1 Kinexus - Berrien Community Foundation

Transcription

Frederick S. Upton Foundation
5/13/2016 Grant Summary Sheets
Education
1
Kinexus
Benton Harbor, MI
Amount Requested:
$64,160.00
Summary: Funding is requested to support the Learn to Achieve Potential Program and
staffing.
Additional Information:

The funding will support the salary of one full time vocational training specialist and
a part time driver.

Kinexus received a grant from the Annie Casey Foundation which requires a local
match to secure. This would help secure the funds.

The students in the the Bridge Acadelmy are interested in some training certifications
that are done in Van Buren County but not available locally – culinary arts,
hospitality, welding and construction. The students would be driven to the program in
Van Buren County every day to receive the training.

The part-time employee is the driver.

The program would work with about 20 kids. The vocational trainer would have
additional students to make a full case load.

The Annie Casey grant specifies work with students who are homeless, from foster
care or adjudicated youth. About 80% of the Bridge Academy students meet the
criteria.

The Jobs for Michigan Graduates program works with in-school youth. The Bridge
Academy works with out of school youth

The salary and fringe benefits requested are at about 50% of the salary amount.

Administrative costs is company overhead.

The student wages are to pay the students as they learn and have an on-the-job
training experience.
FREDERICK S. UPTON FOUNDATION
100 RIDGEWAY
ST. JOSEPH, MICHIGAN 49085
(269) 465-6939
Please submit 3 paper copies of
application and all attachments and
one electronic copy. Email to
uptonfoundation@
berriencommunity org
GRANT APPLICATION
To be considered as a recipient of a Foundation Grant, this application must be completed and
returned to the Frederick S. Upton Foundation, accompanied by copies of any reports or
information, as requested by this Grant Application. If there is an omission of any reports or
information, the Grant Application shall not be accepted for consideration. Please note: Awarded
funds cannot be used to pay any form of fees to grant writers or others for obtaining the grant.
MUST BE TYPED.
For your request to be considered by the Trustees at the next meeting of the Frederick S. Upton
Foundation, the Grant Application must be submitted or postmarked by the 15th of March,
June or October.
Please submit only one grant annually.
Date: March 11, 2016
Organization: Berrien-Cass-Van Buren Workforce Development Board, DBA “Kinexus”
Contact Person/Title: Stephannnie Harvey-Vandenberg
Phone:
(269)
277-5122
ext. 1421 Fax:
E-mail Address: [email protected]
Address (Principal Administrative Office): 499 W. Main Street
City/State/Zip: 49085
1. Amount Requested: $64,160
2. Enclose the following documents:
X Auditor’s Statement or Financial Report
X List of Board of Directors with affiliations
X Operating Budget for organization AND specific program
X IRS Determination Letter indicating 501c(3) tax-exempt status
3. Briefly describe your organization’s Mission Statement and Programs: (No more than 2
pages –
12 pt. type, double spaced.)
Kinexus is an organization of change agents that invests its time and resources
into creating integrated solutions for business, workforce, and community challenges to
promote economic vitality in the Southwest Michigan region. To achieve our mission,
Kinexus is guided by five strategic imperatives or “SI5”, which is the core of our business
strategy. SI5 was developed in collaboration with our business-led board, and is the
framework that guides the organization to promote sustainable and systemic impact in the
communities we serve. It hinges on strong internal capacity to leverage the
interdepencies of business, talent, and place.
The 5 Strategic Imperatives are: SI1: Living our Values; SI2: Investing in our People; SI3:
Continuous Improvement; SI4: Rigorous Portfolio Management; and SI5: Integrating
Business, Talent, and Place. In recognition of our impactful work, the organization was
recently named the MiBiz Best-Managed Non-Profit for $3 million and higher.
Within the Kinexus Talent Division, there are three primary programs (Michigan
Works!, Bridge Academy, and Jobs for Michigan’s Graduates) that impact youth and
adults living in Berrien, Cass, and Van Buren Counties. This grant application requests
support for youth services provided by the Bridge Academy and Jobs for Michigan’s
Graduates. The Bridge Academy is an out of school youth vocational training program
which offers a continuing high school diploma completion and GED program. In
partnership with the Clinton Global Initiative, we are privileged to provide academic
scholarships to trainee’s enrolled into our Career Online High School Diploma program.
Whereas we would like to introduce an even more diverse certified, industry demand job
training and work experience opportunities, we currently offer vocational training in four
distinct areas: manufacturing, construction, health care, and retail/customer service. Upon
enrollment at the Bridge Academy, trainees complete academic assessments and entry
level vocational workshops, including earning the National Career Readiness Certificate.
Staff, trainees, and their parents/guardians work together to develop an individualized
academic and vocational plan. Integrated vocational trainings are offered trainees with a
grade equivalency of 3.5-12.9. This allows those with a lower grade equivalency to
increase their academic performance while learning a trade. For those trainees meeting
additional grade level equivalency and/or transferable high school credits the GED or
-2-
Career Online High School Diploma are also offered. To being able to further offer an
additional accredited high school diploma program to trainee’s which may be ineligible for
COHS or unable to successfully complete the GED due to lack of transferable credits,
learning disabilities, low-functioning mental health issues; however, are committed and
interested in a career option that would require no more than a certificate for an entry
level work position we would extend our new Stepping Stones diploma. Soon after
enrollment, trainees also required to engage in weekly, Friday Service Learning, (FSL).
This program was designed for trainees to explore jobs in High Demand Industry or selfexpressed area of career interest. Jobs for Michigan’s Graduates (JMG) is a statebased dropout prevention and recovery affiliate of the national Jobs for America’s
Graduates (JAG) organization with headquarters in Benton Harbor. Incepted in 2008,
JMG (www.jobsformigrads.org) has been rapidly increasing programming through
commitments from the private and public sectors. In the past two years, the program has
experienced 300% growth in total students served. This year, the program will serve 1600
students across 25 Michigan cities including Benton Harbor, Dowagiac, Cassopolis, and
Hartford. In February 2016, JMG was awarded $190,000 per year over a three year
period from the Annie E. Casey Foundation. The funding will expand JMG programming
with an emphasis on system-involved youth in Benton Harbor, Detroit, and Flint. With
strong population overlap at the Bridge Academy, JMG will provide services to Bridge
Academy youth meeting one or more of the following criteria: foster care, homelessness,
or adjudicated. The foundation funding requires a 1:1 local match. Funding awarded by
the Frederick S. Upton Foundation in alignment with this grant request would be used as
matched funds and publicized accordingly.
4. Date your organization was established: 1984
-3-
5. If your organization has received a grant from the Frederick S. Upton Foundation before,
indicate
Date, Amount and Purpose in the table below. (Add to the table as needed)
Date
12/1/2014
7/3/2012
12/9/2011
Amount
$10,000
$30,000
$40,000
Purpose
Purchase of GED software.
Get SET Manufacturing
Culinary Arts Program
6. Describe the specific Project for which this current grant is sought, and the need it is intended
to address: (Please limit to no more than 5 pages – 12 pt. type, double spaced):
The Learn to Earn to Achieve Potential program will enhance and expand vocational
training offerings, provide transportation to these trainings, and ensure that trainees have
a seamless and fluid transition from enrollment through to employment. More specifically,
the Fred Upton Foundation Grant contributions will also support Friday Service Learning
placement, attendance incentives, and paid work experience opportunities aligned to
trainees individual interest. This also includes the addition of a vocational specialist intern
in order to assist and administrative support to the Bridge Academy staff and trainees.
See the table below for training programs offered, along with certifications, and length of
program. Some program lengths may be shortened through offering intensive training
options.
Industry
(by National
Career Cluster)
Health Science
Course Name
Fundamentals of
Patient Care
Certification
Michigan OBRA
Nurse Aide State
-4-
Proposed
Length of
Program
1 year program
(2 hrs a day, 5
Certification
(C.N.A)
days a week)
Health Science
Emergency
Precision Exam
Medical
(EMT)
Technician (EMT)
1 year program
(2 hrs a day, 5
days a week)
Hospitality &
Tourism
Culinary Arts &
Catering
Management
ServSafe &
ProStart Levels I &
II (National
Restaurant
Association)
1 year program
(2 hrs a day, 5
days a week) +
special
events/catering
Manufacturing
Welding
New certification
for students
coming- a 1 year
certification that
could be renewed.
2 year program
Manufacturing
Polymer
Technologies
(Plastics)
No certification at
this time
2 year program
Transportation,
Distribution &
Logistics
Auto Body
ASE (Automotive
Service
Excellence) &
NATEF certified
(vehicle exteriors)
1 year program
(2 hrs a day, 5
days a week)
Transportation,
Distribution &
Logistics
Auto Technician –
BES (Brakes,
Engines and
Suspensions)-
State of Michigan
1 year program
Automotive
Technician
Certification exams
(1st year)
Transportation,
Distribution &
Logistics
Auto TechnicianEEP (Electrical &
Engine
Performance)
State of Michigan
2nd year of the
Automotive
Auto Tech
Technician
program.
Certification exams
(1st year)
-5-
The Jobs for Michigan’s Graduates (JMG) program will be an integral component of the
LEAP initiative in ensuring graduation success for Bridge Academy trainees with
transition into post-secondary education and/or employment. Through joint funding
provided by the Annie E. Casey Foundation’s LEAP initiative and the Frederick S. Upton
Foundation, JMG will hire a full-time Specialist to work at the Bridge Academy (hire start
date on or after April 1, 2016). The JMG Specialist would offer a comprehensive set of
services designed to supplement the work already underway at the Bridge Academy. The
goals of service delivery are to keep the trainees in school and improve the rate of
success in achieving education and career goals. Core service delivery components
offered through JMG include:
● Instruction: Individual and group instruction to approximately 40 trainees utilizing
the JAG National Out-of-School Model curriculum. The competency-based
curriculum emphasizes soft skill development as well as career readiness and
employability.
● Adult Mentoring: Individual attention to students to overcome barriers that prevent
them from completing requirements for a diploma/GED and/or securing
employment or pursuing post-secondary education. The Specialist will work in
close partnership with the Bridge Academy’s Support Services Coordinator.
● Advisement and Support: The Specialist will over advice and support as students
make significant career and life decisions and serve as a "one-stop" connection for
trainees to personal, psychological, and other youth services in the community.
● Employment Training / Work Experiences: Job placement will be provided to
Bridge Academy trainees meeting readiness requirements.
-6-
● Student-Led Leadership Development: A highly motivational student-led
organization – the Jobs for Michigan’s Graduates Career Association – provides
opportunities for students to develop demonstrate and refine their leadership and
team membership skills.
● Job and Post-secondary Education Placement Services: The Specialist will
identify job opportunities and work in tandem with the Bridge Academy’s
Vocational Specialist. The specialist will also work on behalf of the graduates and
assist graduates in the exploration of post-secondary education opportunities and
help graduates navigate the financial aid enrollment process to pursue a degree.
● Follow-up Services: The Specialist will provide no less than twelve months of
follow-up services and support to graduates for employment and/or post-secondary
enrollment.
● Accountability System: A comprehensive, national Internet-based tracking and
reporting system tracks vital performance-related data.
