990 Questionnaire

This questionnaire addresses many of the issues presented with submitting Form 990. Please answer all questions to the best of your ability. If you are unsure of a question, please leave a note in a comment field. In general, there are certain forms and information we will need that are not directly addressed in this questionnaire. Those include but are not limited to:

A full list of your board members’ names and titles
Compensation information for officers and certain highly-compensated employees
Lists of substantial contributors and recipients of substantial grants and assistance

We will contact you with follow up requests based on responses to this questionnaire where applicable.

Tax 990 Questionnaire

Step 1 of 6

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General Information

Organization Name:

Fiscal Year:

MM slash DD slash YYYY

This questionnaire completed by:

Who will sign the return this year?

Provide the name and title of an officer authorized to sign the return. This does not have to be an officer who was present during the fiscal year being reported.

Who is the caretaker of the organization's books and records?

This should be the person to whom external requests for information can be directed.

Did the organization have paid employees for the year?

Yes

If yes, how many W-2s did you submit for the calendar year ending with or within the current fiscal year?

Please enter a number from 0 to 1999.

Has the organization filed all required Federal Unemployment Tax returns?

Yes

Not Applicable (no employees)

Did the organization file any 1099s for the calendar year ending with or within the current fiscal year?

Yes

If yes, how many 1099s were filed?

Please enter a number from 0 to 1999.

If yes, were any 1099s issued to board members or family members of board members?

Yes (if yes, please provide copies)

If yes, were any 1099s issued for $100,000 or more?

Yes (if yes, please provide copies)

Did the organization file any W2-G forms to report gambling or gaming winnings, and did the organization comply with backup withholding rules?

Yes, filed W2-G and withheld required taxes

Yes, filed W2-G but did NOT withhold taxes

Did the organization receive any Schedules K-1 from partnership or S-corporation investments it participates in or invests in?

Yes (if yes, please provide copies)

Mission & Programs

What is the organization's Mission Statement, as formally approved by the board of directors?

In the Form 990 (Part III) we must report the organization's current Statement of Program Service Accomplishments detailing the organization's three largest programs and any information relevant to those programs. This is an opportunity to tell a story. How shall we obtain this information for the current year?

Use prior year descriptions, no updates are necessary

Use language from the audited financial statement notes for descriptions.

I will provide new/updated language and statistics in a separate file.

Were any of the organization's program service activities new for this year?

Yes

If yes, please describe the new activities

Did the organization cease any prior program service activities this year?

Yes

If yes, what activities ceased?

Please estimate how many volunteers the organization had for the fiscal year.

Policy Questions

Did the organization have a written conflict of interest policy by the end of the tax year?

Yes

No, but one is being considered.

If yes, are your officers, board members, and applicable employees required to disclose, at least annually, any interests that could give rise to conflicts?

Yes, we have annual reviews and confirmations.

No, members do not submit annual confirmations.

If yes, please explain how the organization regularly and consistently monitors and enforces compliance with the policy?

Did the organization have a written whistleblower policy at the end of the year?

Yes

Did the organization have a written document retention and destruction policy at the end of the year?

Yes

Did the organization make changes to its bylaws or other governing documents this year?

Yes (if yes, please send a copy of the new revision)

Will the organization provide a copy of the Form 990 to every current voting board member prior to its being filed with the IRS?

Yes

Did the process for determining the compensation package for the executive director/CEO include a review and approval by the board?

Yes

If yes, which methods were used to determine the Executive Director/CEO's compensation? Check all that apply.

A compensation committee of the board

Independent compensation consultant

Form 990 of other organizations for reference

A written employment contract

Internally-prepared compensation survey or study

Externally-obtained compensation study or survey

Approval by the board or authorized subcommittee of the board

If yes, when was the last time the Executive Director/CEO's compensation reviewed?

MM slash DD slash YYYY

The Internal Revenue Code requires the public disclosure by a tax-exempt entity of its Forms 1023 (or 1024), 990, and 990-T if applicable. Please indicate all methods by which the organization makes these available.

Posted on the organization's website

Posted on another organization's website

Make available upon request

Other

Please indicate which of the following documents the organization makes available for public disclosure (note: it is not required by law to make these documents available, but it is part of the IRS's Best Practices for Good Governance.)

