Community Investment 2018 Request for Proposal (RFP) · PDF file2/21/2018 · (17) mike farquhar 1.00 director 0.00 x 0 0 0 (18) mike garrett 1.00 director 0.00 x 0 0 0 (19) richard

1 - RFP Instructions and Certification Sheet Printed 2/21/2018

Instructions: All documentation must be submitted in paper AND electronic form.

Example: 2 - Geographic Service Summary form, United Way of the Ozarks

Required Financial and Outcomes Information and Documents:• What year did your Agency become a United Way of the Ozarks Agency? _____1955 (community chest)• When was your strategic plan last Board approved? Date: ___ 2015

� 1 - Instructions and Cover sheet, all required documentation check-marked � 2 - Geographic Service Summary forms (2A and 2B…on different tabs on spreadsheet)� 3 - Year-end Outcomes Report document � 4 - Client Success Story form� 5 - Board Roster or Local Advisory Group form � 6 - Marketing Statement � 7 - Anti-Terrorism Compliance and Charitable Status form - signed � 8 - Code of Conduct, Ethics, and Confidentiality Agreement - signed

Mark each box to confirm it’s included in packet submitted. (Forms #1-9 in bold type are provided by UWO)When submitting printed paper copies, keep in the order shown below

Community Investment2018 Request for Proposal (RFP)

INSTRUCTIONS and CERTIFICATION SHEETAGENCY NAME: Ozarks Regional YMCA

Section A. Financial & Outcomes Certification (Required by ALL Partner Agencies)Due: February 8, 2018 at 5:00 pm. (Late submissions will lose 10 points )

• Printed copies - Three (3) sets of 3-hole punched, collated copies of each document. Please do not staple or bind documents - use only paper or binder clips

• Electronically - Submit by email, Google Drive/DropBox, thumb drive, or DVD to [email protected]. Please keep the document file name “as is” and add your agency’s name.

· How frequently is your strategic plan reviewed by the Board? _______annually_____

Agency Mission Statement and brief history: The Ozarks Regional YMCA's mission statement is to put Christian principles into practice through programs that build a healthy mind, body and spirit for all. The Ozarks Regional YMCA was founded on July 27, 1889 as the Young Men's Christian Association of Springfield, MO. As a non-profit, our three areas of focus are youth development, healthy living, and social responsibility. Youth

programs focus on academic enrichment through extended learning activities that occur after school and during the summer. The organization provides youth sports in the community and outdoor education at Camp Wakonda. Healthy living is promoted through programs like Kid Fit, HEPA (Healthy Eating Physical Activity) standards, group exercise classes for children and adults, personal training, silver sneakers, and general wellness facilities. Social responsibility is promoted through equal access to Y programs regardless of socio-economic status. In 2017, nearly $500,000 worth of financial assistance was provided to around 2,800 individuals in our 15 county service area. Financial assistance provides access to high quality childcare for working parents, chronic pain management classes for seniors, sports programming for youth, and facility memberships for individuals and families.

mailto:[email protected]















1 - RFP Instructions and Certification Sheet Printed 2/21/2018

� 9 - Program Budget Summary form- provide 1 per program + narrativeContinued

� 10 - IRS Federal Tax-Exempt Letter or letter stating government/school affiliation� 11 - Reserve Policy with Board approval date� 12 - Anti-Discrimination or Equal Employment Opportunity Commission (EEOC) Policy� 13 - Current year-end & Previous year-end internal financial statements (with budget to actual)� 14 - Most current Balance Sheet� 15 - Last 2 months’ Year-To-Date financial activity (revenue & expense with budget to actual)� 16 - Most recent IRS Form 990 (print front & back)� 17 - Most recent Audit & Management Letter, if applicable (print front & back) � 18 - Most recent Annual Report

� 19 - Program Cover Sheet - 1 needed per agency and signed by board chair and agency CEO

� 20 - Program Application - 1 Program Application needed for each FUNDED PROGRAM

o Literacy / Mentoring panel:

Big Brothers Big Sisters OTC Middle College Ozarks Literacy Council RSVP Reading Buddies

o Youth Services panel:

Boy Scouts Boys and Girls Club Girl scouts Ozarks Regional YMCA

o Basic Needs panel:

Habitat for Humanity NAMI Ozarks Counseling Center Salvation Army

Additional required information by 2018 Presenting Partners listed below

Section B. Request for Proposal Documentation

Required Documents: (When submitting printed paper copies please keep in the following order)

2A - Geographical Service Summary Form Geographical Service Summary - Individuals Served in 2017 Printed 2/21/2018

For each UWO funded program(s), please provide the number of individuals served per county. Individuals may be counted in multiple programs.United Way of the Ozarks - Community Investment

BARR

Y

CHRI

STIA

N

DALL

AS

DOUG

LAS

GREE

NEHI

CKORY

LACL

EDE

LAW

RENC

EPO

LK

STON

E

TANE

YTE

XAS

WEB

STER

WRI

GHT

TOTA

L FOR

UW

O CO

UNTI

ESTO

TAL S

ERVE

D IN

OTH

ER

COUN

TIES

LIST O

THER

COUN

TIES

HER

E

Agency Name

190 41 122 0 2437 0 118 23 161 0 208 0 0 0 3300

914 307 5760 763 1331 723 200 278 10276

Program 3 ______________________Program 4 ______________________

1104 41 429 0 8197 0 881 1354 884 200 486 0 0 0 13576 0

Please circle which is indicative of the data you are providing: Estimate or Accurate

Program 1 School Age Services

Program 2 Healthy Living

Totals

Greene includes: Christian, Webster

N A N AYoung Children Ages 0-9 years N A N APre-teens / teens Ages 10-18 years N A N A

Young Adults Ages 19-29 yearsAdults Ages 30-64 years

Senior Adults Ages 65+ years N A N AN A N A

# of Vol Vol HoursAsian, Hawaiian, Pacific Islander N A N A

N A N A2120 N A N A

N A N A

#

Program 4

Volunteer information1180

Age information Alt. age range LGBTQ

HeterosexualUnknown

Genders Served FemaleMaleOther

Ethnicities Served Hispanic or Latino

3300 ages 0-18

10276 ages 19-65+

Total

Should your "age ranges" be different from these, please mark in "Alt Age

Range"

Income Levels Low Income

Not specifically low-incomeN A

Race

Total Total

Total Total

Program 2Program 3

Sexual Orientation

Not Hispanic or Latino

Program 1Black or African AmericanWhite or CaucasianOther

N AN AN A

1

10

Attend

1

Collaborative

Prosper Springfield

1

4

Collaborative Attend

Please put the number one (1) by each Collaborative attended

by employees of your Agency. Please add others in the space provided.

1

Kids First

Violence Free Families CoalitionList other Collaboratives below:

Down Syndrome of the OzarksArc of the Ozarks, Northwest Project, CPO, and Child

Advocacy CenterHousing Total attended

11

Child Abuse & Neglect (CAN)Continuum of Care

Early Child-hood & EducationHealthy Living AllianceHomeless Task Force

Literacy

3 - Year End Outcomes Report Printed 2/21/2018

Agency Name OZARKS REGIONAL YMCA

Program Name 2017 SCHOOL AGE SERVICES AND HEALTHY LIVING OUTCOMES

Priority Based: Basedon 2015 RFP Application Priorities: Children at Risk and Healthy Families

K-3 4-8 9-12 Total# of Books Distributed per agegroup 180 100 280

NAName of Financial Education Program 1Name of Financial Education Program 2Name of Financial Education Program 3Name of Financial Education Program 4

NA3300NANANANANANANANA

3300NA

NANA

NA13576

480161.1113576 480161.11

NA

Please provide your agency's outcome results for the 2017 year on the next page

Additional notes regarding the information above:

Number of individuals who were placed in jobsTotals

Number of individuals receiving rental assistanceAmount of total rental assistance providedNumber of individuals receiving utility bill assistanceAmount of total utility bill assistance providedNumber of individuals receiving other monetary assistanceAmount of total other monetary assistance provided

TotalsMental Health

Number of individuals you provided referrals to for mental health needs

Number of individuals who were placed in job training

Number of individuals completing stability plansNumber of individuals receiving meals or food itemsNumber of individuals who received temporary housing (less than 6 mos.) Number of days provided for temporary housing (less than 6 mos.) Number of individuals who received sheltering . Include warming / cooling sheltersNumber of days provided for sheltering . Include warming / cooling sheltersNumber of individuals placed in PERMANENT HOUSING (Six (6) months or longer)Number of individuals who were placed in apprenticeships

Program Application2018 United Way of the Ozarks Year-End Outcomes Report

Please place a (N/A) in any empty boxes so that we will know you have intentionally left it blank.Education

Financial Stability / Basic Needs Number of Financial Education Programs Completed

Ozarks Regional YMCA

2018 RFP 2017 Outcomes

Based on the 2015 priorities foe the United Way and the Ozarks Regional YMCA we achieved the following in 2017:

• Provided 280 books to children K-8 180 books. Encouraging the love of reading and working with parents on reading with their children.

• We provided 3,330 children a safe, positive, and nurturing environment. A place to learn, grow, a place of belonging regardless of income or background.

o Prevents unhealthy habits in pre-teens and middle schoolers( drugs, crime and other destructive behaviors)

o Encourage social skills o Those kept busy and engaged in healthy programs are less likely to be depressed or

isolate themselves o Increased homework help o Less stress at home with parents/caregivers by completing homework on site

Additionally giving parents a way to stay at work during no school days(summer, spring break, holidays).

Increase employee productivity and loss of wages • Provided over 742,000 healthy meals/snack in 12 months

o Healthier children o Less stress by parents or caregivers as child has received meals at after school program,

summer day camp(3 a day), and school out days. o Teaching healthy eating habits

• Provided over 10,000 memberships or financial assistance to give access to those to otherwise could not afford.

o We are the only comparable organization that provides financial assistance to programs and memberships.

5 - Board of Directors / Adv. Board Roster Printed 2/21/2018

First Name Last Name Employer Current Board Position

1 Shannon Boggs Merrill Lynch, Assistant VP Chair

2 Mike Farquhar Pella Windows, AR and MO, Owner Vice- Chair

3 Brian Todd BKD, LLP, Partner Treasurer

4 Rachael Dockery Missouri State University, General Council Secretary

5 Matt Mayse Mayse Automotive Group, GM Immediate Past Chair

6 Sam Coryell TLC Properties, President and CEO

7 Charity Elmer Gen. Council Cox Health8 Mike Chiles Emerald Ops, President9 Mike Garrett Retired

10 John Jungmann Springfield Public Schools, Superintendent

11 Frank Gamble OneStone Media, Owner

12 Mac McGregor Edward Jones, Financial Advisor

13 Julie Mercer-Kidd Mercy , Director of Mission Service14 Matt Miller Miller Commerce15 Kelly Parson Mid Missouri Bank, Sr. VP

16 Dwight RahmeyerSimmons, Regional Chairman, Trust

Division17 Tracy Roberts Cox Physicians for Breast Health18 Bill Corbin Retired

19 Shawn WhitneySpencer Fane Britt and Browne, LLP,

Partner20 David Wieland Wieland & Condry, LLC, Attorney21 Christian Lewis Simmons, VP Commercial Lending

22 CatherineReade Haden, Cowherd & Bullock, Attorney

23 Rob YandersYander's Law, Founder/Head Coach

24 Allen Jones Springfield News-Leader, President

25 Dan PraterDrury University, Director Center for

Non-Profit Leadership262728293031323334353637383940414243444546

Agency ____________________________________________________

6 - Marketing Statement Printed 2/21/2018

Is the United Way of the Ozarks’ logo on all agency printed collateral? i.e. envelopes, letterheads, literature, brochures, etc. Yes No

Is there wording in all public service announcements, news releases, articles, etc., to the effect that your agency is a United Way of the Ozarks Partner Agency?

Yes No

Is there a link on your Agency’s website to the United Way of the Ozarks’ website? Yes No

If your Agency is on Facebook and / or Twitter, do you like and / or follow United Way of the Ozarks?

Yes No

Is your agency listed in the United Way 2-1-1 database? *If your answer is no, you are ineligible for United Way of the Ozarks’ funding.

Yes No

The Ozarks Regional YMCA serves each of our communities through our three areas of focus; Youth Development, Healthy Living and Social Responsibility all with the assistance of the United Way. Currently

the United way logo is placed on our quarterly newsletters, membership brochures, annual report, letterhead, press releases, website, child care brochures and Camp Wakonda brochures. In addition, we have banners

and sign located at each of the family centers that benefit from the United Way.

2-1-1 Database - United Way funding eligibility requirement

5/1/2017

*If your answer is more than 12 months ago, you are ineligible for United Way of the Ozarks’ funding.

Agency Name: Ozarks Regionla YMCA

Comments: _________________________________________________________________________________Explain any other ways your Agency promotes this partnership, if any. (200 word maximum) Please write response in this text box. Please do not use separate sheet.

Community Investment2018 Request for Proposal (RFP)

MARKETING STATEMENT

Comments: _________________________________________________________________________________

Comments: _________________________________________________________________________________

Comments: _________________________________________________________________________________

7 - Anti-Terrorism Compliance and Charitable Status form - Signed Printed 2/21/2018

Anti-Terrorism Compliance and Charitable Status

2018 Community InvestmentUnited Way of the Ozarks

In compliance with the USA Patriot Act and other counterterrorism laws, the United Way of the Ozarks requires that each agency certify the following:

I hereby certify on behalf of (agency name)

Name: _____Steven Gimenez_______________________________________

Title: _____________CEO______________________________________

Date: ___2/6/2018___________Signature: ____/Steven Gimenez/_________________

OZARKS REGIONAL YMCA

That ALL United Way of the Ozarks funds and donations will be used in compliance with all applicable anti-terrorist financing and asset control laws, statutes, and executive orders.

8 - Code of Conduct, Ethics and Confidentiality Agreement - SIGNED Printed 2/21/2018

1. Honesty 2. Integrity 3. Promise-keeping 4. Fidelity 5. Fairness 6. Caring

Confirmation:

Agency’s Board Chairman Signature: __/Shannon Boggs/__________________________________________Date: ___2/6/2018_____________

Date: ____2/6/2018____________

*The Josephson Institute

11. Safeguard the Public Trust

Agency’s Executive Director’s Signature: _____/Steven Gimenez/_____________________________________

UNITED WAY OF THE OZARKSCODE OF CONDUCT, ETHICS & CONFIDENTIALITY AGREEMENT

ency Name:___Ozarks Regional YMCA_________________________________________________

Code of Conduct and Ethics:

Confidentiality Agreement:

All United Way of the Ozarks partner agency representatives are expected to adhere to all laws and governmental regulations applicable to their Agency, and adhere to the ethical standards of their own profession.

The following are the core ethical values, which apply to all staff, board members, partner agency representatives, and volunteers: *

Each Person shall exercise care not to disclose any confidential information acquired solely as a result of the affiliation with the United Way of the Ozarks to any person not authorized to receive such information, or use to the disadvantage of United Way of the Ozarks any such confidential information, without the express authorization of United Way of the Ozarks.

I, (please print) __Steven GImenez___, certify that I have read and understand the Code of Conduct and Ethics, and Confidentiality Agreement, both of the United Way of the Ozarks, and agree to comply with the Agreements as they are stated in this document.

7. Respect 8. Citizenship 9. Excellence10. Accountability

9 - Program Budget Summary form Print 2/21/2018

Public Support and Revenue FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget1 Contributions 130,000.00$ 50,910.00$ 112,635.00$ 116,014.05$ 2 Grants & Contracts (non-government) 327,347.00$ 291,554.00$ 318,460.00$ 328,013.80$ 3 Special Events & Sales 25,000.00$ 21,430.00$ 30,000.00$ 30,900.00$ 4 United Way of the Ozarks Allocation 90,520.00$ 90,519.00$ 90,520.00$ 93,235.60$ 5 Other United Way Allocations6 Grants & Contracts from Government Agencies7 Program Fees 2,424,900.00$ 2,475,684.00$ 2,545,339.00$ 2,621,699.17$ 8 Funds From Previous Year9 Other Revenue (Please Specify) - Investments, Etc. 36,206.00$ 68,508.00$ 38,371.00$ 39,522.13$

10 Total Support and Revenue (sum of lines 1-9) 3,033,973.00$ 2,998,605.00$ 3,135,325.00$ 3,229,384.75$

Expenses FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget

11Salary, Benefits, Payroll Taxes (do not include management & fundraising expenses) 1,363,884.00$ 1,366,939.00$ 1,466,879.00$ 1,510,885.37$

12 Occupancy & Related 144,554.00$ 138,516.00$ 137,758.00$ 141,890.74$ 13 Equipment 16,280.00$ 35,813.00$ 20,040.00$ 20,641.20$ 14 Professional Fees & Contract Services 102,000.00$ 72,089.00$ 111,000.00$ 114,330.00$ 15 Staff Training & Development 9,477.00$ 7,070.00$ 11,562.00$ 11,908.86$ 16 Affiliations, Accreditations, & Licensing 35,079.00$ 37,729.00$ 39,937.00$ 41,135.11$ 17 Specific Assistance to Individuals 130,000.00$ 148,680.00$ 112,635.00$ 116,014.05$ 18 Management & Fundraising Expenses 348,153.00$ 353,553.00$ 344,116.00$ 354,439.48$ 19 All Other Expenses - Travel, Supplies, Materials 432,292.00$ 400,426.00$ 374,327.00$ 385,556.81$

20 Total Expenses (sum of lines 11-19) 2,581,719.00$ 2,560,815.00$ 2,618,254.00$ 2,696,801.62$ 21 Overhead Rate % (line 18 / line 10) 11% 12% 11% 11%

Comparative Information FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget

22United Way of the Ozarks Allocation as % of Total Revenue (line 4 / line 10) 3% 3% 3% 3%

Other23 List matching grants where United Way allocated funds were used and the amount of the grant/s. Indicate none if applicable.

24

25 Note any anticipated changes for your agency's 2020 budget. Indicate none if applicable.

Program 1: _____School Aged Services__________________

NAProvide a FY2019 program budget narrative for each requested program.

SEE SCHOOL AGE SERVICES BUDGET NARRATIVE ATTACHMENT

Agency: OZARKS REGIONAL YMCA__________________


2018 RFP School-Age-Services Budget Narrative

• Salary, Benefits, Etc. – Cost: This line item is for the 200 School Age Services and Camp Wakonda staff that serve 3,000+ children at 36+ school sites, summer day camp and Camp Wakonda. Salary pays for program directors, site directors, program teachers, and camp counselors. Staffing for many programs is based on child care ratios set by the state and/or camp guidelines.

• Occupancy and related: The School Age Services program requires space for Camp Wakonda, office space for staff, and space for child care. School-Age-Services pays for the use of space at 36+ schools in the Springfield School District.

• Equipment: Equipment for the School Age Services program includes computers, sports equipment, and other supplies for academic enrichment. It also includes camping gear, outdoor recreation equipment, tools, and other things needed to maintain Camp Wakonda.

• Professional Fees and Contract Services: These professional fees and contract services are for services provided to our youth by individuals who are not YMCA staff. This could include things like enrichment activities for after school or summer day camp.

• Staff Training and Development: All child care staff have to be trained in CPR and first aid. Staff handling food go through several classes to ensure meal preparation is HEPA compliant. Costs also include YUSA trainings and certifications. As training opportunities arise for FT staff via YUSA, we request financial assistance for registration fees to attend. We look to stay relevant and up to date in the most efficient way possible.

• Affiliations, Accreditations, and Licensing: These costs are to YUSA for access to the Y brand, HEPA guidance, and other resources.

• Specific Assistance to Individuals: The YMCA strives to provide equal access through financial assistance for low-income individuals who cannot afford to pay the full cost for membership or other program fees.

• Management and Fundraising Expenses: Cost in this line item cover fundraising for individual branches and costs to ORYMCA corporate for management, general oversight, accounting, grant writing, and operations.

• All other expenses (Travel, supplies, Materials): Cost in this item include credit card processing fees, travel, lodging, insurance expenses and other costs not covered under the other line items.