9. Who and how many people will be affected?
Up to twenty youth ages 16 – 24 will be affected by this grant. All youth will be enrolled at
the Bridge Academy in Benton Harbor, or will be participating in off-site locations in Paw
Paw, Dowagiac, or Lawrence. To qualify for participation, trainees must meet at least one
of the following criteria: 1. System-involved youth, inclusive of youth who are homeless, in
foster care, or have been involved in the court system; or 2. Dropped out of traditional
education and seeking re-enrollment.
Funding received through this grant award will be leveraged against funding from the
Annie E. Casey Foundation, Coloma Community Schools, Benton Harbor Area Schools,
United Way of Southwestern Michigan, the State of Michigan’s Workforce Development
-7-
Agency, and the Department of Labor YouthBuild program. The matched funding from the
Frederick S. Upton Foundation will provide critical foundational support for a collective
effort across Benton Harbor, Detroit, and Flint to educate and employ hundreds of at-risk
youth. The benefits for Michigan employers and eased burden on Michigan taxpayers are
too innumerable to measure.
7. Has your board approved this application?
Date Approved: March 11, 2016
YES X
NO ☐
8. What measurable Benefits will be derived from this project?
(Please limit to no more than 2 pages – 12 pt. type, double spaced)
In addition to the LEAP Grant outcomes, the participants in this program will benefit from:
❏ 100% of enrolled program participants will be provided transportation to and from
vocational training campus.
❏ 60% of enrolled program participants will be placed on paid work experiences
❏ 100% of enrolled program participants will receive job coaching
❏ 80% of enrolled program participants will have one or more barrier removed to
successful employment.
❏ Additionally, the metrics that would be used would be:
❏ 50% vocational training program expansion
❏ 50% Total number of increased job training, work experience and service
learning/job shadowing opportunities
❏ Benefits local and regional out of school youth and aligned with work experience
program
LEAP initiative participants enrolled in JMG programming (as designated through
enrollment in the JAG National Electronic Database Management System) will be
measured on the following in-process performance outcomes:
-8-
●
60% of program participants will conduct a minimum of 10 hours of work based
learning aligned to demand industries;
●
60% of program participants will earn an industry recognized credential;
●
60% of program participants will participate in a minimum of one Michigan Advanced
Technician Training Program workshop;
●
75% of program participants will participate in a minimum of three Talent Tours
aligned
to
the
following
demand
industries:
skilled
trades,
manufacturing,
transportation, IT, hospitality, and/or health care.
LEAP initiative participants enrolled in JMG programming will also be measured on the
following follow-up performance outcomes:
●
50% GED and/or high school graduation rate;
●
80% positive outcome rate, including: employment, post-secondary education
enrollment, and/or the military;
●
60% employed in a job in the public or private sector;
●
60% employed in a full-time job;
●
80% employed in a full-time placement;
●
30% pursuit of post-secondary education
10. What other organizations have provided a similar or related service?
Currently, there are not any other non-profit organizations that provides similar or
related services to this targeted population in our local or regional area with the exception
of Job for Michigan Graduates (JMG), which we are partnering.
Have you explored the possibilities of collaborative efforts?
If NO, why?
-9-
YES X
NO ☐
11. If this is a new activity for your organization, what has been learned from research of similar
programs?
As reflected in this application, extensive research has demonstrated to us the value
and
importance of the JMG program model. We have and are actively researching the
Delancy
Foundation and Manchester Bidwell organizations, as they have similar vocational
focuses.
12. Outline the proposed budget for this specific program: (In addition, See attached budget form)
Total Program Budget: $92,287
Grant Request: $64,160
13. Provide the following financial data for your organization:
Current Year Budget Summary
Audited Prior Year Summary
Income
Income
Expenses
Year
9,988,816
9,988,816
2015-2016
9,173,866
Expenses
9,205,332
Fund Balance
Year
$354,264
2014
14. List other sources that are being approached to fund this project: (Add to table as needed)
Source
Annie E. Casey Foundation
Workforce Development Agency – State
of Michigan
YouthBuild
United Way of Southwest Michigan
Amount
Current Status
1.1
million
$80,000
Awarded
$63,333.00
$20,000
-10-
Awarded
Awarded
Awarded
15. What is the timetable for program implementation?
Timeline for implementation:
By April 30, 2016:
●
Select, on-board, and train a JMG Specialist to serve LEAP trainees at the Bridge
Academy.
●
Finalize formalized referral process with Michigan Youth Opportunities
Initiative/Department of Health and Human Services for referral of LEAP eligible
trainees.
●
Finalize agreement with Van Buren Intermediate School District for facility usage.
Beginning May 1, 2016:
●
Conduct outreach and recruitment strategies; engage process partners for referrals.
●
JMG Specialist begins working with LEAP trainees at Bridge Academy with minimum
target of 20 participants to begin program.
●
Conduct an survey assessment to trainee’s to determine enrolled trainee’s track
By June 30, 2016:
●
Issue press release in partnership with Frederick S. Upton Foundation, Annie E.
Casey Foundation, Kinexus Bridge Academy, and Jobs for Michigan’s Graduates to
announce funding.
●
Begin Auto-Technician, auto body, manufacturing and culinary pilot program
●
Begin construction training program
●
Program evaluation and performance assessment from Annie E. Casey Foundation.
●
Specialist participates in JAG National Training Seminar (July 2016)
-11-
By October 31, 2016
● Enrollment up to a minimum of 35 trainee’s
By November 2, 2016:
●
By February 28, 2017:
●
Increase enrollment to a minimum of 45 trainee
By March 30, 2017:
●
Increase enrollment to a maximum of 50 trainee’s
●
End first year of programming with Annie E. Casey Foundation and submit request to
extent to second year.
●
16. If this is to be an ongoing activity, how are you going to support the program beyond this
grant?
Currently, we have secured funding through both local and federal sources to support
this program over the next three years. Moreover, we have secured foundational funding
for the next year, with an opportunity to renew for the next two. It is our goal that with the
success of this program through the funding support from the Fredrick S. Upton
Foundation, both the JMG and Bridge Academy would look to restructure our current
operational budgets and identify other funding partners to continue to either sustain
and/or enhance the program as written.
17. How will you evaluate the real and measurable impact and extent to which the project’s
objectives have been achieved?
● Participant surveys (Survey Monkey) and analysis
● Partner survey (Survey Monkey) and analysis
-12-
● Number of industry recognized certifications and credentials
● Weekly driving logs
● Intern project log
18. How many full-time staff members, part-time staff members and volunteers are involved in this
project?
Full-time: 1.5
Part – time:
Volunteers:
2
10
-13-
Frederick S. Upton Foundation: Grant Project Budget Form
Agency:
Bridge Academy
Amount Requested:
$64,160
Below is a listing of standard budget items. Please provide the program/project budget on this
form and attach to each copy of the grant application submitted.
A. Organizations fiscal year:
July 1 to June 30
B. Time period this budget covers: April 1 2016 to
June 30, 2017
C. Expenses: include the total amount for each of the following budget categories:
Amount Requested Total Program Expense
Salaries
$33,175
139,050
Payroll Taxes
Fringe Benefits
$9,764
$55,620
Consultants & Professional Fees
Stipends
Insurance
Travel
$9,000
Equipment
$3,700
Supplies
$4,670
Printing & Copying
$3,250
Telephone & Fax
$2,600
Rent
Utilities
Maintenance
Evaluation
Marketing
$4,000
Other (specify) - Student Work Experience Wages $16,800
$16,800
Other (specify) – Administrative
$4,421
$8862
$64,160
$247,552
Totals
D. Revenue: include the total amount for each of the following budget categories, in this order; please
indicate which sources are committed and which are pending.
Received:
Grants/Contracts/Contributions
Local Government
State Government
Federal Government
Foundations
Corporations
Church Groups
Individual Donations
Earned Income from Events
In-kind Support
Other (specify) United Way
Other (specify)
Total Revenue
Amount Received
$100,300
$30,050
$46,700
$5,000
$182,050
Pending:
Amount Pending
Frederick S. Upton Foundation
Grant History by Organization
Decision Date
Description
Request
Grant
Terms
$10,000.00
one-year challenge
Kinexus
14-Aug-09
to support the Adult Education Program
$21,662.00
Challenge
03-Jul-10
to support computer software & equipment for
the Community Career Academy
$70,000.00
$50,000.00
Grant
09-Dec-11
to support the culinary arts program at the Bridge
Academy
$70,600.00
$15,000.00
1-yr challenge; accompanies a $25K
grant.
Challenge
09-Dec-11
to support the Culinary Arts Program at the
Bridge Academy
$70,600.00
$25,000.00
includes a $15,000 one-year
challenge
Grant
03-Jul-12
to support the Get SET Manufacturing program
$50,000.00
$30,000.00
Grant
23-May-14
Kinexus as fiscal agent for BH Parks &
Recreation - play equipment for three parks
$60,000.00
$15,000.00
one-year challenge
Challenge
01-Dec-14
to support housing rehabilitation costs and
microloan support
$51,800.00
$20,000.00
1-year challenge; accompanies a
$10K grant for GED software
Challenge
Monday, April 11, 2016
Page 1 of 2
Decision Date
Description
01-Dec-14
Request
for the purchase of GED software
$51,800.00
Grant
Terms
$10,000.00
Grant
15-Mar-16
to support the Learn to Achieve Potential
Program
Total by
SusanM
Monday, April 11, 2016
$175,000.00
Kinexus
Grand Total
$64,160.00
9
$175,000.00
Name Like "*Kinexus"
Page 2 of 2
Kinexus
Funding and Expenditures
Kinexus Budget
Bridge Academy
Funding
$
1,196,276
PY 15-16
$
9,988,816
Employee Related Expenditures
Salaries & Wages
Employee Benefits and Wages
Sub-total Employee Related
588,291
237,121
825,412
3,736,201
1,261,930
4,998,131
General Expenditures
Professional Fees
Equipment & Software
Telecommunications
Marketing & Public Relations
Travel, Conferences & Training
Supplies & Postage
Occupancy Expense
Miscellaneous Expense
Sub-total Expenditures
15,000
22,103
33,700
5,000
30,465
22,850
114,337
3,347
246,802
183,000
464,103
182,140
165,802
296,100
103,275
816,200
9,105
2,219,725
Direct Program
124,062
2,770,960
Total Expenditures
$
1,196,276
$
9,988,816
3/7/2016
Board of Directors
BERRIEN COUNTY:
Paul Bergan
Lake Michigan College Board of Trustee
6158 Sandy Hill Drive
Eau Claire, MI 49111
Phone 269.461.6693
Cell 269.921.8362
Fax 269.471.9731
Email [email protected]
Tim Calhoun (Treasurer)
Vice President Finance & C.F.O.
Lakeland Regional Health System
1234 Napier Avenue
St. Joseph, MI 49085
Phone 269.983.8398
Cell 269.930.8398
Fax 269.982.4855
John Janick
Senior Vice President
PNC Bank
500 Momany Drive
Phone 269.429.6420
Phone 269.983.9040
Bob Kara
Ironworker Business Manager
Ironworkers Local #292
3515 Boland Drive
South Bend, IN 46628
Phone 574.288.9033
Cell 574.339.2909
Fax 574.288.9033
David Colp
Lead Pastor
First Church of God
2627 Niles Avenue
Phone 269.983.1524
Cell 269.519.8319
Jim Kodis
President
Regal Finishing Co., Inc.
3927 Bessemer Road
Coloma, MI 49038
Phone 269.849.2963
Cell 269.876.7750
Fax 269.849.0142
Jeff Curry
Vice President of Operations
United Federal Credit Union
2807 South State Street
Phone 269.982.1400
Direct 269.982.4701
Cell 269.208.8598
Kathy Valdes
Director
Berrien County Depart of Human Services
401 Eighth Street
Benton Harbor, MI 49022
Phone 269.934.2111
Fax 269.934.2115
Cell 269.235.2354
Jim Finan
Manager, Economic & Business
Development
I & M/AEP
2929 Lathrop St.
Phone 574.236.4965
Cell 574.807.2117
Fax 574.236.1650
CASS COUNTY:
Bill Haase
Assistant Business Manager
IBEW Local 153
56475 Peppermint Road
Phone 574.287.8655 X13
Cell 574.532.9995
Fax 574.233.5234
Board of Directors
David Mathews
President
Southwestern Michigan College
58900 Cherry Grove Road
Dowagiac, MI 49047
Phone 269.782.1270
Cell 269.470.9969
Fax 269.782.1481
Chris Randall (Chair)
CEO
Randall Residence
300 W. White Oak Rd
Lawton, MI 49065
Phone 269.624.4811
Cell 269.377.8111
Fax 269.624.7368
John Ryder (Vice Chairperson)
Chief Operating Officer
Borgess-Lee Memorial Hospital
420 W. High Street
Dowagiac, MI 49047
Phone 269.783.3082
Fax 269.783.3044
Cell 269.270.5885
Arnie Redsicker
President
ROSTA USA CORP.
