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.") . | 505,406 | 404,629 | 529,416 | 2,092,278 | 1,915,706 | 5,447,435 |
| 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 | 3,366,871 | 3,394,106 | 2,463,475 | 2,323,022 | 3,722,183 | 15,269,657 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 45,134 | 57,880 | 10,407 | 32,347 | 11,450 | 157,218 |
| 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 | 3,917,411 | 3,856,615 | 3,003,298 | 4,447,647 | 5,649,339 | 20,874,310 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 1,018,605 | 1,018,605 | ||||
| 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.. | 1,018,605 | 1,018,605 | ||||
| 8 | Public support. (Subtract line 7c from line 6.) | 19,855,705 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 3,917,411 | 3,856,615 | 3,003,298 | 4,447,647 | 5,649,339 | 20,874,310 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 47,311 | 38,201 | 46,713 | 43,599 | 56,914 | 232,738 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 47,311 | 38,201 | 46,713 | 43,599 | 56,914 | 232,738 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 31,598 | 49,318 | 11,338 | 37,680 | 38,093 | 168,027 |
| 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.).. | 3,996,320 | 3,944,134 | 3,061,349 | 4,528,926 | 5,744,346 | 21,275,075 |
| 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 - ORGANIZATION'S MISSION | THE LEBANON VALLEY FAMILY YMCA MISSION IS TO PUT CHRISTIAN PRINCIPLES INTO PRACTICE THROUGH PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND AND BODY FOR ALL. WITH A FOCUS OF BEING THE LEADING NON-PROFIT ORGANIZATION IN PROVIDING PROGRAMS, SERVICES AND FACILITIES THAT POSITIVELY IMPACT THE LIVES OF ALL PEOPLE FROM INFANTS TO SENIORS WITHIN OUR SERVICE AREA BY CREATING A HEALTHY, NURTURING, LEARNING ENVIRONMENT THAT FOSTERS POSITIVE DEVELOPMENT IN ALL ASPECTS OF LIFE. AS PART OF OUR MISSION OUR PROGRAMS ARE ACCESSIBLE, AFFORDABLE, AND OPEN TO ALL FAITHS, BACKGROUNDS, ABILITIES AND INCOME LEVELS. WE PROVIDE FINANCIAL ASSISTANCE TO PEOPLE WHO OTHERWISE MAY NOT HAVE BEEN ABLE TO AFFORD TO PARTICIPATE. |
| FORM 990, PAGE 2, PART III, LINE 4A | HEALTHY LIVING - THE YMCA IS A LEADING VOICE ON HEALTH AND WELL-BEING. WE BRING FAMILIES CLOSER TOGETHER, ENCOURAGE GOOD HEALTH AND FOSTER CONNECTIONS THROUGH FITNESS, SPORTS, FUN AND SHARED INTERESTS. AS A RESULT, PEOPLE IN OUR COMMUNITY ARE RECEIVING THE SUPPORT, GUIDANCE AND RESOURCES THEY NEED TO ACHIEVE GREATER HEALTH IN SPIRIT, MIND AND BODY. THIS IS EVEN MORE IMPORTANT TODAY AS OUR COUNTRY STRUGGLES WITH AN ONGOING PANDEMIC, FAMILIES STRUGGLE WITH ONGOING ECONOMIC CHALLENGES AND INDIVIDUALS SEARCH FOR WAYS TO RECONNECT. OUR YMCA MEETS THOSE NEEDS BY PROVIDING PROGRAMS SUCH AS KNIGHTS OF THE 21ST CENTURY - MEN'S CHRISTIAN ROLE MODEL PROGRAM. OUR YMCA PARTNERS WITH OUR HOMELESS SHELTERS AND WOMEN'S SHELTER TO PROVIDE A SAFE OUTLET FOR INDIVIDUALS AND FAMILIES TO COME AND BE PART OF THE Y FAMILY. WORKING WITH THE OTHER LOCAL NON- PROFITS, WE ARE ABLE TO OFFER RESOURCES SUCH AS SPACE AND STAFFING TO HELP FAMILIES WITHIN OUR COMMUNITY. |
