TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) DORI JOHN 2ND VICE-PRESIDENT	0.5 .................	X	X
(2) JASON PARGETER 1ST VICE-PRESIDENT	0.6 .................	X	X
(3) JOYCE AKSE SECRETARY	0.5 .................	X	X
(4) MIKE WATTERS TREASURER	0.3 .................	X	X
(5) ROBERT DANNENHOFFER PRESIDENT	2.6 .................	X	X
(6) ALISON EGGERS BOARD MEMBER	0.3 .................	X
(7) AMY PALM BOARD MEMBER	0.0 .................	X
(8) JANET BITTER BOARD MEMBER	0.7 .................	X
(9) JOHN MARC WESTON BOARD MEMBER	0.3 .................	X
(10) LARRY RICH BOARD MEMBER	0.2 .................	X
(11) RICHARD EMBERTSON BOARD MEMBER	0.5 .................	X
(12) ROBIN CONRAD BOARD MEMBER	0.6 .................	X
(13) SHELLEY BRIGGS LOOSLEY BOARD MEMBER	1.5 .................	X
(14) STEPHANY MIDDLEKAUFF COLLINS BOARD MEMBER	0.1 .................	X
(15) TONY HANSEN BOARD MEMBER	0.3 .................	X
(16) TONY WRIGHT BOARD MEMBER	0.1 .................	X
(17) ZACK SKOGLIE BOARD MEMBER	0.3 .................	X

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Employer identification number

93-0395593

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

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.

Section B. Total Support

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

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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.") .	2,760,317	1,136,386	569,222	489,277	754,308	5,709,510
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	2,263,503	2,341,305	2,426,096	2,343,279	2,424,844	11,799,027
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....						0
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge						0
6	Total. Add lines 1 through 5	5,023,820	3,477,691	2,995,318	2,832,556	3,179,152	17,508,537
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons	0	0	0	0	0	0
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.	0	0	0	0	0	0
c	Add lines 7a and 7b..	0	0	0	0	0	0
8	Public support. (Subtract line 7c from line 6.)						17,508,537

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...	5,023,820	3,477,691	2,995,318	2,832,556	3,179,152	17,508,537
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	21,767	35,054	42,835	50,098	34,862	184,616
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	21,767	35,054	42,835	50,098	34,862	184,616
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	12,078	25,096	22,552	29,507	64,829	154,062
13	Total support. (Add lines 9, 10c, 11, and 12.)..	5,057,665	3,537,841	3,060,705	2,912,161	3,278,843	17,847,215

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

98.10 %

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

98.39 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

1.03 %

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

0.99 %

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
Schedule A, Part III, Line 12 OTHER INCOME	RESALE MERCHANDISE, ITEMS WITH THE YMCA LOGO SUCH AS T-SHIRTS, SWEATSHIRTS, AND WATER BOTTLES: GROSS REVENUE, $6,572.
Schedule A, Part III, Line 12 OTHER INCOME	OUR PORTION OF STATEWIDE REIMBURSEMENT ("DIVIDEND") FROM WORKERS COMPENSATION INSURANCE COMPANY: $4,013.
Schedule A, Part III, Line 12 OTHER INCOME	MISCELLANEOUS INCOME SUCH AS NSF AND LATE PAYMENT FEES, TOWEL FEES, AND CREDIT CARD REWARDS: $9,160.
Schedule A, Part III, Line 12 OTHER INCOME	INSURANCE CLAIM PROCEEDS, $45,084.
Schedule A, Part III, Line 12 Other Income	DESCRIPTION - OTHER, COLUMN A - 12078.0, COLUMN B - 25096.0, COLUMN C - 22552.0, COLUMN D - 29507.0, COLUMN E - 64829.0, COLUMN F - 154062.0;

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	19010655
Software Version:	2019v5.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Employer identification number

93-0395593

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY		Employer identification number 93-0395593

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY			Employer identification number 93-0395593
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:	19010655
Software Version:	2019v5.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Employer identification number