1425 Kalamazoo Street
South Haven, MI 49090
Phone 269.924.0954
Cell 269.870.0220
VAN BUREN COUNTY:
David Glynn
Human Resources Manager
Special-Lite, Inc.
88448 CR 668, PO Box 6
Decatur, MI 49045
Phone 269.423.7068
Fax 269.423.6127
George Saleeby
Chief Executive Officer
Swing-Lo Systems
P.O. Box 128
75609 County Road 376
Covert, MI 49043
Phone 269.764.8989
Cell 269.757.2796
Fax 269.764.8897
Jeffrey Mills
Superintendent, Van Buren ISD
490 S. Paw Paw
Lawrence, MI 49064
Phone 269.674.8091
Cell 269.208.2493
Fax 269.674.8030
Randall Peat
Owner
Randall Peat Farms
47802 45th Street
Paw Paw, MI 49079
Phone 269.657.4106
Cell 269.598.9252
Lake Superior 906.492.3838
CEOB MEMBERS:
BERRIEN:
Jeanette Leahey
Berrien County Commissioner
2985 E. Bluffwood Terrace
Phone 269.429.6349
Cell 269.369.1225
Fax 269.429.9072
Mamie Yarbrough
Berrien County Commissioner
228 Territorial Road, #2
Benton Harbor, MI 49022
Phone 269.925.2669
Cell 269.519.3061
Board of Directors
CASS:
Bob Wagel (Chair, CEOB)
Cass County Commissioner
53725 O’Keefe Road
Dowagiac, MI 49047
Phone 269.782.6111
Cell 269.462.0348
Fax 269.445.8978
Bernie Williamson
Cass County Commissioner
26260 M-60
Cassopolis, Mi 49031
Phone 269.445.9100
Cell 269.445.7017
VAN BUREN:
Don Hanson
Van Buren County Commissioner
75406 56th Street
Decatur, MI 49045
Phone 269.674.8780
Cell 269.760.9366
Fax 269.674.8780
Mike Toth
Van Buren County Commissioner
51640 35th ½ Street
Paw Paw, MI 49079
Phone 269.655.1814
Cell 269.720.2401* Best # to call
Email [email protected]@aol.com
Rev. 07.29.15
Form
990
Return of Organization Exempt From Income Tax
OMB No. 1545-0047
| Do not enter Social Security numbers on this form as it may be made public.
Open to Public
Inspection
Department of the Treasury
Internal Revenue Service
| Information about Form 990 and its instructions is at www.irs.gov/form990.
JUL 1, 2013
A For the 2013 calendar year, or tax year beginning
and ending JUN 30, 2014
B
C Name of organization
Check if
applicable:
Address
change
Name
change
Initial
return
Terminated
Amended
return
Application
pending
2013
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
D Employer identification number
BERRIEN-CASS-VANBUREN WORKFORCE
DEVELOPMENT BOARD, INC
KINEXUS GROUP
Doing Business As
Number and street (or P.O. box if mail is not delivered to street address)
499 W. MAIN STREET
38-3287818
Room/suite E Telephone number
City or town, state or province, country, and ZIP or foreign postal code
G
Activities & Governance
49022
H(a) Is this a group return
F Name and address of principal officer:CHRIS RANDALL
Yes X No
for subordinates? ~~
SAME AS C ABOVE
H(b) Are all subordinates included?
Yes
No
) § (insert no.)
501(c) (
4947(a)(1) or
527
I Tax-exempt status: X 501(c)(3)
If "No," attach a list. (see instructions)
H(c) Group exemption number |
J Website: | WWW.KINEXUS.ORG
Trust
Association
Other |
K Form of organization: X Corporation
L Year of formation: 1984 M State of legal domicile: MI
Part I Summary
1 Briefly describe the organization's mission or most significant activities: SEE SCHEDULE O
2
3
4
5
6
7a
b
BENTON HARBOR, MI
800-533-5800
9,173,866.
Gross receipts $
Check this box |
if the organization discontinued its operations or disposed of more than 25% of its net assets.
3
Number of voting members of the governing body (Part VI, line 1a) ~~~~~~~~~~~~~~~~~~~~
4
Number of independent voting members of the governing body (Part VI, line 1b) ~~~~~~~~~~~~~~
5
Total number of individuals employed in calendar year 2013 (Part V, line 2a) ~~~~~~~~~~~~~~~~
6
Total number of volunteers (estimate if necessary) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total unrelated business revenue from Part VIII, column (C), line 12 ~~~~~~~~~~~~~~~~~~~~ 7a
Net unrelated business taxable income from Form 990-T, line 34 •••••••••••••••••••••• 7b
Net Assets or
Fund Balances
Expenses
Revenue
Prior Year
8
9
10
11
12
13
14
15
16a
Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~
Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~
Investment income (Part VIII, column (A), lines 3, 4, and 7d) ~~~~~~~~~~~~~
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) •••
Grants and similar amounts paid (Part IX, column (A), lines 1-3) ~~~~~~~~~~~
Benefits paid to or for members (Part IX, column (A), line 4) ~~~~~~~~~~~~~
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ~~~
Professional fundraising fees (Part IX, column (A), line 11e)~~~~~~~~~~~~~~
0.
|
b Total fundraising expenses (Part IX, column (D), line 25)
17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) ~~~~~~~~~~~~~
18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) ~~~~~~~
19 Revenue less expenses. Subtract line 18 from line 12 ••••••••••••••••
Part II
Current Year
10,699,907.
0.
683.
0.
10,700,590.
1,030,601.
0.
4,921,136.
0.
9,173,866.
0.
0.
0.
9,173,866.
1,088,362.
0.
4,644,275.
0.
4,498,324.
10,450,061.
250,529.
3,472,695.
9,205,332.
-31,466.
Beginning of Current Year
20 Total assets (Part X, line 16) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
21 Total liabilities (Part X, line 26) ~~~~~~~~~~~~~~~~~~~~~~~~~~~
22 Net assets or fund balances. Subtract line 21 from line 20 ••••••••••••••
18
18
230
0
0.
0.
1,518,977.
1,133,247.
385,730.
End of Year
1,597,021.
1,242,757.
354,264.
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign
Here
=
=
Signature of officer
Type or print name and title
Print/Type preparer's name
Paid
Preparer
Use Only
Date
CHRIS RANDALL, PRESIDENT
Preparer's signature
WILLIAM I. TUCKER IV
ABRAHAM & GAFFNEY, P.C.
Firm's name
3511 COOLIDGE ROAD, SUITE 100
Firm's address
EAST LANSING, MI 48823
9
9
Date
02/04/15
Check
if
self-employed
Firm's EIN
9
PTIN
P01078910
38-2771117
Phone no.517-351-6836
May the IRS discuss this return with the preparer shown above? (see instructions) •••••••••••••••••••••
332001 10-29-13
LHA For Paperwork Reduction Act Notice, see the separate instructions.
X
Yes
No
Form 990 (2013)
Form 990 (2013)
Part III Statement of Program Service Accomplishments
1
38-3287818
Check if Schedule O contains a response or note to any line in this Part III ••••••••••••••••••••••••••••
Briefly describe the organization's mission:
Page 2
X
TO PROVIDE EMPLOYMENT AND TRAINING SERVICES TO INDIVIDUALS IN THE
TRI-COUNTY AREA OF BERRIEN-CASS-VAN BUREN COUNTIES.
4a
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Yes X No
If "Yes," describe these new services on Schedule O.
Did the organization cease conducting, or make significant changes in how it conducts, any program services?~~~~~~
Yes X No
If "Yes," describe these changes on Schedule O.
Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.
Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and
revenue, if any, for each program service reported.
2,484,189. including grants of $
109,753. ) (Revenue $
2,484,189. )
(Code:
) (Expenses $
4b
(Code:
4c
(Code:
4d
Other program services (Describe in Schedule O.)
(Expenses $
8,182,640.
Total program service expenses |
2
3
4
4e
TO PROVIDE EMPLOYMENT & TRAINING SERVICES TO ELIGIBLE INDIVIDUALS UNDER
THE WORKFORCE INVESTMENT ACT FEDERAL PROGRAMS. THESE PROGRAMS
BENEFITED 1,242 PARTICIPANTS.
58,186. ) (Revenue $
1,459,321.
) (Expenses $
TO PROVIDE EMPLOYMENT & TRAINING SERVICES TO ELIGIBLE INDIVIDUALS UNDER
THE FEDERAL/STATE FUNDED TANF PROGRAMS. THESE PROGRAMS BENEFITED 1,727
PARTICIPANTS.
719,633. including grants of $
37,437. ) (Revenue $
719,633.
) (Expenses $
TAA - TO PROVIDE A FULL RANGE OF RE-EMPLOYMENT SERVICES TO INDIVIDUALS
DISPLACED EITHER BY THE IMPORTATION OF FOREIGN-MADE GOODS OR THE
EXPORTATION OF THE WORK ITSELF UNDER THE TRADE ACT OF 1974, AS AMENDED.
THESE PROGRAMS BENEFITED 321 PARTICIPANTS.
332002
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20130204 766504 216
882,986.)
(Revenue $
)
)
3,519,498.)
Form 990 (2013)
2
2013.05050 BERRIEN-CASS-VANBUREN WORKF 216____1
Form 990 (2013)
Part IV Checklist of Required Schedules
38-3287818
Page 3
Yes
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
If "Yes," complete Schedule A ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization required to complete Schedule B, Schedule of Contributors? ~~~~~~~~~~~~~~~~~~~~~~
1
2
3
4
5
6
7
8
9
10
11
a
b
c
d
e
f
12a
b
13
14a
b
15
16
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office? If "Yes," complete Schedule C, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year? If "Yes," complete Schedule C, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or
similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III ~~~~~~~~~~~~~~
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to
provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II~~~~~~~~~~~~~~
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete
Schedule D, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for
amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
If "Yes," complete Schedule D, Part IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V ~~~~~~~~~~~~~~~~~~~~~~~~
If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X
as applicable.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete Schedule D,
Part VI ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total
assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII ~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII ~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16? If "Yes," complete Schedule D, Part IX ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X ~~~~~~
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X ~~~~
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization included in consolidated, independent audited financial statements for the tax year?
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional ~~~~~
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ~~~~~~~~~~~~~~
Did the organization maintain an office, employees, or agents outside of the United States? ~~~~~~~~~~~~~~~~
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business,
investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000
or more? If "Yes," complete Schedule F, Parts I and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization? If "Yes," complete Schedule F, Parts II and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to
or for foreign individuals? If "Yes," complete Schedule F, Parts III and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a? If "Yes," complete Schedule G, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes,"
complete Schedule G, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
20a Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H ~~~~~~~~~~~~~~~~
b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? ••••••••••
1
2
20130204 766504 216
X
X
3
X
4
X
5
X
6
X
7
X
8
X
9
X
10
X
11a
X
11b
X
11c
X
11d
11e
X
X
11f
X
12a
X
12b
13
14a
X
X
X
14b
X
15
X
16
X
17
X
18
X
17
332003
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No
X
19
X
20a
20b
Form 990 (2013)
3
Form 990 (2013)
Part IV Checklist of Required Schedules (continued)
38-3287818
Page 4
Yes
21
22
23
24a
b
c
d
25a
b
26
27
28
a
b
c
29
30
31
32
33
34
35a
b
36
37
38
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
government on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I and II ~~~~~~~~~~~~~~~~~~
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX,
column (A), line 2? If "Yes," complete Schedule I, Parts I and III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete
Schedule J ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the
last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b through 24d and complete
Schedule K. If "No", go to line 25a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? ~~~~~~~~~~~
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? ~~~~~~~~~~~
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a
disqualified person during the year? If "Yes," complete Schedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and
that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes," complete
Schedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so,
complete Schedule L, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If "Yes," complete Schedule L, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV
instructions for applicable filing thresholds, conditions, and exceptions):
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ~~~~~~~~~~~
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ~~
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,
director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV~~~~~~~~~~~~~~~~~~~~~
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M ~~~~~~~~~
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? If "Yes," complete Schedule M ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete
Schedule N, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a controlled entity within the meaning of section 512(b)(13)? ~~~~~~~~~~~~~~~~~~
If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity
within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ~~~~~~~~~~~~~~~~~~~