9 - Program Budget Summary form Print 2/21/2018

Public Support and Revenue FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget1 Contributions 289,915.00$ 239,662.00$ 296,800.00$ 3057042 Grants & Contracts (non-government) 366,534.00$ 362,613.00$ 254,815.00$ 262,459.45$ 3 Special Events & Sales 142,178.00$ 111,720.00$ 179,550.00$ 184,936.50$ 4 United Way of the Ozarks Allocation 34,224.00$ 34,224.00$ 32,621.00$ 33,599.63$ 5 Other United Way Allocations6 Grants & Contracts from Government Agencies7 Program Fees 6,358,862.00$ 6,162,963.00$ 6,438,041.00$ 6,631,182.23$ 8 Funds From Previous Year9 Other Revenue (Please Specify) - Investments, Etc. 400,818.00$ 433,241.00$ 434,799.00$ 447,842.97$

10 Total Support and Revenue (sum of lines 1-9) 7,592,531.00$ 7,344,423.00$ 7,636,626.00$ 7,865,724.78$

Expenses FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget

11Salary, Benefits, Payroll Taxes (do not include management & fundraising expenses) 3,792,180.00$ 3,597,596.00$ 3,723,555.00$ 3,835,261.65$

12 Occupancy & Related 975,836.00$ 882,293.00$ 908,771.00$ 936,034.13$ 13 Equipment 164,275.00$ 235,803.00$ 143,902.00$ 148,219.06$ 14 Professional Fees & Contract Services 27,364.00$ 27,540.00$ 26,075.00$ 26,857.25$ 15 Staff Training & Development 20,777.00$ 21,961.00$ 27,708.00$ 28,539.24$ 16 Affiliations, Accreditations, & Licensing 106,365.00$ 114,974.00$ 120,659.00$ 124,278.77$ 17 Specific Assistance to Individuals 289,915.00$ 208,178.00$ 296,800.00$ 305,704.00$ 18 Management & Fundraising Expenses 836,967.00$ 856,968.00$ 854,921.00$ 880,568.63$ 19 All Other Expenses - Travel, Supplies, Materials 1,948,018.00$ 1,800,592.00$ 1,871,831.00$ 1,927,985.93$

20 Total Expenses (sum of lines 11-19) 8,161,697.00$ 7,745,905.00$ 7,974,222.00$ 8,213,448.66$ 21 Overhead Rate % (line 18 / line 10) 11% 12% 11% 11%

Comparative Information FY-2017 Budgeted FY-2017 Actual FY-2018 Current Budget FY-2019 Proposed Budget

22United Way of the Ozarks Allocation as % of Total Revenue (line 4 / line 10) 0% 0% 0% 0%

Other23 List matching grants where United Way allocated funds were used and the amount of the grant/s. Indicate none if applicable.

24SEE ATTACHED HEALTHY LIVING BUDGET NARRATIVE

25 Note any anticipated changes for your agency's 2020 budget. Indicate none if applicable.

None

Provide a FY2019 program budget narrative for each requested program.

gency: ___OZARKS REGIONAL YMCA_____________________________Program 2: _________Healthy Living____________________

None


2018 RFP Healthy Living Budget Narrative

• Salary, Benefits, etc.: This covers the cost for 600+ FT and PT staff across 8 family facilities. Positions include: branch executive directors, wellness directors, membership directors, wellness instructors, personal trainers, life guards and others. Corporate leadership and fundraising staff were not included.

• Occupancy and Related: The Healthy Living Program includes 8 facilities across the Ozarks region. Cost include leasing fees, mortgages, and utilities for these buildings.

• Equipment: This line item covers weights, cardio equipment, rock climbing, and other items needed for wellness activities.

• Professional Fees and Contract Services: These costs are for workloads that we cannot handle internally. This could include IT professionals to work on computers.

• Staff Training and Development: 600+ staff across the Healthy Living Program go through different levels of training to ensure programming is delivered at a certain level of quality. Staff go through various certifications through YUSA focused on leadership. Staff also go through certification for wellness classes, CPR, and first aid.

• Affiliations, Accreditations, and Licensing: ORYMCA pays a portion of its revenue to YUSA for technical assistance, access to the Y brand, and other resources.

• Specific Assistance to Individuals: The YMCA strives to provide equal access through financial assistance for low-income individuals who cannot afford to pay the full cost for membership or other program fees.

• Management and Fundraising Expenses: Cost in this line item cover fundraising for individual branches and costs to ORYMCA corporate for management, general oversight, accounting, grant writing, and operations.

• All other expenses (Travel, supplies, Materials): Cost in this item include credit card processing

fees, travel, lodging, insurance expenses and other costs not covered under the other line items.

Ozarks Regional YMCA ORYMCA Operating Reserve Policy 5/25/2016

Policy Effective Date: 5/25/2016 1

I. PURPOSE

The purpose of this Operating Reserve Policy for Ozarks Regional YMCA is to build and maintain an adequate level of unrestricted net assets to support the organization’s day-to-day operations in the event of unforeseen shortfalls. The reserve may also be used for one-time, nonrecurring expenses that will build long-term capacity, such as staff development, research and development, or investment in infrastructure. Operating reserves are not intended to replace a permanent loss of funds or eliminate an ongoing budget gap. The organization intends for the operating reserves to be used and replenished within a reasonable period of time. This Operating Reserve Policy will be implemented in conjunction with the other financial policies of the organization and is intended to support the goals and strategies contained in those related policies and in strategic and operational plans.

II. DEFINITIONS AND GOALS The Operating Reserve Fund is defined as the designated fund set aside by action of the Board of Directors. The minimum amount to be designated as operating reserve will be established in an amount sufficient to maintain ongoing operations and programs for a set period of time, measured in months. The operating reserve serves a dynamic role and will be reviewed and adjusted in response to internal and external changes. The organization’s short term goal is to have 20 days in reserves and then work to build toward three months of average recurring operating costs. The target Operating Reserve Fund is equal to six months of average recurring operating costs plan and an additional fund for facilities maintenance emergencies. In addition to calculating the actual operating reserve at the fiscal year-end, the operating reserve fund target minimum will be calculated each year after approval of the annual budget. These reserves will be reported to the Finance Committee and Board of Directors, and included in the regular financial reports.

III. ACCOUNTING FOR RESERVES

The Operating Reserve Fund will be recorded in the accounting system and financial statements as Board Designated Operating Reserve. The Operating Reserve Fund will be funded and available in cash or cash equivalents. Operating reserves will be maintained in a segregated bank account or investment fund, in accordance with investment policies. FUNDING OF RESERVES The Operating Reserve Fund will be funded with surplus unrestricted operating funds. The Board of Directors may, from time to time, direct that a specific source of revenue be set aside for operating reserves. Examples may include one-time gifts or bequests, special grants, or special appeals. The Chief Executive Officer and/or Chief Financial Officer will identify the need for access to reserve funds and confirm that the use is consistent with the purpose of the reserves as

Ozarks Regional YMCA ORYMCA Operating Reserve Policy 5/25/2016

Policy Effective Date: 5/25/2016 2

described in this Operating Reserve Policy. Determination of need requires analysis of the sufficiency of the current level of reserve funds, the availability of any other sources of funds before using reserves, and evaluation of the time period for which the funds will be required and replenished.

IV. AUTHORITY TO USE OPERATING RESERVES

Authority for the use of operating reserves is delegated to the Chief Executive Officer and/or Chief Financial Officer in consultation with the Treasurer and/or Chair of the Finance Committee. The use of operating reserves will be reported to the Board of Directors at their next scheduled meeting, accompanied by a description of the analysis and determination of the use of funds, and plans for replenishment to restore the Operating Reserve Fund to the target minimum amount. The Chief Executive Officer must receive prior approval from the Board of Directors if the operating reserves will take longer than three months to replenish.

V. REPORTING AND MONITORING The Chief Executive Officer and/or Chief Financial Officer is responsible for ensuring that the Operating Reserve Fund is maintained and used only as described in this Policy. Upon approval of the use of operating reserve funds, the Chief Executive Officer and/or Chief Financial Officer will maintain records of the use of funds and plan for replenishment. She/he will provide regular monthly reports to the Finance Committee and/or Board of Directors of progress to restore the fund to the target minimum amount. The Chief Executive Officer and/or Chief Financial Officer will annually discuss what additional risk factors might be considered for the organization, the impact of budgeting on operating reserve levels, and any requirements with funders or chartering organizations.

VI. REVIEW OF POLICY

This Policy will be reviewed by the Finance Committee annually at a minimum, or sooner if warranted by internal or external events or changes. Changes to the Policy will be recommended by the Finance Committee to the Board of Directors. The Finance Committee is established by Ozarks Regional YMCA board of directors to recommend financial policies, strategies, and budgets that support the mission, values and strategic plan of the organization. Its purpose is to ensure the financial health and integrity of the organization in pursuit of its mission to promote Judeo-Christian values through programs that build a healthy spirit, mind and body for all.

Public Inspection Copy

Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) . . . . . . . . . . . . . . . . . . . .

Gross receipts

Check if applicable:

For the 2016 calendar year, or tax year beginning

Application pending

City or town, state or province, country, and ZIP or foreign postal code

Amended return

terminated

Room/suiteNumber and street (or P.O. box if mail is not delivered to street address)

Initial return

Name change

Address change

Name of organization

u Information about Form 990 and its instructions is at www.irs.gov/form990.Internal Revenue ServiceDepartment of the Treasury

OMB No. 1545-0047

Form

Telephone numberE

Employer identification numberDCB

, and endingA

Open to Publicu Do not enter social security numbers on this form as it may be made public.

Return of Organization Exempt From Income Tax2016990

Inspection

Doing business as

G $

F Name and address of principal officer:

H(a)

H(b)

H(c)

Is this a group return for subordinates?

Are all subordinates included?

If "No," attach a list. (see instructions)

Group exemption number u

Yes No

NoYes

I

J

K

Tax-exempt status:

Website: u

Form of organization:

501(c) 4947(a)(1) or 527( ) t (insert no.)

Corporation Trust Association Other u L Year of formation: M State of legal domicile:

SummaryPart I1

2

3

4

5

6

7a

b

Briefly describe the organization's mission or most significant activities: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Check this box u

Number of voting members of the governing body (Part VI, line 1a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of independent voting members of the governing body (Part VI, line 1b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total number of individuals employed in calendar year 2016 (Part V, line 2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Total number of volunteers (estimate if necessary) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total unrelated business revenue from Part VIII, column (C), line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Net unrelated business taxable income from Form 990-T, line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b

7a

6

5

4

3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

if the organization discontinued its operations or disposed of more than 25% of its net assets.

8

9

10

11

12

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) . . . . . . . . . . . .

Prior Year Current Year

13

14

15

16a

b

17

18

19

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total fundraising expenses (Part IX, column (D), line 25) u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Revenue less expenses. Subtract line 18 from line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20

21

22

Beginning of Current Year End of Year

Total assets (Part X, line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total liabilities (Part X, line 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Net assets or fund balances. Subtract line 21 from line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DAAForm 990 (2016)

SignHere

Paid

Preparer

Use Only

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 istrue, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Signature of officer Date

Type or print name and title

CheckPreparer's signature Date PTIN

self-employed

Firm's name Firm's EIN }

Firm's address Phone no.

For Paperwork Reduction Act Notice, see the separate instructions.

Part II Signature Block

May the IRS discuss this return with the preparer shown above? (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NoYes

Acti

vit

ies &

Go

vern

an

ce

Reven

ue

Exp

en

ses

Net

Ass

ets

orFu

nd B

alan

ces

501(c)(3)

ifPrint/Type preparer's name

}

}

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Final return/


417 S JEFFERSON AVE.

SPRINGFIELD MO 65806

44-0545283

417-862-7456

STEVE GIMENEZ417 S JEFFERSONSPRINGFIELD MO 65806

11,020,445

X

XWWW.ORYMCA.ORG

X 1888 MO

THE MISSION OF OZARKS REGIONAL YMCA IS TO PROMOTE JUDEO-CHRISTIAN VALUESTHROUGH PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND, AND BODY FOR ALL.APPROXIMATE NUMBER OF PROGRAM PARTICIPANTS - 50,000+

212112239000

-4,289-3,858

1,677,609 2,289,6278,122,235 8,402,899-21,764 -32,994521,479 137,034

10,299,559 10,796,56600

5,793,541 5,883,6330

224,7224,532,465 4,470,42310,326,006 10,354,056

-26,447 442,510

27,246,735 26,437,5349,931,565 8,948,12817,315,170 17,489,406

RUTH SHRYACK CFO

BARBARA J. HOUSER, CPA BARBARA J. HOUSER, CPA 08/22/17 P00227583

KPM CPAS, PC 43-11097681445 E REPUBLIC RDSPRINGFIELD, MO 65804 417-882-4300

X

00282800 08/22/2017 9:28 AM Pg 1


Form 990 (2016) Page 2Part III Statement of Program Service Accomplishments

1 Briefly describe the organization's mission:

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Did the organization undertake any significant program services during the year which were not listed on the2

prior Form 990 or 990-EZ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "Yes," describe these new services on Schedule O.

3

4

Did the organization cease conducting, or make significant changes in how it conducts, any program

services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

4a (Code: . . . . . . . . . ) (Expenses $ . . . . . . . . . . . . . . . . . . . . . . . . . . . including grants of $ . . . . . . . . . . . . . . . . . . . . . . . . . . ) (Revenue $ . . . . . . . . . . . . . . . . . . . . . . . . . . )

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)$ . . . . . . . . . . . . . . . . . . . . . . . . . .(Revenue)$ . . . . . . . . . . . . . . . . . . . . . . . . . .including grants of$ . . . . . . . . . . . . . . . . . . . . . . . . . . .) (Expenses(Code: . . . . . . . . .4b

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4c (Code: . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . . . . . . . . including grants of $ . . . . . . . . . . . . . . . . . . . . . . . . . . )) (Expenses $ . . . . . . . . . . . . . . . . . . . . . . . . . . )(Revenue

.

4d Other program services (Describe in Schedule O.)

(Revenue )$(Expenses )$including grants of$

4e Total program service expenses u

Form 990 (2016)DAA

NoYes

Yes No

Check if Schedule O contains a response or note to any line in this Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

OZARKS REGIONAL YMCA 44-0545283

X

SEE SCHEDULE O

X

X

4,976,315 5,165,608HEALTHY LIVING: FITNESS, WELLNESS & RECREATION PROGRAMS PROMOTE JUDEOCHRISTIAN VALUES THROUGH DEVELOPING HEALTHY MINDS, BODIES, AND SPIRITS BYOFFERING CLASSES FOR ALL AGES, ALL LEVELS AND ALL INTERESTS INCLUDINGINDOOR EXCERCISE, OUTDOOR SPORTS, PERSONAL TRAINING, AND MASSAGE THERAPY.

APPROXIMATE NUMBER OF PROGRAM PARTICIPANTS - 21,950

4,229,624 3,237,291YOUTH DEVELOPMENT: CHILD CARE SERVICES AND CAMP WAKONDA PROGRAMS PROMOTEJUDEO CHRISTIAN VALUES THROUGH DEVELOPING HEALTHY MINDS, BODIES, ANDSPIRITS BY NURTURING THE POTENTIAL OF LOCAL CHILDREN AND TEENS BYCULTIVATING THE VALUES, SKILLS AND RELATIONSHIPS THAT LEAD TO POSITIVEBEHAVIORS, BETTER HEALTH, AND EDUCATIONAL ACHIEVEMENT. THE Y IS ALSO ASTARTING POINT FOR MANY YOUTH TO LEARN ABOUT BECOMING AND STAYING ACTIVE,AND DEVELOPING HEALTHY HABITS.

APPROXIMATE NUMBER OF CHILD CARE PROGRAM PARTICIPANTS - 7,374

APPROXIMATE NUMBER OF CAMP WAKONDA PROGRAM PARTICIPANTS - 389

9,205,939

00282800 08/22/2017 9:28 AM Pg 2

Public Inspection Copy1

Checklist of Required SchedulesPart IVPage 3Form 990 (2016)

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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 (see instructions)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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,

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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14a

b

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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

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 obtain separate, independent audited financial statements for the tax year? If “Yes,” complete

Schedule D, Parts XI and XII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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18

19

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on

Did the organization report more than $15,000 total of fundraising event gross income and contributions on

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?

Yes No

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14a

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DAA

Form 990 (2016)

endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes,"

complete Schedule D, Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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—other securities in Part X, line 12 that is 5% or more

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

reported in Part X, line 16? If "Yes," complete Schedule D, Part IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets

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 . . . . . . . . . . . . . . . .

"Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional . . . . . . . . . . . . . . . . . . .

Was the organization included in consolidated, independent audited financial statements for the tax year? If

Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "Yes," complete Schedule G, Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

a

b

c

d

e

f

11a

11b

11c

11d

11e

11f

b

12a

12b

foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


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Form 990 (2016) Page 4Part IV Checklist of Required Schedules (continued)

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31

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34

35a

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37

Was the organization a party to a business transaction with one of the following parties (see Schedule L,

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, Parts 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

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,

37

36

35a

34

33

32

31

30

29

28a

28b

28c

Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21

22

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24a

24b

24c

24d

25a

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26

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substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee,

current or former officers, directors, trustees, key employees, highest compensated employees, or

Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any

year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior

transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

to defease any tax-exempt bonds? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization maintain an escrow account other than a refunding escrow at any time during the year

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

through 24d and complete Schedule K. If “No,” go to line 25a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than

organization's current and former officers, directors, trustees, key employees, and highest compensated

Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or

27

26

b

25a

d

c

b

24a

23

22

21

domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

employees? If "Yes," complete Schedule J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If "Yes," complete Schedule L, Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part IV instructions for applicable filing thresholds, conditions, and exceptions):

38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and

3819? Note. All Form 990 filers are required to complete Schedule O.

b

controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35b

disqualified persons? If "Yes," complete Schedule L, Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20b

20a

If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20a


X

X

X

X

XX

XX

X

X

X

X

X

X

XX

X

X

X

X

XX

X

X

X

00282800 08/22/2017 9:28 AM Pg 4


Statements Regarding Other IRS Filings and Tax CompliancePart VPage 5Form 990 (2016)

Yes No

DAA Form 990 (2016)

1a

b

c

2a

b

3a

b

4a

b

5a

b

Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable . . . . . . . . . . . . . . . . . . . . . . . .

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable . . . . . . . . . . . . . . . . . . . . .

Did the organization comply with backup withholding rules for reportable payments to vendors and

reportable gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax

Statements, filed for the calendar year ending with or within the year covered by this return . . . . . . . . .

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)

Did the organization have unrelated business gross income of $1,000 or more during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” enter the name of the foreign country: u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? . . . . . . . . . . . . . . . . . . . . . . . . . .

c

6a

b

7

a

b

c

d

e

f

g

h

8

9

a

b

10

a

b

11

a

b

12a

b

If “Yes” to line 5a or 5b, did the organization file Form 8886-T? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Does the organization have annual gross receipts that are normally greater than $100,000, and did the

If “Yes,” did the organization include with every solicitation an express statement that such contributions or

gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods

If “Yes,” did the organization notify the donor of the value of the goods or services provided? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was

required to file Form 8282? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” indicate the number of Forms 8282 filed during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . .

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? . . . . . . . . .

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? . . . . . .

Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the

sponsoring organization have excess business holdings at any time during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sponsoring organizations maintaining donor advised funds.

Did the sponsoring organization make any taxable distributions under section 4966? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the sponsoring 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities . . . . . . . . . . . . .

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gross income from other sources (Do not net amounts due or paid to other sources

against amounts due or received from them.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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 . . . . . . . . . . . . . . .

1c

2b

3a

3b

4a

5a

5b

5c

6a

6b

7a

7b

7c

7e

7f

7g

7h

8

9a

9b

12a

1a

1b

7d7d

10a

10b

11a

11b

12b

2a

.

and services provided to the payor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

organization solicit any contributions that were not tax deductible as charitable contributions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Check if Schedule O contains a response or note to any line in this Part V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13aa

13 Section 501(c)(29) qualified nonprofit health insurance issuers.

b

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount of reserves on hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c 13c

13b

14a

14bb

14a 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(FBAR).


