Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
,",- 8879-E0
Department of lhe Treasurylnternal Revenue Service
Name of ex€rhpl organization
UNlTED POULTRY CONCERNS, INCName and title of olticer
KAREN DAVIS, PRESIDENT
IRS e-file Sisnature Authorizationfor an Ex-empt Organization
OlrB No 1545-Ta78
For calendar year 2018, or fiscal year beginning ,2018, and ending 2A
> Do not send to the lRS. Keep tor your records.> Go lo www.irs.govlFormSTgEO lot lhe latest inlormation.
2@18Employer identifi cation number
52-1705678
1a
2a
3a4a5a
FormFormFormFormForm
Elfl Type of Return and Return lnformation Whole Dollars Only)Check the box for the relurn lor which you are using this Form 8879-EO and enter the applicable amount, if any, lrom the return. If youcheck the box on line 1a, 2a, 3a,4a, ot 5a, below, and the amount on that line for the return being filed with this form was blank, thenleave line 1b, 2b, 3b, 4b, or 5b, whichever is applicable, blank (do not enter -0r. But, if you entered -0- on the return, then enter -0- onthe applicable line below. Do not complete more than one line in Part l.
990 checkhere> I b Total revenue, if any (Form 990, PartVlll, column (A), line'12)990-Ez check here > E b Total revenue, if any (Form 990-EZ, line g) .
'l 'l2O-POL check here > n b Totaltax (Form 1120-POL, line 221
990-PF check here> E b Tax based on investment income (Form ggo-PF, Part Vl, line5)
8868checkhere> E b Balance Due (Form 8868, line3c).
Declaration and Si nature Authorization of OfficerUnder penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy ol theorganization's 2018 electronic return and accompanying schedules and statements and to the best of my knowledge and belief, theyare true, correct, and complete. I further declare that the amount in Part I above is the amount shown on the copy of theorganization's electronic return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO)
to send the organization's return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejeclion ofthe transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund. lf applicable, I
authorize the U.S. Treasury and its designated FinancialAgent lo initiate an electronic funds withdrawal (direct debit) entry to theIinancial institution account indicated in the tax preparation software for payment ot the organization's federal taxes owed on thisretum, and the linancial institution to debit the entry to this account. To revoke a payment, I must contact the U.S. Treasury FinancialAgenl at 1-888-353-4537 no later than 2 business days prior to the payment (settlement) date. I also authorize the financial inslitutionsinvolved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries andresolve issues related to the payment. I have selected a personal identification number (PlN) as my signature for the organization'selecironic relurn and, if applicable, the organization's consent to electronic funds withdrawal
Officer's PIN: check one box only
E lauthorize Norberg, Davis, Bourne & Painter loentermyPlN as my signatureEBonrmneme ::::lffi::im:*
on the organization's tax year 2018 electronically liled return. lf I have indicated within this return that a copy of the return isbeing Iiled with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementionedERO to enter my PIN on the return's disclosure consent screen.
E As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2018 electronically filed returnlf I lrave indicated within tllis retum that a copy of the retum is being file,J with a state agency(ies) reguiatirrg ctrarities as part oi
tb2b3b4b5b
643,310
the IRS Fed/S
Officer's signature >
tate ogram, enter mv PIN on the return's disclosure consenl screen.
oav> A8 / 15 / 2A79nan
ERO'S EFIN/PIN. Enter your six-digit electronic filing identiricationnumber (EFIN) lollowed by your five-digit self-selected PlN.
Do not enter all 2eros
I certity that the above numeric entry is my PlN, which is my signature on the 2018 electronically filed return for the organizationindicated above. lconfirm that lam submitti this return in accordance with the requirements of Pub.4163, Modernized e-File (MeDlnformation for Auth IRS e- vid r Business Returns
ERO s signature > oare> 08 / 01/ 2A19
ERO Must Retain This Form - See lnstructionsDo Not Submit This Form to the IRS Unless Requested To Do So
Part ll
B 1 la J
CertifiPart lllir
5 I : , :
For Paperwork Reduction Act Notice, see back of torm. BAA REV 11/05/r8 PRO rorm 8879-EO lzoray
2
Return of Organization Exempt From lncome Tax OMB No. 1545-0047
Deparlment of ilreTreasurylnterna Revenue Servlce
A For the 2018 calendar or laxB Check if appiicable:
E ,laaress chanse
E Name crranse
E tnitiatreturn
E rlnatreru
E Amended return
E Applicaiion pending
status: E sor
2@14Under section 501(c),527, or 4947lall1l ol the lnternal Revenue Code (excepl private foundalions)> Do not enter social security numbers on this form as it may be made public.
> Go lo www.irs.govlFolrnggo for instructions and the latest intormation.ntn , 2018, and endi
l1 asat Z szt
D Employ€r id€ntification number
52-71A56'18E Telephone number
("7 5-/ ) 618-1815
,20
I Tax- E sor
G Gross receipts $ 64 4 807.H{a) b his a gloLrp retum lo' subo,Uinrt"rr E V"" B l.lo
H(b) Are all subord nates incluaear E yes E lolf "No," attach a list. (see instructions)
9
rl)
oo
o
J Website: > wLr!{ . u c-onl ine . or H(c)
K Form of organizationi8 corporation n Trust n Association notn"r> M State of legaldornic le:VASummary
I Briefly describe the organization's mission or most significant activities: TO PROMOTE THE COMPASSIONATEAND RESPECTEUL TREATMENT OF DOMESTIC FOWL
Check this box > E if the organization discontinued its operations or disposed of more than 25% of its net assetsNumber of voting members of the governing body (Part Vl, line 1a) .
Number of independent voting members of the governing body (Part Vl, line 1b)
Total number of individuals employed in calendar year 2018 (Part V, line 2a)
Total number of volunteers (estimate if necessary)Total unrelated business revenue lrom Part Vlll, column (C), line 12
Net unrelated business taxable income from Form 990-T, line 38
638 391 .
4 691 .
222 .
643 310 .
2
2
C
C
234567ab
)
)
3
08/75/2A79
389.
363,601.45i 918 .
191 332 .
End of Year
7 349 112 .
6, 529 .
1,342,643.
4
tr
!l
{9zt
B5
S nature Block
SignHere
Signature of otficer
KAREN DAVI S PRES l DENT
Open to Publiclnspection
C Name of organization UNITED POULTRY CONCERNS, INC,Doing busrness as
Numberand street (or P.O. box if mailis not delivered lo street address)
PO BOX 150City ortown, state or province, country, and ZIP orforeign postalcode
MACHIPONGO, VA 23405F Name and address of princ pa officer:
150 TIACHIPONGO vA 23405DR. ]IAREN DAVI S PO BOX
L Year of formationi 7994
456
7a7b
488,838.
8,262.212.
89
10
fi12
Contributions and grants (Part Vlll, line t h) .
Program service revenue (Part Vlll, line 29)
lnvestmenl income (Part Vlll, column (A), lines 3,4, and 7d)Other revenue (Part Vlll, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) .
Total revenue-add lines 8 through 11 (must equal Part Vlll, column (A), line 12)
74,621.
101,861.
351,098.463,580.
t314t5l6a
b17
t819
Grants and similar amounts paid (Part lX, column (A), lines 1-3)Benefits paid to or for members (Part lX, column (A), line 4)
Salaries, other compensation, employee benefits (Part lX, column (A), lines 5-'10)
Prolessional fundraising fees (Part lX, column (4, line 11e)
Total fundraising expenses (Part lX, column (D), line25) > 36,709.Other expenses (Part lX, column (A), lines 1 1a-11d, 1 1l-24e)Total expenses. Add lines 13-17 (must equal Part lX, column (A),
Revenue less expenses. Subtract line 18 from line 12
line 25)
Beginning of Curent Year
1,097/851.6,466.
2021
22
Total assets (Part X. line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 2'1 from line 20 1,091,785.
Part I
Type or print name and litle
PaidPreparerUse Only
PTIN
P01397537Firm's EIN > 52-2367452
680-8900EYesENoMay the IRS discuss this return with the preparer shown above? (see instructions)
PrinyType preparer's name
Kevin c. Bradl eyDate
aB/ar/2a79check n if
DavrsFirm's name > Norber Bourne & Pa intMD 209C4r1nFirm'saddress > 12069 Tech Road Silver S
For Paperwork Reduction Act Notice, see the separate inskuctions. BAA REV C5l20/19 PRO
301
rorm 990 lzor a1
,",". 990
Part llUnder penalties of perjury, I declare that I have examlned thls return, including accompanying schedules and statements, and io the best of my knowledge and belief, it istrue, cofiect, and complete. Decaration of preparer (other than officer) is based on all information of which preparer has any knowledge,
Dat-"
Forr. 990 (20'18) Pase 2Part lll
Check iI Schedule O contains a response or note to anv line in this Pad lll nBriefly describe the organization's missionTO PROMOTE THE COMPASS IONATEAND RESPECTFUI. TREATMENT OF DOMESTIC EOWL.
2
4
Did the organization undertake any significant program services during the year which were not listed on theprior Form 990 or 99O-EZ?
lf "Yes." describe these new services on Schedule O.Did the organization cease conducting, or make significant changes in how it conducts, any programservices?
E Yes
E Yes
EHo
E tlolf "Yes," describe these changes on Schedule O.
Describe the organization's program service accomplishments for each of its three largest program services, as measured byexpenses. Section 501(cX3) and 501(cX4) organizations are required to report the amount of grants and allocations to others,the total expenses, and revenue, il any, lor each program service reported.
4a (Code )(Expenses $ 386,218. ncluding grants of $ r_ -B__4- _B_ -.- ) (Revenue $ 684,231. \INVEST I GAT IONS
EAN-EEBENEES, AN E FI ,r"1
DI FFERENT I.JAY
2
SENTATIONS TO EDUCATE THE PUBLIC ON,.-.T-44-INTE\ANEE..O.E..CH.ICXEN EANCTUABY, WBIIINCE, .!-4.-I-L.INGS
S.--CAU-LIBI--ABE--IBEATED.--IN..SAEIEII..-
4b (Code ) (Expenses $ including grants of $ ) (Revenue $
4c (Code: ) (Expenses $ including grants of S ) (Revenue $
4d Other program services (Describe in Schedule O.)(Expenses $ including grants of $
4e Total program service expenses >REV 05/20119 PRO
) (Revenue $
Form 99O (2018)
386, 248 .
Statement of Program Service Accomplishments
)
)
)
1 x2 x
4
5
6
7
8
I
10
11a x
t1b
11c
11d11e
111
12a x
12bt3
14a
14b
t5
t6
17
t8
19
2Oa20b
21
Part lVForn 990 (2018) Pase 3
x
Checklist of R uired Schedules
ls the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? lf "Yes,"complete Schedule A .
ls the organization required to complete Schedule B, Schedule of Contribulors (see instructions)?