Financial Statements

Conflict of Interest Policy

Bylaws

Board of Directors Questions

Does the organization have corporate members or stockholders? (If unsure, check bylaws.)

Members: For purposes of the Form 990, the term "members" relates to any person(s) or organization(s) that constitute a membership body of an organization, and has or had the power at any time during the tax year the right to elect or appoint one or more members of the organization's governing body, whether periodically or as vacancies arise, or otherwise. The actual board of directors are NOT "members" for the purposes of this definition.

Yes

Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? (i.e., board members are elected by persons other than current board members.)

Yes

Are any decisions of the board subject to approval or ratification by members, stockholders, or persons other than members of the board?

Yes

if yes, explain conditions that are subject to outside approval.

Does the board have an executive committee?

Yes

Does the board have an audit committee that is responsible for selection of the organization's independent auditor and oversight of the audit?

Yes

Not Applicable (no audit)

Do all committees and subcommittees keep minutes of all full meetings and committee meetings between full meetings?

Board keeps minutes of all full meetings

Committees and subcommittees keep minutes of all their meetings

Minutes are not kept

Do any of the current board members share a family relationship or a business relationship between each other? A relationship is different than an actual transaction, and is reportable even if the organization's conflict of interest policy addresses the relationship. A relationship alone does not impair independence of the board member.

Family Relationship: The family of an individual includes his or her spouse, ancestors, siblings (full or half blood), children (natural or adopted), grandchildren, great grandchildren, and spouses of siblings, children, grandchildren, and great grandchildren. Business Relationship: Relationships between two individuals including the following: One person is employed by the other in a sole proprietorship or by an organization with which the other is associated as a trustee, director, officer, key employee, or greater-than-35% owner, One person is transacting business with the other (other than the ordinary course of business of either party's business on the same terms as offered to the public), directly or indirectly, in one or more contracts of sale, lease, license, loan, performance of services, or other transaction involving transfers of cash or property valued in excess of $10,000 in the aggregate during the organization's tax year, and The two persons are each a director, trustee, officer, or greater than 10% owner in the same business or investment entity.

Yes

If yes, please provide a schedule of all such relationships.

Compensation Questions

For purposes of this section, the reference "ODTKE" means Officers, Directors, Trustees, and Key Employees of the organization.

Please check the box for any benefit below that the organization offers to at least one employee.

Employer contributions/matches to a retirement plan

Health Insurance

Dental Insurance

Life Insurance

Short or Long-Term Disability Insurance

Company-provided transportation

Other company-paid nontaxable benefits

Did any ODTKE participate in, or receive payments from, a supplemental nonqualified retirement plan or an equity-based compensation arrangement?

Yes

Did any ODTKE receive any other type of non-fixed payments (amounts that are not determinable at the time of the arrangement)?

Yes

Did any ODTKE receive or accrue compensation contingent on the revenues or the net earnings of the organization or any related organization?

Yes

Did any ODTKE receive or accrue compensation from any unrelated organization for services rendered to the filing organization?

Yes

If yes, please explain the arrangement and identify the unrelated organization.

Check the appropriate boxes if the organization provided any of the following to an ODTKE or highly compensated employee:

First class or charter travel

Travel for companions (including spouses)

Tax indemnification and gross up payments

Discretionary spending accounts

Housing allowances or residence for personal use

Payments for business use of a personal residence

Health or social club dues or initiation fees

Personal services (e.g. maids, chauffeurs, chefs, etc.)

Reportable Transactions

For purposes of this section, the reference "ODTKE" means Officers, Directors, Trustees, and Key Employees of the organization.

Does the organization have an outstanding loan with an ODTKE, highly compensated employee, or substantial contributor at year end (either to or from the organization)?

Yes

If yes, please indicate who the loan is with, their relationship to the organization, the balance at year end, and the terms of repayment.

Did the organization provide a grant, scholarship, or other financial assistance to an ODTKE, substantial contributor, or a relative to such a person during the year?

Yes

If yes, please indicate who the grant was provided to, their relationship to the organization, and the amount of the assistance.

