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 | |||||
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Total |
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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.") .. | 112,252 | 109,755 | 110,838 | 134,879 | 143,054 | 610,778 |
| 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 | 112,252 | 109,755 | 110,838 | 134,879 | 143,054 | 610,778 |
| 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. | 610,778 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 112,252 | 109,755 | 110,838 | 134,879 | 143,054 | 610,778 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 141 | 210 | 183 | 176 | 177 | 887 |
| 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 | 611,665 | |||||
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) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
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| 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 |
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| 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. |
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| 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) |
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| 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. |
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|
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. |
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7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 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 |
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| Return Reference | Explanation |
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| 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-EZ, PART I, LINE 16 | EXPENSES OFFICE 9,450 CONFERENCES/MEETINGS 202 INSURANCE 3,514 PROGRAM EXPENSES 64,149 TOTAL 77,315 |
| FORM 990-EZ, PART II, LINE 24 | OFFICE EQUIPMENT 9,103 9,103 LESS ACCUMULATED DEPRECIATION 9,103 9,103 TOTAL 0 0 |
| FORM 990-EZ, PART II, LINE 26 | PAYROLL TAX WITHHOLDINGS 1,053 1,090 |
| FORM 990-EZ, PART III | TO ENHANCE THE LIVES OF PEOPLE LIVING WITH DOWN SYNDROME, TO ADVOCATE ON THEIR BEHALF, TO PROVIDE INFORMATION AND SUPPORT TO FAMILIES AND PROFESSIONALS, AND TO PROMOTE ACCEPTANCE AND INCLUSION OF PEOPLE WITH DOWN SYNDROME IN NORTHEAST INDIANA. |
| FORM 990-EZ, PART III, LINE 28 | THE DOWN SYNDROME ASSOCIATION OF NORTHEAST INDIANA, INC. (DSANI) PROVIDED SUPPORT AND SERVICES TO OVER 290 MEMBER FAMILIES AND PROFESSIONALS IN THE FOLLOWING AREAS: INFANT-TODDLER PLAYGROUP: THIS PLAYGROUP CREATES OPPORTUNITIES FOR INFANT AND YOUNGSTERS (AGES 0-4) TO PLAY AND SOCIALIZE WHILE THEIR PARENTS AND SIBLINGS FIND SUPPORT IN A FUN ENVIRONMENT. DURING THE YEAR, 60 FAMILIES TOOK PART IN ACTIVITES OFFERED. ACTIVITIES INCLUDED: PLAYGROUPS IN VARIOUS LOCATIONS, AVERAGE ATTENDANCE 16, ANDORFER COMMONS ACTIVITY - 42, KUEHNERT FARMS - 24. BUDDY CLUB: THIS GROUP OFFERS SOCIAL AND RECREATIONAL ACTIVITIES FOR CHILDREN AGES 5-12, TYPICALLY MEETING EVERY THREE MONTHS. CURRENT AVERAGE ATTENDANCE IS 26. ACTIVITIES INCLUDED: ANDORFER COMMONS ACTIVITY - 15, KUEHNERT FARMS - 62, SKYZONE - 25, DANCE COLLECTIVE - 8. FRIENDSHIP CLUB: AIMED AT TEENS AND YOUNG ADULTS AGES 13-21, THIS GROUP INCLUDES TEENS WITH DOWN SYNDROME AND OTHER LEARNING DISABILITIES, AS YOUTHS WITH DS DEVELOP FRIENDSHIPS IN SCHOOL AND IN THE COMMUNITY. AVERAGE ATTENDANCE FOR EVENTS IS 10. ACTIVITIES INCLUDED: ANDORFER COMMONS - 50, SKYZONE - 24, CRAZY PINZ - 24, COMBAT OPS - 16, KUEHNERT