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition tocandidates for public otfice'l lf "Yes," complete Schedule C, Pai ISection 501(cX3) organizations. Did the organization engage in lobbying activities, or have a section 501(h)election in eflect during the tax year? /f "Yes," complete Schedule C, Paft llIs the organization a section 501(cX4), 501(c)(5), or 501(cX6) organization that receives membership dues,assessments, or similar amounts as delined in Revenue Procedure 98-19? lf "Yes," complete Schedule C, Paft I
Did the organization maintain any donor advised funds or any similar funds or accounts for which donorshave the right to provide advice on the distribution or investment of amounts in such funds or accounts? /f"Yes." complete Schedule D, Patl I
Did the organization receive or hold a conservalion easement, including easements to preserve open space,the environment, historic land areas, or historic structures? lf "Yes," complete Schedule D, Part llDid the organization maintain collections of works of art, historical ireasures, or other similar assets? /f "yes, "complete Schedule D, Part I
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as acustodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, ordebt negotiation seNices? lf "Yes," complete Schedule D, Paft lV .
Did the organization, directly or through a related organization, hold assets in lemporarily restrictedendowments, permanent endowments, or quasi-endowments? /f "yes, " complete Schedule D, Pan V
lf the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts Vl,Vll, Vlll, lX, or X as applicable.
Did the organization report an amount lor land, buildings, and equipment in Part X, line 10? /f "yes,"complete Schedule D, Patl Vl
Did the organization report an amount for inveslments-other securities in Part X, line '12 that is 5% or moreof its totaf assets reported in Part X, line 16? lf "Yes," complete Schedule D, PatT Vll
Did the organization report an amount tor investments-program related in Part X, line 13 that is 5% or moreof its total assets reported in Part X, line 16? lt "Yes," complete Schedule D, Part V l .
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assetsreported in Part X, line 16? lf "Yes," complete Schedule D, Pad lXDid the organization report an amount for other liabilities in Part X, line 25? lf "Yes," complete Schedule D, Pad XDid the organization's separate or consolidated financial statements for the tax year include a footnote that addressesthe organization's liability for uncertain tax positjons under FIN 48 (ASC 740)? /f "Yes, " complete Schedule D, Paft X
Did the organization obtain separate, independent audited financial statements fot lhe lax yeat? ll "Yes," completeSchedule D, Parls Xl and Xll
Was the organization included in consolidated, independent audited financial statements for the tax year? /f"Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Pads Xl and Xll is optionalls the organization a school described in section 170(b)(1)(A)liill lf "Yes," complete Schedule EDid the organization maintain an office, employees, or agents outside of the United States?
Did the organization have aggregate revenues or expenses of more lhan $10,000 from grantmaking,fundraising, business, investment, and program service activities outside the United States, or aggregateforeign investments valued at $100,000 ot morc? lf "Yes," complete Schedule F, Pafts I and lV.
Did the organization repon on Part lX, column (A), line 3, more than $5,000 of grants or other assistance to orfor any foreign organizalion? lf "Yes," complete Schedule F, Pafts ll and lvDid the organization report on Part lX, column (A), line 3, more than $5,000 of aggregate grants or otherassistance to or for foreign individuals? lf "Yes," complete Schedule F, Pafts lll and lV.
Did the organization report a total of more than $15,000 of expenses for professional fundraising services onPart lX, column (A), lines 6 and 11e? lf "Yes," complete Schedule G, Part / (see instructions)
Did the organization report more than $15,000 total of fundraising event gross income and contributions onPart Vlll, lines 1c and 8a'l lf "Yes," complete Schedule G, ParT .
Did the organization repod more than $15,000 of gross income from gaming activities on Part Vlll, line 9a?lf "Yes," complete Schedule G, Part lllDid the organization operate one or more hospital facilities? lf "Yes," complete Schedule H
lf "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
Did the organization report more than $5,000 of grants or other assistance lo any domestic organization or
No
X
X
x
1
2
3
4
5
x
x
x
7
I
9
x
X10
'tl
X
X
X
X
x
a
b
c
d
et
'l2a
bX
t314a
b
X
x
15
16
17
18
19
X
x
x
x
x
xx20a
b21
domestic oove rnment on Part lX, column (A), line 1? ffeiYcadropmolete Schedule l, Parts I and llrorm 990 (zor a)
I
22
23
24a24b
24c24d
25a
25b
26
28a
28c29
3031
32
35a
35b
37
x38
Part lv
Part V
Fo n 990 (2018)
22
23
24a
b
c
d25a
b
26
27
28
a
b
c
N30
3l32
33
34
35a
b
36
37
38
Checklist of Required Schedules (continued)
Oid the organization report more than $5,000 of grants or other assistance to or for domestic individuals onPart lX, column (N,line 2? lf "Yes," complete Schedule l, ParTs I and lllDid the organization answer "Yes" to Part Vll, Section A, line 3, 4, or 5 about compensation of theorganization's current and former officers, directors, trustees, key employees, and highest compensatedemployees? /i "yes," complete Schedule J .
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than$100,000 as of the last day of the year, that was issued after December 31 , 2OO2? lf "Yes," answer lines 24bthrough 24d and complete Schedule K. lf "No," go to line 25aDid the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?Did the organization maintain an escrow account other than a refunding escrow at any time during the yearto defease any tax-exempt bonds?Did the organization act as an "on behalf of" issuer for bonds outstandang at any time during the year?
Section 50'l (cX3), 5O1(cX4), and 501(c)(29) organizations. Did the organization engage in an excess benefittransaction with a disqualified person during the yeat? lf "Yes," complete Schedule L, Paft I
ls the organization aware that it engaged in an excess benefit lransaction with a disqualified person in a prioryear, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?lf "Yes. ' complete Schedule L, Paft I .
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to anycurrent or former officers, directors, trustees, key employees, highest compensated employees, ordisqualified persons? /f "yes, " complete Schedule L, Pan llDid the organization provide a grant or other assistance to an officer, director, trustee, key employee,substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlledentity or family member of any of these persons? /f "yes, " complete Schedule L, Parl l .
Was the organization a party to a business transaction with one of the following parties (see Schedule L,Part lV instructions for applicable filing thresholds, conditions, and exceptions):A current or former officer, director, trustee, or key employee? lf "Yes," complete Schedule L, Paft lVA family member oI a current or lormer officer, director, trustee, or key employee? lf "Yes," completeSchedule L, Paft lVAn entity o, which a current or lormer officer, director, trustee, or key employee (or a family member thereo0was an officer, director, trustee, or direct or indirecl ownefl lf "Yes," complete Schedule L, Paft lVDid the organization receive more than S25,000 in non-cash contributions? /f "Yes, " complete Schedule MDid the organization receive contributions of art, historical treasures, or other similar assets, or qualifiedconservation contributions? /l "yes, " complete Schedule MDid the organization liquidate, terminate, or dissolve and cease operations? /f "Yes," complete Schedule N, Pai IDid the organization sell, exchange, dispose of, or transfer more than 25o/o ot ils net assets? /f "yes, "
complete Schedule N. Patl llDid the organization own 100% o, an entity disregarded as separate rrom the organization under Regulationssections 301 .7701-2 and 3O1.7701-3? lf "Yes," complete Schedule R, Patl L
Was the organization related to any tax-exempt or taxable enllty'? lf "Yes," complete Schedule R, Paft , l ,
or lV, and Patl V, line 1
Did the organization have a controlled entity within the meaning of section 512(bX13)?
lf "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with acontrolled entity within the meaning of section 512(6)(13]-? lf "Yes," complete Schedule R, Patl V, line 2 .
Section 5Ol (cX3) organizaiions. Did the organization make any transfers to an exempt non-charitablerelated organization? lf "Yes," complete Schedule R, Parl V, line 2
Did the organization conduct more than 5% of its activities through an entity that is not a rela'ted organizationand that is treated as a partnership for federal income tax purposes? lf "yes, " complete Schedule R, Paft Vl
Did the organization complete Schedule O and provide explanations in Schedule O for Part Vl, lines 1 1b and19? Note. All Form 990Iilers are required to complete Schedule O.
Statements Regarding Other IRS Filings and Tax ComplianceCheck if Schedule O contains a res nse or nole to an line in this Part V
Page 4
27
z8b
NO
x
x
x
X
x
X
x
trNo
x
x
xx
xX
x
x
Xx
x
X
X
la Enter the number reported in Box 3 of Form 1096. Enter -0- if nol applicableb Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1a
(gambling) winnings to prize winners?
1b c
'lcre le afit r
REV 05/20/19 PRO
0
ro.m 9901zota;
33I
c Did the organization comply with backup withholding rules for reportable payments to vendors and
I
2b x
-3a3b
4a
5a5b5c
6a
6b
7a7b
7c
7e
7T
7s7h
I
9a9b
10b
fib12aI13a
13c14a14b
t5
t6
Part VForm 990 (2018)
Statements R rdi Other IRS Filin and Tax Compliance tin
2a 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 relurn 2ab lf at least one is reported on line 2a, did the organization file all required ,ederal employment tax returns?
Note. lf the sum of lines 1a and 2a is greater than 250, you may be required to e-lile (see instructions)3a Did the organization have unrelated business gross income of $1 ,000 or more during the year?
b lf "Yes," has it filed a Form 990-T for this year? lf "No" to line 3b, provide an explanation in Schedule O .
4a At any time during the calendar year, did the organization have an interesl in, or a signature or olher authority over,a financial account in a foreign country (such as a bank account, securities account, or other Jinancial account)?
b lf "Yes," enter the name of the foreign country: >See instructions Ior Iiling requirements for FinCEN Form '1'14, Report of Foreign Bank and Frnancial Accounts (FBAR).
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 lhat it was or is a party to a prohibited tax shelter transaction?lf "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 theorganization solicit any contributions that were not tax deductible as charitable contributions? .
lf "Yes," did lhe organization include with every solicitation an express statement that such contributions orgifts 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 goodsand services provided to the payor?
lf "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otheMise dispose of tangible personal property for which it wasrequired to file Form 8282'?
d lf "Yes," indicate the number of Forms 8282 filed during the year 7d
Pase 5
x
x
xX
No
x
x
x
5ab
c6a
b
7
a
b
cx
xX
efsh
I
9a
b10
Did the organization receive any funds, directly or indirectly, lo pay premiums on a personal benefit contract?Did the organization, during the year, pay premiums, direclly or indirectly, on a personal benefit contract?ll the organization received a contribution of qualilied intellectual property, did the organization file Form 8899 as required?
lfthe organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization llle a Form 1098-C?
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by thesponsoring 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 5Ol (cX7) organizations. Enter:
Did the organization receive any payments for indoor tanning services during the tax year?
lf 'Yes," has it filed a Form 720 to report these paymenls? ll "No," provide an explanation in Schedule O
ls the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration orexcess parachute payment(s) during the year?
lf "Yes," see instructions and file Form 4720, Schedule N.
ls the organization an educational institution subjecl to the section 4968 excise tax on net investment income?
a lnitiation fees and capital contributions included on Part Vlll, line 12
b Gross receipts, included on Form 990, PartVlll, line'12, for public useof club facilities11 Section 501(cxl2) organizations. Enter:
10a
a Gross income from members or shareholders .
b Gross income from other sources (Do not nel amounts due or paid to other sourcesagainst amounts due or received from them.)
11a
12a Section 4947(a)(1) non-exempt charitable trusts. ls the organization filing Form 990 in lieu of Form 1 041 ?
b lf "Yes," enter the amount of tax-exempt interest received or accrued during the year .