93-0395593

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	38,370	39,701	38,976	38,777	39,203
b	Contributions ...	-1,310	0	0	0	0
c	Net investment earnings, gains, and losses	2,002	-1,331	725	199	-426
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	0	0	0	0	0
f	Administrative expenses ....		0	0	0	0
g	End of year balance ......	39,062	38,370	39,701	38,976	38,777

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	0	3,622		3,622
b	Buildings ....	0	9,471,631	3,655,803	5,815,828
c	Leasehold improvements	0	12,101	10,326	1,775
d	Equipment ....	0	733,703	623,949	109,754
e	Other .....	0	0	0	0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					5,930,979

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	3,223,581
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-358
b	Donated services and use of facilities .........	2b	9,285
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-42,967
e	Add lines 2a through 2d .....................			2e	-34,040
3	Subtract line 2e from line 1..................			3	3,257,621
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	0
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	3,257,621

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	3,075,357
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	-41,657
e	Add lines 2a through 2d....................			2e	-41,657
3	Subtract line 2e from line 1...................			3	3,117,014
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	0
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	3,117,014

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part XI, Line 2(d) SCHOLARSHIPS FOR MEMBERSHIPS & PROGRAMS	MEMBERSHIP AND PROGRAM ASSISTANCE REFLECTED IN AUDITED FINANCIALS MEMBERSHIP DUES REVENUE, NET OF SCHOLARSHIPS, BUT ARE INCLUDED AS EXPENSES IN 990.
Schedule D, Part XII, Line 2(d) SCHOLARSHIPS FOR MEMBERSHIPS & PROGRAMS	MEMBERSHIP AND PROGRAM ASSISTANCE REFLECTED IN AUDITED FINANCIALS MEMBERSHIP DUES REVENUE, NET OF SCHOLARSHIPS, BUT ARE INCLUDED AS EXPENSES IN 990.
Schedule D, Part V, Line 4 ENDOWMENT FUND INTENDED USES	NO DESIGNATED USES AT THIS TIME.
Schedule D, Part V, Line 4 Intended uses of endowment funds	NO SPECIFIC, DESIGNATED USES AT THIS TIME. GENERALLY, EARNINGS FROM ENDOWMENT FUND INVESTMENTS ARE INTENDED TO BE USED BY THE YMCA TO MORE COMPLETELY FULFILL ITS MISSION, DEVELOPING ITS PROGRAMS BEYOND WHAT IS POSSIBLE THROUGH ITS ANNUAL OPERATING FUNDS.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990	ADJUSTMENT TO ORIGINAL STOCK VALUE WHEN STOCK SOLD. STOCK HAD BEEN DONATED SEVERAL DECADES AGO. ESTIMATES HAD BEEN USED AT SOME POINT WHEN STOCK HAD BEEN RECLASSIFIED TO ENDOWMENT. - -1310 SCHOLARSHIPS FOR MEMBERSHIPS AND PROGRAMS - -41657
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990	SCHOLARSHIPS FOR MEMBERSHIPS AND PROGRAMS - -41657

Schedule D (Form 990) 2019

Additional Data

Software ID:	19010655
Software Version:	2019v5.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Employer identification number
93-0395593

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) MEMBERSHIP AND PROGRAM SCHOLARSHIPS	856	41,657
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part III, Column (b) Estimated Number Of Recipients

MEMBERSHIP AND PROGRAM SCHOLARSHIPS : THE OPERATIONS SOFTWARE WE USE DOES NOT TRACK INDIVIDUAL RECIPIENTS OF SCHOLARSHIPS. WE EXTRAPOLATED THE NUMBER OF RECIPIENTS BY COMBINING LISTS OF SCHOLARSHIPPED MEMBERSHIP UNITS WITH SCHOLARSHIPPED PROGRAM PARTICIPANTS, AND REMOVING DUPLICATIONS THAT WE COULD IDENTIFY. HOWEVER, THERE MAY BE SOME DUPLICATION. THE NUMBER OF RECIPIENT MEMBERS WAS CALCULATED BASED ON THE AVERAGE NUMBER OF SPONSORED MEMBERS PER MEMBERSHIP UNIT.