00

1223X

XX

X

XX

X

XX

X

XXXX

X

00282800 08/22/2017 9:28 AM Pg 5


Section C. Disclosure

1b

1a

2

Form 990 (2016)DAA

NoYes

Form 990 (2016) Page 6Part VI Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No"

response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Section A. Governing Body and Management

1a

b

2

3

4

5

6

7a

b

8

a

b

9

10a

11a

Enter the number of voting members of the governing body at the end of the tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the number of voting members included in line 1a, above, who are independent . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with

any other officer, director, trustee, or key employee? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization delegate control over management duties customarily performed by or under the direct

supervision of officers, directors, or trustees, or key employees to a management company or other person? . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? . . . . . . . . . . . . . . . . . .

Did the organization become aware during the year of a significant diversion of the organization’s assets? . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization have members or stockholders? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization have members, stockholders, or other persons who had the power to elect or appoint

one or more members of the governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Are any governance decisions of the organization reserved to (or subject to approval by) members,

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Each committee with authority to act on behalf of the governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization have local chapters, branches, or affiliates? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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? . . . . . . . . . . . . . . . . . . . . . . . . . .

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? . . . . . . .

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

4

5

6

7a

7b

8a

8b

9

10a

11a

Yes No

12a

b

c

13

14

15

a

b

16a

b

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Did the organization have a written conflict of interest policy? If “No,” go to line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? . . . .

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,”

describe in Schedule O how this was done . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12a

12b

12c

13

14

15a

15b

16a

16b

17

18

19

20

List the states with which a copy of this Form 990 is required to be filed u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

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, address, and telephone number of the person who possesses the organization's books and records: u

Own website Another's website Upon request

Check if Schedule O contains a response or note to any line in this Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b

10b

b Describe in Schedule O the process, if any, used by the organization to review this Form 990.

stockholders, or persons other than the governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

Other (explain in Schedule O)


X

21

21

X

XXX

X

X

X

XX

X

X

XX

XX

XXX

XX

X

NONE

X

RUTH SHRYACK 417 S JEFFERSONSPRINGFIELD MO 65806 417-862-7456

00282800 08/22/2017 9:28 AM Pg 6


compensation

organization

compensation from

Section A.

Independent ContractorsCompensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, andPart VII

Page 7Form 990 (2016)

DAA Form 990 (2016)

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the1a

List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount ofcompensation. 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."

who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from theorganization 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 theorganization, 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; highestcompensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A) (B) (C) (D) (E) (F)

Name and Title Position

related

compensation

Reportable

organizations

organization

(W-2/1099-MISC)

Reportable

amount of

Estimated

from the

otherfrom

the

organizations

and related

(W-2/1099-MISC)Individ

ual

truste

eor d

irecto

r

employee

Highest

compensated

Institu

tional

truste

e

Office

r

Key e

mplo

yee

Form

er

•organization's tax year.

List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee)••

•

•

Check if Schedule O contains a response or note to any line in this Part VII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

organizations

below dotted

week

hours for

Average

hours per

related

(list any

line)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

officer and a director/trustee)

box, unless person is both an

(do not check more than one

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


MARK SHARP

CHAIR1.000.00 X X 0 0 0

MATT MAYSE

VICE CHAIR1.000.00 X X 0 0 0

ALAN FEARS

TREASURER1.000.00 X X 0 0 0

CHARITY ELMER

SECRETARY1.000.00 X X 0 0 0

CHRIS SWEET

DIRECTOR1.000.00 X 0 0 0

DANESSA WILLIAMS

DIRECTOR1.000.00 X 0 0 0

DR. JOHN DUFF

DIRECTOR1.000.00 X 0 0 0

DR. TRACY ROBERTS

DIRECTOR1.000.00 X 0 0 0

DWIGHT RAHMEYER

DIRECTOR1.000.00 X 0 0 0

FRANK GAMBLE

DIRECTOR1.000.00 X 0 0 0

JEFF MILLER

DIRECTOR1.000.00 X 0 0 0

00282800 08/22/2017 9:28 AM Pg 7


Form 990 (2016)DAA

Form 990 (2016) Page 8Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

d Total (add lines 1b and 1c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u

2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization u

3

4

5

Yes No

5

4

3Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1a? If “Yes,” complete Schedule J for such individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

1 Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.

2 Total number of independent contractors (including but not limited to those listed above) whoreceived more than $100,000 of compensation from the organization u

(A)Name and business address Description of services

(B) (C)Compensation

Individ

ual

truste

eor d

irecto

r

Institu

tional

truste

e

Office

r

Key e

mplo

yee

employee

Form

er

Highest

compensated

and related

organizations

the

from other

from the

Estimated

amount of

(W-2/1099-MISC)

organization

Reportable

compensation

Name and title

(F)(E)(D)(C)(B)(A)

organization

compensation

line)

(list any

related

hours per

Average

hours for

week

below dotted

organizations

(W-2/1099-MISC)

Reportable

organizations

related

compensation from

uTotal from continuation sheets to Part VII, Section A . . . . . . . . . .c

1b Sub-total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u




Position

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


(12) DR. JOHN JUNGMANN1.00

DIRECTOR 0.00 X 0 0 0(13) JULIE MERCER-KIDD

1.00DIRECTOR 0.00 X 0 0 0(14) KELLY PARSON

1.00DIRECTOR 0.00 X 0 0 0(15) MAC MCGREGOR

1.00DIRECTOR 0.00 X 0 0 0(16) MIKE CHILES

1.00DIRECTOR 0.00 X 0 0 0(17) MIKE FARQUHAR

1.00DIRECTOR 0.00 X 0 0 0(18) MIKE GARRETT

1.00DIRECTOR 0.00 X 0 0 0(19) RICHARD OLLIS

1.00DIRECTOR 0.00 X 0 0 0

201,181 23,471201,181 23,471

1

X

X

X

0

00282800 08/22/2017 9:28 AM Pg 8


Form 990 (2016)

DAA

Form 990 (2016) Page 9Part VIII Statement of Revenue

(A) (B) (C) (D)Total revenue Related or Unrelated Revenue

exemptfunctionrevenue

businessrevenue

excluded from taxunder sections

512-514

1a

b

c

d

e

f

g

h

Federated campaigns . . . . . .

Membership dues . . . . . . . . . .

Fundraising events . . . . . . . . .

Related organizations . . . . . .

Government grants (contributions) . . .

All other contributions, gifts, grants,

and similar amounts not included above

Noncash contributions included in lines 1a-1f:

Total. Add lines 1a–1f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1a

1b

1c

1d

1e

1f

u

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2a

g

f

e

d

c

b

All other program service revenue . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . .

uTotal. Add lines 2a–2f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Co

ntr

ibu

tio

ns,

Gif

ts,

Gra

nts

an

d O

ther

Sim

ilar

Am

ou

nts

Pro

gram

Ser

vice

Rev

enue

3

4

5

6a

b

c

d

Investment income (including dividends, interest,

and other similar amounts) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Income from investment of tax-exempt bond proceeds

Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gross rents

Less: rental exps.

Rental inc. or (loss)

Net rental income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . .

u

u

u

Busn. Code

u

(i) Real (ii) Personal

(ii) Other(i) Securities

ud

c

b

7a Gross amount from

sales of assetsother than inventory

Less: cost or other

basis & sales exps.

Gain or (loss)

Net gain or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

u

a

b

8a

b

c

Gross income from fundraising events

(not including

of contributions reported on line 1c).

See Part IV, line 18 . . . . . . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . .

Less: direct expenses . . . . . . . . . .

Net income or (loss) from fundraising events . . . . . . . .

Gross income from gaming activities.

See Part IV, line 19 . . . . . . . . . . . . . . .

Less: direct expenses . . . . . . . . . .

Net income or (loss) from gaming activities . . . . . . . . . .

Gross sales of inventory, less

returns and allowances . . . . . . . . .

Less: cost of goods sold . . . . . . .

Net income or (loss) from sales of inventory . . . . . . . . .

11a

b

c

d

e

Total revenue. See instructions. . . . . . . . . . . . . . . . . . . . .

10a

9a

b

b

c

c

b

a

a

b

u

u

12

All other revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total. Add lines 11a–11d . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Busn. CodeMiscellaneous Revenue

u

Oth

er

Reven

ue

u

Check if Schedule O contains a response or note to any line in this Part VIII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


131,471

131,343

661,937

1,364,87646,908

2,289,627

MEMBERSHIP DUES 713940 4,774,447 4,774,447PROGRAM SERVICE FEES 900099 3,447,079 3,447,079VENDING/TRADING POST 900099 98,030 98,030OTHER PROGRAM SERVICE REVENUE 900099 83,343 83,343

8,402,899

29,709 29,709

193,78269,209124,573

124,573 128,862 -4,289

62,703-62,703

-62,703 -62,703

131,343

104,42891,967

12,461 12,461

10,796,566 8,469,058 -4,289 42,170

00282800 08/22/2017 9:28 AM Pg 9


Statement of Functional ExpensesPart IXPage 10Form 990 (2016)

DAA Form 990 (2016)

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).

Do not include amounts reported on lines 6b,

7b, 8b, 9b, and 10b of Part VIII.

1

2

3

4

5

6

7

8

9

10

11

a

b

c

d

e

f

g

12

13

14

15

16

17

18

19

20

21

22

23

24

a

b

c

d

e

25

26

Grants and other assistance to domestic organizations

and domestic governments. See Part IV, line 21 . . . . . . . . . . .

Grants and other assistance to domestic

individuals. See Part IV, line 22 . . . . . . . . . . . . .

Grants and other assistance to foreign

organizations, foreign governments, and foreign

individuals. 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) . . . . . . . .Other salaries and wages . . . . . . . . . . . . . . . . . . .

Pension plan accruals and contributions (include

section 401(k) and 403(b) employer contributions)

Other employee benefits . . . . . . . . . . . . . . . . . . . .

Payroll taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fees for services (non-employees):

Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Legal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Accounting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Lobbying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Professional fundraising services. See Part IV, line 17

Investment management fees . . . . . . . . . . . . . . .

Other. (If line 11g amount exceeds 10% of line 25, column

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.)

All other expenses . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total functional expenses. Add lines 1 through 24e . . . . .

fundraising solicitation. Check here u if

organization reported in column (B) joint costsfrom a combined educational campaign and

following SOP 98-2 (ASC 958-720) . . . . . . . . . . . . . . .

(A) (B) (C) (D)Total expenses Program service Management and

general expensesexpensesFundraisingexpenses

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Check if Schedule O contains a response or note to any line in this Part IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Joint costs. Complete this line only if the

(A) amount, list line 11g expenses on Schedule O.) . . . . . . . .


224,652 224,652

4,818,507 4,288,948 346,111 183,448

405,460 336,173 47,494 21,793435,014 383,128 37,915 13,971

9,225 2,345 6,88023,750 23,750

189,741 187,689 2,052148,003 146,094 145 1,764119,418 105,192 14,226

979,888 975,006 4,88276,054 65,316 10,445 293

48,334 38,189 10,145309,333 292,435 16,898

929,727 920,102 9,625169,567 145,597 23,970

SUPPLIES 849,814 760,150 87,131 2,533EQUIPMENT RENT & MAINTNC 214,259 201,290 12,969MEMBERSHIP DUES 140,559 132,621 7,018 920BAD DEBT EXPENSE 115,347 105,347 10,000

147,404 120,317 27,08710,354,056 9,205,939 923,395 224,722

00282800 08/22/2017 9:28 AM Pg 10


Form 990 (2016)

DAA

Form 990 (2016) Page 11Part X Balance Sheet

(A) (B)

Beginning of year End of year

1

2

3

4

5

6

7

8

9

10a

b

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

22

21

20

19

18

17

16

15

14

13

12

11

10c

9

8

7

6

5

4

3

2

1

29

28

27

26

25

24

23

34

33

32

31

30

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.

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

Notes and loans receivable, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Inventories for sale or use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prepaid expenses and deferred charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Land, buildings, and equipment: cost or

Less: accumulated depreciation . . . . . . . . . . . . . . . . . . . . . . .

Investments—publicly traded securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Investments—other securities. See Part IV, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Investments—program-related. See Part IV, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Intangible assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other assets. See Part IV, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total assets. Add lines 1 through 15 (must equal line 34) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accounts payable and accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Grants payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax-exempt bond liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Escrow or custodial account liability. Complete Part IV of Schedule D . . . . . . . . . . . . . . . . . .

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Total liabilities. Add lines 17 through 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organizations that follow SFAS 117 (ASC 958), check here u

complete lines 27 through 29, and lines 33 and 34.

and

Unrestricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Temporarily restricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Permanently restricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

complete lines 30 through 34.

Organizations that do not follow SFAS 117 (ASC 958), check here u

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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Assets

Lia

bilit

ies

Net

Assets

or

Fu

nd

Bala

nces

10a

10b

Complete Part II of Schedule L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

other basis. Complete Part VI of Schedule D . . . . . . . . . .

and

sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary

organizations (see instructions). Complete Part II of Schedule L . . . . . . . . . . . . . . . . . . . . . . . .

of Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

parties, and other liabilities not included on lines 17-24). Complete Part X

Check if Schedule O contains a response or note to any line in this Part X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


578,640 1,115,282

287,834 64,728131,346 143,499

15,130 17,586

34,448,24510,845,924 24,422,154 23,602,321

1,429,293 1,449,992

382,338 44,12627,246,735 26,437,534

357,193 331,637

155,813 160,5745,600,879 4,878,038

3,817,680 3,577,879

9,931,565 8,948,128X

15,322,218 15,766,5871,970,952 1,700,819

22,000 22,000

17,315,170 17,489,40627,246,735 26,437,534

00282800 08/22/2017 9:28 AM Pg 11


OtherAccrualCash

3b

3a

2c

2b

2a

NoYes

If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the

the Single Audit Act and OMB Circular A-133? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in

of the audit, review, or compilation of its financial statements and selection of an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight

Were the organization's financial statements audited by an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Were the organization's financial statements compiled or reviewed by an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accounting method used to prepare the Form 990:

b

3a

c

b

2a

1

Part XII Financial Statements and Reporting

Page 12Form 990 (2016)

DAA

Form 990 (2016)

If the organization changed its method of accounting from a prior year or checked “Other,” explain in

Schedule O.

If the organization changed either its oversight process or selection process during the tax year, explain in

Schedule O.

required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reconciliation of Net AssetsPart XICheck if Schedule O contains a response or note to any line in this Part XI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 Total revenue (must equal Part VIII, column (A), line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total expenses (must equal Part IX, column (A), line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 2

3

4

9

10

Check if Schedule O contains a response or note to any line in this Part XII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 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)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

5

6

5

6

7

88

7

9

10

Net unrealized gains (losses) on investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donated services and use of facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Investment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Prior period adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Both consolidated and separate basisConsolidated basisSeparate basis

separate basis, consolidated basis, or both:

If "Yes," check a box below to indicate whether the financial statements for the year were audited on a


X10,796,56610,354,056

442,51017,315,170

53,221

-321,495

17,489,406

X

X

X

X

X

X

00282800 08/22/2017 9:28 AM Pg 12


Form 990 (2016)DAA

Form 990 (2016) Page 8Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

d Total (add lines 1b and 1c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u

2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization u

3

4

5

Yes No

5

4

3Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1a? If “Yes,” complete Schedule J for such individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

1 Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.

2 Total number of independent contractors (including but not limited to those listed above) whoreceived more than $100,000 of compensation from the organization u

(A)Name and business address Description of services

(B) (C)Compensation

Individ

ual

truste

eor d

irecto

r

Institu

tional

truste

e

Office

r

Key e

mplo

yee

employee

Form

er

Highest

compensated

and related

organizations

the

from other

from the

Estimated

amount of

(W-2/1099-MISC)

organization

Reportable

compensation

Name and title

(F)(E)(D)(C)(B)(A)

organization

compensation

line)

(list any

related

hours per

Average

hours for

week

below dotted

organizations

(W-2/1099-MISC)

Reportable

organizations

related

compensation from

uTotal from continuation sheets to Part VII, Section A . . . . . . . . . .c

1b Sub-total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u




Position

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


(20) SHANNON BOGGS1.00

DIRECTOR 0.00 X 0 0 0(21) SHAWN WHITNEY

1.00DIRECTOR 0.00 X 0 0 0(22) STEVE GIMENEZ

40.00CEO 0.00 X 134,367 0 18,720(23) RUTH SHRYACK

40.00CFO 0.00 X 58,026 0 3,432(24) KEVIN NAEGER

40.00CFO (RESIGNED) 0.00 X 8,788 0 1,319

201,181 23,471

00282800 08/22/2017 9:28 AM Pg 13

Public Inspection CopyEmployer identification number

DAA

Name of the organization

Internal Revenue Service

Department of the Treasury

OMB No. 1545-0047

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

u Attach to Form 990 or Form 990-EZ.

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.(Form 990 or 990-EZ)

Reason for Public Charity Status (All organizations must complete this part.) See instructions.Part I

SCHEDULE A Public Charity Status and Public Support

2016

(i) Name of supported

Open to Public

Inspection

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

1

2

3

4

5

6

7

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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,

city, and state: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

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.)8

10 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 businessesacquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

11

12

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 in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

a

b

c

that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness

d

e

f Enter the number of supported organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Provide the following information about the supported organization(s).g

organization

(ii) EIN (iii) Type of organization

(described on lines 1–10

document?

listed in your governing(iv) Is the organization

Yes No

(v) Amount of monetary

support (see

TotalSchedule A (Form 990 or 990-EZ) 2016

u Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

above (see instructions))

(E)

(D)

(C)

(B)

(A)

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s)

requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with,

organization(s). You must complete Part IV, Sections A and C.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having

control or management of the supporting organization vested in the same persons that control or manage the supported

the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving

supporting organization. You must complete Part IV, Sections A and B.

instructions) instructions)

other support (see

(vi) Amount of

9 An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college

or university or a non-land grant college of agriculture (see instructions). Enter the name, city, and state of the college or

university: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


X

00282800 08/22/2017 9:28 AM Pg 14


(Explain in Part VI.) . . . . . . . . . . . . . . . . . . . . .

governmental unit or publicly

Section A. Public Support

Total support. Add lines 7 through 10

loss from the sale of capital assets

Other income. Do not include gain or

is regularly carried on . . . . . . . . . . . . . . . . . . .

activities, whether or not the businessNet income from unrelated business

rents, royalties and income from similarpayments received on securities loans,Gross income from interest, dividends,

line 1 that exceeds 2% of the amountsupported organization) included on

each person (other than aThe portion of total contributions by

Total. Add lines 1 through 3 . . . . . . . . . . . .

The value of services or facilities

to or expended on its behalf . . . . . . . . . . . .

organization's benefit and either paidTax revenues levied for the

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)

Gross receipts from related activities, etc. (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Amounts from line 4 . . . . . . . . . . . . . . . . . . . . .

Public support. Subtract line 5 from line 4.

include any "unusual grants.") . . . . . . . . . .

membership fees received. (Do notGifts, grants, contributions, and

Page 2Schedule A (Form 990 or 990-EZ) 2016

13

12

11

9

8

6

4

3

2

1

(e) 2016(d) 2015(c) 2014(b) 2013(a) 2012

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify underSupport Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)Part II

Calendar year (or fiscal year beginning in) (f) Total

furnished by a governmental unit to theorganization without charge . . . . . . . . . . . . .

5

Section B. Total Support

7

sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10

organization, check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section C. Computation of Public Support Percentage

12

14 Public support percentage for 2016 (line 6, column (f) divided by line 11, column (f)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Public support percentage from 2015 Schedule A, Part II, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

16a 33 1/3% support test—2016. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b 33 1/3% support test—2015. 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10%-facts-and-circumstances test—2016. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is17a

10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in

Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported

b 10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line

Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly

15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.