'13 Section 501(cX29) qualified nonprotil health insurance issuers.a ls the organization licensed to issue qualified health plans in more than one state?
12b
b Enter the amount of reserves the organization is required to maintain by the states in whichthe organization is licensed to issue qualified health plans
c Enter the amount of reserves on hand13b
14ab
t5
16
lf "Yes ' com ete Form 4720 Schedule O
REV 05/20119 PRO
Fo.m 990 (2018)
Note. See the instructions lor additional information the organization must report on Schedule O.
tl
Check if Schedule O contains a response or note lo any line in this Part VlSection A. Governi Body and Mana ement
'la Enter the number of voting members of the governing body at the end of the tax year.lf there are material differences in voting rights among members of the governing body, orif the governing body delegated broad authority to an executive committee or similarcommittee, explain in Schedule O.
b Enter the number of voting members included in line 1a, above, who are independent
1a
2 Did any officer, director, truslee, or key employee have a lamily relationship or a business relationship withany other officer. director. trustee. or key employee?
3 Did the organization delegate control over management duties customarily performed by or under the directsupervision of officers, directors, or trustees, or key employees to a management company or olher person?
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?5 Did the organization become aware during the year of a significant diversion of the organization's assets? .
6 Did the organization have members or stockholders?7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body?
b Are any governance decisions of the organization reserved to (or subject to approval by) members,stockholders. or persons other than the governing body?
8 Did the organization contemporaneously documenl the meetings held or written actions undedaken duringthe year by the following:
a The governing body?b Each committee with authority to act on behalf of the governing body?
9 ls there any officer, director, trustee, or key employee listed in Part Vll, Section A, who cannot be reached atthe o anization's mailing addtess? lf "Yes," provide the names and addresses rn Scheduie O
Section B. Policies 's Secron I uests information about policies not uired b the lnternal Revenue Code
l0a Did the organization have local chapters, branches. or afliliates?
b lf "Yes," did the organization have written policies and procedures governing the activities of such chapters,affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?b Describe in Schedule O the process, if any, used by the organization to review this Form gg0.
12a Did the organization have a written conflict ol interest policy'? lf "No," go to line 13
b Were ofiicers, directors, or trustees, and key employees required to d sclose annually interests that could give rise to conflicts?
c Did the organization regularly and consistently monitor and enforce compliance with the policy? // "yes, "describe in Schedule O how this was done .
13 Did the organization have a written whistleblower policy?14 Did the organization have a written document retention and destruction policy?
15 Did the process for determining compensalion of the following persons include a review and approval byindependent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a The organization's CEO, Executive Director, or top management officialb Other officers or key employees of the organization
lf "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).'l6a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement
with a taxable entity during the year?
b lf "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate itsparticipation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the
izalion's exempt status with respect to such arran ements?Section C, Disclosure
x
xxxx
x
x
xx
x
No
x
x
x
xx
xx
x
1b 4
2
45
b
7a
7b
8a8b
9
'l0a
10b11a
12a12b
'l2c13
15a15b
'l6a
16b
17
18
List the states with which a copy of this Form 990 is required to be filed >Section 6104 requires an organization to make its Forms 1023 11024 or 1024-A if applicable), 990, and 990-T (Section 501(c)(3)s only) available for public inspection. lndicate how you made these available. Check all that apply.
E Own website E Another's website E Upon request J Olhet (explain in Schedule o)Describe in Schedule O whether (and if so, how) the organization made its governing documenls, conflict of interest policy, andfinancial 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 >KEVrN G. BRADLEY, 12069 TECH ROAD, STLVER SpRrNG, MD 20904 \3Ar)244-5327
19
20
Form 990 (2018) eage 6
response to line 8a, 8b, or 10b below, describe the circumstarces, processes, or changes in Schedule O. See instructions.
No
3
14
REV 05/20119 PRO Form 990 (2018)
Form 990 (2018) Page 7
Compensation of Otficers, Directors, Trustees, Key Employees, Highest Compensated Employees, andlndependent ContractorsCheck if Schedule O contains a response or note to any line in this Part Vll tr
Section A. Ofticers, Directors, Trustees, Key Employees, and Highest Compensated Employeesla Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within theorganization's tax year.
. List all oI lhe organization's cutrent 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."
. List the organization's five curent highest compensated employees (other than an officer, director, trustee, or key employee)who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $'100,000 from theorganization and any related organizations.
. List all of the organizalion's tormer 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 tormer directors or truslees 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.
E Check this box if neither the o anization nor related o anization com sated an current officer, director, or trustee
(A)
Name and Title{n
Estirnated
organlzation
organizations
(.I) DR . KAREN DAVI S
PRES l DENT 0
0
0
C
l?l LI CAO
VlCE PRES l DENT(3) TRANKLIN I/iADE
VICE PRES I DENT
EDA STRAMVICE PRES I DENT
(9)
(7)
pl
(10)
(11)
(121
tt3l
(c)
(do not check more than onebox, unless person is both anofficer and a director/trustee)
(B)
related
line)
(lsl q-
6'D_!!
of
lq a^l
a
l
(D)
theorganization
(w-2l1099-MrSC)
(E)
Reportablecompensation from
organizations
w-2l1099-MrSC)
90.00x X x
30.00x X 0 0
40.00x x 0
20.00x x C 0
(r4)
REV 05/20/19 PRO rorm 990 (zor a)
Part Vll
(5)
(e)
0.
0.
(c)
(do not check more than onebox, unless person is both anotticer and a directorlrustee)
(B)
organizations
line)
9t
=<d_ 9r
IIb_
o
: ;eo33
:
(D)
Reponabie
theorganization
w-2l1099-MrSC)
(E)
Reportablecompensation fiom
organizations(w-z1099,Mrsc)
73,728. 0
13,t28- 0
Form 990 (2018) Pase 8Section A. Offi Di E and H hest Com sated Em
{at
Name and tille
(F)
Esumated
organizationand rolated
organizations
(15)
(17)
(1e)
I?gl
\2?)
t?)
(241
(zsl
1b Sub-totalc Total from continuation sheets to Part Vll, Section Ad Total (add lines lb and 1c)
Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization >
3 Did the organization list any tormer officer, director, or trustee, key employee, or highest compensatedemployee on line 1a? lf "Yes," complete Schedule J lor such individual
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from theorganization and related organizalions greater than $150,000? lf "Yes," complete Schedule J for suchindividual
5 Did any person listed on line I a receive or accrue compensation lrom any unrelated organization or individualfor seryices rendered to the organization'? lf "Yes," complete Schedule J for such person
Section B. lndependent Contractors
Complete this table for your five highest compensated independent contractors that received more than $100,000 oIcompensation from the organization. Report compensation for the calendar year ending with or within the organization's taxyeaL
(A)
Name and business address(c)
Compensation
2 Tolal number of independent contractors (including but not limiled to those listed above) whoreceived more than $ 100,000 of compensation Jrom the ization >
0
No
x
X
x
2
'I
4
5
(B)Description of seruices
REV O52o/19 PRO Form 990 (2018)
I
I
tlI
Part Vll
LA)
I
0.
I
Form 990 (2018) Page 9
EtrNU Stalement of RevenueCheck it Schedule O contains a response or note to an line in lhis Part Vlll
!?
o:!tE96
EoEEC)(!
G.
.E
E
o-
o,cootr(,,
o
1a Federated campaignsb Membership duesc Fundraising eventsd Relatedorganizationse Governmentgrants(contributions)f All other contributions, gifts, grants,
and similar amounts not included above
g Noncash contributions included in lines ]a-1t S
h Total. Add lines 1a-lf
2a
All other program service revenueTotal. Add lines 2a-2t
3 lnvestment income (including dividends, interest,
4 lncome from investment of tax-exempl bond proceeds >
bcdeIs
(D)
512-514
46. 0
6a Gross rentsb Less; rental expenses
c Rental incorne or (loss)
d Net rental income or7a Gro6s amount lrom sales of
assets other than invenlory
b Less: cost or other basis
and sales expenses
c Gain or (loss) .
d Net gain or (loss)
oss
8a Gross income from fundraisingevents (not including $
of contributions repoddd ;n lin;l;)See Part lV, line '18
b Less: direct expenses b
c9a Gross income from gaming activities
See Part lV. line '19 a
bc
10a
bc
Less: direct expenses bNet income or (loss) from gaming activities >Gross sales of inventory, lessreturns and allowances . aLess: cost of goods sold bNet income or s) from sales of inventory . >
(a) lB)Re,itdd or
(c)
1a 6, 424 .
1c1d
1e
'tf 632,313
638, 391 .Business Code
4,697. 4,697 C
00 Real (ii)Personal
(i) Securities (i) Other
r,613-L, 49'7 .
716. 716 0Business Code
11a
bcde
12
All other revenueTotal. Add lines 11a-1 ld .
Total revenue. See instructions
[,4iscellaneous Revenue
643,31CForn 990 (2018)
C.
0.
'tb
46.
913 .
REV 0520/19 PRO
Form 990 (2018) ease l0EEn-statementof FunctionalExpensesSection 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A)
Check if Schedule O contains a res onse or note to an line in this Part lXDo not include amounts reported on lines 6b, 7b,8b,9b, and lob of Part V l,
(B) (c)Managemenl and
(D)Fundraising
2
45
6
Grants and other assistance to domestic organizations
and domestic govemments. See Part lV, line 21
Grants and other assistance to domesticindividuals. See Part lV, line 22
Grants and other assislance to foreignorganizations, foreign govemments, and loreignindividuals. See Part lV, lines 15 and 16 .
Benefits paid to or for membersCompensation of cunent officers, directors,trustees, and key employees
Compensation not included above, to disqualiliedpersons (as defined under seclion 4958(0(1)) andpersons described an section 4958(CX3XB)
Other salaries and wagesPension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Other employee beneritsPayroll taxesFees for services (non-employees):
ManagementLegalAccountingLobbyingProfessional fundraising services. See Part lV, line'17
lnvestment management feesother (lf line 119 amount exceeds 10% of line 25, column
(A)amounl,list line 119 expenses on Schedule 0.)
Advertising and promotionOffice expenseslnformation technologyRoyaltiesOccupancyTravelPayments of travel or entertainment expensesfor any federal, stale, or local public otflcials
Conlerences, conventions, and meetjngslnterestPayments to affiliatesDepreciation, depletion, and amortizationlnsurance
Other expenses. ltemize expenses not coveredabove (List miscellaneous expenses in line 24e. lfline 24e amount exceeds 10% of line 25, column(4 amount, list line 24e expenses on Schedule O.)
AUTO
78
79,5'73
91o'tl
abcde1
g
12
13'14
't5't6
1718
19
2021
22
24
abcd
REPAIRS AND MAINTENANCELICENSES AND PERMITSVETERINARIAN FEES
e All other expenses25 Totalfunctional expenses. Add lines 1 through 24e
Joint costs, Complete this line only if theorganization reported in column (B) joint costs
n andfrom a combined educational campaifundraisino solicitatron. Check here >following soP 98-2 (ASC 958-720)
(A)
2, 988 9EB
6'1 , 631
5,816 4,653. B"t2.