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

MEMBERS & PROGRAM PARTICIPANTS WHO ARE INTERESTED IN RECEIVING A SCHOLARSHIP COMPLETE A FINANCIAL ASSISTANCE APPLICATION. IT IS REVIEWED BY A STAFF MEMBER WITH THE APPLICANT, AND DEPENDING ON THE APPLICANT'S FINANCIAL STATUS, MAY BE GRANTED PARTIAL FINANCIAL ASSISTANCE FOR MEMBERSHIP AND/OR PROGRAM PARTICIPATION. ELIGIBILITY IS REVIEWED AT 3, 6, OR 12 MONTH INTERVALS, DEPENDING ON THE INDIVIDUAL CIRCUMSTANCES.

Schedule I (Form 990) 2019

Additional Data

Software ID:	19010655
Software Version:	2019v5.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

YOUNG MEN'S CHRISTIAN ASSOCIATION OF DOUGLAS COUNTY

Employer identification number

93-0395593

Return Reference	Explanation
Form 990, Part VI, Line 6 Classes of members or stockholders	THE YMCA REMAINS A MEMBERSHIP ORGANIZATION AND PUBLIC CHARITY OPEN TO ALL PEOPLE. THE YMCA WELCOMES SENIORS, ADULTS AND YOUTH OF ALL AGES, ETHNICITY, RELIGIONS, ABILITIES AND FINANCIAL CIRCUMSTANCES. WE HAVE NO STOCKHOLDERS.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	BOARD MEMBERS ARE ELECTED BY THE VOTING MEMBERS OF THE YMCA AT THE ANNUAL MEETING. VACANT, UNEXPIRED TERMS ARE FILLED BY BOARD DECISION AS NEEDED.
Form 990, Part VI, Line 11b Review of form 990 by governing body	AN ELECTRONIC COPY OF THE IRS FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. REVIEW AND DISCUSSION IS UNDERTAKEN AT THE NEXT BOARD MEETING WITH THE FINANCE COMMITTEE AND BOARD. THIS DISCUSSION IS AFTER THE 990 IS SUBMITTED TO THE IRS AND USUALLY TAKES PLACE AT THE NEXT BOARD MEETING. IT IS FACILITATED BY THE BOARD TREASURER AND/OR THE YMCA'S AUDITOR, WHO ALSO DISCUSSES THE AUDITED FINANCIAL REPORTS.
Form 990, Part VI, Line 12c Conflict of interest policy	WE UTILIZE AN ONLINE CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR TO FIND OUT WHETHER ANY BOARD MEMBER OR KEY STAFF MEMBER HAS A CONFLICT OF INTEREST. THE QUESTIONNAIRE ASKS BOARD AND STAFF MEMBERS TO DISCLOSE EXISTING CONFLICTS AND REMINDS THEM TO DISCLOSE ANY THAT MAY CROP UP IN THE FUTURE. A REPORT IS COMPILED THAT IS REFERRED TO AS NEEDED. THE BOARD PRESIDENT IS APPRISED OF ANY CONFLICTS THAT EXIST. THE CEO ATTENDS ALL BOARD AND COMMITTEE MEETINGS TO ENSURE COMPLIANCE WITH THESE GUIDELINES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE CEO/EXECUTIVE DIRECTOR POSITION AT THE YMCA OF DOUGLAS COUNTY IS ANALYZED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANNUAL COMPENSATION OF THE YMCA'S SENIOR EXECUTIVE IS DETERMINED BY 1. VARIOUS NOT-FOR-PROFIT SOURCES THAT MAY BE AVAILABLE TO THE YMCA, 2. VARIOUS FOR-PROFIT SOURCES THAT MAY BE AVAILABLE TO THE YMCA, AND 3. RECOMMENDED YMCA OF THE USA SALARY RANGES FOR THE SIZE OF OUR YMCA. COMPENSATION IS DETERMINED BY THE EXECUTIVE COMMITTEE BASED UPON BOTH THE REVIEW AND THE CEO'S ACHIEVEMENT OF GOALS AND THE ANNUAL BUDGET.
