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 | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 623,092 | 609,519 | 543,543 | 742,330 | 748,658 | 3,267,142 |
| 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 | 623,092 | 609,519 | 543,543 | 742,330 | 748,658 | 3,267,142 |
| 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. | 3,267,142 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 623,092 | 609,519 | 543,543 | 742,330 | 748,658 | 3,267,142 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 11 | 12 | 23 | |||
| 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.).. | 1,005 | 945 | 972 | 851 | 1,485 | 5,258 |
| 11 | Total support. Add lines 7 through 10 | 3,272,423 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | SALES TAX REFUNDS - 2017 AMOUNT: $ 1,005. 2018 AMOUNT: $ 945. 2019 AMOUNT: $ 972. 2020 AMOUNT: $ 851. 2021 AMOUNT: $ 1,485. |
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Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 3 | IN FY 2014-15, THE CASWELL COUNTY PARTNERSHIP FOR CHILDREN (CCPFC) APPLIED FOR AND WAS AWARDED A THREE-YEAR COMPETITIVE GRANT FROM THE NORTH CAROLINA PARTNERSHIP FOR CHILDREN (NCPC) TO EXPAND THE REACH OUT AND READ (ROR) PROGRAM IN CASWELL COUNTY. THE ROR PROGRAM GIVES YOUNG CHILDREN A FOUNDATION FOR SUCCESS BY INCORPORATING BOOKS INTO PEDIATRIC CARE AND ENCOURAGING FAMILIES TO READ ALOUD TOGETHER. TOGETHER WITH ROR CAROLINAS, CCPFC PARTNERED WITH ONE MEDICAL PRACTICE (CASWELL FAMILY MEDICAL CENTER) TO INCORPORATE ROR INTO REGULAR PEDIATRIC CHECKUPS DURING THE FIRST TWO YEARS OF THE GRANT. A SECOND SITE (CASWELL COUNTY HEALTH DEPARTMENT) WAS ADDED IN THE THIRD YEAR OF THE GRANT. CCPFC HAS CONTINUED TO PARTNER WITH THE TWO MEDICAL PRACTICES SINCE THAT TIME TO PROVIDE THE ROR PROGRAM TO CASWELL COUNTY FAMILIES. CCPFC USES SMART START FUNDING TO SUPPORT PROGRAM OPERATING COSTS AND FUNDING FROM CASWELL COUNTY GOVERNMENT TO PURCHASE BOOKS. IN APRIL 2022, ROR CAROLINAS RELEASED THE REDESIGNED SMART START PARTNERSHIP ROLES AND EXPECTATIONS THAT INCLUDED CHANGES TO KEY ROLES AND RESPONSIBILITIES OF LOCAL PARTNERSHIP STAFF. IN ADDITION, CCPFC WAS INFORMED BY THE ROR CAROLINAS STATE DIRECTOR ON AUGUST 26, 2022 THAT ROR CAROLINAS WOULD BE TAKING OVER FULL SUPPORT OF PROGRAMS IN CASWELL COUNTY. AS A RESULT OF THESE CHANGES, THE EXECUTIVE DIRECTOR HAS COMMUNICATED THE CHANGES TO LEADERSHIP AT EACH MEDICAL SITE AND WORKED WITH SITE COORDINATORS TO CONCLUDE LOCAL ACTIVITIES. CCPFC WILL MOVE FORWARD WITH THE BOOK PURCHASES FOR FY 2022-2023 AND WILL FORMALLY TERMINATE THE ROR ACTIVITY IN THE SMART START CONTRACT ONCE ALL EXPENDITURES HAVE BEEN PAID. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE BOARD DELEGATES AUTHORITY TO AN EXECUTIVE COMMITTEE TO ACT ON ITS BEHALF WITH BROAD AUTHORITY. ALL COMMITTEE MEMBERS ARE BOARD MEMBERS AND INCLUDE THE CHAIRPERSON, VICE-CHAIRPERSON, SECRETARY, TREASURER, PLANNING COMMITTEE CHAIRPERSON, EVALUATION COMMITTEE CHAIRPERSON, PROGRAM COMMITTEE CHAIRPERSON, AND ADVISORY COMMITTEE CHAIRPERSON. THE COMMITTEE EXERCISES ALL AUTHORITY OF THE BOARD WHEN IT IS NOT FEASIBLE TO CONVENE THE BOARD EXCEPT AS LIMITED BY NCGS 55A-8-25, HAS THE AUTHORITY TO HIRE AND DISMISS THE EXECUTIVE DIRECTOR, AND SERVES AS THE FINANCE COMMITTEE AND THE AUDIT COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE BOARD OF DIRECTORS UPDATED THE ORGANIZATION'S BYLAWS AT THE BOARD MEETING ON JUNE 15, 2022. THE CHANGES INCLUDED REMOVING ALL REFERENCES TO THE EX OFFICIO AND ADDRESSING THE DUTIES OF VARIOUS OFFICERS AS WELL AS POLICIES AND PROCEDURES FOR THE VARIOUS COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, THE EXECUTIVE DIRECTOR REVIEWED THE FORM 990 AND ALL SCHEDULES. THE EXECUTIVE COMMITTEE REVIEWED THE FORM 990 AT ITS MEETING IN OCTOBER 2022, PRIOR TO FILING OF THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MEMBER OF THE BOARD AND STAFF IS REQUIRED TO REVIEW A COPY OF THE CONFLICT OF INTEREST POLICY AND TO ACKNOWLEDGE HAVING DONE SO IN WRITING. EACH MEMBER OF THE BOARD SHALL ANNUALLY COMPLETE A DISCLOSURE FORM THAT SHALL BE SUBMITTED AND REVIEWED BY THE EXECUTIVE DIRECTOR. THE FORM IDENTIFIES THE BUSINESSES AND NONPROFIT ORGANIZATIONS OF WHICH THE BOARD MEMBER, THE BOARD MEMBER'S SPOUSE (IF ANY) THE BOARD MEMBER'S SIBLING(S)(OR SPOUSES) OR ANY CHILD OF THE BOARD MEMBER (OR SPOUSE) IS A DIRECTOR, OFFICER, EMPLOYEE OR PARTNER. A WRITTEN ACCOUNTING OF ALL POTENTIAL CONFLICTS OF INTEREST BY BOARD MEMBERS WITH RESPECT TO CCPFC CONTRACTS AND TRANSACTIONS IS AVAILABLE UPON REQUEST. IN ADDITION TO THE STEPS OUTLINED ABOVE, THE POLICY IS REVIEWED AT EACH BOARD AND COMMITTEE MEETING. A CONFLICT OF INTEREST REMINDER IS PRINTED ON EACH AGENDA, "IDENTIFICATION OF BOARD MEMBERS WITH CONFLICTS" IS INCLUDED AS AN AGENDA ITEM, AND THE BOARD/COMMITTEE CHAIRMAN ASKS MEMBERS TO IDENTIFY THEMSELVES PRIOR TO EACH VOTE. THE CCPFC CONFLICT OF INTEREST POLICY WAS REVISED AND ADOPTED BY THE BOARD OF DIRECTORS ON JANUARY 20, 2010. THE POLICY DESCRIBES THE REVIEW OF POLICY AND ANNUAL DISCLOSURE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE SERVES AS THE PERSONNEL COMMITTEE. THE COMMITTEE USES THE SMART START EXECUTIVE DIRECTOR SALARY SCHEDULE IMPLEMENTATION GUIDELINES ESTABLISHED BY THE NC PARTNERSHIP FOR CHILDREN TO DETERMINE ADJUSTMENTS TO THE EXECUTIVE DIRECTOR'S COMPENSATION. THE EXECUTIVE DIRECTOR REVIEWS THE PERFORMANCE OF ALL OTHER EMPLOYEES ON AN ANNUAL BASIS AND MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE REGARDING ADJUSTMENTS TO COMPENSATION. THE EXECUTIVE DIRECTOR REVIEWS SIMILAR POSITIONS AND COMPENSATION FROM LOCAL PARTNERSHIPS IN SURROUNDING COUNTIES AND SIMILAR POSITIONS AT OTHER ORGANIZATIONS WITHIN CASWELL COUNTY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND ARE MAINTAINED IN A PUBLIC NOTEBOOK. |
| FORM 990, PART XII, LINE 1: | THE METHOD OF ACCOUNTING USED TO PREPARE FORM 990 IS MODIFIED-CASH BASIS OF ACCOUNTING. |
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