During the tax year, did any ODTKE serve as a board member or officer for an entity doing business with the organization? (i.e., conducting arm's length transactions) Answer yes even if such a transaction was cleared by your board's conflict of interest policy.

Yes

If yes, please name the interested person/party, their relationship to the organization, and a description of the transaction. If complex, please forward documentation to Carter.

Did any ODTKE have a family member receive compensation in excess of $10,000 from the organization during the tax year?

Yes

If yes, please provide the name of the family member, relationship to the ODTKE, and the amount of their W-2 box 5 compensation. If multiple, please forward information to Carter.

For all questions on this page, did the organization make a reasonable effort to determine this information?

A reasonable effort in this case would include such efforts as a written questionnaire or survey distributed to ODTKEs and substantial contributors.

Yes

Fundraising

Did the organization solicit any contributions during the tax year that were not tax deductible by the contributor, in whole or in part?

This would include tickets to fundraising events where a portion of the price was not deductible.

Yes

Did the organization provide goods or services during the tax year in exchange for contributions of $75 or more?

Yes

If yes, did the organization include with these solicitations an express written statement that such contributions were not deductible, or by how much to reduce the deductibility of the amount?

Yes

Does the organization keep sample copies of its fundraising materials, such as dues statements, fundraising solicitations, tickets, receipts, or other evidence of payments received in connection with fundraising activity?

Yes

Not Applicable (no fundraising)

Did the organization conduct one or more special fundraising events during the year?

Yes

Grantmaking & Assistance

Did the organization make total CASH grants in excess of $5,000 to any other organization within the United States?

Yes, certain organizations received more than $5,000

Yes, but no single organization received over $5,000

Did the organization make total NON-CASH grants in excess of $5,000 value to any other organization within the United States?

"Noncash" does not include services. "Noncash" refers to tangible goods, cash-value items, etc.

Yes, certain organizations received more than $5,000

Yes, but no single organization received over $5,000

Did the organization make total grants or assistance to individuals in the United States through the use of programs in excess of $5,000 per program in the tax year?

Yes

Does the organization maintain records to substantiate the amounts of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?

Yes

Please describe the organization's process for monitoring the use of grant funds or non-cash assistance. Explain methods used, such as confirming eligibility, follow-up reporting, etc.

Does the organization's board of directors (or a subset of the board) approve all grants and assistance requests?

Yes

Lobbying & Political Activity

Did your organization engage in lobbying activities?

Lobbying/ Lobbying Activities: All activities intended to influence foreign, national, state, or local legislation. Such activities include direct lobbying and grassroots lobbying (attempting to influence legislation by influencing the general public).

Yes

If yes, has the organization made an election under Section 501(h)?

Yes

Not sure

If the organization collects membership dues, does it provide an annual disclosure stating the portion of those dues that are non-deductible as an allocation of lobbying expenditures?

Yes

If yes, what amount was disclosed to members as non-deductible for this tax year? (percent of dues or dollar amount)

Did your organization engage in political campaign activities?

Political campaign activities: All activities that support or oppose candidates for elective federal, state, or local public office. It does not matter whether the candidate is elected. A candidate is one who offers himself or is proposed by others for the public office. Political campaign activity does NOT include any activity to encourage participation in the electoral process, such as voter registration or voter education, provided that the activity does not directly or indirectly support or oppose any candidate.

Yes

Foreign Issues

At any time during the year, did the organization have an interest in, or have signature authority over, a financial account in a foreign country?

Yes

If yes, what countries and what level of signature authority?

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business ,and program service activities outside of the United States? Check all that apply.

Fundraising activities

Program service activities

Investments

Grantmaking

Did the organization grant more than $5,000 to entities or individuals outside of the United States?

Yes

Miscellaneous Questions

Does the organization manage any Donor Advised Funds?

Donor Advised Fund: A fund that has all of the following characteristics: It is seperately identified by reference to contributions of a donor or donors, it is owned and controlled by sponsoring organizations, the donor or donor advisor has or reasonably expects to have advisory privileges in the distribution or investment of amounts held in the donor advised funds or accounts because of the donor's status as a donor.

Yes

Did the organization receive or hold a conservation easement, including an easement to preserve open lands, historic lands, or historical structures?