Form 990, Part VI, Line 19 Required documents available to the public	OUR YMCA'S ARTICLES OF INCORPORATION, BYLAWS, CONFLICT OF INTEREST POLICY, FORM 990, AND ANNUAL REPORT WILL BE PROVIDED FOR PUBLIC REVIEW UPON WRITTEN REQUEST TO THE CEO.
Form 990, Part VIII, Line 11a MISCELLANEOUS REVENUE	MISCELLANEOUS REVENUE WAS MORE THAN USUAL IN 2019. WE HAD TWO INSURANCE CLAIMS THAT RESULTED IN $45,000 OF MISCELLANEOUS REVENUE. DUE TO A SEVERE SNOW STORM (VERY UNUSUAL FOR OUR REGION), WE LOST POWER FOR AN EXTENDED PERIOD OF TIME, AND BEFORE IT COULD BE PREVENTED, THE BASEMENT FLOODED, DAMAGING POOL PUMPS AND OTHER POOL EQUIPMENT ($30,000). IN THE FALL, A COMPROMISED DRIVER LOST CONTROL OF HIS SMALL PICKUP TRUCK AND CRASHED INTO OUR BUILDING, DESTROYING SOME SUPPORTS, A WALL, AND INTERIOR CUPBOARDS ($15,000). THE PROCEEDS FROM THE CLAIMS WERE USED TO REPAIR OR REPLACE DAMAGED EQUIPMENT, SUPPORTS, WALL, AND CUPBOARDS.
Form 990, Part VIII, Line 2f Other Program Service Revenue	- Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part X, Line 2 Supplemental information	THE DIFFERENCE IN SAVINGS AND TEMPORARY CASH INVESTMENTS AND IN PLEDGES RECEIVABLES FROM THE BEGINNING OF THE YEAR TO THE END OF THE YEAR IS ATTRIBUTABLE TO THE ACCOMPLISHMENT OF AND PAYMENTS FOR THE REMAINDER OF PHASE 1 OF A CAPITAL CONSTRUCTION AND REMODEL PROJECT THAT WAS COMPLETED IN 2019 WITH THE EXCEPTION OF REPLACEMENT OF OUR PARKING LOT, WHICH WILL BE ACCOMPLISHED IN THE SUMMER OF 2020. THE PROJECT INCLUDED THE REPLACEMENT OF OUR LOCKER ROOMS AND NORTH POOL, ALONG WITH SEVERAL SMALLER UPGRADES AND UPDATES.
Form 990, Part III, 4a HEALTHY LIVING	WE PROVIDED COMMUNITY PROGRAMS FREE TO THE COMMUNITY TO ENHANCE HEALTHY LIVING. THESE INCLUDE YMCA HEALTHY KIDS DAY, OFFERED AT OUR TWO LOCATIONS, WHICH ATTRACTED OVER 400 PARTICIPANTS. IN THE SUMMER WE CONDUCTED OUR ANNUAL KICK-START DOUGLAS COUNTY, 100 DAYS OF FREE HEALTHY ACTIVITIES SUCH AS ZUMBA IN THE PARK, WALKING GROUPS, TAI CHI, COMMUNITY SWIMMING, AND YOGA FOR OVER 2,000 PEOPLE OF ALL AGES AND ABILITIES. WE OFFERED ENHANCE FITNESS, AN EVIDENCE-BASED GROUP EXERCISE PROGRAM FOR OLDER ADULTS THAT USES SIMPLE, EASY-TO-LEARN MOVEMENTS THAT MOTIVATE INDIVIDUALS, PARTICULARLY THOSE WITH ARTHRITIS, TO STAY ACTIVE THROUGHOUT THEIR LIFE. YMCA STAFF REGULARLY WORK WITH COMMUNITY PARTNERS TO PROVIDE BLOOD PRESSURE SCREENINGS, ALZHEIMER'S EDUCATION AND HEALTH