7A ,720 . 't ,894 . 2,226.10,133 2, B5B
126, 554 . 113,899. 0
72,L36. 7,888 3, 647
0I 93C
4,662 4,796 2338,146 6,964
513 411 51656 590. 33.262
3,961 3,967 C
712,401 145,104 10 , 017457 , 918 386 ,248 29 , 421
29
12 , 655
233.
5133
c
0
103
0
16, BB636 , 149
26
REV 05/20/19 PRO ro,m 9901zota1
607.
871.
0.
if
I
033.
871.
0. 262.
Form 990 (2018) Page l lfiHlI'.I Balance Sheet
Check if Schedule O contains a res or note to a line in this Part X(B)
End o, year
549, A22.563 841 .
76,249.
o
(,E
GJ
3,417.
752, A43.
2 6'7 .
7t349tr12.6t529.
6,529.
21, 5lB -
7, 342 , 643 .
349 112.
ooqsGo
,l!
(,
(,z
(a)Beginning of year
303 , 1,42. 1
6L,267. 2
316,249 . 4
5
6
7
2,'7 65 . I
156,104 . 'l0c
o
491 , 463. 11
12
13
14261 . 15
Cash - non-rnterest-bearingSavings and temporary cash investmentsPledges and grants recervable. netAccounts recervable, netLoans and other receivables from currenl and former officers, directors,trustees, key employees, and highest compensated employees.Complete Part ll of Schedule L
Loans and other receivables from other disqualified persons (as delined under section4958(0(1)), persons described in section 4958(C)(3)(B), and conlributing employers andsponsoring organizations of section 501(c)(9) voluntary employees' beneficiaryorganizations (see instructions). Complete Part ll of Schedule L
Notes and loans receivable. netlnventories for sale or usePrepaid expenses and defened chargesLand, buildings, and equipment: cost orother basis. Complete Part Vl of Schedule D
Less: accumulated depreciationlnvestmenls-publicly traded securitieslnvestments-other securities. See Part lV, line 11
lnvestments-program-related. See Part IV, line 11
lntangible assetsOther assets. See Part lV, line '1
1
Total assets. Add lines 1 through 15 (must equal line
'l0a 224 , 109 .
11
12131415t6
1
2
45
6
789
't 0a
b
34) 1,097,851. 166,466. 17
'18
192021
2223
24
25
Accounts payable and accrued expensesGrants payable
Deferred revenueTax-exempt bond liabilities .
Escrow or custodial account liability. Complete Part lV of Schedule D .
Loans and other payables to current and Iormer oificers, directors,trustees, key employees, highest compensated employees, anddisqualified persons. Complete Part ll ol 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 thirdparties, and other liabilities not included on lanes 17-24). Complete Part Xof Schedule D
Total liabilities. Add lines 17 through 25
24
25
26
17
18
t92021
22
6, 066. 26
1,060,599. 2731,186. 28
29
303l32
1,091,185. 33
272A
29
3031
323334
Organizations that follow SFAS 117 (ASC 95a), check here > Ecomplete lines 27 lhrough 29, and lines 33 and 34.
Unrestricted net assetsTemporarily restricted net assetsPermanently restricted net assets .
Organizations that do not follow SFAS 117 (ASC 958), check here > Ecomplete lines 30 through 34.
Capital slock or trusl principal, or currenl fundsPaid-in or capital surplus, or land, building, or equipment fundBetained earnings, endowment, accumulated income, or other fundsTotal net assets or fund balancesTotal liabilities and net assets/fund balances
and
and
1,097,851. 34
REV 05/20119 PRO
1
rorm 990 1zotal
'12 , 666 .
Form 990 (2018) ease 12
I234567
I90,l
Check if Schedule O contains a res onse or note to line in this Part XlTotal revenue (must equal Part Vlll, column (A), line 12) .
Total expenses (must equal Part lX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) .
Net unrealized gains (losses) on investmentsDonated services and use oi facilitieslnvestment expensesPrior period adjustmentsOther 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,33, column (B))
Financial Statements and ReportingCheck if Schedule O contains a res or note lo an line in this Part Xll
1 Accounting method used to prepare the Form 990: E Cash B Accrual E Otherlf the organizalion changed its method oI accounting Irom a prior year or checked "Other," explarn inSchedule O.
2a Were the organization's financial statements compiled or reviewed by an independent accountant?lf "Yes," check a box below to indicate whether the financial statements lor the year were compiled orreviewed on a separate basis, consolidated basis, or both:
E Separate basis E Consolidated basis D Both consolidated and separate basisb Were the organization's financial statements audited by an independent accountant?
lf "Yes," check a box below to indicate whether the financial statements for the year were audited on aseparate basis, consolidated basis, or both:E Separate basis n Consolidaled basis n Both consolidated and separate basis
c lf "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversightof the audit, review, or compilation of its financial statements and selection of an independent accountant?lf the organization changed either its oversight process or selection process during the tax year, explain inSchedule O.
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth inthe Single Audit Act and OMB Circular A-133?.
b lf "Yes," did the organization undergo the required audit or audits? lf the organization did not undergo theired audit or audits, in Schedule O and describe any steps taken to und such audils.
line
64 3 310 .
451 9lB191 332
1 091 ?85.
7,283,171 .
No
rorm 99O 1zoral
x
x
X
2
34
6
7
8o
10Part Xll
2b x
2c
3a
3b
REV 05/20/19 PRO
Elfl! Reconciliation of Net Assets
2a
I
I
Open to Publiclnspection
OMB No. 1545-0047SCHEDULE A(Form 990 or 990-E4
Public Charity Status and Public Support2@14
oepartment of the Treasurylntemal Revenue SeNice
Name o, lll€ organlzaton
UNITED POULTRY CONCERNS, INC
Complete il the organization is a section 5Ol (cX3) oryanization or a section 4947(axl) nonexempt charitable trust.
> Attach to Form 990 or Form 990-EZ.> Go to www.irs.govlFomggo for inslructions and lhe latest intormation.
Employer identitication numbor
52-11 A 5 618Reason for Public Cha Status ll o anizations must com lete this art See instructions.
The organization is not a private ,oundation because it is: (For lines 1 through 12, check only one box.)1 E A church, convention of churches, or associalion of churches described in section 170(bxl XAXi).2 E A school described in section f70(bxlXAXii). (Attach Schedule E (Form 990 or 990-EZ).)3 D A hospital or a cooperative hospital service organization described in section f ToFXf XAXiii).4 EAmedical research organization operated in conjunction with a hospital described in section 170(bxlXAXiii). Enter the
hospital's name, city, and state:
5 E An organization operated for the benefit of a college or university owned or operated by a governmental unit described insection 170(bxlXA)(iv). (Complete Part ll.)
6 n A federal, state, or local government or govemmental unit described in section 170(bXl XAXv).7 I An organization that normally receives a substantial part ol its support from a governmental unit or from the general public
described in section 170(bxlXAXvi). (Complete Part ll.)
8 n A community trust described in section 170(bXlXAXvi), (Complete Part Il.)
9 E An agricultural research organization described in section f 7O(bXl XAXix) operated in conjunction with a land-grant collegeor university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and stale of the college oruniversity:
10 An organiz-a'ficiii that normaiirrecetves o) more t an 33rr:%o of ts support n'tribiiiio ns, memno more than 331/3oZ oJ
ership fees, and grossits
Iioiir' co
support from gross investment income and unrelated business taxable inreceipts lrom activities related to its exempt functions-subject to certain exceplions, and (2)
n51'l tax) from businessesacquired by the organization after June 30, 1975. See section 509(aX2).
come (less sectio(Complete Part lll
n An organization organized and operated exclusively to test for public safety. See section 509(aX4).
n An organization organized and operated exclusively for the benelit of, to perform the functions or, or to carry out the purposesof one or more publicly supported organizations described in section 509(aX1) or section 509(aX2). See section 509(aX3).Check the box in lines '12a through 12d that describes the lype of supporting organization and complete lines 12e, 12t, and 129.
a n Type l. Asupporting organization operated, supervised, or controlled by its supported organization(s), lypically bygivingthe supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of lhesupporting organization. You must complete Part lV, Sections A and B.
b ! Type ll. A supporting organization supervised or controlled in connection with its supported organization(s), by havingcontrol or management of the supporting organization vested in the same persons that control or manage the supportedorganization(s). You must complete Part lV, Sections A and C.
c n Type lllfunctionally integrated. A supporting organization operated in connection with, and functionally integrated with,its supported organization(s) (see instructions). You must complete Part lV, Sections A, D, and E,
d ! Type lll non-functionally integrated. A supporting organization operated in connection with its supported organization(s)that is not funclionally integrated. The organization generally must satisfy a distribution requirement and an attentivenessrequirement (see instructions). You must complete Part lV, Sections A and D, and Part V,
e E Check this box if the organization received a written determination lrom the IRS that it is a Type l, Type ll, Type lll
h
1l12
(B)
(c)
(D)
(E)
Total
functionally integrated, or Type lll non-functionally integrated supporting organizationI Enter the number of supported organizations
9 Provide the following information about the supported organization(s).(i) Name of suppo(ed organization 0v) ls the orcanization
listsd in your governing(iD ErN
No
{v) Amount of monetarysupport (see
instructions)
For Paperwork Reduction Act Notice, see the lnstructions for Form 990 or 990-Ez. BAA ScheduleA (Form 990 or 99O-EZ)2018REV 10/24118 PRO
Part I
(A)
I I
(iii) Type of organization(described on lines 1-10above (see instructions))
I
Schedule A (Form 990 or 990-Ea 2018
EEru Support Schedule for Organizations Described in Sections 17o(bXl XAXiv) and 170(bxlXAXvi)(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify underPart lll. lf the orqanization fails to qualify under the tests listed below, please complete Part lll.)
Page 2
Section A. PublicCalendar year (or tiscal year beginning in) >
I Gifts, grants, contributions, andmembership lees received. (Do notinclude any "unusual grants.")
2 fax revenues levied for theorganization's benefit and either paidto or expended on its behalf
3 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge .
4 Total. Add lines '1 through 3 .
5 The portion of total contributions byeach person (other than agovernmental unil or publiclysupported organization) included online 1 that exceeds zyo oi the amountshown on line 11, column (0 .
6 Public Subtract line 5 from line 4
Section B. TotalCalendar year (or tiscal year beginning in) >
7 Amounts from line 4
8 Gross income lrom interest, dividends,payments received on securities loans,rents, royalties, and income ,romsrmilar sources
9 Net income from unrelated businessactivities. whether or not the businessis regularly carried on
10 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part Vl.) .
1l Total support, Add lines 7 through 10
't3
Tolal
2 084,849
2,484 849.
673, 245 .
1 ATl 604.
Total2 ,084
t5,756.
30 629 .