Conservation Easement: A restriction on the use that may be made of, or changes made to, real property that is granted in perpetuity to a qualified organization exclusively for conservation purposes. Conservation purposes include protection of natural habitat, the preservation of open space; or the preservation of property for historic, educational, or recreational purposes. Qualified organizations include governmental units and certain tax-exempt organizations described in Section 501(c )(3) that have a commitment to protect the conservation purposes of the easement and the resources to enforce the restrictions.

Yes

Did the organization hold assets in term, permanent, or quasi-endowments?

Quasi-endowment: Funds functioning as an endowment that are established by the organization itself, either from donor or institutional funds, and which must retain the purpose and intent as specified by the donor or source of the original funds.

Yes

Did the organization hold or receive works of art, historical treasures, or other similar valuable assets?

Works of art: Includes paintings, sculptures, prints, drawings, ceramics, antiques, decorative arts, textiles, carpets, silver, photography, film, video, installation and multimedia arts, rare books and manuscripts, historical memorabilia, and other similar objects.

Yes

Did the organization provide credit counseling, debt-management, credit repair, or debt negotiation assets?

Credit counseling services: Include the providing of information to the general public on budgeting, personal finance, and saving and spending practices, or assisting individuals and families with financial problems by providing them with counseling.

Yes

Did the organization receive non-cash contributions in excess of $25,000 for the year?

Non-cash Contributions: Contributions of property, tangible or intangible, other than money. Non-cash contributions include, but are not limited to, stocks, bonds, and other securities; real estate; works of art; stamps, coins or other collectibles; clothing and household goods; vehicles, boats, airplanes; inventories of food, medical equipment or supplies, books, or seeds; intellectual property, including patents, trademarks, copyrights, and trade secrets; donated items that are sold immediately after donation, such as publicly traded stock or used cars; and items donated for sale at a charity auction. Non-cash contributions to NOT include volunteer services performed for the reporting organization or use of facilities.

Yes

Did the organization liquidate, terminate, or dissolve and cease operations during the year?

Yes

Did the organization sell or dispose of more than 25% of its net assets or undergo a substantial contraction in the tax year?

(Not considering turnover of publicly-traded securities.)

Yes

Did the organization make any transfers to non-charitable organizations? This includes tax-exempt organizations that are not considered charities.

Yes

Did the organization delegate its usual management duties to a management company or other person who was not an employee during the year?

Yes

Did the organization become aware of a material diversion of its assets during the year?

Material diversion: Includes any unauthorized conversion or use of the organization's assets other than for the organization's authorized purposes, including but not limited to, embezzlement or theft. A diversion of assets does NOT include an authorized transfer of assets for fair market value consideration. For this purpose, a diversion is considered material if the gross dollar amount exceeds the lesser of (1) $250,000, or (2) 5% of the lesser of the organization's gross receipts for its tax year, or total assets as of the end of the tax year.

Yes

Did the organization, during the tax year, receive any funds used to pay premiums, directly or indirectly, on a personal benefit contract?

Personal benefit contract: Generally any life insurance, annuity, or endowment contract that benefits, directly or indirectly, the transferor, a member of the transferor's family, or any other person designated by the transferor. In other words, did the organization receive funds by a donor with the understanding that the charity will use the funds received to pay premiums on a policy that benefits both the charity and the donor's heirs.

Yes

Was the organization a party to a prohibited tax shelter transaction during the year?

Prohibited tax shelter transaction: Any listed transaction, within the meaning of Section 6707A(c )(2), and any prohibited reportable transaction. A prohibited reportable transaction is a confidential transaction within the meaning of Regulation Section 1.6011-4(b)(3), and a transaction with a contractual protection within the meaning of Regulation Section 1.6011-4(b)(4).

Yes

Did the organization invest in, or participate in, a joint venture or similar arrangement with a taxable entity during the year?

Yes

Did the organization receive payments for indoor tanning services during the year?

Yes

Tax 990 Questionnaire

General Information

Mission & Programs

Policy Questions

Board of Directors Questions

Compensation Questions

Reportable Transactions

Fundraising

Grantmaking & Assistance

Lobbying & Political Activity

Foreign Issues

Miscellaneous Questions

ASHEVILLE

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