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization?
If "Yes," complete Schedule R, Part V, line 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization conduct more than 5% of its activities through an entity that is not a related organization
and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI ~~~~~~~~
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
Note. All Form 990 filers are required to complete Schedule O •••••••••••••••••••••••••••••••
332004
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20130204 766504 216
21
X
X
22
23
24a
24b
No
X
X
24c
24d
25a
X
25b
X
26
X
27
X
28a
28b
X
X
28c
29
X
X
30
X
31
X
32
X
33
X
34
35a
X
X
35b
36
X
37
X
X
Form 990 (2013)
38
4
Form 990 (2013)
Part V Statements Regarding Other IRS Filings and Tax Compliance
38-3287818
Page 5
Check if Schedule O contains a response or note to any line in this Part V •••••••••••••••••••••••••••
Yes
29
1a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~
1a
0
b Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~
1b
c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
X
(gambling) winnings to prize winners? •••••••••••••••••••••••••••••••••••••••••••
1c
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
230
filed for the calendar year ending with or within the year covered by this return ~~~~~~~~~~
2a
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?~~~~~~~~~~
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions) ~~~~~~~~~~~
3a Did the organization have unrelated business gross income of $1,000 or more during the year? ~~~~~~~~~~~~~~
b If "Yes," has it filed a Form 990-T for this year? If "No," to line 3b, provide an explanation in Schedule O ~~~~~~~~~~
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)?~~~~~~~
b If "Yes," enter the name of the foreign country: J
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ~~~~~~~~~~~~
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?~~~~~~~~~
c If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions? ~~~~~~~~~~~~~~~~~~~~~~~~
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?
b If "Yes," did the organization notify the donor of the value of the goods or services provided? ~~~~~~~~~~~~~~~
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282? ••••••••••••••••••••••••••••••••••••••••••••••••••••
d If "Yes," indicate the number of Forms 8282 filed during the year ~~~~~~~~~~~~~~~~
7d
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? ~~~~~~~
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ~~~~~~~~~
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?~
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting
organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?
9
a
b
10
a
b
11
a
b
12a
b
13
a
b
c
14a
b
Sponsoring organizations maintaining donor advised funds.
Did the organization make any taxable distributions under section 4966?~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization make a distribution to a donor, donor advisor, or related person? ~~~~~~~~~~~~~~~~~~~
Section 501(c)(7) organizations. Enter:
Initiation fees and capital contributions included on Part VIII, line 12 ~~~~~~~~~~~~~~~ 10a
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities ~~~~~~ 10b
Section 501(c)(12) organizations. Enter:
Gross income from members or shareholders ~~~~~~~~~~~~~~~~~~~~~~~~~~ 11a
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11b
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year •••••• 12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
Is the organization licensed to issue qualified health plans in more than one state? ~~~~~~~~~~~~~~~~~~~~~
Note. See the instructions for additional information the organization must report on Schedule O.
Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans ~~~~~~~~~~~~~~~~~~~~~~ 13b
Enter the amount of reserves on hand ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13c
Did the organization receive any payments for indoor tanning services during the tax year? ~~~~~~~~~~~~~~~~
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O ••••••••••
332005
10-29-13
20130204 766504 216
2b
3a
3b
4a
5a
5b
5c
6a
No
X
X
X
X
X
X
6b
7a
7b
7c
X
X
7e
7f
7g
7h
8
9a
9b
12a
13a
X
14a
14b
Form 990 (2013)
5
38-3287818
Form 990 (2013)
Page 6
For
each
"Yes"
response
to
lines
2
through
7b
below,
and for a "No" response
Part VI Governance, Management, and Disclosure
to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI •••••••••••••••••••••••••••
Section A. Governing Body and Management
1a Enter the number of voting members of the governing body at the end of the tax year ~~~~~~
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
Yes
18
18
1b
b Enter the number of voting members included in line 1a, above, who are independent ~~~~~~
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other
2
officer, director, trustee, or key employee? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3 Did the organization delegate control over management duties customarily performed by or under the direct supervision
3
of officers, directors, or trustees, or key employees to a management company or other person? ~~~~~~~~~~~~~~
4
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ~~~~~
5
5 Did the organization become aware during the year of a significant diversion of the organization's assets? ~~~~~~~~~
6
6 Did the organization have members or stockholders? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or
7a
more members of the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
7b
persons other than the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a The governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b Each committee with authority to act on behalf of the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the
organization's mailing address? If "Yes," provide the names and addresses in Schedule O •••••••••••••••••
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
8a
8b
X
X
X
X
X
X
X
X
X
9
Yes
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ~~~~~~
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe
in Schedule O how this was done ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
13
14
15
a
b
16a
b
Did the organization have a written whistleblower policy? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a written document retention and destruction policy? ~~~~~~~~~~~~~~~~~~~~~~
Did the process for determining compensation of the following persons include a review and approval by independent
persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
The organization's CEO, Executive Director, or top management official ~~~~~~~~~~~~~~~~~~~~~~~~~~
Other officers or key employees of the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's
exempt status with respect to such arrangements? ••••••••••••••••••••••••••••••••••••
Section C. Disclosure
17
18
19
20
No
X
9
10a Did the organization have local chapters, branches, or affiliates? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent with the organization's exempt purposes? ~~~~~~~~~~~~~
11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
b Describe in Schedule O the process, if any, used by the organization to review this Form 990.
12a Did the organization have a written conflict of interest policy? If "No," go to line 13 ~~~~~~~~~~~~~~~~~~~~
X
10a
10b
11a
X
12a
12b
X
X
12c
13
14
X
X
X
15a
15b
X
X
16a
No
X
X
16b
NONE
List the states with which a copy of this Form 990 is required to be filed J
Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
X Another's website
X Upon request
Own website
Other (explain in Schedule O)
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial
statements available to the public during the tax year.
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: |
LISA ANKENBRUCK, CFO - (800) 533-5800
499 WEST MAIN STREET, BENTON HARBOR, MI
332006 10-29-13
20130204 766504 216
49022
Form 990 (2013)
6
38-3287818
Form 990 (2013)
Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
Page 7
Check if Schedule O contains a response or note to any line in this Part VII •••••••••••••••••••••••••••
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
¥ List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.
Enter -0- in columns (D), (E), and (F) if no compensation was paid.
¥ List all of the organization's current key employees, if any. See instructions for definition of "key employee."
¥ List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.
¥ List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of
reportable compensation from the organization and any related organizations.
¥ List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization,
more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees;
and former such persons.
(1) JEFF CURRY
BOARD MEMBER
(2) JOHN JANICK
BOARD MEMBER
(3) FELICIA FLOWERS
BOARD MEMBER
(4) DAVID GLYNN
BOARD MEMBER
(5) JOHN RYDER
BOARD MEMBER
(6) RANDALL PEAT
BOARD MEMBER
(7) MAMIE YARBROUGH
BOARD MEMBER
(8) JEANETTE LEAHEY
BOARD MEMBER
(9) PAUL BERGAN
BOARD MEMBER
(10) KATHY EMANS
BOARD MEMBER
(11) JIM FINAN
BOARD MEMBER
(12) CHRIS RANDALL
BOARD MEMBER
(13) KATHY VALDES
BOARD MEMBER
(14) DON HANSON
BOARD MEMBER
(15) BOB WAGEL
BOARD MEMBER
(16) BERNIE WILLIAMSON
BOARD MEMBER
(17) GEORGE SALEEBY
BOARD MEMBER
332007 10-29-13
20130204 766504 216
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
2.00
Former
Highest compensated
employee
Key employee
Officer
Institutional trustee
2.00
Individual trustee or director
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
(B)
(C)
(D)
(E)
Position
Name and Title
Average
Reportable
Reportable
(do not check more than one
hours per box, unless person is both an
compensation
compensation
officer and a director/trustee)
week
from
from related
(list any
the
organizations
hours for
organization
(W-2/1099-MISC)
related
(W-2/1099-MISC)
organizations
below
line)
(F)
Estimated
amount of
other
compensation
from the
organization
and related
organizations
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
Form 990 (2013)
7
(18) JACK MCCLOUGHAN
BOARD MEMBER
(19) BILL HAASE
BOARD MEMBER
(20) MIKE TOTH
BOARD MEMBER
(21) TIM CALHOUN
TREASURER
(22) ARNIE REDSICKER
VICE CHAIRPERSON
(23) DR. FRED MATHEWS
SECRETARY
(24) JIM KODIS
CHAIRPERSON
(25) TODD GUSTAFSON
EXECUTIVE DIRECTOR
(26) LISA ANKENBRUCK
CHIEF FINANCIAL OFFICER
1b
c
d
2
2.00
2.00
2.00
2.00
2.00
6.00
40.00
40.00
Former
Highest compensated
employee
Officer
Key employee
2.00
38-3287818
Page 8
Form 990 (2013)
(continued)
Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(B)
(C)
(A)
(D)
(E)
(F)
Position
Average
Name and title
Reportable
Reportable
Estimated
(do not check more than one
hours per box, unless person is both an
compensation
compensation
amount of
officer
and a director/trustee)
week
from
from related
other
(list any
the
organizations
compensation
hours for
organization
(W-2/1099-MISC)
from the
related
(W-2/1099-MISC)
organization
organizations
and related
below
organizations
line)
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
X
0.
0.
0.
159,919.
0.
16,208.
113,611.
273,530.
109,596.
383,126.
0.
0.
0.
0.
13,464.
29,672.
7,080.
36,752.
X
X
Sub-total ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
Total from continuation sheets to Part VII, Section A ~~~~~~~~~~ |
Total (add lines 1b and 1c) •••••••••••••••••••••••• |
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from the organization |
3
Yes
3
Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
line 1a? If "Yes," complete Schedule J for such individual ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual~~~~~~~~~~~~~
5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? If "Yes," complete Schedule J for such person ••••••••••••••••••••••••
Section B. Independent Contractors
X
3
4
X
5
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from
the organization. Report compensation for the calendar year ending with or within the organization's tax year.
(A)
(B)
(C)
Name and business address
Description of services
Compensation
NONE
2
Total number of independent contractors (including but not limited to those listed above) who received more than
0
$100,000 of compensation from the organization |
SEE PART VII, SECTION A CONTINUATION SHEETS
332008
10-29-13
20130204 766504 216
No
X
Form 990 (2013)
8
Form 990
(27) GWEN WOOD
CHIEF OPERATING OFFICER
40.00
X
Total to Part VII, Section A, line 1c •••••••••••••••••••••••••
332201
05-01-13
20130204 766504 216
(F)
Estimated
amount of
other
compensation
from the
organization
and related
organizations
Former
Highest compensated employee
Key employee
Officer
Part VII
38-3287818
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
(B)
(C)
(D)
(E)
Name and title
Average
Position
Reportable
Reportable
hours
(check all that apply)
compensation
compensation
per
from
from related
week
the
organizations
(list any
organization
(W-2/1099-MISC)
hours for
(W-2/1099-MISC)
related
organizations
below
line)
109,596.
109,596.
0.
7,080.
7,080.
9
Form 990 (2013)