2 130 644.12 Gross receipts from related activities, etc. (see instructions)
First five years, lf the Form 990 is for the organization's first, second, third, ,ourth, or fifth tax year as a section 501(cX3)organization, check this box and stop here > tr
Section C. of Public rt e14 Public support percentage for 2018 (line 6, column (0 divided by line 11, column (f))
l5 Public support percentage from 2017 Schedule A, Part ll, line 14
69 . A1 0/o
96.47 0/o
16a
b
331rc% support test-2018. lf the organization did not check the box on line 13, and line 14 is 3313o/o or more, check thisboXandstophere.TheorganizationqualifiesasapUbliclySUpportedorganizalion>33r/3% support test-2017. lf the organization did not check a box on line 13 or 16a, and line '15 ls 331i37o or more, checkthisboxandstophere.Theorganizationqua|iJiesasapubliclySUpportedorganization>l0yo-facts-and-circumstances test-2018. lf the organization did not check a box on line 13, 16a, or 16b, and line 14 is10yo or mote, and il the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain inPart Vl how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly suppofted
l07o-tacts-and-circumstances test-2017. l, the organization did not check a box on line 13, 16a, 16b, or 17a, and line15 is 10% or more, and if the organization meels the "Iacts-and-circumstances" test, check this box and stop here,Explain in Part Vl how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
Private foundation. lf the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
17a
b
18
n
tr
tr
(al 2014 (b) 2015 (c) 2016 (dl2017 (e) 2018
5'72,82'7. 185,31s. 100 A)1 488,838. 638 , 442 -
5'12 , 821 . 1B 5, 315 . 199 , 421 - 488, B3B 638 , 442 .
lal 2014 (b) 2015 (c) 2016 (dl2017 (e) 2018512 , 82'7 . 185,315. 199 , 421 4BB.B3B. 638,442.
6,365 . 4,110. at69t.
3A,2Ct. 252 . 116.
12
't4
15
REV 10/2418 PRO
Schedule A (Form 99O or 99O-EZ) 2018
Schedule A (Folm 990 or 990-E4 2018 Page 3Pad lll Support Schedule for Organizations Described in Section 509(aX2)
(Complete only if you checked the box on line 10 of Part I or it the organization failed to qualify under Part ll.lf the organization fails to qualify under the tests listed below, please complete Part ll.)
(al2014 (b) 2015 (c) 2016 (dl 2017 (e) 2018Section A. Public Su ortCalendar year (or fiscal year beginning in) >
1 G fls, grants, contributions, and membership fees
received. (Do not include any "unusualgrants.")
2 Gross receipts from admissions, merchandisesold or services performed, or facilitiesfurnished in any activity that is related to theorganization's tax-exempt purpose
3 Gross receipts from activities that are not an
unrelated trade or business under section 5'13
4 Tax revenues levied for theorganization's benefit and either paid toor expended on its behalf
5 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge .
6 Total. Add lines 1 through 5 .
7a Amounts included on lines 1, 2, and 3received from disqualif ied persons
b Amounts included on lines 2 and 3
recelved 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 7b8 Public support. (Subtract line 7c from
line 6.) .
(0 Total
on . Tota upport(f) Total
14 First five years. lf the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(cX3)organization, check this box and stop here > tr
Section C. Com utation of Public Support Pe el5 Public support percentage for 2018 (line 8, column (0, divided by line 13, column (0)
'16 Public su rt perce from 2017 Schedule A, Part lll, line 15
Section D, Computation of lnvestment lncome Percenta'17 lnvestment income percentage for 2018 (line 10c, column (0, divided by line 13, column (0)
18 lnvestment income percentage from 2017 Schedule A, Part lll, line '17 .
%o/o
19a 33rra% support tests-2018. lf 'the organization did not check the box on line '14, and line '15 is more than 33ri3%, and line
17 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization > nb 331rso/o support tests-2017. lf the organization did not check a box on line '14 or line 19a, and line 16 is more than 33r/3o%, and
line l8 is not more than 331/3%, checkthis box and stop here. The organization qualifies as a publicly supported organization > E20 Private foundation. lf the orqanization did not check a box on line 14, 19a, or 19b, check this box and see instructions > E
%o/o
(al 2014 (b) 2015 (c) 20'1 6 ldl2017 (e) 2018
'15
16
17
18
REV 10/24118 PRO Schedule A (Form 99O or99O-E4 2018
Calendar year (or fiscal year beginning in) >9 Amounts from line 6
10a Gross income from interest, dividends,payments received on securilies loans, rents,
royalties, and income from similar sources .
b Unrelated business taxable income (less
section 511 taxes) {rom businessesacquired after June 30. 1975 .
c Add lines 10a and 10b
ll Net income from unrelated businessactivities not included in line 10b. whetheror not the business is regularly carried on
12 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part VI.) .
13 Total support. (Add lines 9, '10c, 11,and 12-)
Schedule A (Form 990 or 990-Ea 2018 Pase 4Part lV Supporting Organizations
(Complete only if you checked a box in line 12 on Part l. lf you checked 12a oI Patl l, complete Sections Aand B. lf you checked l2b of Part l, complete SectionsAand C. lf you checked '12c of Part l, completeSections A, D, and E. lf you checked 12d of Part l, complete Sections A and D, and complete Part V.)
Yes
2
5b5c
9a
10b
Section A. All Su orti izatio ns
'l Are all of the organization's supported organizations listed by name in the organizalion's governingdocuments? lf "No," describe in Part Vl how the suppofted organizations are designated. lf designated byclass or purpose, descibe the designation. lf histoic and continuing relationship, explain.
2 Djd the organization have any supported organization that does not have an IRS determination oI statusunder section 509(aX1) or (2)? /f "Yes," explain in Part Vl how the organization determined that the supponedorganization was descibed in section 509(a)(1) or (2).
3a Did the organization have a supported organization described in section 501(cX4), (5), ot (61? lf "Yes," answer@) and (c) below.
b Did the organization confirm that each supported organization qualitied under section 501(c)(4), (5), or (6) andsatisfied the public support tests under section 509(aX2)? lf "Yes," descibe in Part Vl when and how theorganization made the determination.
c Did the organization ensure that all support to such organizations was used exclusively ror section 170(c)(2XB)purposes? /f "yes, " explain in Paft Vt what controls the organization put in place to ensure such use.
4a Was any supported organization not organized in the United States ("foreign supported organization")? /l"Yes," and if you checked 12a or 12b in Paft l, answer (b) and (c) below.
b Did the organization have ultimate control and discretion in deciding whether to make grants to the Joreignsupported organization? lf "Yes," describe in Pert Vl how the organization had such control and discretiondespite being controlled or supervised by or in connection with its supported organizations.
c Did the organization support any foreign supported organization that does not have an IRS determinationunder sections 501(cX3) and 509(aX1) or \2).l lf "Yes," explain in Part Vl what controls the organization usedto ensure that all support to the foreign suppotted organization was used exclusively for section 170()X2XB)purposes.
5a Did the organization add, substitute, or remove any supported organizations during the iax yeat? lf "Yes,"answer (b) and (c) below At applicable). Also, provide detail in Part Vl, including (i) the names and EINnumbers ol the suppofted organizations added, substituted, or removed; (ii) the reasons for each such action;(iii) the authority under the organization's organizing document authoizing such action: and (iv) how the actionwas accomplished (such as by amendment to the organizing document).
b Type I or Type ll only. Was any added or substituted supported organization part of a class alreadydesignated in the organization's organizing document?
c Substitutions only. Was the substitution the result of an event beyond the organization's control?6 Did the organization provide suppori (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 benefitedby one or more of its supported organizations, or (iii) other supporting organizations that also support orbenefit one or more of the filing organization's supported organizations? lf "Yes," provide detail in Part W.
7 Did the organization provide a grant, Ioan, compensation, or other similar payment to a substantial contributor(as defined in section 4958(CX3XC)), a family member of a substantial contributor, or a 35% controlled entitywith regard to a substantial contributor? lf "Yes," complete Paft I of Schedule L (Form 990 or 990-EZ).
8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?lf "Yes," complete Paft I of Schedule L (Form 99O or 990-E4.
9a Was the organization controlled directly or indireclly at any time during the tax year by one or moredisqualified persons as defined in section 4946 (other than foundation managers and organizations describedin section 509(a)(1) ot (2\l'? lf "Yes," provide detail in Part Vl.
b Did one or more disqualilied persons (as defined in line 9a) hold a controlling interest in any entity in whichthe supporting organization had an interest? /f "yes, " provide detail in Part Vl.
c Did a disqualilied person (as defined in line 9a) have an ownership interest in, or derive any personal benefitIrom, assets in which the supporting organization also had an interest? If "Yes," provide detail in Part Vl.
'loa Was the organization subject to the excess business holdings rules of section 4943 because of section4943(f) (regarding certain Type ll supporting organizations, and all Type lll non-functionally integratedsupporting organizations)? /l "Yes,"answer 10b below.
b Did the organization have any excess business holdings in the tax yeat? (Use Schedule C, Form 4720, todetermine whether the organization had excess busness holdngs.)
No
REV 10/24118 PRO
Schedule A (Form 99O or 99O-EZ) 2018
3b
7
9b
9c
3a
I
6
3c
4a
4b
4c
5a
Schedule A (Form 990 or 990-E4 2018
rtin anizations
11 Has the organization accepted a gift or contribution from any of the following persons?a 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?
b A family member of a person described in (a) above?c A 35% controlled ofa rson described in or aboYe? lf "Yes" to a, b, or c, detail in Part Vl.
Section B, lSu rtin anizations
I Did the directors, lrustees, or membership of one or more supported organizations have the power toregularly appoint or elect at least a majority of the organization's directors or trustees at all times during thelax year? lf "No," descibe in Part Vl how the suppofted organization(s) effectively operated, supervised, orcontrolled the organization's activities. lf the organization had more than one suppofted organization,descibe how the powers to appoint and/or remove directors or trustees were altocated among the supportedorganizations and what conditions or restictions, if any, applied to such powers during the tax year.
2 Did the organization operate lor the benefit of any supported organization other than the supportedorganization(s) that operated, supervised, or conlrolled the supporting organization2 lf "Yes," explain in PariVl how providing such benelit canied out the purposes of the suppoied organization(s) that operated,superuised, or controlled the suppofting organization.
Section C. Type ll Su orting izations
Were a majority of lhe organization's directors or trustees during the tax year also a majority of the directorsor trustees of each of the organization's supported organization(s)? /f 'No, " describe in Part Vl how controlor management of the supporling organization was vested in the same persons that controlled or managedthe su p po fted org an i zati on (s).
Section D. All Type lll Supportin o anizations
I Did the organization provide to each of its supported organizations, by the last day of the fifth month of theorganization's tax year, (i) a written notice describing the type and amount of support provided during the prior laxyear, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies oI theorganization's governing documents in effect on the date of nolification, to lhe exlent not previously provided?
2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supportedorganization(s) or (ii) serving on the governing body ot a supported organization? lf "No," explain in Part Vl howthe organization maintained a close and continuous wotking relationship with the suppofted organization(s).
3 By reason of the relationship described in (2), did the organization's supported organizations have asignificant voice in the organization's investment policies and in directing the use of the organization'sincome or assets at all times during the lax year2 lf "Yes," descibe in Part Vl the role the organization'ssuppotted organizations played in this rcgard.