18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see

14

15

%

%

DAA

Schedule A (Form 990 or 990-EZ) 2016

Calendar year (or fiscal year beginning in) (f) Total

Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

(a) 2012

shown on line 11, column (f) . . . . . . . . . . . .

organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

supported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b) 2013 (c) 2014 (d) 2015 (e) 2016u

u


00282800 08/22/2017 9:28 AM Pg 15


Section B. Total Support

unrelated trade or business under section 513

Part III Support Schedule for Organizations Described in Section 509(a)(2)(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II.

1

2

3

6

8

Schedule A (Form 990 or 990-EZ) 2016 Page 3

Gifts, grants, contributions, and membership

fees received. (Do not include any "unusual grants.") . . .

Public support. (Subtract line 7c from

Gross receipts from admissions, merchandisesold or services performed, or facilitiesfurnished in any activity that is related to the

Gross receipts from activities that are not an

Total. Add lines 1 through 5 . . . . . . . . . . . .

Section A. Public Support

organization’s tax-exempt purpose . . . . . . . . . .

Tax revenues levied for the4

organization's benefit and either paid

to or expended on its behalf . . . . . . . . . . . .

organization without charge . . . . . . . . . . . . .

furnished by a governmental unit to the5 The value of services or facilities

Amounts included on lines 1, 2, and 37areceived from disqualified persons . . . . . .

Amounts included on lines 2 and 3breceived from other than disqualifiedpersons that exceed the greater of $5,000or 1% of the amount on line 13 for the year . . .

c Add lines 7a and 7b . . . . . . . . . . . . . . . . . . . . .

Amounts from line 6 . . . . . . . . . . . . . . . . . . . . .9

royalties and income from similar sources . . . .

payments received on securities loans, rents,10a Gross income from interest, dividends,

Unrelated business taxable income (lessbsection 511 taxes) from businessesacquired after June 30, 1975 . . . . . . . . . . . .

c Add lines 10a and 10b . . . . . . . . . . . . . . . . . .

Net income from unrelated business11activities not included in line 10b, whetheror not the business is regularly carried on . . . .

(Explain in Part VI.) . . . . . . . . . . . . . . . . . . . . .

loss from the sale of capital assets12 Other income. Do not include gain or

Total support. (Add lines 9, 10c, 11,13

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

Public support percentage from 2015 Schedule A, Part III, line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 Public support percentage for 2016 (line 8, column (f) divided by line 13, column (f)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16

Section D. Computation of Investment Income Percentage

18

Investment income percentage for 2016 (line 10c, column (f) divided by line 13, column (f)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Investment income percentage from 2015 Schedule A, Part III, line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . . . . . . . . . . .

33 1/3% support tests—2016. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line19a

b 33 1/3% support tests—2015. 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 . . . . . . . . . . . . . . . . . . . . . . . . .

%

%

16

15

17

18

%

%

DAA


(f) Total(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) 2016

(f) Total

line 6.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Calendar year (or fiscal year beginning in)

Calendar year (or fiscal year beginning in)

and 12.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the organization fails to qualify under the tests listed below, please complete Part II.)

(e) 2016(d) 2015(c) 2014(b) 2013(a) 2012

u

u


2,006,588 2,427,351 2,147,124 1,691,529 2,289,627 10,562,219

7,933,770 8,208,517 8,099,820 8,122,235 8,531,761 40,896,103

104,428 104,428

9,940,358 10,635,868 10,246,944 9,813,764 10,925,816 51,562,750

77,573 85,333 92,589 103,240 69,108 427,843

77,573 85,333 92,589 103,240 69,108 427,843

51,134,907

9,940,358 10,635,868 10,246,944 9,813,764 10,925,816 51,562,750

151,274 192,759 260,277 303,167 158,571 1,066,048

151,274 192,759 260,277 303,167 158,571 1,066,048

183,724 196,736 194,268 186,155 760,883

10,275,356 11,025,363 10,701,489 10,303,086 11,084,387 53,389,681

95.78

95.43

2

2

X

00282800 08/22/2017 9:28 AM Pg 16


DAA


Part IV Supporting Organizations

Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Schedule A (Form 990 or 990-EZ) 2016 Page 4

Section A. All Supporting Organizations

(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections Aand B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete

Are all of the organization’s supported organizations listed by name in the organization’s governing

documents? If "No," describe in Part VI how the supported organizations are designated. If designated by

class or purpose, describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status

under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported

organization was described in section 509(a)(1) or (2).

1

2

3a

b

c

4a

b

c

5a

b

c

6

7

8

9a

b

c

10a

b

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer

(b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and

satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the

organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)

purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If

"Yes," and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign

supported organization? If "Yes," describe in Part VI how the organization had such control and discretion

despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination

under sections 501(c)(3) and 509(a)(1) or (2)? If "Yes," explain in Part VI what controls the organization used

to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)

purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If "Yes,"

answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN

numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;

(iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action

was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already

designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to

anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited

by one or more of its supported organizations, or (iii) other supporting organizations that also support or

benefit one or more of the filing organization’s supported organizations? If "Yes," provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor

(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with

regard to a substantial contributor? If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?

If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more

disqualified persons as defined in section 4946 (other than foundation managers and organizations described

in section 509(a)(1) or (2))? If "Yes," provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which

the supporting organization had an interest? If "Yes," provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit

from, assets in which the supporting organization also had an interest? If "Yes," provide detail in Part VI.

Was the organization subject to the excess business holdings rules of section 4943 because of section

4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated

supporting organizations)? If "Yes," answer 10b below.

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to

determine whether the organization had excess business holdings.)

Yes No

1

2

3a

3b

3c

4a

4b

4c

5a

5b

5c

6

7

8

9a

9b

9c

10a

10b


00282800 08/22/2017 9:28 AM Pg 17


DAA Schedule A (Form 990 or 990-EZ) 2016

Part IV Supporting Organizations (continued)Schedule A (Form 990 or 990-EZ) 2016 Page 5

NoYes

2

1

organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

describe how the powers to appoint and/or remove directors or trustees were allocated among the supported

controlled the organization’s activities. If the organization had more than one supported organization,

tax year? If "No," describe in Part VI how the supported organization(s) effectively operated, supervised, or

regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the

Section B. Type I Supporting Organizations

11

c

b

a

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)

below, the governing body of a supported organization?

A family member of a person described in (a) above?

A 35% controlled entity of a person described in (a) or (b) above? If "Yes" to a, b, or c, provide detail in Part VI.

11a

11b

11c

Did the directors, trustees, or membership of one or more supported organizations have the power to

Did the organization operate for the benefit of any supported organization other than the supported

organization(s) that operated, supervised, or controlled the supporting organization? If "Yes," explain in Part

VI how providing such benefit carried out the purposes of the supported organization(s) that operated,

supervised, or controlled the supporting organization.

Section C. Type II Supporting Organizations

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors

or trustees of each of the organization’s supported organization(s)? If "No," describe in Part VI how control

1

or management of the supporting organization was vested in the same persons that controlled or managed

the supported organization(s).

Section D. All Type III Supporting Organizations

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the

organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax

1

year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the

organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported2

the organization maintained a close and continuous working relationship with the supported organization(s).

organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how

supported organizations played in this regard.

income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s

3

significant voice in the organization’s investment policies and in directing the use of the organization’s

By reason of the relationship described in (2), did the organization’s supported organizations have a

Section E. Type III Functionally-Integrated Supporting Organizations

3

2

1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions).

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).

Activities Test. Answer (a) and (b) below.

a

b

a

c

b

a

b

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of

the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify

those supported organizations and explain how these activities directly furthered their exempt purposes,

how the organization was responsive to those supported organizations, and how the organization determined

that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more

of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the

reasons for the organization’s position that its supported organization(s) would have engaged in these

activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or

trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each

of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Yes No

1

2

1

NoYes

Yes No

1

2

3

NoYes

2a

2b

3a

3b


00282800 08/22/2017 9:28 AM Pg 18


DAA


Part V Type III Non-Functionally Integrated 509(a)(3) Supporting OrganizationsSchedule A (Form 990 or 990-EZ) 2016 Page 6

1 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI).See

instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

1

2

3

4

5

6

7

8

1

Section A - Adjusted Net Income

Net short-term capital gain

Recoveries of prior-year distributions

Other gross income (see instructions)

Add lines 1 through 3.

Depreciation and depletion

Portion of operating expenses paid or incurred for production or

collection of gross income or for management, conservation, or

maintenance of property held for production of income (see instructions)

Other expenses (see instructions)

Adjusted Net Income (subtract lines 5, 6 and 7 from line 4).

Section B - Minimum Asset Amount

Aggregate fair market value of all non-exempt-use assets (see

instructions for short tax year or assets held for part of year):

a

b

c

d

e

Average monthly value of securities

Average monthly cash balances

Fair market value of other non-exempt-use assets

Total (add lines 1a, 1b, and 1c)

Discount claimed for blockage or other

factors (explain in detail in Part VI):

8

7

6

5

4

3

2 Acquisition indebtedness applicable to non-exempt-use assets

Subtract line 2 from line 1d.

Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,

see instructions).

Net value of non-exempt-use assets (subtract line 4 from line 3)

Multiply line 5 by .035.

Recoveries of prior-year distributions

Minimum Asset Amount (add line 7 to line 6)

Section C - Distributable Amount

7

6

5

4

3

2

1 Adjusted net income for prior year (from Section A, line 8, Column A)

Enter 85% of line 1.

Minimum asset amount for prior year (from Section B, line 8, Column A)

Enter greater of line 2 or line 3.

Income tax imposed in prior year

Distributable Amount. Subtract line 5 from line 4, unless subject to

emergency temporary reduction (see instructions).

instructions).

Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see

8

7

6

5

4

3

2

1

(A) Prior Year(B) Current Year

(optional)

(optional)

(B) Current Year(A) Prior Year

1a

1b

1c

1d

2

3

4

5

6

7

8

3

2

1

6

5

4

Current Year


00282800 08/22/2017 9:28 AM Pg 19



Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)Part V


DAA

Section D - Distributions Current Year

1

2

3

4

5

6

7

8

9

10

Amounts paid to supported organizations to accomplish exempt purposes

Amounts paid to perform activity that directly furthers exempt purposes of supported

organizations, in excess of income from activity

Administrative expenses paid to accomplish exempt purposes of supported organizations

Amounts paid to acquire exempt-use assets

Qualified set-aside amounts (prior IRS approval required)

Other distributions (describe in Part VI). See instructions.

Total annual distributions. Add lines 1 through 6.

Distributions to attentive supported organizations to which the organization is responsive

(provide details in Part VI). See instructions.

Distributable amount for 2016 from Section C, line 6

Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions) Excess Distributions

(i) (ii)

Underdistributions

Pre-2016

(iii)

Distributable

Amount for 2016

8

7

6

5

4

3

2

1

a

b

c

d

e

f

g

h

i

j

a

b

c

a

b

c

d

e

Distributable amount for 2016 from Section C, line 6

Underdistributions, if any, for years prior to 2016

(reasonable cause required-explain in Part VI). See

Excess distributions carryover, if any, to 2016:

From 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total of lines 3a through e

Applied to underdistributions of prior years

Applied to 2016 distributable amount

Carryover from 2011 not applied (see instructions)

Remainder. Subtract lines 3g, 3h, and 3i from 3f.

Distributions for 2016 from

Section D, line 7: $

Applied to underdistributions of prior years

Applied to 2016 distributable amount

Remainder. Subtract lines 4a and 4b from 4.

Remaining underdistributions for years prior to 2016, if

any. Subtract lines 3g and 4a from line 2. For result

greater than zero, explain in Part VI. See instructions.

Remaining underdistributions for 2016. Subtract lines 3h

and 4b from line 1. For result greater than zero, explain in

Part VI. See instructions.

Excess distributions carryover to 2017. Add lines 3j

and 4c.

Breakdown of line 7:

Excess from 2013 . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess from 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . .

From 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess from 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . .

From 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess from 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . .

instructions.


00282800 08/22/2017 9:28 AM Pg 20



III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, SectionSupplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; PartPart VI

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Schedule A (Form 990 or 990-EZ) 2016DAA

B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b,3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E,lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)


PART III, LINE 12 - OTHER INCOME DETAIL

OTHER INCOME $ 760,883

00282800 08/22/2017 9:28 AM Pg 21


literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one

contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such

contributions totaled 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. Don't complete any of the parts unless the

General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions

totaling $5,000 or more during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ . . . . . . . . . . . . . . . . . . . . . . . . . . .

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 doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).

OMB No. 1545-0047

Department of the TreasuryInternal Revenue Service


DAA

2016Schedule of ContributorsSchedule B

(Form 990, 990-EZ,

or 990-PF) u Attach to Form 990, Form 990-EZ, or Form 990-PF.

Employer identification number

Organization type (check one):

Filers of: Section:

General Rule

Special Rules

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,

For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.

Form 990 or 990-EZ 501(c)( ) (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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000

or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 331/3 % support test of the

regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line

13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1)

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one

contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific,

$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.

Schedule B (Form 990, 990-EZ, or 990-PF) (2016)

instructions.

u Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

contributor's total contributions.


X 3

X

00282800 08/22/2017 9:28 AM Pg 22

Public Inspection CopyPart I

Type of contribution

Person

Payroll

Noncash

(a) (b) (c) (d)

No. Name, address, and ZIP + 4 Type of contribution

Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Complete Part II for

noncash contributions.)

$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA

Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.

(a) (b) (c) (d)

No. Name, address, and ZIP + 4 Total contributions Type of contribution

Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)

No. Name, address, and ZIP + 4

Name of organization Employer identification number

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Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


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44-0545283

1

122,240

X

2

344,145

X

3

12,187

X

4

7,602

X

5

88,121

X

6

40,000

X

00282800 08/22/2017 9:28 AM Pg 23



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


PAGE 2 OF 8

44-0545283

7

13,500

X

8

40,000

X

9

6,330

X

10

70,889

X

11

131,471

X

12

261,168

X

00282800 08/22/2017 9:28 AM Pg 24



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



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DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


PAGE 3 OF 8

44-0545283

13

178,728

X

14

165,281

X

15

101,914

X

16

76,000

X

17

70,889

X

18

25,000

X

00282800 08/22/2017 9:28 AM Pg 25



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


PAGE 4 OF 8

44-0545283

19

20,000

X

20

17,864

X

21

16,600

X

22

15,000

X

23

11,449

X

24

11,200

X

00282800 08/22/2017 9:28 AM Pg 26



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



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$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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Total contributions

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Total contributions

Total contributions

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PAGE 5 OF 8

44-0545283

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11,000

X

26

10,497

X

27

10,000

X

28

10,000

X

29

10,000

X

30

10,000

X

00282800 08/22/2017 9:28 AM Pg 27



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



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$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

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PAGE 6 OF 8

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32

10,000

X

33

10,000

X

34

10,000

X

35

9,000

X

36

7,764

X

00282800 08/22/2017 9:28 AM Pg 28



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



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$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


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6,150

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6,000

X

41

6,000

X

42

5,260

X

00282800 08/22/2017 9:28 AM Pg 29



Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash


$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .



DAA


(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)


Person

Payroll

Noncash

(a) (b) (c) (d)



. . . . . . .

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. . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Total contributions

Total contributions

Total contributions

Total contributions

Total contributions

Page 2


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00282800 08/22/2017 9:28 AM Pg 30


u Attach to Form 990.

Schedule D (Form 990) 2016

Conservation Easements.

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)

Number of states where property subject to conservation easement is located u . . . . . . . .

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the

2016Supplemental Financial StatementsSCHEDULE D

Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.

(Form 990)Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.


OMB No. 1545-0047




u Complete if the organization answered “Yes” on Form 990,

(a) Donor advised funds (b) Funds and other accounts

a

b

c

d

Total number of conservation easements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total acreage restricted by conservation easements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of conservation easements on a certified historic structure included in (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Number of conservation easements included in (c) acquired after 8/17/06, and not on a

Assets included in Form 990, Part X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Revenue included on Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Assets included in Form 990, Part X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Held at the End of the Tax Year

Complete if the organization answered “Yes” on Form 990, Part IV, line 6.

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.

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)

(ii)

Revenue included on Form 990, Part VIII, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

2

3

4

5

6

Total number at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Aggregate value of contributions to (during year) . . . . . . . . . . . . . . . . . . . . .

Aggregate value of 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

Yes

Yes

No

No

Part II

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation

Purpose(s) of conservation easements held by the organization (check all that apply).

2

1

easement on the last day of the tax year.

Preservation of land for public use (e.g., recreation or education)

Protection of natural habitat

Preservation of open space

Preservation of a certified historic structure

Preservation of a historically important land area

Open to PublicInspection

tax year u . . . . . . . . . . . . . . . .

3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the

4

5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of

violations, and enforcement of the conservation easements it holds? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year6

7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year

8

and section 170(h)(4)(B)(ii)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes the

9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and

organization’s accounting for conservation easements.

NoYes

Yes No

Complete if the organization answered “Yes” on Form 990, Part IV, line 8.Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.Part III

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet1a

b

2

following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

a

b

$ . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . . . . . . . .

$

DAA

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

conferring impermissible private benefit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2a

2b

2c

2d

u . . . . . . . . . . . . . . . .

u $ . . . . . . . . . . . . . . . . . . . . . . . . . . .

u

u

u

u

historic structure listed in the National Register . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

u Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.



00282800 08/22/2017 9:28 AM Pg 31


(a) Current year

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Are there endowment funds not in the possession of the organization that are held and administered for the


DAA


Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form

Amount

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)Part IIIPage 2

Public exhibition

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its3

a

collection items (check all that apply):

Scholarly research

Preservation for future generations

b

c

e Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loan or exchange programs

XIII.

4 Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in Part

During the year, did the organization solicit or receive donations of art, historical treasures, or other similar5

assets to be sold to raise funds rather than to be maintained as part of the organization’s collection? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NoYes

Part IV Escrow and Custodial Arrangements.

Yes Noincluded on Form 990, Part X? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not

b If “Yes,” explain the arrangement in Part XIII and complete the following table:

Beginning balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c

d Additions during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Distributions during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e

f Ending balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? . . . . . . . . . . . . . . . . . . . . . . .2a

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

NoYes

Endowment Funds.Part V

Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

Beginning of year balance . . . . . . . . . . . . . . .1a

c Net investment earnings, gains, and

Grants or scholarships . . . . . . . . . . . . . . . . . .d

e Other expenditures for facilities and

Administrative expenses . . . . . . . . . . . . . . . .f

g End of year balance . . . . . . . . . . . . . . . . . . . . .

programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(b) Prior year (c) Two years back (d) Three years back (e) Four years back

c Temporarily restricted endowment u . . . . . . . . . . . . . . .

Permanent endowment u . . . . . . . . . . . . . . .b

2

a Board designated or quasi-endowment u . . . . . . . . . . . . . . .%

%

%

3a

organization by:

(i)

(ii)

unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

related organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” on line 3a(ii), are the related organizations listed as required on Schedule R? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

4 Describe in Part XIII the intended uses of the organization’s endowment funds.

Yes No

3a(i)

3a(ii)

3b

Part VI Land, Buildings, and Equipment.

1a

b

c

d

e

Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Buildings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Leasehold improvements . . . . . . . . . . . . . . . . . . . .

Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10c.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(d) Book value(c) Accumulated(b) Cost or other basis(a) Cost or other basis

(investment) (other)

Description of property

1c

1d

1e

1f

u

losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

depreciation

The percentages on lines 2a, 2b, and 2c should equal 100%.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.


990, Part X, line 21.


1,429,2936,256

29,415

53,08715,105

1,449,992

1,198,590357,312

66,959

45,12714,523

1,429,293

723,419500,515

30,120

44,75710,707

1,198,590

515,122150,000

82,360

19,3834,681

723,419

494,607

56,698

32,2943,889

515,122

33.431.52

65.05

XX

1,161,484 1,161,48429,669,557 10,845,924 18,823,633

10,000 10,0003,607,204 3,607,204

23,602,321

00282800 08/22/2017 9:28 AM Pg 32

Public Inspection CopyCost or end-of-year market value

(b) Book value (c) Method of valuation:

Page 3Part VII Investments—Other Securities.



