOARD ARE SUBJECT TO REVIEW BY THE ARKANSAS CHILDREN'S FOUNDATION BOARD OF DIRECTORS AND, WITH LIAISON THROUGH THE PRESIDENT OF THE FOUNDATION, APPROVAL FROM THE ACH BOARD OF DIRECTORS. ACH DOES NOT HAVE THE POWER TO REGULARLY APPOINT OR ELECT A MAJORITY OF THE AUXILIARY'S DIRECTORS OR TRUSTEES AT ALL TIMES DURING THE TAX YEAR. ANY CHANGES IN THE AUXILIARY'S GOVERNING DOCUMENTS AS APPROVED BY ITS MEMBERS MUST BE APPROVED BY THE BOARD OF TRUSTEES OF THE HOSPITAL. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP IN THE AUXILIARY IS OPEN TO ALL PERSONS WHO ARE INTERESTED IN ARKANSAS CHILDREN'S HOSPITAL. MEMBERS CONSIST OF THE FOLLOWING TYPES: ACTIVE MEMBERS, WHO PAY ANNUAL DUES AND WHO PARTICIPATE IN THE ACTIVE SERVICE PROGRAMS OF THE AUXILIARY; ASSOCIATE MEMBERS, WHO PAY ANNUAL DUES AND DO NOT WISH TO TAKE AN ACTIVE ROLE; ACTIVE LIFETIME MEMBERS, WHO MAKE A ONE-TIME DUES PAYMENT AND WHO PARTICIPATE IN THE ACTIVE SERVICE PROGRAMS OF THE AUXILIARY; AND ASSOCIATE LIFETIME MEMBERS, WHO MAKE A ONE-TIME DUES PAYMENT AND DO NOT WISH TO TAKE AN ACTIVE ROLE. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE AUXILIARY BOARD OF DIRECTORS CONSISTS OF THE EXECUTIVE COMMITTEE, THE CHAIRS OF THE STANDING COMMITTEES AND THE CHAIRS OF SUCH SPECIAL COMMITTEES AS MAY BE NECESSARY. THE OFFICERS OF THE AUXILIARY (COLLECTIVELY REFERRED TO AS THE "EXECUTIVE COMMITTEE" OF THE AUXILIARY BOARD) SHALL BE PRESIDENT, FIRST VICE PRESIDENT, SECOND VICE PRESIDENT, RECORDING SECRETARY, CORRESPONDING SECRETARY, TREASURER AND HISTORIAN. THE AUXILIARY BOARD PRESIDENT IS THE CHIEF EXECUTIVE OFFICER OF THE AUXILIARY AND OF THE AUXILIARY BOARD, AND HAS THE SUPERVISION OVER THE GENERAL MANAGEMENT OF THE AUXILIARY. THE PRESIDENT OF THE AUXILIARY MAY APPOINT SUCH SPECIAL COMMITTEES AND CHAIRS OF COMMITTEES AS SHE MAY CONSIDER NECESSARY TO CARRY OUT THE PURPOSE OF THE AUXILIARY. THEY SHALL BE AUTOMATICALLY DISSOLVED WHEN THEY HAVE DISCHARGED THEIR FUNCTION. ON AN ANNUAL BASIS, THE FIRST VICE PRESIDENT SHALL APPOINT FOUR MEMBERS WHO CURRENTLY SERVE OR PREVIOUSLY HAVE SERVED ON THE AUXILIARY BOARD TO BE ON THE NOMINATING COMMITTEE. THE NOMINATING COMMITTEE APPOINTS THE CHAIRS OF ALL STANDING COMMITTEES IN CONFORMITY WITH THE BYLAWS. EACH STANDING COMMITTEE CHAIR, IN CONFERENCE WITH THE PRESIDENT, APPOINTS THE MEMBERS OF HER COMMITTEE EXCEPT AS OTHERWISE DIRECTED IN BYLAWS. WHEN NECESSARY, THE NOMINATING COMMITTEE SHALL NAME, FOR AUXILIARY BOARD APPROVAL, ANY OFFICERS TO FILL UNEXPIRED TERMS OCCURRING BETWEEN ELECTIONS WHEN NOT OTHERWISE PROVIDED FOR IN THE BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL ACTIONS OF THE AUXILIARY BOARD ARE SUBJECT TO REVIEW OF THE ARKANSAS CHILDREN'S FOUNDATION BOARD OF DIRECTORS AND, WITH LIAISON THROUGH THE PRESIDENT OF THE FOUNDATION, APPROVAL FROM THE ACH BOARD OF DIRECTORS. WITH THE ABOVE LIMITATION, THE AFFAIRS OF THE AUXILIARY SHALL BE ADMINISTERED BY ITS BOARD OF DIRECTORS ON BEHALF OF THE MEMBERSHIP. THE MEMBERSHIP SHALL HAVE THE RIGHT OF FINAL APPROVAL ON MATTERS OF AUXILIARY POLICY. THE AUXILIARY BOARD OF DIRECTORS MAY ADOPT ITS OWN RULES OF PROCEDURE NOT INCONSISTENT WITH THE BYLAWS OF THE AUXILIARY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM 990, WHICH IS RECONCILED TO THE AUXILIARY'S INTERNAL FINANCIAL STATEMENTS AND AUDIT REPORT, IS INITIALLY REVIEWED IN DETAIL WITH THE ARKANSAS CHILDREN'S FOUNDATION'S PRESIDENT AND VICE PRESIDENT. THE DRAFT IS ALSO REVIEWED IN DETAIL WITH THE VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S. IF THESE REVIEWS RESULT IN REVISIONS TO THE DRAFT FORM 990, THOSE REVISIONS ARE MADE. A PUBLIC DISCLOSURE COPY OF THE FORM 990 IS MADE AVAILABLE TO THE ELECTED OFFICERS OF THE AUXILIARY BOARD PRIOR TO FILING IN ORDER TO PRESERVE THE PRIVACY OF DONORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL DISCLOSURE OF CONFLICTS OF INTEREST IS REQUIRED OF ALL BOARD MEMBERS. THESE DISCLOSURES ARE REVIEWED BY THE ARKANSAS CHILDREN'S FOUNDATION VICE PRESIDENT. THE ANNUAL DISCLOSURES ARE ALSO RECEIVED BY THE ARKANSAS CHILDREN'S HOSPITAL VP OF FINANCIAL OPERATIONS FOR REPORTING PURPOSES. DURING THE YEAR, WHILE BOARD MEMBERS MAY PARTICIPATE IN INITIAL DISCUSSION, BOARD MEMBERS WHO HAVE A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN THE RELATED TRANSACTION AND ABSTAIN FROM VOTING, WHICH IS NOTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE AUXILIARY'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED. |
| Software ID: | |
| Software Version: |