FAIRS. WITH THE SUPPORT OF THE DOUGLAS COUNTY AGING AND DISABILITY RESOURCES CONNECTION AND ARCHITRAVE HEALTH, THE YMCA HAS DEVELOPED EFFECTIVE, SUSTAINABLE STRATEGIES TO PROMOTE HEALTHY LIFESTYLES THROUGHOUT THE COUNTY FOR PEOPLE LIVING WITH CHRONIC DISEASES SUCH AS ARTHRITIS AND PARKINSON'S DISEASE. OUR POPULAR INDOOR FAMILY PLAY GYM GIVES PARENTS WITH KIDS 0 - 7 A SAFE AND FUN PLACE TO EXERCISE, PLAY TOGETHER, AND MEET AND SPEND TIME WITH FRIENDS.
Form 990, Part III, 4b YOUTH DEVELOPMENT	WE SERVED OVER 1,500 YOUTH IN OUR YOUTH SPORTS, SWIM TEAM, SWIM LESSONS, CHILD/PARENT CLASSES (GIGGLES & WIGGLES), AND MARTIAL ARTS PROGRAMS. OUR HIGH QUALITY, AFFORDABLE CHILDCARE FOR WEE ONES AND SCHOOL AGE CHILDREN PROVIDES A SAFE, ENRICHING AND EDUCATIONAL ENVIRONMENT FOR OVER 200 YOUTH AND PROVIDE NEEDED SUPPORT FOR WORKING FAMILIES. THROUGH OUR PARTNERSHIP WITH SMART READING AND THE UMPQUA READING COUNCIL, WE ENCOURAGE YOUTH TO READ FOR A MINIMUM OF 30 MINUTES PER DAY IN ORDER TO COMBAT SUMMER READING LOSS. AN INNOVATIVE TEEN MUSIC LAB PROVIDES FREE MUSIC LESSONS AND GROUP PLAYING EXPERIENCE TO MIDDLE SCHOOL AND HIGH SCHOOL YOUTH, AND OUR LEGO ROBOTICS PROGRAMS IN ROSEBURG AND SOUTH COUNTY ARE MAGNETS FOR KIDS TO PARTICIPATE AND IN ADDITION GIVE THEM AN OPPORTUNITY TO RECEIVE HEALTHY SNACKS AND MEALS.
Form 990, Part III, 4c SOCIAL RESPONSIBILITY	(CONTINUED FROM FORM 990, PART III, 4C) FUTURE GENERATIONS TO THRIVE. WE CONDUCTED OUR ANNUAL YMCA WATER SAFETY DAY AT THE NEIGHBORING COMMUNITY PARK, GIVING AWAY 285 LIFEJACKETS, A DOZEN SETS OF FREE SWIM LESSON GIFT CERTIFICATES, AND INSTRUCTION TO PARENTS AND GUARDIANS ABOUT HOW TO KEEP THEIR KIDS SAFE IN, ON AND AROUND THE WATER. AT SCHOOLS, CHURCHES, BUSINESSES AND OTHER ORGANIZATIONS IN THE ROSEBURG AREA, WE OFFER FREE DARKNESS TO LIGHT CHILD SEXUAL ABUSE PREVENTION TRAINING TO RAISE AWARENESS OF THE PREVALENCE AND CONSEQUENCES OF CHILD SEXUAL ABUSE BY EDUCATING ADULTS ABOUT THE STEPS THEY CAN TAKE TO PREVENT, RECOGNIZE AND REACT RESPONSIBLY TO THE REALITY OF CHILD SEXUAL ABUSE. WORKING AS A LEADER OF THE "RESPECT FOR WATER COMMITTEE," WE WERE INSTRUMENTAL IN GETTING A TEMPERATURE SENSOR INSTALLED IN THE NORTH UMPQUA RIVER THAT PROVIDES LIVE TEMPERATURE READINGS WHICH ARE POSTED ON THE YMCA AND LOCAL MEDIA WEBSITES TO HELP KEEP PEOPLE SAFE AT THE POPULAR RIVER SPOTS IN OUR AREA. IN 2019 WE PROVIDED A TOTAL OF $41,657 IN DIRECT FINANCIAL ASSISTANCE TO PEOPLE WHO OTHERWISE MAY NOT HAVE BEEN ABLE TO AFFORD TO PARTICIPATE IN YMCA PROGRAMS, MEMBERSHIPS, AND SERVICES.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:	19010655
Software Version:	2019v5.0