(a) Description of security or category

(including name of security)

Financial derivatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Closely-held equity interests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.) u

(a) Description of investment

Investments—Program Related.Part VIII

(c) Method of valuation:(b) Book value

Cost or end-of-year market value

(b) Book value

Other Assets.

(a) Description

Part IX

DAA

Part X

(a) Description of liability

Other Liabilities.

(b) Book value

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 . . . . . . . . . . .

Federal income taxes


Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u


1.

2.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1)

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(9)

(8)

(7)

(6)

(5)

(4)

(3)

(2)

(1)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(9)

(8)

(7)

(6)

(5)

(4)

(3)

(2)

(1)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(3)

(2)

Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X,line 25.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

Complete if the organization answered “Yes” on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.


COMMUNITY FOUNDATION OF THE OZ 1,449,992 MARKET

1,449,992

X

00282800 08/22/2017 9:28 AM Pg 33


Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.

Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.

DAA



Part XIPage 4

Part XII

a

1 Total revenue, gains, and other support per audited financial statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2

b

c

d

e

b

c

a

3

4

5

Amounts included on line 1 but not on Form 990, Part VIII, line 12:

Net unrealized gains (losses) on investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donated services and use of facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Recoveries of prior year grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other (Describe in Part XIII.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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 . . . . . . . . . . . . . . . . . . . .


Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

2a

2b

2c

2d

2e

3

4a

4b

4c

5

1

Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Investment expenses not included on Form 990, Part VIII, line 7b . . . . . . . . . . . . . . . . . . . .

Amounts included on Form 990, Part IX, line 25, but not on line 1:

Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Other losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donated services and use of facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Amounts included on line 1 but not on Form 990, Part IX, line 25:

5

4

3

a

c

b

e

Prior year adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c

b

2

Total expenses and losses per audited financial statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

a

5

4c

4b

d

4a

3

2e

2d

2c

2b

2a

Part XIIIProvide 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.

Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Supplemental Information.

Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.

Complete if the organization answered “Yes” on Form 990, Part IV, line 12a.


10,918,996

53,221

69,209122,430

10,796,566

10,796,566

10,423,265

69,20969,209

10,354,056

10,354,056

PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS

THE ORGANIZATION HAS MONEY INVESTED IN THE COMMUNITY FOUNDATION OF THE

OZARKS AND THE MONIES ARE TO BE USED FOR PROGRAMS AS APPROVED THROUGH THE

ANNUAL BUDGETING PROCESS. OTHER ENDOWMENT FUNDS ARE BEING HELD TO FUND

THE BUILDING OF FUTURE YMCA FACILITIES.

PART X - FIN 48 FOOTNOTE

THE ASSOCIATION HAS BEEN CLASSIFIED AS AN EXEMPT ORGANIZATION UNDER

INTERNAL REVENUE CODE SECTION 501(C)(3) AND AS A PUBLIC CHARITY QUALIFIED

FOR CHARITABLE CONTRIBUTIONS UNDER INTERNAL REVENUE CODE SECTION 170.

THE ASSOCIATION HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT

00282800 08/22/2017 9:28 AM Pg 34


Page 5Part XIII Supplemental Information (continued)



DAA

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


AS OF DECEMBER 31, 2016 AND 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN,

OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF AN ASSET OR

LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. A TAX ASSET OR

LIABILITY WOULD BE RECOGNIZED IF THE ASSOCIATION HAS TAKEN AN UNCERTAIN

POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION

BY TAXING AUTHORITIES. THE ASSOCIATION IS SUBJECT TO ROUTINE AUDITS BY

TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX

PERIODS IN PROGRESS. THE ASSOCIATION DOES NOT BELIEVE IT LIKELY THAT

CHANGES WILL OCCUR WITHIN THE NEXT FISCAL YEAR THAT WILL HAVE A MATERIAL

IMPACT ON THE FINANCIAL STATEMENTS.

PART XI, LINE 2D - REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER

UBI RENTAL EXPENSES $ 69,209

PART XII, LINE 2D - EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER


00282800 08/22/2017 9:28 AM Pg 35

Public Inspection CopyInternal Revenue Service


OMB No. 1545-0047


u Attach to Form 990 or Form 990-EZ.

(Form 990 or 990-EZ)SCHEDULE G Supplemental Information Regarding Fundraising or Gaming Activities


organization entered more than $15,000 on Form 990-EZ, line 6a. 2016Open to PublicInspection

Part I Fundraising Activities. Complete if the organization answered “Yes” on Form 990, Part IV, line 17.

1 Indicate whether the organization raised funds through any of the following activities. Check all that apply.

Mail solicitations

Internet and email solicitations

Phone solicitations

In-person solicitations

Special fundraising events

Solicitation of government grants

Solicitation of non-government grants

2a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees,or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? . . . . . . . . . . . . . . . . . . . . . . Yes No

compensated at least $5,000 by the organization.If “Yes,” list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to beb

(i) Name and address of individual

or entity (fundraiser) (ii) Activity

NoYes

custody or

contributions?

from activity

raiser have(iv) Gross receipts

fundraiser listed in

(or retained by)

(v) Amount paid to (vi) Amount paid to

(or retained by)

organization

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

registration or licensing.List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.

.

...

..For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule G (Form 990 or 990-EZ) 2016DAA

control of

(iii) Did fund-

col. (i)

a

b

c

d

e

f

g

Complete if the organization answered “Yes” on Form 990, Part IV, line 17, 18, or 19, or if the

Form 990-EZ filers are not required to complete this part.

1

2

3

6

5

4

8

9

10

7

u Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.


00282800 08/22/2017 9:28 AM Pg 36


Gaming. Complete if the organization answered “Yes” on Form 990, Part IV, line 19, or reported more

Schedule G (Form 990 or 990-EZ) 2016 Page 2

Fundraising Events. Complete if the organization answered “Yes” on Form 990, Part IV, line 18, or reported morePart II

gross receipts greater than $5,000.(a) Event #1 (b) Event #2 (c) Other events

(d) Total events

(add col. (a) through

(event type) (event type) (total number)

Reve

nue

Direct

E

xpense

s

Gross receipts . . . . . . . . .1

2

3

4

5

Less: Contributions . . . .

Gross income (line 1 minus

line 2) . . . . . . . . . . . . . . . . . . .

Rent/facility costs . . . . .

Noncash prizes . . . . . . . .

Cash prizes . . . . . . . . . . . .

Other direct expenses

Net income summary. Subtract line 10 from line 3, column (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

7

8

9

than $15,000 on Form 990-EZ, line 6a.Part III

Direct

E

xpense

sR

eve

nue

8

7

6

5

4

3

2

1

Net gaming income summary. Subtract line 7 from line 1, column (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rent/facility costs . . . . .

Other direct expenses

Volunteer labor . . . . . . . .

Noncash prizes . . . . . . . .

Cash prizes . . . . . . . . . . . .

Gross revenue . . . . . . . . .

(a) Bingo(b) Pull tabs/instant

(c) Other gaming(d) Total gaming (add

col. (a) through col. (c))bingo/progressive bingo

Yes . . . . . . . . . . . . . . . . .

No

% %

No

Yes . . . . . . . . . . . . . . . . %

No

Yes . . . . . . . . . . . . . .

9

a

b

10a

b

Enter the state(s) in which the organization conducts gaming activities: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “No,” explain:

Were any of the organization’s gaming licenses revoked, suspended, or terminated during the tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” explain:

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DAA Schedule G (Form 990 or 990-EZ) 2016

col. (c))

10

11

Food and beverages . .

Entertainment . . . . . . . . .

Yes No

NoYes

than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with


NIGHT FOR THE Y MOONLIGHT CRUIS 3

99,247 49,544 79,427 228,218

72,272 26,203 32,868 131,343

26,975 23,341 46,559 96,875

2,870 614 3,484

5,108 1,191 2,000 8,299

9,784 394 63 10,241

1,823 316 2,139

8,146 17,328 35,675 61,149

85,31211,563

00282800 08/22/2017 9:28 AM Pg 37


NoYes

Page 3Schedule G (Form 990 or 990-EZ) 2016

13

a

b

14

15a

b

c

16

17

a

b

Indicate the percentage of gaming activity conducted in:

The organization’s facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

An outside facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the name and address of the person who prepares the organization’s gaming/special events books and

records:

Name u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes,” enter the amount of gaming revenue received by the organization u

amount of gaming revenue retained by the third party u

If “Yes,” enter name and address of the third party:

Gaming manager information:

Gaming manager compensation u

Description of services provided u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount of distributions required under state law to be distributed to other exempt organizations or

spent in the organization’s own exempt activities during the tax year u

%

%

13a

13b

$ . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule G (Form 990 or 990-EZ) 2016

DAA

$

$ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and the

Address u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information.Part IV Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and

See instructions

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

NoYes

formed to administer charitable gaming? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Is the organization a grantor, beneficiary or trustee of a trust, or a member of a partnership or other entity

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12

11


00282800 08/22/2017 9:28 AM Pg 38

Public Inspection Copyu Attach to Form 990.

Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form1a

Questions Regarding CompensationPart I

InspectionOpen to Public

2016

uInformation about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.


Compensation InformationSCHEDULE J(Form 990)


OMB No. 1545-0047



Compensated Employees

u Complete if the organization answered "Yes" on Form 990, Part IV, line 23.

Yes No

990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel

Travel for companions

Tax indemnification and gross-up payments

Discretionary spending account Personal services (such as, maid, chauffeur, chef)

Health or social club dues or initiation fees

Payments for business use of personal residence

Housing allowance or residence for personal use

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

1a? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all2

1b

2

3 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

Written employment contract

Compensation survey or study

Approval by the board or compensation committeeForm 990 of other organizations

Independent compensation consultant

Compensation committee

4 During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing

Receive a severance payment or change-of-control payment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a

b Participate in, or receive payment from, a supplemental nonqualified retirement plan? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Participate in, or receive payment from, an equity-based compensation arrangement? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c

4a

4b

4c

If "Yes" to any of lines 4a–c, list the persons and provide the applicable amounts for each item in Part III.

Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5–9.

compensation contingent on the revenues of:

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any5

Any related organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

a The organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” on line 5a or 5b, describe in Part III.

Any related organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

a The organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any6

compensation contingent on the net earnings of:

5b

5a

6a

6b

payments not described on lines 5 and 6? If “Yes,” describe in Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed

If “Yes” on line 6a or 6b, describe in Part III.

Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject8

to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If “Yes,” describe

in Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

8

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2016

DAA

For certain Officers, Directors, Trustees, Key Employees, and Highest

9Regulations section 53.4958-6(c)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9 If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in

explain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

organization or a related organization:

related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

directors, trustees, and officers, including the CEO/Executive Director, regarding the items checked in line


X

XXX

XX

XX

X

X

00282800 08/22/2017 9:28 AM Pg 39


DAA

Schedule J (Form 990) 2016

(A) Name and Title

(B) Breakdown of W-2 and/or 1099-MISC compensation

Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.Page 2Schedule J (Form 990) 2016

For each individual whose compensation must be reported on 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 aren't 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.

(i) Basecompensation compensation

(ii) Bonus & incentive

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(iii) Otherreportable

(C) Retirement and

compensationbenefits

(D) Nontaxable (E) Total of columns

(B)(i)–(D) in column (B) reported

(F) Compensation

as deferred on prior

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

compensation

other deferred

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

(i)

(ii)

(ii)

(i)

(i)

(ii)

(ii)

(i)

(i)

(ii)

(ii)

(i)

(i)

(ii)

(ii)

(i)

(i)

(ii)

(i)

(ii)

(ii)

(ii)

(i)

(i)

(i)

(ii)

(i)

(ii)

(ii)

(i)

(ii)

(i)

Form 990


STEVE GIMENEZ 134,367 0 0 12,792 5,928 153,087 0CEO 0 0 0 0 0 0 0

00282800 08/22/2017 9:28 AM Pg 40

Public Inspection Copy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule J (Form 990) 2016 Page 3Supplemental InformationPart III

Schedule J (Form 990) 2016

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DAA


00282800 08/22/2017 9:28 AM Pg 41


For Paperwork Reduction Act Notice, see the Instructions for Form 990.

DAA

Schedule K (Form 990) 2016

(a) Issuer name (b) Issuer EIN

.

behalf of

(h) On

issuer

Part I Bond Issues

explanations, and any additional information in Part VI.

Employer identification numberName of the organization

Internal Revenue ServiceDepartment of the Treasury

OMB No. 1545-0047

u Complete if the organization answered “Yes” on Form 990, Part IV, line 24a. Provide descriptions,(Form 990)SCHEDULE K Supplemental Information on Tax-Exempt Bonds

Open to PublicInspection

A

(c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased

Yes No NoYes

B .

.C

D .

ProceedsPart II

1

2

3

4

5

6

7

8

9

10

11

12

Total proceeds of issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gross proceeds in reserve funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Proceeds in refunding escrows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other unspent proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Issuance costs from proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Working capital expenditures from proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Capital expenditures from proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Year of substantial completion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Were the bonds issued as part of a current refunding issue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Were the bonds issued as part of an advance refunding issue? . . . . . . . . . . . . . . . . . . . . . . . . . . .

Has the final allocation of proceeds been made? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Does the organization maintain adequate books and records to support the final allocation of proceeds?

Yes No

A B C D

Yes No NoYes Yes No

Part III Private Business UseDCBA

NoYesYes NoNoYesNoYes

Are there any lease arrangements that may result in private business use of2

1 Was the organization a partner in a partnership, or a member of an LLC,

2016u Attach to Form 990.

Amount of bonds legally defeased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Amount of bonds retired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

which owned property financed by tax-exempt bonds? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17

16

15

14

13

bond-financed property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Capitalized interest from proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Credit enhancement from proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other spent proceeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes No

(i) Pooled

financing

u Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.


MISSOURI DEVELOPMENT FINANCE BOARD 43-1387649 06/30/06 15,000,000 ACQUISITION, CONSTRU X X X

XXXX

X

X

INDUSTRIAL DEVELOPMENT AUTHORITY 44-6000225 07/29/11 8,000,000 ACQUISITION, CONSTRU X X X

XXXX

X

X

00282800 08/22/2017 9:28 AM Pg 42


Page 2Schedule K (Form 990) 2016

Private Business Use (Continued)Part III

1

3 Is the bond issue a variable rate issue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ArbitragePart IV

Schedule K (Form 990) 2016DAA

NoYesYes NoNoYesNo

Are there any research agreements that may result in private business use of

b

3a

bond-financed property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

business use of bond-financed property? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Are there any management or service contracts that may result in private Yes

DCBA

outside counsel to review any research agreements relating to the financed property? . . . . .

c

If “Yes” to line 3c, does the organization routinely engage bond counsel or other

Enter the percentage of financed property used in a private business use by entities4

other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . . .

another section 501(c)(3) organization, or a state or local government . . . . . . . . .

result of unrelated trade or business activity carried on by your organization,

5 Enter the percentage of financed property used in a private business use as a

Total of lines 4 and 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Has the organization established written procedures to ensure that all9

A B C D

Yes No Yes No NoYes Yes No

Has the organization or the governmental issuer entered into a qualifiedhedge with respect to the bond issue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4a

b Name of provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Term of hedge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c

u

u

Penalty in Lieu of Arbitrage Rebate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

%

%

% %

%

% %

%

% %

%

%

d Was the hedge superintegrated? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Was the hedge terminated? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e

If “Yes” to line 3a, does the organization routinely engage bond counsel or other outside

counsel to review any management or service contracts relating to the financed property?

d

requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . . . .

performed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” to line 2c, provide in Part VI the date the rebate computation was

c No rebate due? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Exception to rebate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b

a Rebate not due yet? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “No” to line 1, did the following apply? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

nonqualified bonds of the issue are remediated in accordance with the

c

sections 1.141-12 and 1.145-2? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If “Yes” to line 8a, was any remedial action taken pursuant to Regulations

If “Yes” to line 8a, enter the percentage of bond-financed property sold or

disposed of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b

Has there been a sale or disposition of any of the bond-financed property to a

nongovernmental person other than a 501(c)(3) organization since the bonds were issued?

8a

7 Does the bond issue meet the private security or payment test? . . . . . . . . . . . . . . . .

%%%%

Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and


X

X

X

X

X

X

XXX

X

X

X

X

X

X

X

X

XXX

X

X

00282800 08/22/2017 9:28 AM Pg 43


Part VI

DAASchedule K (Form 990) 2016

Part IV Arbitrage (Continued)Schedule K (Form 990) 2016 Page 3

Supplemental Information. Provide additional information for responses to questions on Schedule K. See instructions

applicable regulations?

Procedures To Undertake Corrective ActionPart V

voluntary closing agreement program if self-remediation isn't available under

NoYesYes NoNoYesNoYes

DCBA

Has the organization established written procedures to ensure that violations

of federal tax requirements are timely identified and corrected through the

7 Has the organization established written procedures to monitor the

Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . .d

Were any gross proceeds invested beyond an available temporary period? . . . .6

b Name of provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Term of GIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .c

Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . .5a

A B C D

Yes No Yes No NoYes Yes No

requirements of section 148? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


X

X

X

X

X

X

X

X

00282800 08/22/2017 9:28 AM Pg 44


DAA Schedule K (Form 990) 2016

Part VISchedule K (Form 990) 2016 Page 4

Supplemental Information. Provide additional information for responses to questions on Schedule K. See instructions (Continued)OZARKS REGIONAL YMCA 44-0545283

00282800 08/22/2017 9:28 AM Pg 45

Public Inspection CopyEmployer identification numberName of the organization


OMB No. 1545-0047

(Form 990)

Types of PropertyPart I

u Complete if the organizations answered “Yes” on Form 990, Part IV, lines 29 or 30.

SCHEDULE M Noncash Contributions

InspectionOpen To Public

2016

(a) (b) (c) (d)

Check if

applicable

Number of contributions orNoncash contribution

Form 990, Part VIII, line 1g

Method of determining

noncash contribution amounts

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

25

24

26

27

28

Clothing and household

Cars and other vehicles . . . . . . . . . .

Art — Works of art . . . . . . . . . . . . . . . .

Art — Historical treasures . . . . . . . .

Art — Fractional interests . . . . . . . . .

Books and publications . . . . . . . . . . .

Boats and planes . . . . . . . . . . . . . . . . .

Intellectual property . . . . . . . . . . . . . . .

Securities — Publicly traded . . . . . .

Securities — Closely held stock . .

Securities — Partnership, LLC,

goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

or trust interests . . . . . . . . . . . . . . . . . .

Securities — Miscellaneous . . . . . .

Qualified conservation

contribution — Historic

structures . . . . . . . . . . . . . . . . . . . . . . . . .

Qualified conservation

contribution — Other . . . . . . . . . . . . . .

Real estate — Residential . . . . . . . .

Real estate — Commercial . . . . . . .

Real estate — Other . . . . . . . . . . . . . .

Collectibles . . . . . . . . . . . . . . . . . . . . . . .

Food inventory . . . . . . . . . . . . . . . . . . . .

Drugs and medical supplies . . . . . .

Taxidermy . . . . . . . . . . . . . . . . . . . . . . . .

Historical artifacts . . . . . . . . . . . . . . . .

Scientific specimens . . . . . . . . . . . . . .

Archeological artifacts . . . . . . . . . . . .

Other u )

Number of Forms 8283 received by the organization during the tax year for contributions for29

which the organization completed Form 8283, Part IV, Donee Acknowledgement . . . . . . . . . . . . . . 29

30a During the year, did the organization receive by contribution any property reported in Part I, lines 1 through

Yes No

30a

28, that it must hold for at least three years from the date of the initial contribution, and which isn't required

to be used for exempt purposes for the entire holding period? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b If “Yes,” describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard31

contributions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

contributions? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

If “Yes,” describe in Part II.b

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,33

describe in Part II.