Part VIII
Statement of Revenue
38-3287818
Page 9
Contributions, Gifts, Grants
and Other Similar Amounts
1 a
b
c
d
e
f
Program Service
Revenue
Check if Schedule O contains a response or note to any line in this Part VIII •••••••••••••••••••••••••
(A)
(B)
(C)
(D)
Revenue excluded
Related or
Unrelated
Total revenue
from
tax
under
exempt function
business
sections
revenue
revenue
512 - 514
2
3
4
5
6
Other Revenue
7
8
9
10
11
12
Federated campaigns ~~~~~~
Membership dues ~~~~~~~~
Fundraising events ~~~~~~~~
Related organizations ~~~~~~
Government grants (contributions)
All other contributions, gifts, grants, and
similar amounts not included above ~~
1a
1b
1c
1d
1e 8,222,742.
1f
951,124.
g Noncash contributions included in lines 1a-1f: $
h Total. Add lines 1a-1f ••••••••••••••••• | 9,173,866.
Business Code
a
b
c
d
e
f All other program service revenue ~~~~~
g Total. Add lines 2a-2f ••••••••••••••••• |
Investment income (including dividends, interest, and
other similar amounts)~~~~~~~~~~~~~~~~~ |
Income from investment of tax-exempt bond proceeds
|
Royalties ••••••••••••••••••••••• |
(i) Real
(ii) Personal
a Gross rents ~~~~~~~
b Less: rental expenses ~~~
c Rental income or (loss) ~~
d Net rental income or (loss) •••••••••••••• |
a Gross amount from sales of
(i) Securities
(ii) Other
assets other than inventory
b Less: cost or other basis
and sales expenses ~~~
c Gain or (loss) ~~~~~~~
d Net gain or (loss) ••••••••••••••••••• |
a Gross income from fundraising events (not
including $
of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~ a
b Less: direct expenses~~~~~~~~~~ b
c Net income or (loss) from fundraising events ••••• |
a Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~ a
b Less: direct expenses ~~~~~~~~~ b
c Net income or (loss) from gaming activities •••••• |
a Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~ a
b Less: cost of goods sold ~~~~~~~~ b
c Net income or (loss) from sales of inventory •••••• |
Miscellaneous Revenue
Business Code
a
b
c
d All other revenue ~~~~~~~~~~~~~
e Total. Add lines 11a-11d ~~~~~~~~~~~~~~~ |
Total revenue. See instructions. ••••••••••••• | 9,173,866.
332009
10-29-13
20130204 766504 216
0.
0.
0.
Form 990 (2013)
10
Form 990 (2013)
Part IX Statement of Functional Expenses
38-3287818
Page 10
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX ••••••••••••••••••••••••••
(A)
(B)
(C)
(D)
Total expenses
Program service
Management and
Fundraising
expenses
general expenses
expenses
Grants and other assistance to governments and
1,088,362. 1,088,362.
organizations in the United States. See Part IV, line 21
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
1
Grants and other assistance to individuals in
the United States. See Part IV, line 22 ~~~
Grants and other assistance to governments,
organizations, and individuals outside the
United States. See Part IV, lines 15 and 16 ~
Benefits paid to or for members ~~~~~~~
Compensation of current officers, directors,
trustees, and key employees ~~~~~~~~
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B) ~~~
2
3
4
5
6
7
8
Other salaries and wages ~~~~~~~~~~
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
9
10
11
Other employee benefits ~~~~~~~~~~
Payroll taxes ~~~~~~~~~~~~~~~~
Fees for services (non-employees):
Management ~~~~~~~~~~~~~~~~
Legal ~~~~~~~~~~~~~~~~~~~~
Accounting ~~~~~~~~~~~~~~~~~
Lobbying ~~~~~~~~~~~~~~~~~~
Professional fundraising services. See Part IV, line 17
a
b
c
d
e
f Investment management fees ~~~~~~~~
g Other. (If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.)
12
13
14
15
16
17
18
19
20
21
22
23
24
Advertising and promotion ~~~~~~~~~
Office expenses~~~~~~~~~~~~~~~
Information technology ~~~~~~~~~~~
Royalties ~~~~~~~~~~~~~~~~~~
Occupancy ~~~~~~~~~~~~~~~~~
Travel ~~~~~~~~~~~~~~~~~~~
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings ~~
Interest ~~~~~~~~~~~~~~~~~~
Payments to affiliates ~~~~~~~~~~~~
Depreciation, depletion, and amortization ~~
Insurance ~~~~~~~~~~~~~~~~~
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 TRAINING AND SUPPORTIVE
b EQUIPMENT PURCHASE
c MISCELLANEOUS
d SUBCONTRACTOR & STAFFIN
e All other expenses
25 Total functional expenses. Add lines 1 through 24e
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
|
189,707.
189,707.
3,380,626.
2,938,039.
442,587.
156,453.
580,191.
337,298.
118,822.
520,526.
288,800.
37,631.
59,665.
48,498.
32,512.
49,324.
1,774.
32,512.
47,550.
122,771.
99,076.
527,126.
81,465.
68,153.
97,479.
500,136.
81,451.
54,618.
1,597.
26,990.
14.
956,916.
56,154.
939,106.
51,375.
17,810.
4,779.
295,353.
253,586.
41,767.
51,694.
20,925.
49,778.
17,522.
1,916.
3,403.
1,035,858.
118,344.
23,511.
1,666.
1,035,495.
110,242.
21,994.
363.
8,102.
1,517.
1,666.
9,205,332.
8,182,640.
1,022,692.
0.
if following SOP 98-2 (ASC 958-720)
332010 10-29-13
20130204 766504 216
Form 990 (2013)
11
Form 990 (2013)
Part X
38-3287818
Balance Sheet
Page 11
Check if Schedule O contains a response or note to any line in this Part X •••••••••••••••••••••••••••••
(A)
(B)
Beginning of year
End of year
Cash - non-interest-bearing ~~~~~~~~~~~~~~~~~~~~~~~~~
Savings and temporary cash investments ~~~~~~~~~~~~~~~~~~
Pledges and grants receivable, net ~~~~~~~~~~~~~~~~~~~~~
Accounts receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~~
Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6 Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501(c)(9) voluntary
employees' beneficiary organizations (see instr). Complete Part II of Sch L ~~
7 Notes and loans receivable, net ~~~~~~~~~~~~~~~~~~~~~~~
8 Inventories for sale or use ~~~~~~~~~~~~~~~~~~~~~~~~~~
9 Prepaid expenses and deferred charges ~~~~~~~~~~~~~~~~~~
10 a Land, buildings, and equipment: cost or other
440,964.
basis. Complete Part VI of Schedule D ~~~ 10a
216,406.
b Less: accumulated depreciation ~~~~~~ 10b
11 Investments - publicly traded securities ~~~~~~~~~~~~~~~~~~~
12 Investments - other securities. See Part IV, line 11 ~~~~~~~~~~~~~~
13 Investments - program-related. See Part IV, line 11 ~~~~~~~~~~~~~
14 Intangible assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
15 Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~
16 Total assets. Add lines 1 through 15 (must equal line 34) ••••••••••
17 Accounts payable and accrued expenses ~~~~~~~~~~~~~~~~~~
18 Grants payable ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
19 Deferred revenue ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
20 Tax-exempt bond liabilities ~~~~~~~~~~~~~~~~~~~~~~~~~
21 Escrow or custodial account liability. Complete Part IV of Schedule D ~~~~
22 Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~
Liabilities
Assets
1
2
3
4
5
23
24
25
Net Assets or Fund Balances
26
27
28
29
30
31
32
33
34
Secured mortgages and notes payable to unrelated third parties ~~~~~~
Unsecured notes and loans payable to unrelated third parties ~~~~~~~~
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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total liabilities. Add lines 17 through 25 ••••••••••••••••••
X and
Organizations that follow SFAS 117 (ASC 958), check here |
complete lines 27 through 29, and lines 33 and 34.
Unrestricted net assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~
Temporarily restricted net assets ~~~~~~~~~~~~~~~~~~~~~~
Permanently restricted net assets ~~~~~~~~~~~~~~~~~~~~~
Organizations that do not follow SFAS 117 (ASC 958), check here |
and complete lines 30 through 34.
Capital stock or trust principal, or current funds ~~~~~~~~~~~~~~~
Paid-in or capital surplus, or land, building, or equipment fund ~~~~~~~~
Retained earnings, endowment, accumulated income, or other funds ~~~~
Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~
Total liabilities and net assets/fund balances ••••••••••••••••
332011
10-29-13
20130204 766504 216
701,139.
574,647.
8,869.
1
2
3
4
664,193.
595,525.
33,607.
5
6,934.
227,388.
1,518,977.
797,947.
335,300.
6
7
8
9
10c
11
12
13
14
15
16
17
18
19
20
21
79,138.
224,558.
1,597,021.
824,646.
418,111.
22
23
24
1,133,247.
163,542.
222,188.
385,730.
1,518,977.
25
26
27
28
29
30
31
32
33
34
1,242,757.
134,906.
219,358.
354,264.
1,597,021.
Form 990 (2013)
12
Form 990 (2013)
Part XI Reconciliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI
1
2
3
4
5
6
7
8
9
10
Page 12
•••••••••••••••••••••••••••
Total revenue (must equal Part VIII, column (A), line 12) ~~~~~~~~~~~~~~~~~~~~~~~~~~
Total expenses (must equal Part IX, column (A), line 25) ~~~~~~~~~~~~~~~~~~~~~~~~~~
Revenue less expenses. Subtract line 2 from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ~~~~~~~~~~
Net unrealized gains (losses) on investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Donated services and use of facilities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Investment expenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Prior period adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other changes in net assets or fund balances (explain in Schedule O) ~~~~~~~~~~~~~~~~~~~
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B)) •••••••••••••••••••••••••••••••••••••••••••••••
Part XII Financial Statements and Reporting
38-3287818
1
2
3
4
5
6
7
8
9
9,173,866.
9,205,332.
-31,466.
385,730.
10
0.
354,264.
Check if Schedule O contains a response or note to any line in this Part XII •••••••••••••••••••••••••••
Yes
1
2a
b
c
3a
b
X Accrual
Accounting method used to prepare the Form 990:
Cash
Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
Were the organization's financial statements compiled or reviewed by an independent accountant? ~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
Separate basis
Consolidated basis
Both consolidated and separate basis
Were the organization's financial statements audited by an independent accountant? ~~~~~~~~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis, or both:
X Separate basis
Consolidated basis
Both consolidated and separate basis
If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant?~~~~~~~~~~~~~~~
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit
Act and OMB Circular A-133? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain why in Schedule O and describe any steps taken to undergo such audits ••••••••••••••••
332012
10-29-13
20130204 766504 216
X
No
X
2a
2b
X
2c
X
3a
X
3b X
Form 990 (2013)
13
SCHEDULE A
Public Charity Status and Public Support
(Form 990 or 990-EZ)
OMB No. 1545-0047
2013
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Open to Public
| Attach to Form 990 or Form 990-EZ.
Inspection
| Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
Name of the organization BERRIEN-CASS-VANBUREN WORKFORCE
Employer identification number
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
38-3287818
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)
3
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,
4
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
X
8
9
10
11
e
f
g
h
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 organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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 that
describes the type of supporting organization and complete lines 11e through 11h.
a
Type I
b
Type II
c
Type III - Functionally integrated
d
Type III - Non-functionally integrated
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than
foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III
supporting organization, check this box ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below,
Yes No
the governing body of the supported organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11g(i)
(ii) A family member of a person described in (i) above? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11g(ii)
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ~~~~~~~~~~~~~~~~~~~~~~~~ 11g(iii)
Provide the following information about the supported organization(s).
(i) Name of supported
organization
(ii) EIN
(vi) Is the
(iii) Type of organization (iv) Is the organization (v) Did you notify the organization
in col. (vii) Amount of monetary
(i)
in
col.
listed
in
your
organization
in
col.
(described on lines 1-9
support
(i) organized in the
above or IRC section governing document? (i) of your support?
U.S.?
(see instructions))
Yes
No
Yes
No
Yes
No
Total
LHA For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
332021
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Schedule A (Form 990 or 990-EZ) 2013
14
38-3287818
Schedule A (Form 990 or 990-EZ) 2013 DEVELOPMENT BOARD, INC
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
Page 2
(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
fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) |
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
15475568.15850311.12877666.10699907. 9173866.64077318.
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) ~~~~~~~~~~~~
15475568.15850311.12877666.10699907. 9173866.64077318.
64077318.
6 Public support. Subtract line 5 from line 4.
Section B. Total Support