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF THE YMCA IS TO BUILD STRONG KIDS, STRONG FAMILIES, AND STRONG COMMUNITIES. WITH A FOCUS ON NURTURING THE POTENTIAL OF EVERY CHILD AND TEEN, IMPROVING OUR COMMUNITY'S HEALTH AND WELL-BEING AND PROVIDING OPPORTUNITIES TO GIVE BACK AND SUPPORT NEIGHBORS, THE YMCA ENABLES YOUTH, ADULTS, FAMILIES AND COMMUNITIES TO BE HEALTHY, CONFIDENT, CONNECTED AND SECURE. MEMBERS, STAFF AND VOLUNTEERS OF THE YMCA INCLUDE MEN, WOMEN AND CHILDREN OF ALL AGES AND FROM ALL WALKS OF LIFE. THE Y IS ACCESSIBLE TO ALL PEOPLE AND FINANCIAL ASSISTANCE IS OFFERED TO INDIVIDUALS AND FAMILIES WHO CANNOT AFFORD MEMBERSHIP AND PROGRAM FEES. THE Y IS GUIDED BY FOUR CORE VALUES: CARING, HONESTY, RESPECT AND RESPONSIBILITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	229
6	Total number of volunteers (estimate if necessary) .............	6	229
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	489,277	754,308
9	Program service revenue (Part VIII, line 2g) .........	2,343,279	2,424,843
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-9,069	2,427
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	39,701	76,043
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,863,188	3,257,621
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	52,569	41,957
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,781,821	1,859,228
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 131,574
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,088,905	1,215,829
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,923,295	3,117,014
19	Revenue less expenses. Subtract line 18 from line 12.......	-60,107	140,607
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	6,397,840	6,567,750
21	Total liabilities (Part X, line 26).............	140,393	162,080
22	Net assets or fund balances. Subtract line 21 from line 20.....	6,257,447	6,405,670