Section E, Type lll Functionally lntegrated Supporting Organizations1 Check the box next to the method that the organization used to satisfy the lntegnl Paft Test duing the year (see instructions)a E The organization satisfied the Activities Test. Complete tine 2 below.b E The organization is the parent of each of its supported organizations. Complete line 3 betow.c I The organization supported a governmental enlity. Describe in Patt Vl how you suppofted a govemment entity (see ins
2 Activities Test. Answer (a) and (b) below.a Did substantially all of the organization's activities during the tax year directly further the exempl purposes of
the supported organization(s) to which the organization was responsive? /f "Yes," then in Pafi Vl identifythose suppofted otganizations and explain how these activities directly furlhered their exempt purposes,how the organization was responsive to those suppotted organizations, and how the organization determinedthat these activities constltuted substa,tially all of its activities.
b Did the activities described in (a) constitute activities that, but lor the organization's involvement, one or moreof the organization's supporled organization(s) would have been engaged in? ll "Yes," explain in Part Vl thereasons for the organization's position that its suppoied organization(s) would have engaged in theseactivities but for the organization's involvement.
3 Parent of Supported Organizations. Answer (a) and (b) below.a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or
truslees of each oI the supported organizalions? Provide details in Part Vl.
b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each" describe in Part Vl the role nization in this
No
Page 5
No
No
No
No
Yes
11a11b1lc
Yes
Yes
I
Yes
2
3
Yes
of its su edo anizations? /f "Yes
REV 10/24118 PRO
the
Schedule A (Form 99O or 99O-EZ) 2018
I
I
1
2
,l
3a
II
2a
2b
3b
Schedule A (Form 990 or 990-EZ) 2018 eaqe 6
EEEU Type lll Non-Functionally lntegrated 509(aX3) Supporting OrganizationsI n Check here if the organization satisfied the lntegral Part Test as a qualiiying trust on Nov. 20, 1970 (explain in Part Vl). See
instructions. All other lll non-functional izations must com Sections A thn E
6 Portion of operating expenses paid or incuned for production orcollection of gross income or for management, conservation, ormaintenance of property held lor production of income (see instructions)7 Other instructi
Section A-Adiusted Net lncome
1 Net short-term tn
2 Becoveries of distributions3 Other ross income4 Add lines '1 h3.5 reciation and d
8
2
1
(B) Current Year(optional)
(B) Current Year(optional)
Current Year
Net lncome lines 5 6 and 7 lrom line 4
Section B-Minimum Asset Amount
1 Aggregale fair market value ol all non-exempt-use assets (seeinstructions lor short tax or assets held for of
month value of securitiesa
b month cash balancesc Fair market value of other non-exem -use assetsd Total lines 1a, 1b, and 1
e Oiscount claimed for blockage or otherfactors ain in detail in Part
uisition indebtedness icable to non- -use assets3 Subtract line 2lrom line.ld.4 Cash deemed held for exempt use. Enle( 1-1/zyo ol line 3 (for greater amount,see instructio5 Net value of non-exem -use assets ubtract line 4 from line
6 Multi line 5 035.7 Recoveries of rior- distributionsI Minimum Asset Amount line 7 to line
Section C-Distributable Amount
usted net income lor rior Section A, line 8, Column2 Enter 85% of line '1.
3 lvinimum asset amount for m Section line 8, Column4 Enter of line 2 or line 3.
5 lncome tax in or
6 Distributable Amount. Subtract line 5 from line 4, unless subject toreduction
7 E Check here il the current year is the organizalion's first as a non-functionally int€rated Type lll supporting organization (seeinstructions).
Schedule A (Form 99O or 990-Ez) 2018
(A) Prior Year
1
2345
6
7
8
(A) Prior Year
1a1b1c1d
23
456
7
'I
2J45
o
REV 10/24118 PRO
I
8
Part V Type lll Non-Functionally lnte rated s(xr(ax3) Supportin o anizations continu
Section D-Distributions
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supportedorganizations, in excess oI income from activity
3 Administrative expenses paid to accomplish exempt purposes of su ported o anizations4 Amounts paid to acquire exempl-use assets5 Oualified set-aside amounts (prior IRS approval requir€d)6 Other distributions describe in Part , See instructions7 Total annual distributions. Add lines 1 through 68 Distributions to attentive supported organizations to which the organization is responsive
(provide details in Part Vl). See instructions-I Distributable amount lor 2018 from Section C. line 6
lO Line I amount divided line I amount
Section E-Distribution Allocations (see instructions)
1 Distributable amount for 2018 from Section C, line 6
Currenl Year
(iii)Distributable
Amount for 2018
3 Excess distributions carryover, if an , to 2018a From 20'13
b From 2014c From 2015
d From 2016e Ftom 2017f Total of lines 3a throu heg Applied to underdistributions of prior years
h lied to 2018 distributable amountuar r from 2013 not a ied see instruction
i Remainder. Subtract lines , 3h, and 3i from 3fDistributions for 2018 fromSection D. line 7: $
a lied to underdistributions of nor rS
b Applied to 2018 distribulable amount
Bemaining underdistributions for years prior to 2018, ifany. Subtract lines 39 and 4a lrom line 2. For resultgreater than zero, explain in Part Vl. See instructions.
4
5
6 Remaining underdistributjons for 2018. Subtract lines 3hand 4b from line 1 . For result greater than zero, explain i
Part Vl. See instructions.7 Excess distributions carryover to 2019. Add lines 3j
and 4c-
a Excess from 2014b Excess jrom 2015c Excess from 2016d Excess from 2017
(0
Excess Distributions
(ii)Underdistributions
Pre-2018
e Excess from 2018
REV 10r24h8 PRO
Schedule A (Foi.rr\ 990 or 990-EZ) 2018
2 Underdistributions, if any, for years prior to 2018(reasonable cause required - explain in Part Vl). Seeinslructions.
c Remainder. Subtract lines 4a and 4b from 4.
8 Breakdown of line 7:
eage 7
I
I
Schedule A (Form 99O or 99O-EZ) 2018
Schedule A (Form 990 or 990-E4 2018 eage 8Part Vl Supplemental lnformation. Provide the explanations required by Part ll, line 10; Part ll, line 17a or 17b; Part
lll, line 12; Part lV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6,9a, 9b, 9c, 11a, 11b, and 11c; Part lV, SectionB, lines 1 and 2; Part lV, Section C, line 1; Part lV, Section D, lines 2 and 3; Part lV, 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.)
Pt II Ln 10: Other lncome Part II, Lj-ne 10 Descrl! tion: SALES NET OF COGS 2014:
3A201. 2a15t 252. 2A),Bt 116
REV 10/24118 PRO Schedule A (Form 99O or 99O-E4 2018
Schedule B(Form 99O, 990-EZ,or 990-PRDepadment of the TreasurylnlemalRevenle Serv ce
Schedule of Contributors> Attach to Form 990, Form 990-EZ, or Form 99O-PF.
> Go to www-r|s-govlFormggo for the latest inlormation.2@18
Employer idenlifi calion number
52-t'7456'78
OMB No. 1545-0047
Name o, the organization
UNITED POULTRY CONCERNS INC .
Check if your organization is covered by the Genoral Rule or a Special Rule.
Note: Only a section 501{cX7), (8), or (10) organizalion can check boxes for both the General Rule and a Special Rule. Seeinstructions.
General Rule
B For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,OOOor more (in money or property) from any one contributor. Complete Parts I and ll. See instructions for determining acontributor's total contributions.
Special Rules
E For an organization described in section 501(cX3) filing Form g9O or 990-EZ that met the 331/3% support test of theregulations under sections 509(aX1) and 170(bX1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part ll, line13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1)
$5,000: or l2l2% of the amount on (i) Form 990, Part Vlll, line t h; or (ii) Form 990-EZ, line '1. Complete Parts I and ll
E For an organization described in section 501(cX7), (8), or (10) filing Form gg0 or ggO-EZ that received from any oneconlributor, during the year, total contributions of more than $'1,000 excluslye/y for religious, charitable, scientific,literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I (entering"N/A" in column (b) instead of the contributor name and address), ll, and lll.
E Foran organization described in section 501(c)(7), (8), or(10) filing Form ggo or 99O-EZ that received from anyonecontributor, during the year, contributions exclusively lor religious, charitable, etc., purposes, but no suchcontributions totaled more than $1 ,000. lf this box is checked, enter here the total contributions that were receivedduring the year for an exctusively religious, charitable, etc., purpose. Don't complete any of the parts unless theGeneral Rule applies to this organization because it received nonexclusively teligious, charitable, etc., contributionstotaling $5.000 or more during the year > $
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,990-EZ, or 990-PF), but it must answer "No" on Part lV, line 2, of its Form 990i or check the box on line H of its Form 990-EZ or on itsForm 990-PF, Part l, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PD.
For Paperwork Reduction Act Notice, see the instructions lor Form 99o, 990-EZ, or 990-PF. REv 11/1zr I pRo
BAASchedule B {Form 99O, 99O-EZ, or 990-PR (2018)
Organization tlDe (check one):
Filers oft Section:
Form 990 or 990-EZ E SOl1c11 3 ) (enter number) organization
n +eaZ1a;1t1 nonexempt charitable trust not treated as a private foundalion
D 527 political organization
Form 990-PF ! SOtlc;1S1 exempt private foundation
E 4947(aXl) nonexempt charilable trust treated as a private toundation
E 501(cX3) taxable private ,oundation
Schedule B (Fo.m 990, 990-EZ. or 990-PR (2018) Pase 2Name of organization
UNITED POULTRY CONCERNS, INC.Employer identitication numbet
52-17056?B
EEEI Contributors (see instructions). Use duplicate copies of Part I if additional space is needed
(a)No,
I
(d)Type of contribution
Person APayroll trNoncash tr
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
Person APayroll nNoncash n
(Complete Part ll fornoncash contributions.)
(d)Type ot contribution
Person trPayroll trNoncash tr
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
Person trPayroll trNoncash tr
(Complete Part ll fornoncash contributions.)
(d)Type ol contribution
Person trPayroll trNoncash tr
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
Person APayroll trNoncash n
(Complete Part ll fornoncash contributions.)
(a)No.
2
(a)No.
3
(a)No.
A
(b)Name, address, and ZIP + 4
(c)Total contributions
Estate of Nina Joan Rosen
1810 NE Stanton
Portland AR 9'1212
$ 324
(b)Name, address, and ZIP + 4
(c)Total contributions
HaroId B Larsen Charitable Trust
Po Box 40430
Reno NV 89504
$. - - - - - - - - - - - - - - - - - -?!-'-? ! 9.- -
(b)Name, address, and ZIP + 4
(c)Total contributions
ESTATE OF NANCY S HILD MARY F MCAULEY
135 S LASALLE ST SU]TE 2310
,. qI-E_qq_lq_B
CHICAGO IL 60603
34,-t49.$
(b)Name, address, and ZlP.i 4
(c)Total contributions
FlDELITY CHARITABLE EOR LAUREN MARINO
DOVER MA O2O3O
145 CENTRE ST 30,000.$
(b)Name, address, and ZIP + 4
(c)Total contributions
72,044.$
l.: r:-1 ,',-1. l
BELLE MEAD NJ OB5O2
4 DOYLE LANE
(c)Total contributions
(b)Name, address, and ZIP + 4
67,590.$
CAROL LUSHEAR ESTATE
PO BOX 1511
(a)No.