FARMS - 60. SELF-ADVOCATES: FOR INDIVIDUALS WITH DOWN SYNDROME WHO ARE 21 OR OLDER. AVERAGE ATTENDANCE FOR SOCIAL EVENTS IS 23. ACTIVITIES INCLUDED: PIZZA & MOVIE NIGHT - 58, SUMMER PARTY - 24, GAME NIGHT - 17, KUEHNERT FARMS - 10, MEAL PREP VOLUNTEERS - 5. GRANDPARENT'S GROUP: THIS GROUP OFFERS A WONDERFUL OPPORTUNITY FOR GRANDPARENTS TO SUPPORT FAMILY MEMBERS AND EACH OTHER IN A NURTURING, CARING ENVIRONMENT. AVERAGE ATTENDANCE IS 8. ACTIVITIES INCLUDED: 6 OFFICIAL MEETINGS WITH AN AVERAGE ATTENDANCE OF 7-10. DADS GROUP - DADS APPRECIATING DOWN SYNDROME. THIS GROUP PROVIDES SPECIAL EVENTS TO BRING TOGETHER DADS IN SUPPORT OF EACH OTHER AND TO BUILD STRONG FAMILIES. AVERAGE ATTENDANCE IS 5. ACTIVITIES INCLUDED: DADS GOLF OUTING - 80, PROVIDED GIFTS FOR THE ALL DSANI HOLIDAY PARTY - GIFTS FOR 153 CHILDREN, BI-MONTHLY MEETINGS - 26. MOMS GROUP - THIS GROUP WAS FORMED TO PROVIDE DSANI MOTHERS THE OPPORTUNITY TO NETWORK WITH OTHER MOTHERS, LISTEN TO GUEST SPEAKERS AND ENJOY TIME WITH OTHER MOMS. AVERAGE ATTENDANCE IS 18. ACTIVITIES INCLUDED: DINNER MEETINGS - 80. OUTREACH: THE OUTREACH COMMITTEE IS UNDOUBTEDLY OUR MOST IMPORTANT, AS THIS IS THE COMMITTEE WHO WELCOMES FAMILIES NEW TO THE WORLD OF DOWN SYNDROME INTO OUR ORGANIZATION. IN 2019, WE CONTINUED MEETING WITH HOSPITALS IN OUR 11 COUNTY SERVICE AREA. THIS WAS DONE TO INTRODUCE DSANI TO THEM, PROVIDE INFORMATION TO THEM FOR WHEN A DOWN SYNDROME DIAGNOSIS IS MADE, AND TO EMPHASIZE THAT THEY ARE CRITICAL IN CONNECTING NEW FAMILIES TO DSANI. IN 2019, WE WELCOMED 11 NEW FAMILIES TO DSANI. OTHER PROGRAM EVENTS: IN ADDITION TO THE SPECIAL-INTEREST OR AGE-SPECIFIC ACTIVITIES THAT DSANI SPONSORED IN 2019, A NUMBER OF OTHER PROGRAMS ALSO MET WITH GREAT SUCCESS. EVENTS INCLUDED: DSANI ANNUAL MEETING - 18; SPONSORED EDUCATIONAL WORKSHOPS IN THE AREAS OF SPECIAL NEEDS TRUSTS/WILLS, CASS HOUSING, MEDICAID WAIVER SERVICES, ABLE ACT UPDATES, RESTAURANT NIGHTS, SELF-ADVOCATE LETTER WRITING NIGHT, ETC. ESTIMATED 65 PEOPLE ATTENDED THESE EVENTS; SPONSORED CAMP RED CEDAR IN JULY AND AUGUST WITH PARTIAL SCHOLARSHIPS FOR 50 CHILDREN; DSANI FAMILY OUTING TIN CAPS GAME - 149; DSANI FAMILY OUTING MAD ANTS GAME - 135; 21ST ANNUAL BUDDY WALK - ESTIMATED 1,500 PLUS 100 AT PRE-PARTY EVENT; SPONSORED A FALL FEST EVENT AT KUEHNERT FARMS - 158; CO-SPONSORED A WORLD DOWN SYNDROME DAY CELEBRATION - 140; PARTICIPATED IN A TRUNK OR TREAT EVENT - 300; SPONSORED ALL DSANI HOLIDAY PARTY - 320; SPONSORED DSANI TALENT SHOW - 48; DSANI FAMILY OUTING OAKWOOD RESORT - 147; BROUGHT DR. BRIAN SKOTKO, A WORLD RENOWNED DOWN SYNDROME EXPERT TO FORT WAYNE TO ADDRESS FAMILIES AND AREA MEDICAL PROFESSIONALS - 180. ALONG WITH OUR MANY GROUPS AND PROGRAMS, DSANI ALSO PROVIDES LIBRARY RESOURCES, INFORMATIONAL EMAILS TO MEMBERS, OUTREACH AND EDUCATIONAL MATERIALS TO MEDICAL PROFESSIONALS AND COMMUNITY GROUPS, RESOURCE REFERRALS TO REQUESTING FAMILIES, A WEBSITE, A DIRECTORY DISTRIBUTED TO MEMBERS. DSANI IS A TREMENDOUS SUPPORT/MENTOR NETWORK FOR PARENTS. IN 2019, DSANI MADE A CONCERTED EFFORT TO BE A PART OF A NUMBER OF COMMUNITY EVENTS AND SPOKE TO A NUMBER OF COMMUNITY GROUPS. THIS INCLUDED SPONSORSHIPS FOR THE FANTASY OF LIGHTS DISPLAY AT FRANKE PARK, A JESTER PERFORMANCE (A THEATER GROUP FOR PEOPLE WITH DISABILITIES) AND THE THREE RIVERS FESTIVAL CHALK WALK. DSANI ALSO PARTCIPATED IN A NUMBER OF AREA RESOURCE AND INFORMATION FAIRS. IT IS ESTIMATED THAT THE NUMBER OF PEOPLE MADE AWARE OF DSANI'S MISSION THROUGH THESE EFFORTS TOTALED OVER 15,000. |
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