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.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 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.") . | 218,148 | 473,510 | 602,864 | 10,424,755 | 10,119,595 | 21,838,872 |
| 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 | 12,537,624 | 11,616,187 | 11,613,628 | 3,021,088 | 2,540,914 | 41,329,441 |
| 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 | 12,755,772 | 12,089,697 | 12,216,492 | 13,445,843 | 12,660,509 | 63,168,313 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 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 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 63,168,313 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 12,755,772 | 12,089,697 | 12,216,492 | 13,445,843 | 12,660,509 | 63,168,313 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,477 | 2,818 | 419 | 34,046 | 4,063 | 43,823 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2,477 | 2,818 | 419 | 34,046 | 4,063 | 43,823 |
| 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.) .. | 54,515 | 27,600 | 18,600 | 100,715 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 12,812,764 | 12,120,115 | 12,235,511 | 13,479,889 | 12,664,572 | 63,312,851 |
| 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 |
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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, PART VI, SECTION A, LINE 7B | THE KEYSTONE GROUP WAS FORMED IN 2010 TO PROVIDE FINANCIAL, HUMAN RESOURCE, MARKETING, PUBLIC RELATIONS AND INFORMATION TECHNOLOGY SUPPORT IN ORDER TO DECREASE ADMINISTRATIVE COSTS FOR MEMBER ORGANIZATIONS. DECISIONS SUBJECT TO APPROVAL BY OTHER PERSONS ARE DETAILED BELOW: MAJOR DECISIONS THAT REQUIRE APPROVAL BY THE KEYSTONE GROUP BOARD: (1) ADOPTING ANNUAL OPERATING OR CAPITAL BUDGETS; (2) AUTHORIZING OFF-BUDGET TRANSACTIONS OF $50,000 OR MORE; (3) ORGANIZING OR ACQUIRING AN AFFILIATE OR SUBSIDIARY, INCLUDING BECOMING THE CORPORATE MEMBER OF ANY OTHER NON-PROFIT ORGANIZATION; (4) AUTHORIZING THE FILING OF ANY RECEIVERSHIP, BANKRUPTCY OR SIMILAR PROCEEDING; (5) AUTHORIZING THE SALE OF OTHER TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (6) AUTHORIZING THE DISSOLUTION, MERGER OR CONSOLIDATION OF THE ORGANIZATION; OR (7) AMENDING THE ORGANIZATION'S ARTICLES OF INCORPORATION OR BYLAWS. MAJOR DECISIONS THAT REQUIRE APPROVAL BY THE KEYSTONE GROUP CEO: (1) AUTHORIZING OFF-BUDGET TRANSACTIONS THAT ARE $10,000 OR MORE, BUT LESS THAN $50,000; (2) BORROWING MONEY, UNLESS ALREADY APPROVED IN THE CURRENT BUDGET; (3) OPENING OR CLOSING LOCATIONS OR SERVICE LINES; (4) AUTHORIZING THE SALE OF ANY REAL ESTATE OWNED BY THE ORGANIZATION; OR (5) AUTHORIZING THE ORGANIZATION TO CONTRACT DIRECTLY OR INDIRECTLY WITH THIRD PARTY PAYERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE EXTERNAL ACCOUNTANTS AND REVIEWED BY MANAGEMENT. ONCE ALL ARE SATISFIED WITH THE FORM, IT IS FINALIZED AND A COPY IS SENT TO ALL BOARD EXECUTIVE COMMITTEE MEMBERS. AT THE SUBSEQUENT BOARD EXECUTIVE COMMITTEE MEETING, THE MEMBERS ARE ASKED IF THEY HAVE ANY QUESTIONS OR COMMENTS AND A GENERAL REVIEW OF THE FORM IS CONDUCTED BY MANAGEMENT. REVISIONS, CORRECTIONS, ETC. ARE MADE AS NECESSARY. SUBSEQUENT TO THIS MEETING THE FORM IS SUBMITTED TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THESE PEOPLE ARE ASKED TO REVIEW THE POLICY AND SIGN A STATEMENT INDICATING THAT THEY UNDERSTAND THE POLICY AND HAVE REPORTED ALL POTENTIAL CONFLICTS DURING THE PAST YEAR IN ACCORDANCE WITH THE POLICY AND WILL REPORT ALL POTENTIAL CONFLICTS DURING THE COMING YEAR. ALL POTENTIAL CONFLICTS ARE EVALUATED BY THE BOARD TO DETERMINE IF A CONFLICT ACTUALLY EXISTS. IN THOSE INSTANCES WHERE THE POTENTIAL TRANSACTION IS A CONFLICT, THE BOARD EXAMINES THE TRANSACTION AND A VOTE IS TAKEN (WITH THOSE INVOLVED RECUSING THEMSELVES) AS TO WHETHER THE ORGANIZATION WILL ENTER INTO THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUALLY THE EXECUTIVE COMMITTEE ON BEHALF OF THE BOARD CONDUCTS A PERFORMANCE REVIEW AND EVALUATION OF THE CHIEF EXECUTIVE OFFICER. THE REVIEW ALSO ESTABLISHES THE INDIVIDUAL'S COMPENSATION FOR THE FOLLOWING YEAR. THIS PROCESS INVOLVES THE EVALUATION OF THE INDIVIDUAL AND A REVIEW OF COMPENSATION OF COMPARABLE POSITIONS OBTAINED FROM COMPENSATION SURVEYS. THE PERFORMANCE APPRAISAL, WHICH CONTAINS COMPENSATION IS THE RECORD OF THE MEETING. THE CHIEF EXECUTIVE OFFICER ESTABLISHES THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND REVIEWS THE PERFORMANCE EVALUATIONS AND RECOMMENDED COMPENSATION WITH THE FINANCE COMMITTEE, ALTHOUGH NO VOTE OF APPROVAL OF THE CHIEF EXECUTIVE OFFICER'S DECISION IS REQUIRED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND BY-LAWS), ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION WILL MAIL COPIES UPON REQUEST OR PROVIDE COPIES TO THOSE WHO COME TO THE ADMINISTRATIVE OFFICE DURING NORMAL BUSINESS HOURS. THE ORGANIZATION CHARGES FOR THE COPIES IN ACCORDANCE WITH IRS REGULATIONS. |
| FORM 990, PART IX, LINE 17 | TRAVEL EXPENSES CONSIST OF COSTS RELATING TO THE TRANSPORTATION OF CLIENTS TO AND FROM THEIR DAY PROGRAMS, AS WELL AS ACTIVITIES AND APPOINTMENTS IN THE COMMUNITY. IT ALSO INCLUDES THE COSTS OF OTHER AGENCY VEHICLES CONDUCTING AGENCY BUSINESS, AS WELL AS MILEAGE REIMBURSEMENTS TO EMPLOYEES CONDUCTING AGENCY BUSINESS IN THEIR PERSONAL VEHICLES. THE BREAKDOWN IS AS FOLLOWS: CLIENT TRANSPORTATION (PAID TO PROFESSIONAL SECURITY SERVICES FOR TRANSPORTING CLIENTS TO/FROM ADULT DAY PROGRAMS) - $114,066 AUTOMOBILE - GASOLINE (FOR AGENCY VANS/VEHICLES) - $46,044 AUTOMOBILE - MAINTENANCE/REPAIRS (FOR AGENCY VANS/VEHICLES) - $30,052 MILEAGE REIMBURSEMENT (REIMBURSING EMPLOYEES FOR TRANSPORTING CLIENTS IN THEIR PERSONAL VEHICLES) - $17,859 TOTAL TRAVEL EXPENSES - $208,021 |
| Software ID: | |
| Software Version: |