31

32a

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2016)

DAA

u Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.

( . . . . . . . . . . . . . . . . . . . . . . . . . . . .( . . . . . . . . . . . . . . . . . . . . . . . . . . . .)Other u

Other u )( . . . . . . . . . . . . . . . . . . . . . . . . . . . .( )Other u

items contributedamounts reported on

u Attach to Form 990.


AUCTION ITEMS X 4 46,908 FAIR MARKET VALUE

0

X

X

X

00282800 08/22/2017 9:28 AM Pg 46


DAA

Schedule M (Form 990) (2016)

Part II Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether

Schedule M (Form 990) (2016) Page 2

or a combination of both. Also complete this part for any additional information.

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the organization is reporting in Part I, column (b), the number of contributions, the number of items received,

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


00282800 08/22/2017 9:28 AM Pg 47

Public Inspection CopyForm 990 or 990-EZ or to provide any additional information.

Employer identification numberName of the organization


OMB No. 1545-0047

Complete to provide information for responses to specific questions on(Form 990 or 990-EZ)

SCHEDULE O Supplemental Information to Form 990 or 990-EZ

2016Open to PublicInspection

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For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2016)DAA

u Attach to Form 990 or 990-EZ.

u Information about Schedule O (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.


FORM 990 - ORGANIZATION'S MISSION

THE MISSION OF OZARKS REGIONAL YMCA IS TO PROMOTE JUDEO-CHRISTIAN VALUES

THROUGH PROGRAMS THAT BUILD HEALTHY SPIRIT, MIND, AND BODY FOR ALL. THE

YMCA BELIEVES THAT NO ONE SHOULD BE DENIED PROGRAMS OR SERVICES DUE TO THE

INABILITY TO PAY; THEREFORE,FINANCIAL ASSISTANCE IS AVAILABLE TO ALL WHO

QUALIFY, REGARDLESS OF AGE, GENDER, RELIGION, OR ETHNICITY.

FORM 990, PART VI, LINE 6 – CLASSES OF MEMBERS OR STOCKHOLDERS

THE ORGANIZATION IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION WITH MEMBERS

THAT PARTICIPATE IN THE GOVERNANCE OF THE ENTITY.

FORM 990, PART VI, LINE 11B - ORGANIZATION'S PROCESS TO REVIEW FORM 990

MANAGEMENT AND THE BOARD OF DIRECTORS OF THE OZARKS REGIONAL YMCA REVIEW

THE FORM 990 BEFORE IT IS FILED.

FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY

IF A DIRECTOR BELIEVES THEY HAVE A CONFLICT OF INTEREST, THEY SHALL FULLY

DISCLOSE THE CONFLICT TO THE PRESIDENT IF THE PRESIDENT DETERMINES THERE IS

A POTENTIAL CONFLICT, IT SHALL BE REPORTED TO THE FULL BOARD OF DIRECTORS

IF THE TRANSACTION REQUIRES A VOTE, THE DIRECTOR WILL NOT BE PRESENT FOR

THE DISCUSSION OR VOTE.

FORM 990, PART VI, LINE 15A - COMPENSATION PROCESS FOR TOP OFFICIAL

OZARKS REGIONAL YMCA’S CORPORATE BOARD EXECUTIVE COMMITTEE PERFORMS AN

ANNUAL REVIEW OF THE CEO. THIS PERFORMANCE EVALUATION IS GIVEN IN THE FORM

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Schedule O (Form 990 or 990-EZ) (2016)

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Name of the organization Employer identification number

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OF AN EXECUTIVE LETTER, WHICH OUTLINES MUTUALLY AGREED-UPON OBJECTIVES AND

PROGRESS OBJECTIVES ARE CLOSELY TIED TO OUTCOMES OF THE STRATEGIC PLAN. THE

CEO’S COMPENSATION IS DETERMINED BASED ON PROGRESS THAT HAS BEEN MADE

TOWARD THE OBJECTIVES AND NATIONAL WAGE COMPARISONS OF SIMILAR

ORGANIZATIONS(ADJUSTED FOR LOCAL COST OF LIVING).

FORM 990, PART VI, LINE 15B - COMPENSATION PROCESS FOR OFFICERS

THE YMCA ALSO UTILIZES A SALARY ADMINISTRATION PROGRAM FOR ALL POSITIONS,

TAILORED FOR OUR YMCA AND SUPPORTED BY YMCA OF THE USA.

FORM 990, PART VI, LINE 19 - GOVERNING DOCUMENTS DISCLOSURE EXPLANATION

THE OZARKS REGIONAL YMCA PROVIDES UPON REQUEST ITS GOVERNING DOCUMENTS,

CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT.

FORM 990, PART XI - ADDITIONAL INFORMATION

CERTAIN ERRORS RESULTING IN AN OVERSTATEMENT OF PREVIOUSLY REPORTED

PROPERTY AND EQUIPMENT WERE DISCOVERED DURING THE CURRENT YEAR. PRIOR TO

DECEMBER 31, 2014, THE ASSOCIATION DONATED LAND TO THE CITY OF MONETT.

THE ASSOCIATION DID NOT RECORD A DONATION OF LAND TO THE CITY OF MONETT

WHICH WAS SUBSEQUENTLY LEASED BACK TO THE ASSOCIATION. THIS TRANSACTION

DOES NOT MEET THE GUIDELINES FOR A CAPITAL LEASE AND, ACCORDINGLY, AN

ADJUSTMENT OF $321,495 WAS MADE DURING 2016 TO WRITE DOWN PROPERTY AND

EQUIPMENT AS OF THE BEGINNING OF 2015. THE EFFECT OF THE CORRECTION ON

THE CHANGE IN NET ASSETS AND CHANGE IN PROPERTY AND EQUIPMENT FOR THE

YEAR ENDED DECEMBER 31, 2015 WAS A DECREASE OF $321,495, RESPECTIVELY.

FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS EXPLANATION

PAGE 1 OF 2

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Schedule O (Form 990 or 990-EZ) (2016)

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Name of the organization Employer identification number

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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UBI RENTAL EXPENSES $ -69,209

PAGE 2 OF 2

00282800 08/22/2017 9:28 AM Pg 50


990-T 2016Exempt Organization Business Income Tax Return

(and proxy tax under section 6033(e))

Part I Unrelated Trade or Business Income

Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions,

u Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3).

A D Employer identification number

B

Print

Type E Unrelated business activity codes

CF

G

H

I

J

1a

b c 1c

2 2

3 3

4a 4a

b 4b

c 4c

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 Total. Combine lines 3 through 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

14 14

15 15

16 16

17 17

18 18

19 19

20 20

21 21

22 22a 22b

23 23

24 24

25 25

26 26

27 27

28 28

29 Total deductions. Add lines 14 through 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

30 30

31 31

32 32

33 33

34 Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32,

34

For Paperwork Reduction Act Notice, see instructions.

Form

Group exemption number (See instructions.) u

Check organization type u 501(c) corporation 501(c) trust 401(a) trust Other trust

Describe the organization's primary unrelated business activity.

During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? . . . . . . . . . . . . . . . . Yes NoIf "Yes," enter the name and identifying number of the parent corporation.

The books are in care of u Telephone number u

Gross receipts or sales

Less returns and allowances Balance . . . . . . .

Cost of goods sold (Schedule A, line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Capital gain net income (attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) . . . . . . . . . . . . . . . . . . . . . . .

Capital loss deduction for trusts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Income (loss) from partnerships and S corporations (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Rent income (Schedule C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unrelated debt-financed income (Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interest, annuities, royalties, and rents from controlled organizations (Schedule F) . . . . . .

Investment income of a section 501(c)(7), (9), or (17) organization (Schedule G) . . . . . . . .

Exploited exempt activity income (Schedule I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Advertising income (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other income (See instructions; attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Compensation of officers, directors, and trustees (Schedule K) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Interest (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Charitable contributions (See instructions for limitation rules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Depreciation (attach Form 4562) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Less depreciation claimed on Schedule A and elsewhere on return . . . . . . . . . . . . . . . . . . . . . . . . . . .

Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contributions to deferred compensation plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess exempt expenses (Schedule I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Excess readership costs (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 . . . . . . . . . . . . . . . . . . . . .

Net operating loss deduction (limited to the amount on line 30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unrelated business taxable income before specific deduction. Subtract line 31 from line 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Specific deduction (Generally $1,000, but see line 33 instructions for exceptions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

enter the smaller of zero or line 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OMB No. 1545-0687

Department of the TreasuryInternal Revenue Service

Check box ifName of organization ( Check box if name changed and see instructions.)address changed

Exempt under section(Employees' trust, see instructions.)

501( ) ( )

408(e) 220(e) Number, street, and room or suite no. If a P.O. box, see instructions.

408A 530(a)

529(a) City or town, state or province, country, and ZIP or foreign postal code(See instructions.)

Book value of all assets

at end of year

Form 990-T (2016)DAA

u

u

u

u

deductions must be directly connected with the unrelated business income.)

For calendar year 2016 or other tax year beginning . . . . . . . . . . . . . . . . . . , and ending . . . . . . . . . . . . . . . . . . .

(A) Income (B) Expenses (C) Net

.Open to Public Inspection for501(c)(3) Organizations Only

or

u Information about Form 990-T and its instructions is available at www.irs.gov/form990t.

X C 3 OZARKS REGIONAL YMCA44-0545283

417 S JEFFERSON AVE.

SPRINGFIELD MO 65806 531120

26,437,534 X

COMMERCIAL LEASEX

RUTH SHRYACK 417-862-7456

58,409 62,267 -3,858

58,409 62,267 -3,858

10,92510,925 0

-3,858

-3,8581,000

-3,858

00282800 08/22/2017 9:28 AM Pg 51


with the preparer shown belowMay the IRS discuss this return

45g

Part III Tax Computation

Part IV Tax and Payments

Part V Statements Regarding Certain Activities and Other Information (see instructions)

SignHere

35 Organizations Taxable as Corporations. See instructions for tax computation. Controlled group

See instructions and:

a

(1) $ (2) $ (3) $

b $

(2) $

c 35c

36 Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on

36

37 Proxy tax. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

38 38

39

Total. Add lines 37, 38 and 39 to line 35c or 36, whichever applies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39

41a 41a

b 41b

c 41c

d 41d

e Total credits. Add lines 41a through 41d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41e

44

4242

4343

Total tax. Add lines 42 and 43 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

45a 45a

b 45b

c 45c

d 45d

e 45e

f

50

Total payments. Add lines 45a through 45g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4646

50

47

Tax due. If line 46 is less than the total of lines 44 and 47, enter amount owed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

47

48

Overpayment. If line 46 is larger than the total of lines 44 and 47, enter amount overpaid . . . . . . . . . . . . . . . . . . . . . . . . .

48

49

Refunded u

49

Yes No51

52

53

Paid

Preparer

Use Only

Form 990-T (2016) Page 2

members (sections 1561 and 1563) check here u

Enter your share of the $50,000, $25,000, and $9,925,000 taxable income brackets (in that order):

Enter organization's share of: (1) Additional 5% tax (not more than $11,750) . . . . . . . . . . . . . . . . .

Additional 3% tax (not more than $100,000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Income tax on the amount on line 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

the amount on line 34 from: Tax rate schedule or Schedule D (Form 1041) . . . . . . . . . . . . . . . . . . . . . .

Alternative minimum tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116) . . . . . . . . .

Other credits (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General business credit. Attach Form 3800 (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . .

Credit for prior year minimum tax (attach Form 8801 or 8827) . . . . . . . . . . . . . . . . . . . . . . . . .

Subtract line 41e from line 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Payments: A 2015 overpayment credited to 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2016 estimated tax payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax deposited with Form 8868 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign organizations: Tax paid or withheld at source (see instructions) . . . . . . . . . . . . . .

Backup withholding (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other credits and payments:

Estimated tax penalty (see instructions). Check if Form 2220 is attached . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Enter the amount of line 49 you want: Credited to 2017 estimated tax u

At any time during the 2016 calendar year, did the organization have an interest in or a signature or other authority

over a financial account (bank, securities, or other) in a foreign country? If YES, the organization may have to file

During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? . . . . . . . . . . . . . .

If YES, see instructions for other forms the organization may have to file.

Enter the amount of tax-exempt interest received or accrued during the tax year u $

Other taxes.Form 4255 Form 8611 Form 8697 Form 8866 Other (att. sch.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Check if from:

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 istrue, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

(see instructions)?

Signature of officer Date Title

DAA

u

u

u

Yes No

Form 2439

OtherForm 4136 Total u

here u . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g

45fCredit for small employer health insurance premiums (Attach Form 8941) . . . . . . . . . . . .

u u

FinCEN Form 114, Report of Foreign Bank and Financial Accounts. If YES, enter the name of the foreign country

Form 990-T (2016)

}

}

Print/Type preparer's name if

Phone no.Firm's address

Firm's EIN }Firm's name

self-employed

PTINDatePreparer's signature Check

4040

Tax on Non-Compliant Facility Income. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


0

XX

CFO X

BARBARA J. HOUSER, CPA BARBARA J. HOUSER, CPA 08/22/17 P00227583

KPM CPAS, PC 43-11097681445 E REPUBLIC RDSPRINGFIELD, MO 65804 417-882-4300

00282800 08/22/2017 9:28 AM Pg 52

Public Inspection Copy1. Description of property

Schedule C – Rent Income (From Real Property and Personal Property Leased With Real Property)

Schedule E – Unrelated Debt-Financed Income (see instructions)

(b) Total deductions.(c) Total income. Add totals of columns 2(a) and 2(b). Enter

Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total dividends-received deductions included in column 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 990-T (2016) Page 3

(1)

(2)

(3)

(4)

2. Rent received or accrued

(1)

(2)

(3)

(4)

Total Total

Enter here and on page 1,here and on page 1, Part I, line 6, column (A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part I, line 6, column (B) u

(1)

(2)

(3)

(4)

(1) %

(2) %

(3) %

(4) %

Enter here and on page 1, Enter here and on page 1,Part I, line 7, column (A). Part I, line 7, column (B).

(a) From personal property (if the percentage of rent (b) From real and personal property (if the 3(a) Deductions directly connected with the income

for personal property is more than 10% but not percentage of rent for personal property exceeds in columns 2(a) and 2(b) (attach schedule)

more than 50%) 50% or if the rent is based on profit or income)

3. Deductions directly connected with or allocable to2. Gross income from or

debt-financed property1. Description of debt-financed property allocable to debt-financed

(a) Straight line depreciation (b) Other deductionsproperty

(attach schedule) (attach schedule)

4. Amount of average 5. Average adjusted basis 8. Allocable deductionsacquisition debt on or of or allocable to

6. Column7. Gross income reportable (column 6 x total of columns

allocable to debt-financed debt-financed property4 divided

(column 2 x column 6) 3(a) and 3(b))property (attach schedule) (attach schedule)

by column 5

DAA

u

u

u

(see instructions)

Form 990-T (2016)

(attach schedule) . . . . . . . . . . . . . . . . . . . . . .Other costscosts (attach schedule) . . . . . . . . . . . . . . . . .Additional sec. 263A

to the organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

property produced or acquired for resale) apply

Do the rules of section 263A (with respect to

line 5. Enter here and in Part I, line 2 . . . . . . . . .Cost of labor . . . . . . . . . . . . . . . . . . . . . .

Purchases . . . . . . . . . . . . . . . . . . . . . . . .

Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . .Inventory at beginning of year . . . .

5Total. Add lines 1 through 4b . . . .5

4bbNoYes84aa4

733

Cost of goods sold. Subtract line 6 from722

6611

Schedule A – Cost of Goods Sold. Enter method of inventory valuation uOZARKS REGIONAL YMCA 44-0545283

N/A

STMT 1 STMT 2

OZARK MOUNTAIN LAUNDRY 64,920 10,925 58,284

418,509 465,155 89.97 58,409 62,267

58,409 62,267

SEE STATEMENT 3 SEE STATEMENT 4

00282800 08/22/2017 9:28 AM Pg 53


Schedule G – Investment Income of a Section 501(c)(7), (9), or (17) Organization (see instructions)

Schedule I – Exploited Exempt Activity Income, Other Than Advertising Income (see instructions)

Schedule J – Advertising Income (see instructions)

Part I Income From Periodicals Reported on a Consolidated Basis

Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Totals . . . . . . . . . . . . . . . . . . . . . . . .

Totals (carry to Part II, line (5)) . .

Form 990-T (2016) Page 4

Enter here and on page 1, Enter here and on page 1,Part I, line 9, column (A). Part I, line 9, column (B).

3. Deductions 5. Total deductions

1. Description of income 2. Amount of income directly connected 4. Set-asides and set-asides (col. 3

(attach schedule) (attach schedule) plus col.4)

(1)

(2)

(3)

(4)

4. Net income (loss)

from unrelated trade2. Gross 3. Expenses

5. Gross income7. Excess exempt

or business (column1. Description of exploited activity

unrelated directly

from activity that6. Expenses expenses

2 minus column 3).business income connected with

is not unrelatedattributable to (column 6 minus

If a gain, computefrom trade or

production of

business incomecolumn 5 column 5, but not

cols. 5 through 7.business

unrelated more thanbusiness income column 4).

(1)

(2)

(3)

(4)

Enter here and on Enter here and on Enter here and

page 1, Part I, page 1, Part I, on page 1,

line 10, col. (A). line 10, col. (B). Part ll, line 26.

4. Advertising 7. Excess readership2. Gross gain or (loss) (col. costs (column 6

1. Name of periodicaladvertising 3. Direct

2 minus col. 3). If5. Circulation 6. Readership

minus column 5, but

incomeadvertising costs

a gain, computeincome costs

not more than

cols. 5 through 7. column 4).

(1)

(2)

(3)

(4)

DAA

u

u

u

Form 990-T (2016)

5. Part of column 4 that is

u

Part I, line 8, column (B).Part I, line 8, column (A).Enter here and on page 1,Enter here and on page 1,

Add columns 6 and 11.Add columns 5 and 10.

column 10organization's gross income

connected with income inincluded in the controllingpayments made(loss) (see instructions)

11. Deductions directly10. Part of column 9 that is9. Total of specified8. Net unrelated income7. Taxable Income

in column 5organization's gross inc.

connected with incomeincluded in the controllingpayments made(loss) (see instructions)identification numberorganization

6. Deductions directly4. Total of specified3. Net unrelated income2. Employer1. Name of controlled

(4)

(3)

(2)

(1)

Nonexempt Controlled Organizations

(4)

(3)

(2)

(1)

Exempt Controlled Organizations

Totals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule F – Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions)


N/A

N/A

N/A

N/A

00282800 08/22/2017 9:28 AM Pg 54

Public Inspection Copyu

4. Advertising 7. Excess readership2. Gross gain or (loss) (col. costs (column 6

1. Name of periodicaladvertising 3. Direct

2 minus col. 3). If5. Circulation 6. Readership

minus column 5, but

incomeadvertising costs

a gain, computeincome costs

not more than

cols. 5 through 7. column 4).

Form 990-T (2016)

(1)

(2)

(3)

(4)

page 1, Part I,

2 through 7 on a line-by-line basis.)

u

u

DAA

businessunrelated business

2. Title1. Name time devoted to4. Compensation attributable to3. Percent of

Part ll, line 27.line 11, col. (B).line 11, col. (A).

on page 1,page 1, Part I,

Enter here andEnter here and onEnter here and on

(4)

(3)

(2)

(1)

%

%

%

%

Page 5Form 990-T (2016)

Total. Enter here and on page 1, Part ll, line 14

Totals, Part II (lines 1-5) . . . . .

Totals from Part I . . . . . . . . . . .

Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns Part II

Schedule K – Compensation of Officers, Directors, and Trustees (see instructions)


N/A

N/A

00282800 08/22/2017 9:28 AM Pg 55


00282800 Ozarks Regional YMCA 8/22/2017 9:28 AM

44-0545283 Federal Statements Page 1

FYE: 12/31/2016

Statement 1 - Form 990-T, Schedule E, Column 3a - Straight Line Depreciation

Description DeductionOZARK MOUNTAIN LAUNDRY DEPRECIATION 10,925

TOTAL 10,925

Statement 2 - Form 990-T, Schedule E, Column 3b - Other Deductions

Description Deduction

OZARK MOUNTAIN LAUNDRY LEGAL FEES 110 INTEREST 18,115 INSURANCE 4,050 REPAIRS 937 TAXES 6,575 ASSOCIATION 26,747 STAFF 1,750

TOTAL 58,284

Statement 3 - Form 990-T, Schedule E, Column 4 - Average Acquisition Debt

Description DeductionOZARK MOUNTAIN LAUNDRYSUM OF DEBT OUTSTANDING AT FIRST OF EACH MONTH 5,022,104DIVIDED BY TOTAL NUMBER OF MONTHS PROPERTY HELD 12

AVERAGE ACQUISITION DEBT 418,509

Statement 4 - Form 990-T, Schedule E, Column 5 - Average Adjusted Basis

Description DeductionOZARK MOUNTAIN LAUNDRYADJUSTED BASIS ON FIRST DAY PROPERTY WAS HELD 470,638ADJUSTED BASIS ON LAST DAY PROPERTY WAS HELD 459,672

930,310DIVIDED BY 2 2

AVERAGE ADJUSTED BASIS 465,155

1-4


2016For calendar year 2016, or tax year beginning

NOL carryover available to next year

990-TNet Operating Loss Carryover Worksheet

Prior Year Current Year

Next YearNOL Carryback /Preceding Adj. To NOL NOL Utilized

Current Year CarryoverTaxable Year Inc/(Loss) After Adj. (Income Offset) Carryover Utilized

Form

, ending

Name

Employer Identification Number

NOL carryover available to current year

Current year

15th

4th

3rd

2nd

1st

Carryovers to

14th

13th

12th

11th

10th

9th

8th

7th

6th

5th

Income Offset By

16th

17th

18th

19th


12/30/97

12/30/98

12/30/99

12/31/00

12/31/01

12/31/02

12/31/03

12/31/04

12/31/05

12/31/06

12/31/07

12/31/08

12/31/09

12/31/10

12/31/11

12/31/12

12/31/13

12/31/14

12/31/15

0

-3,858 3,858

3,858

00282800 08/22/2017 9:28 AM Pg 57


Independent Auditors’ Report and Financial Statements

Years Ended December 31, 2016 and 2015

C O N T E N T S Pages Independent Auditors' Report 1 Financial Statements: Statements of Financial Position 2 Statements of Activities 3 Statements of Functional Expenses 4 Statements of Cash Flows 5 Notes to Financial Statements 6-18

INDEPENDENT AUDITORS' REPORT To the Board of Directors Ozarks Regional YMCA Springfield, Missouri We have audited the accompanying financial statements of Ozarks Regional YMCA, (a nonprofit organization), which comprises the statement of financial position as of December 31, 2016, and the related statements of activities, functional expenses, and cash flows for the year then ended, and the related notes to the financial statements.

Management's Responsibility for the Financial Statements

Management is responsible for the preparation and fair presentation of these financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error.

Auditors' Responsibility

Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditors' judgment, including the assessment of the risk of material misstatements of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity's preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion of the effectiveness of the Association's internal control. Accordingly, we express no such opinion. An audit includes evaluating the appropriateness of accounting policies used and the reasonableness of significant accounting estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

www.kpmcpa.com

1445 E. Republic Road, Springfield, MO 65804 | 417-882-4300 | fax 417-882-4343 500 W. Main Street Suite 200, Branson, MO 65616 | 417-334-2987 | fax 417-336-3403

Member CPA Associates International, Inc., with offices in principal U.S. and international cities

Opinion

In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Ozarks Regional YMCA, as of December 31, 2016, and the changes in its net assets and its cash flows for the year then ended in accordance with accounting principles generally accepted in the United States of America. Prior Period Financial Statements and Summarized Comparative Information The financial statements of Ozarks Regional YMCA as of December 31, 2015, were audited by other auditors whose report dated June 20, 2016, expressed an unmodified opinion on those statements. The summarized comparative information presented herein as of and for the year ended December 31, 2015, has been derived from these audited financial statements. Other Matters As part of our audit of the 2016 financial statements, we also audited adjustments described in Note 15 which were applied to restate the 2015 financial statements. In our opinion, such adjustments are appropriate and have been properly applied. We were not engaged to audit, review, or apply any procedures to the 2015 financial statements of the Company other than with respect to the adjustments and, accordingly, we do not express an opinion or any other form of assurance on the 2015 financial statements as a whole. April 28, 2017 Springfield, Missouri

kseiwert

New Stamp

2016 2015

ASSETS

Current Assets:

Cash and cash equivalents 1,115,282$ 578,639$ Accounts receivable 143,499 133,811 Pledges receivable - current portion 64,728 195,622 Prepaid expenses 17,586 15,130

Total current assets 1,341,095 923,202

Property and Equipment:

Cost 34,448,245 34,717,507 Less accumulated depreciation 10,845,924 10,616,847

Net property and equipment 23,602,321 24,100,660

Other Assets:

Beneficial interest in community foundation 1,449,992 1,429,293 Cash restricted for building future YMCA facilities - 327,882 Pledges receivable - long term - 89,747 Other assets 44,126 54,456

Total other assets 1,494,118 1,901,378

Total assets 26,437,534$ 26,925,240$

LIABILITIES AND NET ASSETS

Current Liabilities:

Debt maturing within one year 799,694$ 4,184,589$ Accounts payable 90,254 160,659 Accrued expenses 241,383 196,534 Deferred revenue 160,574 155,813

Total current liabilities 1,291,905 4,697,595

Long-term Debt 7,656,223 5,233,970

Net Assets:

Unrestricted: Operating 135,480 (44,695) Board designated 484,703 481,914 Property and equipment 15,146,404 14,563,504

Total unrestricted 15,766,587 15,000,723

Temporarily restricted 1,700,819 1,970,952

Permanently restricted 22,000 22,000

Total net assets 17,489,406 16,993,675

Total liabilities and net assets 26,437,534$ 26,925,240$

DECEMBER 31, 2016 AND 2015


STATEMENTS OF FINANCIAL POSITION

The accompanying notes are an integral part of these financial statements-2-

Temporarily Permanently Total TotalUnrestricted Restricted Restricted Net Assets Net Assets

PUBLIC SUPPORT AND REVENUES:

Contributions and support 540,338$ 1,761,750$ -$ 2,302,088$ 1,727,380$ Membership dues and fees 4,774,447 - - 4,774,447 4,847,827 Program service fees 3,447,079 - - 3,447,079 3,276,591 Investment income (loss) 29,366 53,564 - 82,930 (66,905) Miscellaneous revenue 375,155 - - 375,155 469,526 Loss on disposition of property and equipment (62,703) - - (62,703) (51,068)

Total public support and revenues 9,103,682 1,815,314 - 10,918,996 10,203,351

Net assets released from restrictions 2,085,447 (2,085,447) - - -

Total public support, revenues

and reclassifications 11,189,129 (270,133) - 10,918,996 10,203,351

EXPENSES

Program services 9,274,744 - - 9,274,744 9,105,140 Management and general 923,799 - - 923,799 896,030 Fundraising 224,722 - - 224,722 324,836 Total expenses 10,423,265 - - 10,423,265 10,326,006

Increase (decrease) in net assets 765,864 (270,133) - 495,731 (122,655)

Net assets, beginning of year, restated 15,000,723 1,970,952 22,000 16,993,675 17,116,330

Net assets, end of year 15,766,587$ 1,700,819$ 22,000$ 17,489,406$ 16,993,675$

2016

Net Assets

2015


STATEMENTS OF ACTIVITIES AND NET ASSETS

YEAR ENDED DECEMBER 31, 2016

WITH SUMMARIZED FINANCIAL INFORMATION FOR THE YEAR ENDED DECEMBER 31, 2015


Total Management TotalHealthy Youth Program and Support 2016 2015Living Development Services General Fundraising Services Total Total

Salaries 1,914,664$ 2,374,284$ 4,288,948$ 547,292$ 183,448$ 730,740$ 5,019,688$ 4,929,525$ Employee health and retirement benefits 190,859 145,314 336,173 70,965 21,793 92,758 428,931 406,657 Payroll taxes 168,980 214,148 383,128 37,915 13,971 51,886 435,014 457,359

Total salaries and related expenses 2,274,503 2,733,746 5,008,249 656,172 219,212 875,384 5,883,633 5,793,541

Supplies 267,412 492,738 760,150 87,131 2,533 89,664 849,814 898,622 Insurance 110,654 34,943 145,597 23,970 - 23,970 169,567 189,049 Postage and shipping 4,449 17,003 21,452 2,938 - 2,938 24,390 19,173 Travel and

employee expenses 49,530 15,786 65,316 10,445 293 10,738 76,054 70,122 Conference, conventions,

and meetings 20,811 17,378 38,189 10,145 - 10,145 48,334 52,874 Dues 98,823 33,798 132,621 7,018 920 7,938 140,559 139,325 Printing, publication

and promotion 129,595 16,499 146,094 145 1,764 1,909 148,003 101,850 Miscellaneous 11,020 2,045 13,065 27,087 - 27,087 40,152 40,003 Telecommunications 65,155 18,585 83,740 11,288 - 11,288 95,028 89,615 Professional fees 32,619 157,414 190,033 32,683 - 32,683 222,716 204,133 Occupancy 699,909 333,091 1,033,000 5,172 - 5,172 1,038,172 1,159,522 Rent and maintenance

of equipment 123,679 77,611 201,290 12,969 - 12,969 214,259 172,701 Interest expense and fees 349,812 49,875 399,687 16,898 - 16,898 416,585 460,590 Bad debt loss 99,654 5,693 105,347 10,000 - 10,000 115,347 - Depreciation 707,495 223,419 930,914 9,738 - 9,738 940,652 934,886

Total expenses 5,045,120$ 4,229,624$ 9,274,744$ 923,799$ 224,722$ 1,148,521$ 10,423,265$ 10,326,006$

Program Services Supporting Services


STATEMENTS OF FUNCTIONAL EXPENSES

YEAR ENDED DECEMBER 31, 2016

WITH SUMMARIZED FINANCIAL INFORMATION FOR THE YEAR ENDED DECEMBER 31, 2015


2016 2015

Cash flows from operating activities:

Increase (decrease) in net assets 495,731$ (122,655)$ Adjustments: Depreciation 940,652 934,886 Unrealized (gain) loss on investments (53,221) 96,210 Realized gain on sale of investments (6,686) (9,362) Loss on disposal of property and equipment 62,703 51,068 Change in cash restricted for long-term assets 327,882 (46,631)

Changes in discounts on restricted unconditional promises to give - 7,631

Net changes in operating accounts: Accounts receivable (9,688) 2,775 Pledges receivable 220,641 (259,109) Prepaid expenses (2,456) 110,636 Accounts payable (70,405) (116,675) Other assets 10,330 10,470 Accrued expenses 44,849 (61,260) Deferred revenue 4,761 (57,337)

Net cash from operating activities 1,965,093 540,647

Cash flows from investing activities:

Withdrawal (contribution) from community foundation 39,208 (317,551) Acquisition of property and equipment (505,016) (210,086)

Net cash used in investing activities (465,808) (527,637)

Cash flows from financing activities:

Payments on long-term debt (937,682) (696,361) Net repayments on line of credit (24,960) (75,219) Proceeds from contributions restricted for building projects - 821,955

Net cash from (used in) financing activities (962,642) 50,375

Increase in cash and cash equivalents 536,643 63,385 Cash and cash equivalents, beginning of year 578,639 515,254

Cash and cash equivalents, end of year 1,115,282$ 578,639$

Supplemental disclosure of cash flow information:

Cash paid during the year for interest 281,432$ 287,945$


STATEMENTS OF CASH FLOWS

YEARS ENDED DECEMBER 31, 2016 AND 2015



NOTES TO FINANCIAL STATEMENTS

YEARS ENDED DECEMBER 31, 2016 and 2015

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(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Nature of operations - The Ozarks Regional YMCA was established in Springfield, Missouri in 1888, and is made up of eight family centers, including two Springfield locations, Ozark Mountain Family YMCA in Hollister, Monett Area YMCA, Cassville YMCA, Roy Blunt YMCA of Bolivar, Dallas County Area YMCA in Buffalo, Lebanon Family YMCA, YMCA Camp Wakonda and the School Age Services branch. Its programs, services and initiatives enable kids to realize their potential, prepare teens for college, offer ways for families to have fun together, empower people to be healthier in spirit, mind and body, prepare people for employment, welcome and embrace newcomers and help foster a nationwide service ethic.

Basis of presentation - Ozarks Regional YMCA is required to report information regarding

its financial position and activities according to three classes of net assets; unrestricted net assets, temporarily restricted net assets, and permanently restricted net assets.

Comparative financial information – The financial statements include certain prior-year

summarized comparative information in total but not by net asset class. Such information does not include sufficient detail to constitute a presentation in conformity with U.S. generally accepted accounting principles. Accordingly, such information should be read in conjunction with the Association’s financial statements for the year ended December 31, 2015 from which the summarized information was derived.

Accounting estimates - Management uses estimates and assumptions in preparing these financial statements in accordance with U.S. generally accepted accounting principles. Those estimates and assumptions affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities, and the reported revenues and expenses. Actual results could vary from the estimates that were used.

During the year ended December 31, 2015, the Association changed its vacation policy

and the manner in which benefits carry over to subsequent years. This change in estimate for the year ended December 31, 2016 resulted in a $50,614 increase in net assets.

Receivables and Credit Policies – Accounts receivable consists primarily of

uncollateralized funds due from various funding sources in connection with the school-age childcare programs for which the Association serves as a contractor to provide services. These obligations are required to be repaid under normal trade terms within 30 days from the invoice date. It is the Association’s policy not to charge interest on past due accounts.

Accounts receivable are stated at the amount billed to the funding sources. Account

balances with invoices dated over 30 days old are considered delinquent. Payments of accounts receivable are allocated to the specific invoices identified on the

remittance advice. Management individually reviews all accounts receivable balances and, based on an

assessment of current creditworthiness, estimates the portion of the balance that will not be collected. Management has concluded that realization losses on balances outstanding at year-end will be immaterial.




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(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Pledges receivable - Unconditional promises to give that are expected to be collected within

one year are recorded at their net realizable value. Unconditional promises to give that are expected to be collected in future years are recorded at the present value of estimated future cash flows. The discounts on those amounts are computed using a risk-free interest rate applicable to the year in which the promise is received. Amortization of the discount is included in contribution revenue. Conditional promises to give are not included as support until such time as the conditions are substantially met.

The carrying amount of pledges receivable is reduced by a valuation allowance that

reflects management’s best estimate of the amounts that may not be collected. Management reviews all pledge balances that are considered delinquent and, based upon donor history with the Association, estimates the portion, if any, of the balance that may not be collected.

Property and equipment and related depreciation - Property and equipment have been

stated at cost. Depreciation has been computed by applying the following methods and estimated lives:

Category Estimated Life Method Equipment 3-8 years Straight-line Building and improvements 15-100 years Straight-line

Acquisitions of property and equipment or repairs, maintenance or betterments that materially prolong the useful lives of assets in excess of $5,000 are capitalized.

Deferred revenue - Income from membership dues and subscription fees is deferred and

recognized over the periods to which the dues and fees relate. Investments - Investments in marketable equity securities with readily determinable fair

values are stated at fair value. Unrealized gains and losses are included in the change of net assets in the accompanying statement of activities.

Tax exempt status - The Association has been classified as an exempt organization under

Internal Revenue Code Section 501(c)(3) and as a public charity qualified for charitable contributions under Internal Revenue Code Section 170.

The Association has analyzed the tax positions taken and has concluded that as of December 31, 2016 and 2015, there are no uncertain positions taken, or expected to be taken, that would require recognition of an asset or liability or disclosure in the financial statements. A tax asset or liability would be recognized if the Association has taken an uncertain position that more likely than not would not be sustained upon examination by taxing authorities. The Association is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The Association does not believe it likely that changes will occur within the next fiscal year that will have a material impact on the financial statements.




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(1) SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) Contribution revenue - Contributions received are recorded as increases in unrestricted,

temporarily restricted or permanently restricted net assets, depending on the existence and/or nature of any donor restrictions. All donor restricted contributions are reported as increases in temporarily or permanently restricted net assets, depending on the nature of the restriction. When a restriction expires (that is, when a stipulated time restriction ends or the purpose is accomplished), temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statements of activities as net assets released from restrictions.

Donated assets - Donated investments and other noncash donations received by the

Association are recorded at their fair value at the date of donation.

Contributed services - The Association receives a substantial amount of services donated by volunteers in carrying out the Associations programs and fundraising. No amounts have been reflected in the financial statements for those services since they do not meet the criteria for recognition under accounting principles generally accepted in the United States of America.

Transactions with National Organization - The Association has a relationship with a

national affiliate and is required to remit a percentage of its revenues based on certain criteria. During the years ended December 31, 2016 and 2015, the Association was required to remit to the national affiliate $140,537 and $132,832, respectively.

Functional expense allocation - The cost of providing various programs and other activities have been summarized on a functional basis in the statement of activities and net assets and in the statement of functional expenses. Accordingly, certain costs have been allocated among the programs and supporting services identified.

Advertising costs - The Association expenses non-direct response advertising costs as they are incurred.

Statements of cash flows – Cash equivalents include time deposits, certificates of deposit,

money market funds, and all highly liquid debt instruments with maturities of three months or less at the date of their acquisition.

Fair value measurement – The definition of fair value focuses on the exit price (i.e., the

price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date) not the entry price (i.e., the price that would be paid to acquire the asset or received to assume the liability at the measurement date). Fair value is a market-based measurement; not an entity-specific measurement. Therefore, the fair value measurement should be determined based on the assumptions that market participants would use in pricing the asset or liability.

Subsequent events – The Association has evaluated subsequent events between the end

of the most recent fiscal year end and April 28, 2017, the date the financial statements were available to be issued.




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(2) BENEFICIAL INTEREST IN COMMUNITY FOUNDATION Beneficial interest in community foundation, as presented in the other assets section of the

statements of financial position, consists of unrestricted, temporarily, and permanently restricted funds held at Community Foundation of the Ozarks by the Association. The investment structure of the assets is to seek higher returns than a cash account while providing reasonable stability of principle.

Beneficial interest in community foundation consists of the following funds:

2016 2015 Unrestricted $ 484,703 $ 481,977 Temporarily restricted 943,289 925,316 Permanently restricted 22,000 22,000

Beneficial interest in community foundation $ 1,449,992 $ 1,429,293

(3) PLEDGES RECEIVABLE Pledges receivable consist of the following unconditional promises to give: 2016 2015 Gross unconditional promises to give $ 64,728 $ 310,701 Less: Allowance for uncollectibles - (20,079) Unamortized discount - (5,253) Net unconditional promises to give $ 64,728 $ 285,369 Unconditional promises to give are due as follows: Less than one year $ 64,728

The Association used the average incremental borrowing rate of 3.25% to calculate the unamortized discount for the year ended December 31, 2015.

(4) CHANGES IN THE ALLOWANCE FOR UNCOLLECTIBLE PLEDGES 2016 2015 Beginning balance $ 20,079 $ 71,055 Net write-offs (20,079) (50,976) Ending balance $ - $ 20,079




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(5) PROPERTY AND EQUIPMENT Property, plant and equipment consists of the following: 2016 2015 Land $ 1,161,484 $ 1,161,484

Buildings and improvements 29,679,557 29,642,890 Equipment 3,607,204 3,912,633 Construction in progress - 500

Property, plant and equipment at cost 34,448,245 34,717,507 Less: Accumulated depreciation 10,845,924 10,616,847 $ 23,602,321 $ 24,100,660

Depreciation charged to expense for the years ended December 31, 2016 and 2015 amounted to $940,652 and $934,886, respectively.