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 IV.) ~~~~
11 Total support. Add lines 7 through 10
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
15475568.15850311.12877666.10699907. 9173866.64077318.
625.
536.
84,626.
788.
683.
2,632.
84,626.
64164576.
12 Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~ 12
13 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 ••••••••••••••••••••••••••••••••••••••••••••• |
Section C. Computation of Public Support Percentage
99.86 %
14 Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) ~~~~~~~~~~~~ 14
99.84 %
15 Public support percentage from 2012 Schedule A, Part II, line 14 ~~~~~~~~~~~~~~~~~~~~~ 15
16a 33 1/3% support test - 2013. 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | X
b 33 1/3% support test - 2012. 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
17a 10% -facts-and-circumstances test - 2013. 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 IV how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
b 10% -facts-and-circumstances test - 2012. 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 IV how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions ••• |
332022
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15
Part III Support Schedule for Organizations Described in Section 509(a)(2)
38-3287818
Page 3
(Complete only if you checked the box on line 9 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
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 ~~~
7 a 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.)
Section B. Total Support
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 IV.) ~~~~
13 Total support. (Add lines 9, 10c, 11, and 12.)
14 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 •••••••••••••••••••••••••••••••••••••••••••••••••••• |
Section C. Computation of Public Support Percentage
15 Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) ~~~~~~~~~~~~
16 Public support percentage from 2012 Schedule A, Part III, line 15 ••••••••••••••••••••
Section D. Computation of Investment Income Percentage
15
16
17 Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ~~~~~~~~ 17
18 Investment income percentage from 2012 Schedule A, Part III, line 17 ~~~~~~~~~~~~~~~~~~ 18
19 a 33 1/3% support tests - 2013. 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 ~~~~~~~~~~ |
b 33 1/3% support tests - 2012. 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~~~~ |
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions •••••••• |
332023 09-25-13
20130204 766504 216
%
%
%
%
16
38-3287818 Page 4
Part IV Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12.
Also complete this part for any additional information. (See instructions).
332024 09-25-13
20130204 766504 216
17
Schedule B
Schedule of Contributors
(Form 990, 990-EZ,
or 990-PF)
| Attach to Form 990, Form 990-EZ, or Form 990-PF.
| Information about Schedule B (Form 990, 990-EZ, or 990-PF) and
its instructions is at www.irs.gov/form990 .
Name of the organization
OMB No. 1545-0047
2013
38-3287818
Organization type (check one):
Filers of:
Form 990 or 990-EZ
Section:
X
501(c)(
3
) (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, $5,000 or more (in money or property) from any one
contributor. Complete Parts I and II.
Special Rules
X
For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections
509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution 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 a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
total contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not total to 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. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc., contributions of $5,000 or more during the year ~~~~~~~~~~~~~~~~~ | $
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not 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 990-PF, Part I, line 2, to
certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
323451
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Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Name of organization
Part I
Contributors
(see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
1
38-3287818
(b)
Name, address, and ZIP + 4
MICHIGAN DEPARTMENT OF CORRECTIONS
206 E. MICHIGAN AVENUE, GRANDVIEW
PLAZA, P.O. BOX 30003
(c)
Total contributions
$
831,982.
2
(b)
(c)
Total contributions
MICHIGAN WORKFORCE DEVELOPMENT AGENCY
201 N WASHINGTON SQ, 5TH FLOOR
$
6,275,340.
3
(b)
(c)
Total contributions
US DEPARTMENT OF LABOR
200 CONSTITUTION AVENUE, NW
$
464,992.
4
(b)
(c)
Total contributions
COLOMA COMMUNITY SCHOOLS
PO BOX 550
$
343,305.
5
(b)
BENTON HARBOR AREA SCHOOLS
823 RIVERVIEW DRIVE, 2ND FLOOR PO BOX
1107
(c)
Total contributions
$
319,949.
6
(b)
(c)
Total contributions
STATE OF MICHIGAN LAND BANK FAST TRACK
AUTHORITY
300 N WASHINGTON SQUARE
LANSING, MI 48913
323452 10-24-13
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X
(d)
Type of contribution
Person
Payroll
Noncash
X
(d)
Person
Payroll
Noncash
X
(d)
Person
Payroll
Noncash
X
(Complete Part II for
noncash contributions.)
BENTON HARBOR, MI 49023
(a)
No.
Person
Payroll
Noncash
COLOMA, MI 49038
(a)
No.
(d)
WASHINGTON, DC 20210
(a)
No.
X
LANSING, MI 48913
(a)
No.
Person
Payroll
Noncash
LANSING, MI 48909
(a)
No.
(d)
$
229,953.
(d)
Person
Payroll
Noncash
X
19
Page 3
Part II
Noncash Property
(a)
No.
from
Part I
38-3287818
(see instructions). Use duplicate copies of Part II if additional space is needed.
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
$
(a)
No.
from
Part I
(b)
$
(a)
No.
from
Part I
(b)
$
(a)
No.
from
Part I
(b)
$
(a)
No.
from
Part I
(b)
$
(a)
No.
from
Part I
(b)
$
323453 10-24-13
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20
Page 4
38-3287818
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations that total more than $1,000 for the
Part III
year. 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.) | $
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(a) No.
from
Part I
(b) Purpose of gift
Relationship of transferor to transferee
(c) Use of gift
(a) No.
from
Part I
(b) Purpose of gift
(c) Use of gift
(a) No.
from
Part I
(b) Purpose of gift
(c) Use of gift
323454 10-24-13
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21
SCHEDULE D
(Form 990)
OMB No. 1545-0047
Supplemental Financial Statements
2013
| Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
Open to Public
| Attach to Form 990.
Inspection
| Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
BERRIEN-CASS-VANBUREN
WORKFORCE
Part I
38-3287818
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.Complete if the
organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds
(b) Funds and other accounts
Total number at end of year ~~~~~~~~~~~~~~~
Aggregate contributions to (during year) ~~~~~~~~
Aggregate grants from (during year) ~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~
6 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? ••••••••••••••••••••••••••••••••••••••••••••
Part II Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
2
3
4
5
Yes
No
Yes
No
1
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
2
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.
Held at the End of the Tax Year
a
b
c
d
3
4
5
6
7
8
9
Total number of conservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2a
Total acreage restricted by conservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~
2b
Number of conservation easements on a certified historic structure included in (a) ~~~~~~~~~~~~
2c
Number of conservation easements included in (c) acquired after 8/17/06, 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 |
Number of states where property subject to conservation easement is located |
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~
Yes
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year |
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year | $
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
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
No
No
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a If the organization elected, as permitted under SFAS 116 (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.
b If the organization elected, as permitted under SFAS 116 (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) Revenues included in Form 990, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
(ii) Assets included in Form 990, Part X ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
2 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 SFAS 116 (ASC 958) relating to these items:
a Revenues included in Form 990, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
b Assets included in Form 990, Part X ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
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Schedule D (Form 990) 2013
22
38-3287818 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):
a
Public exhibition
d
Loan or exchange programs
b
Scholarly research
e
Other
c
Preservation for future generations
4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
5 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" to Form 990, Part IV, line 9, or
reported an amount on Form 990, Part X, line 21.
3
1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b If "Yes," explain the arrangement in Part XIII and complete the following table:
Yes
Amount
Beginning balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1c
Additions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1d
Distributions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1e
Ending balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1f
Did the organization include an amount on Form 990, Part X, line 21? ~~~~~~~~~~~~~~~~~~~~~~~~~
Yes
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" to Form 990, Part IV, line 10.
c
d
e
f
2a
b
1a
b
c
d
e
f
g
2
a
b
c
3a
b
4
No
No
(a) Current year
(b) Prior year
(c) Two years back (d) Three years back (e) Four years back
Beginning of year balance ~~~~~~~
Contributions ~~~~~~~~~~~~~~
Net investment earnings, gains, and losses
Grants or scholarships ~~~~~~~~~
Other expenditures for facilities
and programs ~~~~~~~~~~~~~
Administrative expenses ~~~~~~~~
End of year balance ~~~~~~~~~~
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment |
%
Permanent endowment |
%
Temporarily restricted endowment |
%
The percentages in 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 No
(i) unrelated organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(i)
(ii) related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(ii)
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? ~~~~~~~~~~~~~~~~~~~~~~
3b
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" to 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
5,200.
5,200.
1a Land ~~~~~~~~~~~~~~~~~~~~
b Buildings ~~~~~~~~~~~~~~~~~~
c Leasehold improvements ~~~~~~~~~~
400,143.
213,938.
186,205.
d Equipment ~~~~~~~~~~~~~~~~~
35,621.
2,468.
33,153.
e Other ••••••••••••••••••••
224,558.
(Column
(d)
must
equal
Form
990,
Part
X,
column
(B),
line
10(c).)
Total. Add lines 1a through 1e.
•••••••••••• |
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23
Part VII Investments - Other Securities.
38-3287818
Page 3
Complete if the organization answered "Yes" to 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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
Part VIII Investments - Program Related.
Complete if the organization answered "Yes" to 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Part IX
Other Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description
(b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.) •••••••••••••••••••••••••••• |
Part X
Other Liabilities.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
(a) Description of liability
(b) Book value
1.
(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 X
332053
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24
38-3287818
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
1
2
a
b
c
d
e
3
4
a
b
c
5
Total revenue, gains, and other support per audited financial statements ~~~~~~~~~~~~~~~~~~~
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
Net unrealized gains on investments ~~~~~~~~~~~~~~~~~~~~~~
2a
Donated services and use of facilities ~~~~~~~~~~~~~~~~~~~~~~
2b
Recoveries of prior year grants ~~~~~~~~~~~~~~~~~~~~~~~~~
2c
Other (Describe in Part XIII.) ~~~~~~~~~~~~~~~~~~~~~~~~~~
2d
Add lines 2a through 2d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line 2e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b ~~~~~~~~
4a
4b
Add lines 4a and 4b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) •••••••••••••••••
1
2
a
b
c
d
e
3
4
a
b
c
5
Total expenses and losses per audited financial statements ~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on line 1 but not on Form 990, Part IX, line 25:
Donated services and use of facilities ~~~~~~~~~~~~~~~~~~~~~~
2a
Prior year adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2b
Other losses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2c