5
(a)
No.
a
BAA REV 11/1218 PRO Schedule B (Form 99O, 99O-EZ, or 990-PR (20r8)
PORT RICHEY FL 346]3I
Schedule B (Form 990, 990-EZ, or 990-PD (2018) case 2Name ol organization
UNITED POULTRY CONCERNS, INCEmployer identifi cation number
52-71456'78
EEEI Contributors (see instructions). Use duplicate copies of Pad I if additional space is needed
(a)No,
1
(d)Type of contribution
Person trPayroll nNoncash n
(Complete Part ll fornoncash contribulions.)
(d)Typ€ of contribution
PersonPayrollNoncash
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
PersonPayrollNoncash
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
PersonPayrollNoncash
(a)No.
3 trtrtr
(a)No
trDtr
(Complete Part ll fornoncash contributions.)
(d)Type of contribution
PersonPayrollNoncash
(Complete Pad ll fornoncash contribulions.)
(d)Type of contribution
PersonPayrollNoncash
trntr
trtrtr
(b)Name, address, and ZIP + 4
(c)Total contributions
Dharrna Trust c/o Satish Karandikar TRTEE
3414 Peachtnee Rd NE Ste 1600
At.Iant a GA 30326
16,000.$
(b)Name, address, and ZIP + 4
(c)Total contributions
14050 North 83rd Ave, Ste 290
-B-eI0,Estate of Sher l'iard c/c La],,I offices of ],uke tas PLLC
Peoria AZ 85381
47, 692 .$
(b)Name, address, and ZIP + 4
(c)Total contributions
$
(b)Name, address, and ZIP + 4
(c)Total contributions
$
(b)Name, address, and ZIP + 4
(c)Total contributions
(b)Name, address, and ZIP + 4
(c)Total contributions
(a)No.
(a)No.
$
(a)No
(Complete Part Il fornoncash contributions.)
BAA REV I1112l18 PRO Sche.lule B (Form 99O, 99O-EZ, or 990-PR (2018)
I
$ --"---,-
!trn
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Pase 3Name oI organization
UNITED POULTRY CONCERNS
Employer identitrcation number
52-L'7 456'7 B1NC.
EdI Noncash Property (see instructions). Use duplicate copies of Part ll if additional space is needed
(a) No.IromPart I
(d)Date received
(a) No.fromPart I
(d)Date received
(d)Date received
(a) No.,romPart I
(d)Date received
(a) No.fromPart I
(d)Date received
(a) No.fromPart I
(d)Date received
(b)Description of noncash property given
(c)FMV (or estimate)
(See instructions.)
$
(b)Description ot noncash property given
(c)FMV (or estimate)
(See instructions.)
$
(b)Description of noncash property given
(c)FMV (or estimate)
(See instructions.)
(b)Description of noncash property given
(c)FMV (or estimate)
(See instnictions.)
(b)Description of noncash property given
(c)FMV (or estimate)
(See instructions.)
(b)Description of noncash property given
(c)FMV (or estimate)
(See instructions.)
$
BAA REV 11/12l18 PRO Schedule B (Form 99O, 99O-EZ, or 990-PR (2018)
(a) No.tromPart I
$l
$
Schedule B (Form 990, 990-EZ. or 990-PR (2018) Page 4Name ol organization
UNITED POULTRY CONCERNS, ]NC.Employer identif cation number
52-7'7 4561 B
(a) No.{romPart I
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)f7), (8), or(10) that total more than $1,00O for the year from any one contributor. Complete columns (a) through (e) andthe following line entry. For organizations completing Pad lll, enter the tolal ot exclusively religious, charitabie, etc.,contributions of$1,000 or lessfortheyear. (Enter this information once. See instructions.) > $
Use du icate co ies of Part lll if additional ace is needed
(d) Description ol how gift is held
Part lll
(e) Transler ot gift
Transferee's name, address, and zlP + 4 Relationship ot transferor to transteree
(a) NoIromPart I
(d) Description of how gift is held
(c) Use ol gift(b) Purpose of gift
(c) Use of gift(b) Purpose ot gift
(c) Use ol gift(b) Purpose ot gift
(c) Use ot gift(b) Purpose ot gift
(e) Transler of gift
Transferee's name, address, and ZIP + 4 Relationship of transreror to transferee
fiomPart I
(d) Description of how gift is held
(e) Transfer of gift
Transreree's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) NofromPart I
(d) Description ot how gift is held
(e) TransJer ot gift
Relationship ol transferor lo transteree
BAA
Transferee's name, address, and ZIP + 4
REV I t/12l18 PRO Schedule B {Form 99O, 99O-EZ, or 990-PR {2018)
t------------
I
SCHEDULE D(Form 990)
Depanment ot lhe T.easurylntemalBev€nue Serv ce
Nam€ of the organizalion
UNITED POULTRY CONCERNS, INC.
Supplemental Financial Statements> Complete if the organization answered "Yes" on Form 990,
Part lV, line 6, 7, 8, 9, 10, I la, l lb, 1lc, 1ld, l'le, I lf, 12a, ot 12b.> Attach to Form 990.
> Go to www.rlrs-govlFormggo for instructions and the latest information,
O[48 No. 1545-0047
Employer identitrcation number
2@1a
Yes E
Yes E
1
2
45
6
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.Complete if the o anization answered "Yes" on Form 990, Part lV, line 6.
(b) Funds and other accounts
Total number at end of year .
Aggregate value of contribulions to (during year)
Aggregate value oI grants from (during year)
Aggregate value at end of yearDid the organization inform all donors and donor advisors in writing that the assets held in donor advisedfunds are the organization's property, subiect to the organization's exclusive legal control?
Did the organization inform all granlees, donors, and donor advisors in writing that grant funds can be usedonly for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purposeconferring impermissible private benefit?
No
No
Open to Publiclnspection
Part I
(al Donor advised funds
Part ll Conservation Easements.Completelf@gg0, PartlV, line 7
1 Purpose(s) of conservation easements held by the organization (check all that apply).
n Preservation of land for public use (e.g., recreation or education) E Preservation of a historically importanl land area
n Protection ol natural habitat E Preservation of a certified historic structuren Preservation of open space
2 Complete lines 2a through 2d il the organization held a qualified conservation contribution in the form o, a conservationeasement on the last day of the tax year.
a Tolal number of conservation easementsb Total acreage restricted by conservation easements
c Number ol conservation easements on a certified historic structure included in (a) ,
d Number of conservation easements included in (c) acquired altet 7 /25/06, and not on ahistoric structure listed in the National Register
Number of conservation easemenls modified, transferred, released, extinguished, or terminated by the organization during thetax year >Number of stales where property subject to conservation easement is located >Does the organization have a written policy regarding the periodic monitoring, inspection, handling ofviolations, and enforcement ofthe conservation easements it holds? E yesE NoStaff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enlorcing conservation easements during the year
7 Amount of expenses incuned in monitoring, inspecting, handling of violations, and enrorcing conservation easements during the year>$
8 Does each conservation easement reported on line 2(d) above satisty the requirements ot section 17o(hX4XBXDand section 170(hX4XBXii)? EVesE Uo
9 ln Part Xlll, describe how the organization reports conservation easemenls in its revenue and expense statement, andbalance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes theorganization's accounting for conservation easements.
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.Complete if the organization answered "Yes" on Form 990, Part lV, line 8.
la lf the organization elected, as permitted under SFAS 1 16 (ASC 958), not to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide, in Part Xlll, the text of the ,ootnote to its financial statements that describes these items.
b lf the organization elected, as permitted under SFAS 1 16 (ASC 958), to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide the following amounts relating to these items
(i) Revenue included on Form 990, Part VIll, line 1
(ii) Assets included in Form 990, Part X2 lf the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
tollowing amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
Revenue included on Form 990, Part Vlll, line 1 > $Assets included in Form 990. Part X >$
Held al the End olthe Tax Year
3
45
6
.> $
.> $
a
b
2a2b2c
2d
For Paperwork Reduction Act Notice, sse the lnstructions for Form 990.
BAA REV 11l1?/1a PROSchedule o (Form 990) 2018
I 52-7"7 056'18
Part lll
Schedule D (Form 990) 2018 eage 2anizations Maintaini Collections of Historical Treasures, or Other Similar Assets
3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of itscollection items (check all that apply):
a E Public exhibition d E Loan or exchange programs
b n Scholarly researchc D Preservation for future generations
€ E other
4 Provide a description of lhe organization's collections and explain how they further the organization's exempt purpose in PartXIII.
5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similarassets to be sold to raise funds rather than to be maintained as part of the organization's collection? E yes E No
Escrow and Custodial Arrangements.Complete if the organization answered "Yes" on Form 990, Part lV, line 9, or reported an amount on Form990, Part X, line 21.
la ls the organization an agent, trustee, custodian or other intermediary for contributions or other assets notincluded on Form 990, Part X? . n yes E l.to
b lf "Yes," explain the arrangement in Part Xlll and complete the following table:Amount
c Begrnning balanced Additions during the year
e Distributions during lhe yearf Ending balance
2a Did the organization include an amount on Form 990, Part X, line 21 , Ior escrow or custodial account liability? E Yesb lf "Yes," ex lain the arra ent in Part Xlll. Check here il the ex anation has been rovlded on Part Xlll
Endowment Funds,Complete if the o anization answered "Yes" on Form 990, Part lV, line 10
{e) Four years back
Beginning of year balanceContributionsNet investment earnings, gains, andlosses
Grants or scholarshipsOther expenditures for facilities andprograms
Administrative expensesEnd of year balanceProvide the estimated percentage oI the current year end balance (line 19, column (a)) held as
Permanent endowment > o/o
Temporarily restricted endowment > %The percentages on lines 2a,2b, and 2c should equal 100%.Are there endowment funds not in the possession of the organization that are held and administered fororganization by:
(i) unrelated organizations(ii) related organizationslf "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R?Describe in Part Xlll the intended uses of the organization's endowment tunds.
No
ENo!
a
bc
de
'I
I2
a
bc
I
3a
b4
the
Part lV
1c1d1e
1f
Part V
(a) Cunenl year (b) Prior year (c) Two years back (d) Three years back
Yes3a(i)3a(ii)3b
Part Vl Land, Buildings, and Equipment.Com lete il the anization answered "Yes" on Form 990, Part lV, line 11a. See Form 990, Part X, line 10.
Descr ption of property {d) Book value
la Landb Buildingsc Leaseholdimprovementsd Equipmente Other
Total. Add lines 1a throu Form 990, Pai column
30,000.722,443.
752,443.
(a) Cost or other basis(investmen0
(bl Cost or other basis(othe4
(c) Accumulated
30.000.71 6, 934 54, B8'7 .
1-/t1'79. l1 ,'1'7 9
BAA
n te. mustREV 11/12l18 PRO
ne 1Ac.
Schedule O (Form 990) 2018
Part lll
I
0.