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,201,816 including grants of $ 16,385 ) (Revenue $ 1,951,783 )
	HEALTHY LIVING. THE Y IS A LEADING VOICE IN OUR COMMUNITY AND IS COMMITTED TO IMPROVING DOUGLAS COUNTY'S HEALTH AND WELL-BEING. WE BRING FAMILIES CLOSER TOGETHER, ENCOURAGE HEALTHY CHOICES, AND FOSTER CONNECTIONS THROUGH EXERCISE, SPORTS, FUN, AND SHARED INTERESTS. AS A RESULT, THOUSANDS OF PEOPLE IN OUR RURAL COMMUNITY ARE RECEIVING THE SUPPORT, GUIDANCE AND RESOURCES THEY NEED TO ACHIEVE GREATER HEALTH IN SPIRIT, MIND AND BODY. THIS IS PARTICULARLY IMPORTANT AS OUR COUNTY STRUGGLES WITH CHRONIC DISEASE AND OBESITY, FAMILIES WRESTLE WITH WORK/LIFE BALANCE AND INDIVIDUALS SEARCH FOR PERSONAL FULFILLMENT. OUR PROGRAMS ARE ACCESSIBLE, AFFORDABLE AND OPEN TO ALL FAITHS, BACKGROUNDS, ABILITIES AND INCOME LEVELS. IN 2019 WE PROVIDED $16,385 IN FINANCIAL ASSISTANCE FOR MEMBERSHIPS TO PEOPLE WHO OTHERWISE MAY NOT HAVE BEEN ABLE TO AFFORD TO PARTICIPATE. FOR ADDITIONAL DETAILS REGARDING THESE CRITICAL PROGRAMS AND THEIR IMPACT SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 1,075,197 including grants of $ 8,435 ) (Revenue $ 412,015 )
	YOUTH DEVELOPMENT. OUR YMCA IS COMMITTED TO NURTURING THE POTENTIAL OF EVERY CHILD AND TEEN. WE BELIEVE ALL KIDS DESERVE THE OPPORTUNITY TO DISCOVER WHO THEY ARE AND WHAT THEY CAN ACHIEVE. THAT'S WHY WE HELP YOUNG PEOPLE CULTIVATE THE VALUES, SKILLS AND RELATIONSHIPS THAT LEAD TO POSITIVE BEHAVIORS, BETTER HEALTH AND EDUCATIONAL ACHIEVEMENT. OUR YMCA PROGRAMS, SUCH AS Y PRESCHOOL AND Y AFTERSCHOOL CHILD CARE, SWIM LESSONS, SAFETY AROUND WATER, SWIM TEAM, TEEN MUSIC LAB, ROBOTICS, AND YOUTH SPORTS, OFFERED A RANGE OF EXPERIENCES THAT ENRICH SOCIAL-EMOTIONAL, COGNITIVE AND PHYSICAL GROWTH. WE SERVED OUR COMMUNITY'S INFANTS, TODDLERS AND PRESCHOOLERS (BIRTH TO AGE 5), ELEMENTARY YOUTH (AGES 6 - 11), AND MIDDLE SCHOOL AND HIGH SCHOOL YOUTH (AGES 12 - 18). EXPENSES INCLUDE SUBSIDIES OF YOUTH PROGRAMS PLUS $8,435 IN DIRECT FINANCIAL ASSISTANCE TO INDIVIDUALS THAT MAKES PARTICIPATION IN YOUTH PROGRAMS POSSIBLE FOR ALL YOUNG PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. FOR ADDITIONAL DETAILS REGARDING THESE CRITICAL PROGRAMS AND THEIR IMPACT SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 213,606 including grants of $ 17,137 ) (Revenue $ 61,045 )
	SOCIAL RESPONSIBILITY. OUR YMCA BELIEVES IN GIVING BACK AND IN SUPPORTING OUR NEIGHBORS. WE HAVE BEEN LISTENING AND RESPONDING TO OUR COMMUNITY'S MOST CRITICAL SOCIAL NEEDS FOR MORE THAN 70 YEARS. Y PROGRAMS SUCH AS DARKNESS TO LIGHT CHILD SEXUAL ABUSE PREVENTION TRAINING, ANNUAL WATER SAFETY DAY, THE RIVER RESCUE PROJECT, KICK-START DOUGLAS COUNTY (A FREE SUMMER WELLNESS INITIATIVE FOR THE COMMUNITY), PEDALING FOR PARKINSON'S, FREE SUMMER SWIM LESSONS FOR NON-SWIMMERS AND BEGINNERS, AND FREE AFTER-SCHOOL STEM PROGRAMS AT OUR SOUTH COUNTY PROGRAM EXTENSION AND ROSEBURG SITES ARE EXAMPLES OF HOW WE DELIVER TRAINING, RESOURCES AND SUPPORT THAT EMPOWER OUR NEIGHBORS TO EFFECT CHANGE, BRIDGE GAPS, AND OVERCOME OBSTACLES. WE PROVIDED OVER 24,000 AFTER SCHOOL AND SUMMER MEALS FOR YOUTH AGES 0 -18. THESE PROGRAMS AND SERVICES WERE SUPPORTED WITH $17,137 IN DIRECT FINANCIAL ASSISTANCE TO INDIVIDUALS IN 2019. THIS YEAR WE ENGAGED 229 VOLUNTEERS PROVIDING 2,740 HOURS OF SERVICE IN ACTIVITIES THAT STRENGTHEN OUR COMMUNITY AND PAVE THE WAY FOR (CONTINUED ON SCHEDULE 0)