| FORM 990, PAGE 2, PART III, LINE 4B | YOUTH DEVELOPMENT - OUR YMCA IS COMMITTED TO NURTURING THE POTENTIAL OF EVERY CHILD AND TEEN. WE BELIEVE THAT ALL KIDS DESERVE THE OPPORTUNITY TO DISCOVER WHO THEY ARE AND WHAT THEY CAN ACHIEVE. THAT IS 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 SCHOOL AGE CHILD CARE, THE HALLMAN YOUTH CENTER AND KIDS KORNER OFFER A RANGE OF EXPERIENCES THAT ENRICH COGNITIVE, SOCIAL, PHYSICAL AND EMOTIONAL GROWTH. NEW THIS YEAR, CAMP ROCKY CREEK OFFERED CHILDREN FROM THE SURROUNDING REGION AN OPPORTUNITY TO PARTICIPATE IN SUMMER AND RESIDENT CAMP. BEGINNING JAN 2021, THE YMCA ENTERED INTO A LEASE AGREEMENT WITH THE COUNTY OF LEBANON FOR THE USE OF CAMP ROCKY CREEK WITH A RENTAL FEE OF 1.00 PER YEAR FOR A TERM OF 99 YEARS. THE FMV OF THE USE OF PROPERTY IS 36,000 PER YEAR. |
| FORM 990, PAGE 2, PART III, LINE 4C | SOCIAL RESPONSIBILITY - OUR YMCA BELIEVES IN GIVING BACK AND SUPPORTING OUR NEIGHBORS. WE HAVE BEEN LISTENING AND RESPONDING TO OUR COMMUNITY'S MOST CRITICAL SOCIAL NEEDS. YMCA PROGRAMS, SUCH AS MONDAY'S MARKET, ARE EXAMPLES OF HOW WE DELIVER FRESH FRUIT AND VEGETABLES TO OUR COMMUNITY AT A LOW PRICE. WE ENGAGE YMCA MEMBERS, PARTICIPANTS AND VOLUNTEERS IN ACTIVITIES THAT STRENGTHEN OUR COMMUNITY AND PAVE THE WAY FOR FUTURE GENERATIONS TO THRIVE. SOME PROGRAMS THAT WE PROVIDE IMPACTING OUR SOCIAL RESPONSIBILITIES ARE: THE EDWARD AND JEANNE ARNOLD EARLY LEARNING CENTER, FREER FAMILY YOUTH CENTER, A HEALTHY YOU - HEALTHY LIFESTYLES PROGRAM, FREE LUNCH SUMMER FOOD PROGRAM, AND THE LEBANON COUNTY SENIOR GAMES. THIS PAST YEAR IN PARTNERSHIP WITH OUR COUNTY COMMISSIONERS AND PRIVATE DONATIONS, WE REVITALIZED A CAMP WHICH HAD BEEN CLOSED AND OFFERED TEN WEEKS OF CAMPING FOR KIDS. |
| FORM 990, PAGE 6, PART VI, LINE 2 | JAMIE HANFORD SCOTT HANFORD DIRECTOR DIRECTOR BROTHERS |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ALL ASSOCIATION BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE QUESTIONNAIRES ARE REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE ASSOCIATION BOARD OF DIRECTORS WHEN AND IF A CONFLICT EXISTS, THE AFFECTED BOARD MEMBER IS REMOVED FROM THE DECISION MAKING PROCESS OF ANY ISSUE THAT MAY RESULT IN A POTENTIAL OR PRECEIVED CONFLICT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | BOARD REVIEWS AND APPROVES ON AN ANNUAL BASIS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD REVIEWS AND APPROVES ON AN ANNUAL BASIS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND OTHER FINANCIAL STATEMENTS AVAIALBLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | TRUSTEE FEES -9,723 TRUSTEE FEES 9,723 |
| Software ID: | |
| Software Version: |