S€hedule D (Form 990)2018 Pase 3
intaaima-ia= Oihei Sacnriiiea:Complete if the o anization answered "Yes" on Form 990, Part lV, line 1 1 b. See Form 990, Part X, line 12
(a) Desciption of security or category(including name of securin
(c) Method of valuation:Cost or end-ol-year market value
(l) Financial derivatives(2) Closely-held equity interests(3) Other
(A)
(B)
(c)
(D)
(E)
(D
(G)
Tolal. h) must equal Fam 990, Pat X, cal line 12
lnvestments- Program Related,Com lete if the o anization answered "Yes" on Form 990, Part lV, line 11c. See Form 990, Part X, line 13
(a) Description of investment (b) Eook vaiue (c) l4ethod ol valualion:Cosi or end-of-year markel value
(4)
(s)
lolal. (Column (b) must EualFom 990, Pan X, cal. (B) line 13.) >Other Assets.Com lete if the anization answered "Yes" on Form 990, Part lV, line 1 1d. See Form 990, Part X, line 1 5.
(a) Description (b) Book value
(1)
Tot2l. (Column (b) must equal Form 99O, Paft X, col. (B) line 15.)
(7)
'1.
Other Liabilities.Complete if the organization answered "Yes" on Form 990, Part lV, line 1 1e or 1 1f. See Form 990, Pad X,line 25.
(a) Descrlpton of liabilly
(1) Federal income taxes
t2)
(3)
(4)
(5)
(6)
\7)
(8)
(e)
lolaL (Colunn b) nust qual Fom 990, Pan X, col. F)lke 25) )2. Liability for uncertain tax positions. ln Part Xlll, provide the text ol the lootnole to lhe organization's linancial statements that reports theorganization's liability for uncertain lax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part Xlll E
{b) aook value
Part Vlll
Part lX
Part X
(b) Book va ue
Schedule D (Form 990)2018
(H)
(2'l
Schedule D (Form 990)2018 ease 4Reconciliation of Revenue per Audited Financial Statements With Revenue per Return,Com lete if the anization answered "Yes" on Form 990, Part lV, line 12a
I Total revenue, gains, and other support per audited ,inancial statements2 Amounts included on line 1 but not on Form 990, Part Vlll, line 12:
Net unrealized gains (losses) on investmentsDonated services and use of facilitiesRecoveries of prior year grantsOther (Describe in Part Xlll.) .
Add lines 2a through 2dSubtract line 2e {rom line 1
Amounts included on Form 990, Part Vlll, line 12, but not on Iine 1
lnvestment expenses not included on Form 990, Part Vlll, line 7bOther (Describe in Part Xlll.) .
Add lines 4a and 4b
a
bcde
a
bc
2a
649 145.
58 9 145
689 145.
468 289.
4 68 289.
468 , 289 .
34
1
2
5 Total revenue. Add lines 3 and 4c. (Thls must equal Form 990, Part I, line 12.)
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.Com lete if the o anization answered "Yes" on Form 990, Part lV, line 12a.
Total expenses and losses per audited ,inancial statementsAmounts included on line 1 but not on Form 990, Part lX, line 25:
Donated services and use of facilitiesPrior year adiustmentsOther losses
Other (Describe in Part Xlll.) .
Add lines 2a through 2dSubtract line 2e ,rom line IAmounts included on Form 990, Part lX, line 25, but not on line 1:
lnvestment expenses not included on Form 990, Part Vlll, line 7b
Other (Describe in Part Xlll.) .
Add lines 4a and 4b
2a
5 Total expenses. Add lines3and 4c. (This must equal Form990, Part I, line18.).
4a
4a
abcde
a
bc
34
emental lnformation.Provide the descriptions required for Part ll, lines 3, 5, and 9; Part lll, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line2; Part Xl, lines 2d and 4b; and Part Xll, lines 2d and 4b. Also complete this part to provide any additional information.
Pt XI, Line 2d: SALES OF SMALL ITEMS I,^7ITH INSIGNIA OR MESSAGE TO PROMOTE MISSION
1
2b2c2d
4b4c
1
2b2c2d
2e
4b4c5
OF THE ORGANI ZATlON
BA,A Schedule D (Form 990) 2018
Part Xl
2e
I
5Part Xll
Part Xlll
Schedule D (Form 990)2018 Pase 5Part Xlll emental lnformation
Schedule D (Form 990) 2018
SCHEDULE O(Form 990 or 990-EZ)
Department of lhe TreasurylnternalBevenue Serv ce
Name of the organization
UNlTED POULTRY CONCERNS
Supplemental lnformation to Form 990 or 99GEZComplete to provide inlormation tor responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.> Attach to Form 990 or 990-EZ.
> Go lo www,its.govlFozrggo for the latesl informatiorl
OMa No.1545-0047
2@1A
Employer identifi calion numb6r
52-71 A56181NC.
-!_!--_v--1-,----!l_l-C_--qe_:__-I_N_q-o__81_,14_1r-_-q_o-_t4_,1_u--t!-I_c-41-I-o_-N_q-_I_4_ry-E_--p,L-ACE BETwEEN MEMBERS vIA EMAlI- .
---Y-o-9I-"-I-q"q-q.Eq 4_B-q--_N-o-l-_-ql_q-t-{-1_ry_c-4.l_i--4_q-Q-o__B-q_1_N-G-L-_Y_,,-,No MTNUTES ARE KEPr.
Pt VI, Line 11b: PRESIDENT REVIEWS BEEORE SIGNING AND INFORMS BOARD MEMBERS
OF ANY SIGN] FICANT ISSUES.
Open to Publiclnspection
Pt Ix, Line 24e:
Descr tion I OFFICE SUPPLI ES-t-P
Total: $421
Program services: $358
Management and generaL: S63
Fundra i s 1n s0
Description: OPERATING SUPPLI ES
Total: S3,556
Progran serv.ices: S3, 023
Mana ement and general : 5533
Fundraising: S0
Description: POSTAGE & DELIVERY
Total: S38,441
Program services: S30,753
Management and general: S3,844
DescriDtion: PRT NT ING
Total: $56,113
Program services: 541 ,696
For Paperwork Reduction Acl Nolice, see the lnstructions lor Form 990 or 990-EZ. BAl. No. 51056K schedute o (Form geo or 990-E4 (2018)
REV 10/24118 PRO
Fundraising: S3,844
Management and general: $0
Schedu e O 990 or 990-E4 (2018) 2Name of the organization
UNITED POULTRY CONCERNS INC
Employer identifi cation number
52 -114 5 61e
Fundraisin-g_i,_L1
Desc f 10n: 5Et(v 1UEs
Total: $36 r00
P am services: S3
Mana ement an eneral: $1 ,8 35
$1,835
Descri tion: TAXES
Total : S9
Pro ram services: $8
ment a eraf : S 1
Fundraisi s0
Descri tion: TELEPHONE
Total: S2 '1
-----B-f-g-s--!am services: S1 ,or
ement and eral: $108
TotaL: S9 . Q 9 l----------.--..........
am servlces: SB, 183
Mana ement and
Fundra i s in $45s
Total:.5221
Program services: 5204
ent and eneral: 90
Fundra.isin $23
Descri tion: DUES AND SUBSCRI PT I ONS
REV 10/24118 PROScheclule O {Form 99O or 990-Ea (2018)
Eundraisinq:
F und-ra---s-i-n-g-: ---S-l 0 8
Description: UTILITIES
Description: BOOKS
Name of the organlzation
UNITED POULTRY CONCERNS
Schedule O (Fom 990 or 99o-
Total: $534
2
INC.Employer identificalion number
52-1705678
---_-B-r--o, g-r,-qm services: 5267
Mana ment an ralt i26]
Fundraisi s0
Descrl tion: INTERNET EX PENSES
Tol aI : S186
!!ostqm services: S150
ement and eral : 518
Fundraisi : $18
Descri ion: BANK SERVICE CHARGESP_,!
Total: $194
am services: s0
Mana ement and eral: S194
Fundra i s i $0
Descrl ion: P al Eee s
Total : S1, 383
P am services: 91
Mana ement and --'-9-------: : Soo
Fundrai s i -!,c s69
Descr t Lon: Grt 15
Tota1 : S1,200
am services: S500
Mana ement and nera 1 : $ 600
Fundraisi SC
Descript.ion : MAILBOX RENEIiAL
Total: S 119
Pr arn services: S0
Schedule O (Form 990 or 990-EZ) (2018)
Name of the organization
UNITED POULTRY CONCERNS
Schedule o (Form 990 or 990-EZ)(2018)
INC.
ment and eneral: S107
Employe. identilication number
52-t'7 456'7 B
,----Y-e,!,e,s,g
Fundrai s i s12
Descri t ion: PHOTOGRAPHY
Total : S30
Pro services: S27
Man ent and eneraf: S3
Fundraisi s0
Descri Iion: PIIBLTC RELATIONS
Total : S4,000
Fundrai s i $400
Descri tion: WEBSITE HOST ING
Tot aI : $203
am services: S183
Ma ment and eneral: S20
Fundra i s I
Descri
!!ostqm services: 5f3,642
Ile!e9ement and eneral: S1, f05
Eundrai s i $1,705
Descri tion: CFC FEE
Total: S389
Program services: S 194
Mana ment and
Fundrar s i n s0
eneral: $ 195
Schedule O (Form 99O or 990-EZ) (2018)
,----B-t-o--g-r,q4 9,9-f-y-l-9-?-9-t---9-?-r q I q
Manaqement and general: S0
Total: $1?,052
REV 10/24118 PRO
Name
I]NTTF,D POI]LTRY CONCERNS
Description
All Other Expenses 2018
Employer ldentification No
52- 7t 45618
(D)Fundraising
INC
OFFICE SUP PL IES c
OPERAT]NG SUPPLI ES
POSTAGE & DELIVERYPRINTINGSERVICESTAXES
C
3
8
1 835
844 -
0.TELEPHONE 108UTILITlES 455BOOKS 23DUES AND SUBSCRI PTIONSINTERNET EX PENSES
BANK SERVICE CHARGES
18.C
Paypal FeqgGI ETS
69.C
),2 .
PHOTOGRAPHY 0
PUBLIC RELATIONSI{EBS I TE HOS T lNG
400.0
ANIMAL CARE EXPENSECFC FEE
1,705.c
(A)Total
(B)Prog ramservices
(c)Managementand general
112 , A0'7 .
427 .
3,556.
22"7 .
534.186.794 .
30.
f.i
4
157.
5636
9,093.
383.
000.203.452.389.
2AA.119.
113.r00.
9.
3,423.
73, 642 .
T O,4 T
261 -
150.
21
794
145 104.
B
C
1
J
304133
153.
183.244 .
245.600.
600183.
696.030.
8.
63.s33
108.455
26'7.1B
t9A69.
600.101
20.1,705.
195.
10 017 .
0
3
0
0
844
835
Total to Form 990, Part lX,line 24e
reew1601 SCR 02]0119
76 886
Form 990Part lX, Line 24e
4L1 .
UNITED POULTRY CONCERNS, INC, 52-1705678
Additional information from your 2018 Federal Exempt Tax Return
Schedule A: Public Charity Status and Public SupportLine 5
I
Itemization Statement
Description Amount2014 222 ,1C6 -
2017 81 ,716.2015 0
2016 3
2018 303,363.
613,245.Tota I
I
I
I