2d
Add lines 2a through 2d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line 2e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b ~~~~~~~~
4a
4b
Add lines 4a and 4b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ••••••••••••••••
Page 4
1
9,173,866.
2e
3
0.
9,173,866.
0.
9,173,866.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
4c
5
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
Part XIII Supplemental Information.
1
9,205,332.
2e
3
0.
9,205,332.
4c
5
0.
9,205,332.
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, 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.
PART X, LINE 2:
EXPLANATION: FEDERAL TAX LAW PROVIDES TAX BENEFITS TO NONPROFIT
ORGANIZATIONS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION
501(C)(3) OF THE INTERNAL REVENUE CODE (CODE).
THE CODE REQUIRES THAT
TAX-EXEMPT ORGANIZATIONS MUST COMPLY WITH FEDERAL TAX LAW TO MAINTAIN
TAX-EXEMPT STATUS AND AVOID PENALTIES.
AS AN EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE
THAT HAS BEEN CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION, THE
BERRIEN-CASS-VAN BUREN WORKFORCE DEVELOPMENT BOARD, INC. IS ONLY SUBJECT
TO TAX ON UNRELATED BUSINESS INCOME AS DEFINED BY SECTION 509(A)(1) OF THE
CODE.
THE BERRIEN-CASS-VAN BUREN WORKFORCE DEVELOPMENT BOARD, INC. HAS NO
UNRELATED BUSINESS INCOME FOR THE YEAR ENDED JUNE 30, 2014. ACCORDINGLY, A
332054
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25
Part XIII Supplemental Information (continued)
38-3287818
Page 5
PROVISION FOR INCOME TAXES HAS NOT BEEN MADE ON THE FINANCIAL STATEMENTS.
THE AMOUNT OF INCOME TAX BENEFIT THAT MAY BE DISALLOWED BY THE INTERNAL
REVENUE SERVICE (IRS), IF ANY, CANNOT BE DETERMINED AT THIS TIME ALTHOUGH
THE BERRIEN-CASS-VAN BUREN WORKFORCE DEVELOPMENT BOARD, INC. EXPECTS SUCH
AMOUNTS, IF ANY, TO BE IMMATERIAL.
INTEREST AND/OR PENALTIES ON AN AMOUNT OF INCOME TAXES DEEMED UNDERPAID,
IF ANY, WILL BE CLASSIFIED AS INCOME TAXES IN THE FINANCIAL STATEMENTS.
THE BERRIEN-CASS-VAN BUREN WORKFORCE DEVELOPMENT BOARD, INC. HAS NOT
RECOGNIZED ANY INTEREST OR PENALTIES PAYABLE IN THE STATEMENT OF FINANCIAL
POSITION AS OF JUNE 30, 2014, OR INTEREST OR PENALTIES EXPENSE IN THE
STATEMENT OF ACTIVITIES FOR THE YEAR THEN ENDED.
THE BERRIEN-CASS-VAN
BUREN WORKFORCE DEVELOPMENT BOARD, INC. IS SUBJECT TO IRS AND STATE
EXAMINATIONS FOR A PERIOD OF AT LEAST THREE (3) YEARS AFTER THE FORM 990
HAS BEEN FILED.
332055
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26
Grants and Other Assistance to Organizations,
Governments, and Individuals in the United States
SCHEDULE I
(Form 990)
Part I
Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
| Attach to Form 990.
| Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
38-3287818
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
X Yes
criteria used to award the grants or assistance? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2 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 Governments and Organizations in the United States. Complete if the organization answered "Yes" to 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.
(f) Method of
1 (a) Name and address of organization
(b) EIN
(c) IRC section
(d) Amount of
(e) Amount of
(g) Description of
(h) Purpose of grant
valuation (book,
or government
if applicable
cash grant
non-cash
non-cash assistance
or assistance
FMV, appraisal,
assistance
other)
1
LAKE MICHIGAN COLLEGE
2755 E. NAPIER AVE.
SOUTHWEST MICHIGAN COMMUNITY
ACTION AGENCY - 185 EAST MAIN,
SUITE 200 - BENTON HARBOR, MI
49022
No
306,369.
0.
TO PROVIDE DIRECT
TRAINING AND EMPLOYMENT
SERVICES.
407,107.
0.
TO PROVIDE PRISONER
RE-ENTRY SERVICES.
MOSAIC RESALE
510 WEST MAIN STREET
10,000.
0.
JOLLAY ORCHARDS
1850 FRIDAY RD
COLOMA, MI 49038
12,719.
0.
TO PROVIDE DIRECT
SERVICES.
TO PROVIDE ASSISTANCE
RELATED TO THE USDA
FARMER'S MARKET PROMO
PROGRAM
0.
TO PROVIDE DIRECT
SERVICES.
STATE OF MICHIGAN
499 WEST MAIN - MDLEG-MRS
10,000.
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
3 Enter total number of other organizations listed in the line 1 table •••••••••••••••••••••••••••••••••••••••••••••••••• |
Schedule I (Form 990) (2013)
332101
10-29-13
27
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance
Part IV
(b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of noncash assistance
(e) Method of valuation
(book, FMV, appraisal, other)
38-3287818
Page 2
(f) Description of non-cash assistance
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
PART I, LINE 2:
EXPLANATION: EACH ORGANIZATION THAT RECEIVES GRANT FUNDS HAS A SUBCONTRACT
AGREEMENT WITH THE BERRIEN-CASS-VANBUREN WFB THAT DETAILS THE VARIOUS
FINANCIAL AND PROGRAMMATIC COMPLIANCE REQUIREMENTS THAT MUST BE ADHERED TO.
THE ORGANIZATION IS REQUIRED TO SUBMIT PERIODIC FINANCIAL AND PROGRAMMATIC
REPORTS THAT ARE REVIEWED BY MANAGEMENT TO ASSURE COMPLIANCE. SITE VISITS
ARE ALSO CONDUCTED AT THE ORGANIZATION'S OFFICES AND PROGRAM SITES TO
MONITOR COMPLIANCE.
332102 10-29-13
28
SCHEDULE J
(Form 990)
Part I
Compensation Information
OMB No. 1545-0047
2013
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
| Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Open to Public
| Attach to Form 990. | See separate instructions.
Inspection
| Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
Questions Regarding Compensation
38-3287818
Yes
No
1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990,
Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax indemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain ~~~~~~~~~~~
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees, and officers, including the CEO/Executive Director, regarding the items checked in line 1a? ~~~~~~~~~~~~
3
1b
2
Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part III.
X Written employment contract
Compensation committee
Independent compensation consultant
Compensation survey or study
X Approval by the board or compensation committee
Form 990 of other organizations
During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filing
organization or a related organization:
a Receive a severance payment or change-of-control payment? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b Participate in, or receive payment from, a supplemental nonqualified retirement plan? ~~~~~~~~~~~~~~~~~~~~
c Participate in, or receive payment from, an equity-based compensation arrangement?~~~~~~~~~~~~~~~~~~~~
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
4
4a
4b
4c
X
X
X
Only section 501(c)(3) and 501(c)(4) organizations must complete lines 5-9.
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the revenues of:
X
5a
a The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
X
5b
b Any related organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" to line 5a or 5b, describe in Part III.
6 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the net earnings of:
X
6a
a The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
X
6b
b Any related organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" to line 6a or 6b, describe in Part III.
7 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments
X
7
not described in lines 5 and 6? If "Yes," describe in Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
8 Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
X
8
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III ~~~~~~~~~~~
9 If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in
9
Regulations section 53.4958-6(c)? •••••••••••••••••••••••••••••••••••••••••••••
Schedule J (Form 990) 2013
5
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29
38-3287818
Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
Page 2
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii).
Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(B) Breakdown of W-2 and/or 1099-MISC compensation
(i) Base
compensation
(A) Name and Title
(1) TODD GUSTAFSON
EXECUTIVE DIRECTOR
332112
09-13-13
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
159,919.
0.
(ii) Bonus &
incentive
compensation
(iii) Other
reportable
compensation
0.
0.
0.
0.
30
(C) Retirement and
other deferred
compensation
0.
0.
(D) Nontaxable
benefits
16,208.
0.
(E) Total of columns (F) Compensation
(B)(i)-(D)
reported as deferred
in prior Form 990
176,127.
0.
0.
0.
Part III Supplemental Information
38-3287818
Page 3
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
332113
09-13-13
31
SCHEDULE O
(Form 990 or 990-EZ)
Supplemental
Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
OMB No. 1545-0047
2013
Form 990 or 990-EZ or to provide any additional information.
Open to Public
| Attach to Form 990 or 990-EZ.
Inspection
| Information about Schedule O (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
38-3287818
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:
TO PROVIDE EMPLOYMENT AND TRAINING SERVICES TO INDIVIDUALS IN THE
TRI-COUNTY AREA OF BERRIEN-CASS-VAN BUREN COUNTIES.
FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES:
OTHER
EXPENSES $ 3,519,497.
INCL GRANTS OF $ 882,986.
REVENUE $ 3,519,498.
FORM 990, PART VI, SECTION B, LINE 11:
EXPLANATION: THE IRS FORM 990 IS PREPARED BY A CONTRACTED CPA AND IS
REVIEWED BY THE FINANCE DIRECTOR. THE COMPLETED FORM IS THEN SUBMITTED TO
THE ORGANIZATION BOARD FOR REVIEW AND APPROVAL PRIOR TO SUBMITTING TO THE
IRS.
FORM 990, PART VI, SECTION B, LINE 12C:
EXPLANATION: WE HAVE ADOPTED A CONFLICT OF INTEREST POLICY TO PROTECT THE
ORGANIZATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A
TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN
OFFICER OR DIRECTOR OF THE ORGANIZATION OR MIGHT RESULT IN A POSSIBLE
EXCESS BENEFIT TRANSACTION. AN INTERESTED PERSON MUST DISCLOSE THE
EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO
DISCLOSE ALL MATERIAL FACTS TO THE BOARD. AFTER DISCLOSURE OF THE FINANCIAL
INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE
INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD MEETING WHILE THE
DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE
REMAINING BOARD MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
332211
09-04-13
20130204 766504 216
Schedule O (Form 990 or 990-EZ) (2013)
32
Name of the organization BERRIEN-CASS-VANBUREN
WORKFORCE
Page 2
38-3287818
MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE
UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTERSET, THE BOARD MAY
DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE
TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS
OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE
ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO
THE TRANSACTION OR ARRANGEMENT. IF THE BOARD BELIEVES THERE HAS BEEN A
VIOLATION OF THE POLICY OR HAS REASONABLE CAUSE TO BELIEVE A MEMBER HAS
FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL
INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN
OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF AFTER HEARING
THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED
BY THE CIRCUMSTANCES, THE BOARD DETERMINES THE MEMBER HAS FAILED TO
DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE
APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. EACH BOARD MEMBER AND
EXECUTIVE DIRECTOR SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON
HAS AGREED TO COMPLY WITH THE POLICY. PERIODIC REVIEWS SHALL ALSO BE
CONDUCTED.
FORM 990, PART VI, SECTION B, LINE 15:
EXPLANATION: THE WDB IS RESPONSIBLE FOR SETTING THE COMPENSATION FOR NEWLY
HIRED OR PROMOTED EMPLOYEES WHO ARE CLASSIFIED AS EXECUTIVE OR KEY
EMPLOYEES, AS WELL AS RECOMMENDING CHANGES IN COMPENSATION FOR SUCH
EMPLOYEES. THE BOARD WILL REVIEW AND APPROVE THE COMPENSATION AT LEAST ON
AN ANNUAL BASIS. THE REVIEW WILL INCLUDE AT A MINIMUM A COMPARISON WITH THE
DATA FROM THE PEER ORGANIZATIONS. THE BOARD WILL MAKE RECOMMENDATIONS FOR
ADJUSTMENTS TO THE COMPENSATION OF THE EXECUTIVE AND KEY EMPLOYEES AS
APPROPRIATE. THE BOARD WILL KEEP A DETAILED RECORD OF THE MEETINGS AND
332212
09-04-13
20130204 766504 216
33
Name of the organization BERRIEN-CASS-VANBUREN
Page 2
WORKFORCE
38-3287818
DISCUSSIONS RELATIVE TO EXECUTIVE AND KEY EMPLOYEE COMPENSATION. THE
JUSTIFICATION FOR RECOMMENDED ADJUSTMENTS WILL BE APPROPRIATELY DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19:
EXPLANATION: UPON REQUEST, OPEN WDB MEETINGS, MINUTES POSTED ON THE
INTERNET AT WWW.MIWORKS.ORG.
FORM 990, PART XII, LINE 2C
EXPLANATION: PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
332212
09-04-13
20130204 766504 216
34
2013 DEPRECIATION AND AMORTIZATION REPORT
FORM 990 PAGE 10
Asset
No.
Description
* 990 PAGE 10 TOTAL
OTHER
MACHINERY &
EQUIPMENT
328102
05-01-13
Date
Acquired
Method
Life
990
Line
No.
Unadjusted
Cost Or Basis
0.
(D) - Asset disposed
34.1
Bus %
Excl
*
Reduction In
Basis
0.
Basis For
Depreciation
0.
Accumulated
Depreciation
0.
Current
Sec 179
0.
Current Year
Deduction
0.
* ITC, Section 179, Salvage, Bonus, Commercial Revitalization Deduction
FORM 990 PAGE 10
Asset
No.
Description
Date
Acquired
Method