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses2,490,619

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	107,633	0	8,110

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) MARISA FINK CEO/EXECUTIVE DIRECTOR	40.0 .......................	X	107,633	0	8,110

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..		1a	2,047
b	Membership dues..		1b	0
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	74,311

f	All other contributions, gifts, grants, and similar amounts not included above		1f	677,950

g	Noncash contributions included in lines 1a - 1f:$		1g	249

h Total. Add lines 1a-1f.......		754,308

		Business Code
2a	Healthy Living	813410	1,951,783	1,951,783
b	Youth Development	813410	412,015	412,015
c	Social Responsibility	813410	61,045	61,045
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		2,424,843

3 Investment income (including dividends, interest, and othersimilar amounts) ......			4,920	0	0	4,920
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents	0	29,942	6a
b	Less: rental expenses	0	17,546	6b
c	Rental income or (loss)	0	12,396	6c
d	Net rental income or (loss).......			12,396	0	0	12,396
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	0	0	7a
b	Less: cost or other basis and sales expenses	2,493	0	7b
c	Gain or (loss)	-2,493	0	7c
d	Net gain or (loss).........			-2,493	0	0	-2,493
8a	Gross income from fundraising events (not including $ 0of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0		0	0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0	0	0	0
10a	Gross sales of inventory, less returns and allowances ..
			10a	6,571
b	Less: cost of goods sold ..		10b	1,182
c	Net income or (loss) from sales of inventory..			5,390	0	0	5,390
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS		813410	54,244	0	0	54,244
b	Wrkrs Comp Insur Surplus Dividend		813410	4,013	0	0	4,013
c				0	0	0	0
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			58,257
12	Total revenue. See instructions.....			3,257,621	2,424,843	0	78,470

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	41,657	41,657
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	300	300
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	115,415	2,175	97,204	16,036
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0	0	0	0
7	Other salaries and wages........	1,523,932	1,332,148	190,131	1,653
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	59,682	46,697	12,942	43
9	Other employee benefits .......	16,632	10,990	5,257	385
10	Payroll taxes ...........	143,567	96,102	25,199	22,266
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	0	0	0	0
c	Accounting ...........	16,000	0	16,000	0
d	Lobbying ...........	0	0	0	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	29,082	15,767	13,315	0
12	Advertising and promotion ....	56,661	48,930	6,082	1,649
13	Office expenses .......	262,307	250,073	9,794	2,440
14	Information technology ......	9,981	986	8,995	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	308,146	305,231	2,915	0
17	Travel ............	27,468	25,783	1,448	237
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	8,017	5,502	2,471	44
20	Interest ...........	0	0	0	0
21	Payments to affiliates .......	43,656	0	43,656	0
22	Depreciation, depletion, and amortization ..	290,716	232,293	46,152	12,271
23	Insurance ...	68,823	63,620	5,203	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	FEES, LICENSES/PERMITS	6,857	5,849	1,008	0
b	BAD DEBT	76,753	2,203	0	74,550
c	RECRUITMENT	5,683	1,836	3,847	0
d	BACKGROUND CHECKS	2,504	2,477	27	0
e	All other expenses	3,175	0	3,175	0
25	Total functional expenses. Add lines 1 through 24e	3,117,014	2,490,619	494,821	131,574
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			187,901	1	53,037
2	Savings and temporary cash investments .........			1,105,034	2	447,539
3	Pledges and grants receivable, net ......			403,409	3	13,982
4	Accounts receivable, net .............			26,855	4	18,351
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			0	8	0
9	Prepaid expenses and deferred charges ......			84,707	9	103,862
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	10,221,057
b	Less: accumulated depreciation	10b	4,290,078	4,587,334	10c	5,930,979
11	Investments—publicly traded securities .			2,600	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 33)...			6,397,840	16	6,567,750

17	Accounts payable and accrued expenses .....	71,744	17	86,007
18	Grants payable ...	0	18	0
19	Deferred revenue .........	44,177	19	56,845
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	24,472	24	19,228
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	0	25	0
26	Total liabilities. Add lines 17 through 25..	140,393	26	162,080

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	4,824,521	27	6,170,712
28	Net assets with donor restrictions ...........	1,432,926	28	234,956
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....	0	29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...	0	30	0
31	Retained earnings, endowment, accumulated income, or other funds	0	31	0
32	Total net assets or fund balances ...........	6,257,447	32	6,405,668
33	Total liabilities and net assets/fund balances ........	6,397,840	33	6,567,748