(6) DEBT Debt maturing within one year consists of the following: 2016 2015

Prime +1% floating; with a floor of 5.00%; Central Bank of the Ozarks, secured by real estate; payable $2,500 per month plus interest; matures September 2017 $ 132,394 $ 157,354 Long-term debt maturing within one year 667,300 4,027,235 Debt maturing within one year $ 799,694 $ 4,184,589 Long-term debt consists of the following:

2016 2015 5.00%; Commerce Bank N.A.; secured by real estate; payable $7,579 per month including interest; refinanced July 2016 $ - $ 576,951 3.75%; Commerce Bank N.A.; secured by real estate; payable $4,549 per month including interest;

refinanced July 2016 - 461,798 4.00%; Commerce Bank, N.A.; secured by real estate; payable $11,101 per month including interest; matures February 2018 1,317,738 1,384,017

3.75%; Commerce Bank N.A.; secured by real estate; payable $12,059 per month including interest;

matures July 2019 951,986 -




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(6) DEBT (CONTINUED) 2016 2015

3.75%; Commerce Bank N.A.; secured by accounts receivable, inventory, and equipment; payable $1,615 per month including interest; matures September 2019 $ 76,366 $ 91,077

4.00%; Commerce Bank N.A.; secured by real estate; payable $8,627 per month including interest; matures February 2020 1,099,395 1,146,483

2.80%; Industrial Development Authority of the City of Monett; secured by real estate and receivables; payable $22,148 per month including interest; matures July 2021 2,926,799 3,437,933 Libor + 2%, Missouri Development Finance Board; secured by real estate and receivables; payable $17,642 per month including interest; matures June 2026 $ 1,951,239 $ 2,162,946 8,323,523 9,261,205

Less debt maturing within one year 667,300 4,027,235 Long-term debt $ 7,656,223 $ 5,233,970 Interest charged to expense amounted to $309,333 and $460,590 for the years ended

December 31, 2016 and 2015, respectively.

Principal payments due on long-term debt are as follows:

Year Ended Aggregate Annual December 31 Maturities

2018 $ 1,832,400 2019 1,240,500

2020 1,329,300 2021 2,361,400 Thereafter 892,623

$ 7,656,223

The obligations require the Association to comply with certain covenants, the more important of which requires the maintenance of certain financial ratios. The Association is considered to be in compliance with all terms of the financing agreement at December 31, 2016.




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(7) ENDOWMENTS The Association's net assets include endowment funds established for its long-term growth. The endowment funds consist of donor-restricted endowment funds and funds designated by the board of directors to function as endowments. As required by accounting principles generally accepted in the United States of America, net assets associated with endowment funds, including funds designated by the board of directors as endowments, are classified and reported based on the existence or absence of donor-imposed restrictions. The State of Missouri enacted the Uniform Prudent Management of Institutional Funds Act (UPMIFA) in 2009, the provisions of which apply to endowment funds existing on or established after that date. The Board of Directors of the Association has interpreted the UPMIFA as requiring the preservation of the fair value of the original gift as of the gift date of the donor-restricted endowment funds unless there are explicit donor stipulations to the contrary. As of December 31, 2016, the Board of Directors of the Association had designated $462,703 of unrestricted net assets as a general endowment fund to support the mission of the Association. Since the amount resulted from an internal designation and is not donor-restricted, it is classified and reported as unrestricted net assets. The Association's endowments also consist of two individual funds established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments, are classified and reported based on the existence or absence of donor-imposed restrictions. As a result of this interpretation, the Association classifies as permanently restricted net assets (a) the original value of gifts donated to the permanent endowment, (b) the original value of subsequent gifts to the permanent endowment, and (c) accumulations to the permanent endowment made in accordance with the direction of the applicable donor gift instrument at the time the accumulation is added to the fund. The remaining portion of the donor-restricted endowment fund that is not classified in permanently restricted assets is classified as board designated net assets until those amounts are appropriated for expenditure by the Association in a manner consistent with the standards of prudence prescribed by UPMIFA. In accordance with UPMIFA, the Association considers the following factors in making a determination to appropriate or accumulate donor-restricted endowment funds: 1. The duration and preservation of the fund 2. The purposes of the Association and the donor-restricted endowment fund 3. General economic conditions 4. The possible effect of inflation and deflation 5. The expected total return from income and the appreciation of investments 6. Other resources of the Association 7. The investment policies of the Association




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(7) ENDOWMENTS (CONTINUED) Funds with deficiencies - From time to time, the fair value of assets associated with

individual donor-restricted endowment funds may fall below the level that the donor or UPMIFA requires the Association to retain as a fund of perpetual duration. In accordance with accounting principles generally accepted in the United States of America, as of December 31, 2016 and 2015 there were no deficiencies of this nature that are reported in unrestricted net assets.

Return objectives and risk parameters - The Association has adopted investment and

spending policies for endowment assets that attempt to provide a predictable stream of funding to programs supplied by its endowment while seeking to maintain the purchasing power of the endowment assets. Endowment assets include those assets of donor-restricted funds that the Association must hold in perpetuity.

Under this policy, as approved by the board, the endowment assets are invested in a manner that is intended to produce results that exceed the spending rate, aggregate costs of portfolio management, the long-term inflation rate and any growth factor that the board may, from time to time, determine appropriate while assuming a moderate level of investment risk. The Association expects its endowment funds, over time, to provide an average rate of return of approximately 5 percent net of inflation annually. Actual returns in any given year may vary from this amount.

Strategies employed for achieving objectives - To satisfy its long-term rate-of-return

objectives, the Association relies on a total return strategy in which investment returns are achieved through both capital appreciation (realized and unrealized) and current yield (interest and dividends). The Association targets a diversified asset allocation that places a greater emphasis on equity-based investments to achieve its long-term return objectives within prudent risk constraints.

Spending policies and how the investment objectives relate to spending policy - The

Association has no formal spending policy related to the endowment fund. In the current year, the amount appropriated for expenditure consisted solely of the administrative fee charged to the investment account held at the foundation.

Endowment net asset composition by type of fund as of December 31, 2016 and 2015, are

as follows:

2016 Temporarily Permanently Unrestricted Restricted Restricted Total Board-designated endowment funds $ 484,703 $ - $ - $ 484,703 Donor-restricted endowment funds - 943,289 22,000 965,289 Total $ 484,703 $ 943,289 $ 22,000 $ 1,449,992




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(7) ENDOWMENTS (CONTINUED) 2015

Temporarily Permanently Unrestricted Restricted Restricted Total Board-designated endowment funds $ 481,914 $ - $ - $ 481,914 Donor-restricted endowment funds - 925,379 22,000 947,379 Total $ 481,914 $ 925,379 $ 22,000 $ 1,429,293 Changes in endowment net assets for the years ended December 31, 2016 and 2015 are as

follows: 2016 Temporarily Permanently Unrestricted Restricted Restricted Total Endowment net assets, beginning of year $ 481,914 $ 925,379 $ 22,000 $ 1,429,293 Investment income 10,303 19,112 - 29,415 Unrealized gain 18,768 34,452 - 53,220 Investment fees (5,592) (9,513) - (15,105) Contributions - 6,256 - 6,256 Appropriation of endowment assets for expenditures (20,690) (32,397) - (53,087) $ 484,703 $ 943,289 $ 22,000 $ 1,449,992

2015 Temporarily Permanently Unrestricted Restricted Restricted Total Endowment net assets, beginning of year $ 532,123 $ 644,467 $ 22,000 $ 1,198,590 Investment income 10,608 18,566 - 29,174 Unrealized loss (31,647) (64,563) - (96,210) Investment fees (4,848) (9,598) - (14,446) Contributions 1,478 355,834 - 357,312 Appropriation of endowment assets for expenditures (25,800) (19,327) - (45,127) $ 481,914 $ 925,379 $ 22,000 $ 1,429,293 Endowment net assets of $1,449,992 and $1,429,293 as of December 31, 2016 and 2015,

respectively, are included within the beneficial interest in community foundation in the accompanying statements of financial position.




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(8) RESTRICTIONS ON NET ASSETS

Board designated net assets:

It is the policy of the Board of Directors of the Association to review its plans for future property improvements and acquisitions from time to time and to designate appropriate sums of unrestricted net assets to assure adequate financing of such improvements and acquisitions.

Temporarily restricted net assets are available for the following purposes:

2016 2015 Restricted for subsequent years’ activities $ 1,700,819 $ 1,970,952 Permanently restricted net assets consist of endowment fund assets to be held indefinitely.

The income from the assets can be used to support the Association’s general activities. (9) INVESTMENTS Investment return is summarized as follows: 2016 2015 Investment income $ 23,023 $ 19,943 Net realized gain 6,686 9,362 Net unrealized gain (loss) 53,221 (96,210)

Total unrestricted investment income (loss) $ 82,930 $ (66,905) (10) RETIREMENT PLANS

The Association participates in a multiple employer, defined contribution, individual account, money purchase plan, which is administered by The Young Men's Christian Association Retirement Fund (a separate Corporation). The plan is open to all full-time, part-time, and seasonal employees who are at least 21 years old and have 1,000 hours of service during two 12-month periods. Retirement plan expense for the years ended December 31, 2016 and 2015 amounted to $189,848 and $195,674, respectively.

(11) LEASES The Association leases its Cassville, Missouri branch facility under a yearly renewable lease

for $30,000.

Leases for land and branch facilities expire at various dates through May 2107. The Association also leases facilities and equipment used in various programs under various operating leases. Certain leases contain renewal options which may be exercised at the discretion of the Association.

Rental expense amounted to $279,499 and $300,381 for the years ended December 31, 2016 and 2015, respectively.




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(12) FAIR VALUE MEASUREMENT

The Association has an established process for determining fair values. Fair value is based upon quoted market prices, where available. If listed prices or quotes are not available, fair value is based upon internally developed models or processes that use primarily market-based or independently-sourced market data, including interest rate yield curves, option volatilities and third party information. Valuation adjustments may be made to ensure that financial instruments are recorded at fair value. Furthermore, while the Association believes its valuation methods are appropriate and consistent with other market participants, the use of different methodologies, or assumptions, to determine the fair value of certain financial instruments could result in a different estimate of fair value at the reporting date. Valuation Hierarchy ASC 820 establishes a three-level valuation hierarchy for disclosure of fair value measurements. The valuation hierarchy is based upon the transparency of inputs to the valuation of an asset or liability as of the measurement date. The three levels are defined as follows:

Level 1 – inputs to the valuation methodology are quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 – inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument. Level 3 – inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument’s categorization within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. Following is a description of the valuation methodologies used for instruments measured at fair value, as well as the general classification of such instruments pursuant to the valuation hierarchy. Assets held at Community Foundation of the Ozarks – The Association uses quoted market

prices from actively traded markets to estimate the fair value of the Level 1 securities that it holds. If quoted market prices were not available, then fair values would be estimated by using pricing models, quoted prices of securities with similar characteristics, or discounted cash flows and would be classified within Level 2 of the valuation hierarchy. In certain cases where there is limited activity or less transparency around inputs to the valuation, securities would be classified within level 3 of the valuation hierarchy.




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(12) FAIR VALUE MEASUREMENT (CONTINUED) The following table presents the financial instruments carried at fair value on a recurring basis as of December 31, 2016 and 2015, by caption on the statements of financial position and by ASC 820 valuation hierarchy:

Internal models

Internal models with significant

Quoted market with significant unobservable

prices in an observable market market

Carrying active market parameters parameters

value (Level 1) (Level 2) (Level 3)

December 31, 2016: Assets held at Community Foundation of the Ozarks $ 1,449,992 $ $ 1,449,992 $ -

December 31, 2015: Assets held at Community Foundation of the Ozarks $ 1,429,293 $ $ 1,429,293 $ -

During the years ended December 31, 2016 and 2015, the Association had no financial instruments classified within Level 3 of the valuation hierarchy for assets and liabilities measured at fair value on a recurring basis.

(13) CONCENTRATION OF CREDIT RISK

The Association maintains bank accounts at various financial institutions. At certain times during the year ended December 31, 2016, the balance at Central Bank of the Ozarks exceeded standard FDIC insurance limits.

The Association has established a relationship with Springfield Public Schools (SPS) which

accounted for approximately 14% and 16% of the Association’s annual revenues in 2016 and 2015, respectively. The Association provides program services to school aged children. The contract with Springfield Public Schools renewed through June 2020. During the years ended December 31, 2016 and 2015, the Association paid SPS $139,531 and $115,145, respectively under a revenue sharing agreement.

(14) RECLASSIFICATIONS Certain reclassifications have been made to the 2015 financial statements to conform to the

2016 financial statement presentation. These reclassifications had no effect on the change in net assets.




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(15) ERROR CORRECTION

Certain errors resulting in an overstatement of previously reported property and equipment were discovered during the current year. Prior to December 31, 2014, the Association donated land to the City of Monett. The Association did not record a donation of land to the City of Monett which was subsequently leased back to the Association. This transaction does not meet the guidelines for a capital lease and, accordingly, an adjustment of $321,495 was made during 2016 to write down property and equipment as of the beginning of 2015. The effect of the correction on the change in net assets and change in property and equipment for the year ended December 31, 2015 was a decrease of $321,495, respectively. These corrections resulted in the following restatement in the statement of financial position for December 31, 2015:

Temporarily Permanently Unrestricted Restricted Restricted Total Net assets December 31, 2014 as previously reported $ 15,282,055 $ 2,133,770 $ 22,000 $ 17,437,825 Donated property (321,495) - - (321,495) Net assets December 31, 2014 as restated 14,960,560 2,133,770 22,000 17,116,330 2015 increase (decrease) in net assets 40,163 (162,818) - (122,655) Net assets December 31, 2015 As restated $ 15,000,723 $ 1,970,950 $ 22,000 $ 17,116,330

April 28, 2017 Board of Directors Ozarks Regional YMCA 417 S Jefferson Springfield, MO 65806 Dear Members of the Board: In planning and performing our audit of the financial statements of Ozarks Regional YMCA as of and for the year ended December 31, 2016, in accordance with auditing standards generally accepted in the United States of America, we considered Ozarks Regional YMCA’s control over financial reporting (internal control) as a basis for designing our auditing procedures for the purpose of expressing our opinion on the financial statements, but not for the purpose of expressing an opinion on the effectiveness of the Association’s internal control. Accordingly, we do not express an opinion on the effectiveness of the Association’s internal control. A deficiency in internal control exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. A material weakness is a deficiency or combination of deficiencies in internal control, such that there is a reasonable possibility that a material misstatement of the Association’s financial statements will not be prevented, or detected and corrected on a timely basis. Our consideration of internal control was for the limited purpose described in the preceding paragraph and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses and, therefore, there can be no assurance that all such deficiencies have been identified. We did not identify any deficiencies in internal control that we consider to be material weaknesses. In addition, during our audit we noted certain matters involving internal control and other operational matters that are presented for your consideration. Our comments and recommendations are intended to improve internal control or result in other operating efficiencies. We will be pleased to discuss these comments in further detail at your convenience, perform any additional study of these matters, or assist you in implementing the recommendations. Our comments are summarized as follows:

1. Recently, the FASB released Accounting Standards Update 2016-14, Presentation of

Financial Statements of Not-for-Profit Entities. The standard is effective for annual financial statements issued for fiscal years beginning after December 15, 2017. The newly released ASU will change the way all not-for-profit entities classify net assets and prepare financial statements. KPM is currently evaluating the impact the changes will have on your financial statements and the best way to implement the new reporting model.

www.kpmcpa.com

1445 E. Republic Road, Springfield, MO 65804 | 417-882-4300 | fax 417-882-4343 500 W. Main Street Suite 200, Branson, MO 65616 | 417-334-2987 | fax 417-336-3403

Member CPA Associates International, Inc., with offices in principal U.S. and international cities

Board of Directors Ozarks Regional YMCA April 28, 2017 Page Two

2. We recommend the board minutes include approval of Steve Gimenez and any other

2016 officers’ compensation. Compensation includes salary, retirement benefits, fringe benefits and bonuses. Establishing and documenting reasonable compensation is important because excessive compensation may result in excise taxes on both the individual and the organization. “Reasonable compensation” is the amount that would ordinarily be paid for like services by like organizations under like circumstances as of the date the compensation arrangement is made.

3. During the audit of fixed assets, we noted the organization maintains the fixed asset subledger. The following items came to our attention:

a. Currently, the accounting department maintains a detail subledger for all assets purchased since 2007. The prior audit firm was maintaining the detail records for assets purchased prior to 2007. In order to accurately record depreciation for 2017 and into the future, the older assets will have to be added to the CCC system. Please make sure this is complete prior to December 31, 2017. Please provide a copy of the merged records to KPM as soon as it is complete so we can verify it agrees to the prior year records.

b. Due to the number of fixed assets owned by the Association, accounting for fixed assets is complicated. In order to ensure the assets listed in the subledger are complete, we recommend each branch or department be responsible for performing test counts of major fixed assets. Management should develop a policy so that over the course of a year, each branch or department is responsible for verifying its subledger activity is complete and accurate.

4. During our audit, we only reviewed the internal control policies and procedures the

Association maintains at the corporate office. As our procedures were not applied to the branch locations of the Association, we recommend management review and evaluate the policies and procedures at the branch locations of the organization to ensure the branches are applying procedures consistently with the corporate office.

5. Enclosed is a copy of the IRS Governance check sheet used by Revenue Agents in the examination of 501(c)(3) public charities. Please review it for policies or procedures deemed important by the IRS. Please visit http://www.irs.gov/pub/irs-tege/governance_check_sheet.pdf for a complete form including selection options in the drop down boxes.

We would like to thank Ruth, her staff and others involved in the audit for their assistance and cooperation throughout the audit process. We greatly appreciate all their hard work. This communication is intended solely for the information and use of management, the board of directors and others within the Association, and is not intended to be and should not be used by anyone other than these specified parties. Sincerely, KPM CPAs, PC

http://www.irs.gov/pub/irs-tege/governance_check_sheet.pdf

http://www.irs.gov/pub/irs-tege/governance_check_sheet.pdf

[email protected]

Firm Signature - Use

19 - Programs Cover Sheet - Signed Printed 2/21/2018

Agency name:

Primary contact:

Phone:

Program Title

2017 actual2018 current 2019 proposed

2017 actual2018 current 2019 proposed 2017

actual2018

current2019

proposed2017

actual2018

current2019

proposed2017

actual2018

current2019

proposed

School Ages Services

2,988,605$ 3,135,325$ 3,229,385$ 21,430$ 30,000$ 30,900$ 1% 1% 1% $1,008.30 $1,045.11 $1,055.35 2,964 3,000 3,060

Healthy Living

$ 7,344,423 7,636,626.00$ 7,865,725$ 111,720.00$ 179,550.00$ 184,793$ 2% 2% 2% $714.72 $742.86 $749.12 10,276 10,280 10,500

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!



AUTHORIZED SIGNATURE By signing below, I affirm that I have reviewed the form, and to the best of my knowledge, the information furnished is correct and provides full and fair disclosure of the agency.

Agency CEO Name & Title Steve Gimenez, CEOSignature /Steve Gimenez/ Date 2/8/2018Chief Volunteer Officer /Shannon Boggs/, Board Chair Date 2/8/2018

Budget Request Program Budget Participant

2018 Community Investment Request for Proposal (RFP)(for funding in 2019 and 2020)

PROGRAMS COVER SHEET

Total United Way of the Ozarks % of UWO Program Cost Number

Program Budget InformationA B C D E

2019 2019

Program Funds Funding to Total Per Served

by Agency

2019 2019

10,814,253.68$ 187,883$ 2% 13,560

Total Total % of United Way of the Ozarks

Budget Funds Request Agency Budget

Total

Agency United Way of the Ozarks Funding to Total # to be Served

Ozarks Regional YMCAAgency address:

417 S Jefferson, Springfield, MO 65806

E

Steve Gimenez Email: [email protected]

417-862-8962 X2110 Fax: 417-866-9527

Agency Budget InformationA B C D