Life
990
Line
No.
Unadjusted
Cost Or Basis
Bus %
Excl
*
Reduction In
Basis
Basis For
Depreciation
Accumulated
Depreciation
Current
Sec 179
Current Year
Deduction
42VIDEO/AUDIO
063004SL
5.00 16
5,900.
5,900.
5,900.
0.
43MULTIMEDIA
061504SL
5.00 16
9,325.
9,325.
9,325.
0.
44APC RACK SYSTEM
093003SL
5.00 16
14,949.
14,949.
14,949.
0.
49SERVER
063007SL
5.00 16
7,278.
7,278.
7,280.
0.
51SERVER
063007SL
5.00 16
10,726.
10,726.
10,725.
0.
69COPIER
063008SL
5.00 16
11,289.
11,289.
11,289.
0.
70COPIER
063008SL
5.00 16
11,289.
11,289.
11,289.
0.
71COPIER
SHARP MX M700N
79COPIER
SHARP MX M700N
80COPIER
COPIER RICOH MP
817000
COPIER RICOH MP
827000
063008SL
5.00 16
11,289.
11,289.
11,289.
0.
063009SL
5.00 16
10,976.
10,976.
8,780.
2,195.
063009SL
5.00 16
10,976.
10,976.
8,780.
2,195.
063008SL
5.00 16
9,765.
9,765.
9,765.
0.
063008SL
5.00 16
9,765.
9,765.
9,765.
0.
93FILE SERVER
063010SL
AUTOMATION ANYWHERE
94SERVER 6.5
061512SL
5.00 16
6,994.
6,994.
4,197.
1,399.
5.00 16
7,000.
7,000.
2,100.
1,400.
95SERVER
060512SL
5.00 16
7,098.
7,098.
2,130.
1,420.
96SERVER
060512SL
5.00 16
7,098.
7,098.
2,130.
1,420.
97SERVER
050112SL
KACE K1100 SYSTEMS
98MGT
062812SL
5.00 16
6,940.
6,940.
2,082.
1,388.
5.00 16
16,045.
16,045.
4,813.
3,209.
328102
05-01-13
34.2
FORM 990 PAGE 10
Asset
No.
Description
Date
Acquired
Method
KACE K2100 SYSTEMS
99MGT
062812SL
CISCO NETWORK
100SYSTEMS PRODUCT
060112SL
Life
990
Line
No.
Unadjusted
Cost Or Basis
Bus %
Excl
*
Reduction In
Basis
Basis For
Depreciation
Accumulated
Depreciation
Current
Sec 179
Current Year
Deduction
5.00 16
8,711.
8,711.
2,613.
1,742.
5.00 16
38,735.
38,735.
11,620.
7,747.
1012008 FORD F350 VAN 011212SL
EQUALLOGIC PS6100XV
102SAN
050913SL
MERAKI - NETWORKING
103&SECURITY SYSTEM
061313SL
SHORTEL TELEPHONE
104SYSTEM
063013SL
5.00 16
17,625.
17,625.
5,287.
3,525.
5.00 16
41,528.
41,528.
4,153.
8,306.
5.00 16
44,506.
44,506.
4,451.
8,901.
10.0016
61,092.
61,092.
3,055.
105FILE SERVER
093013SL
5.00 16
6,622.
6,622.
662.
106FILE SERVER
093013SL
* 990 PAGE 10 TOTAL
MACHINERY & EQUIPM
5.00 16
6,622.
6,622.
662.
OTHER
EQUALLOGIC PS6100XV
107SAN
073013SL
MERAKI CLOUD
108MANAGED GIGE POE SW111213SL
MERAKI CLOUD
109MANAGED GIGE POE SW111213SL
MERAKI CLOUD
110MANAGED APP
120113SL
SHORTEL TELEPHONE
111SYSTEM
120113SL
* 990 PAGE 10 TOTAL
OTHER
* GRAND TOTAL 990
PAGE 10 DEPR
328102
05-01-13
400,143.
0. 400,143. 164,712.
0.
49,226.
5.00 16
6,000.
6,000.
600.
5.00 16
2,681.
2,681.
268.
5.00 16
2,681.
2,681.
268.
5.00 16
2,380.
2,380.
238.
5.00 16
21,879.
21,879.
1,094.
35,621.
435,764.
34.3
0.
35,621.
0.
0.
2,468.
0. 435,764. 164,712.
0.
51,694.
4562
Form
OMB No. 1545-0172
9
Internal Revenue Service (99)
Name(s) shown on return
Depreciation and Amortization
9
2013
990
(Including Information on Listed Property)
See separate instructions.
Part I Election To Expense Certain Property Under Section 179
Attachment
Sequence No. 179
Attach to your tax return.
Business or activity to which this form relates
Identifying number
FORM 990 PAGE 10
38-3287818
Note: If you have any listed property, complete Part V before you complete Part I.
(a) Description of property
(b) Cost (business use only)
2,000,000.
(c) Elected cost
7 Listed property. Enter the amount from line 29 ~~~~~~~~~~~~~~~~~~~
7
8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 ~~~~~~~~~~~~~~
9 Tentative deduction. Enter the smaller of line 5 or line 8 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
10 Carryover of disallowed deduction from line 13 of your 2012 Form 4562 ~~~~~~~~~~~~~~~~~~~~
11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 ~~~~~~~~~
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 ••••••••••••
13
13 Carryover of disallowed deduction to 2014. Add lines 9 and 10, less line 12 ••••
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
9
Part II
500,000.
1
2
3
4
5
Maximum amount (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total cost of section 179 property placed in service (see instructions) ~~~~~~~~~~~~~~~~~~~~~
Threshold cost of section 179 property before reduction in limitation ~~~~~~~~~~~~~~~~~~~~~~
Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~
Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions ••••••••••
1
2
3
4
5
6
8
9
10
11
12
Special Depreciation Allowance and Other Depreciation (Do not include listed property.)
14 Special depreciation allowance for qualified property (other than listed property) placed in service during
the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
15 Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
16 Other depreciation (including ACRS) •••••••••••••••••••••••••••••••••••••
Part III MACRS Depreciation (Do not include listed property.) (See instructions.)
Section A
14
15
16
51,694.
17
17 MACRS deductions for assets placed in service in tax years beginning before 2013 ~~~~~~~~~~~~~~
18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here ••• J
Section B - Assets Placed in Service During 2013 Tax Year Using the General Depreciation System
(a) Classification of property
19a
b
c
d
e
f
g
h
i
20a
b
c
Part
(b) Month and
year placed
in service
(c) Basis for depreciation
(business/investment use
only - see instructions)
(d) Recovery
period
(e) Convention
(f) Method
(g) Depreciation deduction
3-year property
5-year property
7-year property
10-year property
15-year property
20-year property
25-year property
25 yrs.
S/L
27.5 yrs.
MM
S/L
/
Residential rental property
27.5 yrs.
MM
S/L
/
MM
S/L
/
39 yrs.
Nonresidential real property
MM
S/L
/
Section C - Assets Placed in Service During 2013 Tax Year Using the Alternative Depreciation System
Class life
12-year
40-year
IV Summary (See instructions.)
/
12 yrs.
40 yrs.
MM
21 Listed property. Enter amount from line 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.
Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instr. •••••••
23 For assets shown above and placed in service during the current year, enter the
23
portion of the basis attributable to section 263A costs ••••••••••••••••
316251
LHA For Paperwork Reduction Act Notice, see separate instructions.
12-19-13
20130204 766504 216
S/L
S/L
S/L
21
22
51,694.
Form 4562 (2013)
35
38-3287818 Page 2
Form 4562 (2013)
Listed
Property
(Include
automobiles,
certain
other
vehicles,
certain
computers,
and
property
used
for
entertainment,
recreation, or
Part V
amusement.)
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a)
through (c) of Section A, all of Section B, and Section C if applicable.
Section A - Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)
24a Do you have evidence to support the business/investment use claimed?
(b)
(c)
(a)
(d)
Date
Business/
Type of property
Cost or
placed
in
investment
(list vehicles first )
other basis
use percentage
service
No 24b If "Yes," is the evidence written?
(f)
(g)
(h)
Basis for depreciation
Recovery
Depreciation
Method/
(business/investment
period
deduction
Convention
use only)
Yes
25 Special depreciation allowance for qualified listed property placed in service during the tax year and
used more than 50% in a qualified business use•••••••••••••••••••••••••••••
26 Property used more than 50% in a qualified business use:
!
!
!
!
!
!
Yes
No
(i)
Elected
section 179
cost
(e)
25
!
!
!
!
!
!
%
%
%
27 Property used 50% or less in a qualified business use:
%
S/L %
S/L %
S/L 28
28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~
29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 •••••••••••••••••••••••••••
Section B - Information on Use of Vehicles
29
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
(a)
Vehicle
30 Total business/investment miles driven during the
year (do not include commuting miles) ~~~~~~
31 Total commuting miles driven during the year ~
32 Total other personal (noncommuting) miles
driven~~~~~~~~~~~~~~~~~~~~~
33 Total miles driven during the year.
Add lines 30 through 32~~~~~~~~~~~~
34 Was the vehicle available for personal use
during off-duty hours? ~~~~~~~~~~~~
35 Was the vehicle used primarily by a more
than 5% owner or related person? ~~~~~~
36 Is another vehicle available for personal
use? •••••••••••••••••••••
Yes
No
(b)
Vehicle
Yes
No
(c)
Vehicle
Yes
No
(d)
Vehicle
Yes
(e)
Vehicle
No
Yes
(f)
Vehicle
No
Yes
No
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than 5%
owners or related persons.
37 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your
employees?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
38 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners ~~~~~~~~~~~~
39 Do you treat all use of vehicles by employees as personal use? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
40 Do you provide more than five vehicles to your employees, obtain information from your employees about
the use of the vehicles, and retain the information received? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
41 Do you meet the requirements concerning qualified automobile demonstration use? ~~~~~~~~~~~~~~~~~~~~~~~
Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.
Part VI
Amortization
(a)
Description of costs
(b)
Date amortization
begins
! !
! !
(c)
Amortizable
amount
(d)
Code
section
(e)
Amortization
period or percentage
Yes
No
(f)
Amortization
for this year
42 Amortization of costs that begins during your 2013 tax year:
43 Amortization of costs that began before your 2013 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~
44 Total. Add amounts in column (f). See the instructions for where to report •••••••••••••••••••
316252 12-19-13
20130204 766504 216
43
44
Form 4562 (2013)
36
8868
Application for Extension of Time To File an
Exempt Organization Return
Form
(Rev. January 2014)
OMB No. 1545-1709
| File a separate application for each return.
| Information about Form 8868 and its instructions is at www.irs.gov/form8868 .
¥ If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box ~~~~~~~~~~~~~~~~~~~ | X
¥ If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing (e-file) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation
required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension
of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain
Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,
visit www.irs.gov/efile and click on e-file for Charities & Nonprofits.
Part I
Automatic 3-Month Extension of Time. Only submit original (no copies needed).
A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete
Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time
to file income tax returns.
Enter filer's identifying number
Type or
Name of exempt organization or other filer, see instructions.
Employer identification number (EIN) or
print
File by the
due date for
filing your
return. See
instructions.
38-3287818
Number, street, and room or suite no. If a P.O. box, see instructions.
499 W. MAIN STREET
Social security number (SSN)
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
BENTON HARBOR, MI
49022
Enter the Return code for the return that this application is for (file a separate application for each return) ~~~~~~~~~~~~~~~~~
0 1
Application
Is For
Form 990 or Form 990-EZ
Form 990-BL
Form 4720 (individual)
Form 990-PF
Form 990-T (sec. 401(a) or 408(a) trust)
Form 990-T (trust other than above)
Return
Code
07
08
09
10
11
12
¥
Return
Code
01
02
03
04
05
06
Application
Is For
Form 990-T (corporation)
Form 1041-A
Form 4720 (other than individual)
Form 5227
Form 6069
Form 8870
LISA ANKENBRUCK, CFO
The books are in the care of | 499 WEST MAIN STREET - BENTON HARBOR, MI 49022
Telephone No. | (800) 533-5800
Fax No. |
¥ If the organization does not have an office or place of business in the United States, check this box ~~~~~~~~~~~~~~~~~ |
¥ If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
. If this is for the whole group, check this
box |
. If it is for part of the group, check this box |
and attach a list with the names and EINs of all members the extension is for.
1
I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until
FEBRUARY 15, 2015 , to file the exempt organization return for the organization named above. The extension
is for the organization's return for:
|
calendar year
or
JUL 1, 2013
| X tax year beginning
, and ending JUN 30, 2014
.
If the tax year entered in line 1 is for less than 12 months, check reason:
Initial return
Final return
Change in accounting period
3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
0.
nonrefundable credits. See instructions.
3a
$
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
0.
estimated tax payments made. Include any prior year overpayment allowed as a credit.
3b
$
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
0.
by using EFTPS (Electronic Federal Tax Payment System). See instructions.
3c
$
Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment
instructions.
2
LHA
323841
12-31-13
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
20130204 766504 216
Form 8868 (Rev. 1-2014)
37

1 Kinexus - Berrien Community Foundation

Transcription

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