IIAYASHI & WAYLAND, CPA'S 1188 PADRE DRIVE, SUITE 101 ...
Transcript of IIAYASHI & WAYLAND, CPA'S 1188 PADRE DRIVE, SUITE 101 ...
CLIENT 753670
IIAYASHI & WAYLAND, CPA'S 1188 PADRE DRIVE, SUITE 101
SALINAS, CA 93901 831-759-6300
November 8,2012
MEALS ON WHEELS OF THE SALINAS VALLEY 40 Clark Street, Suite C Salinas, CA 93901-4713
Dear Gordon:
Your 2011 Federal Return of Organization Exempt from Income Tax will be electronically filed with the Internal Revenue Service upon receipt of a signed Form 8879-EO - IRS e-file Sigtiaturc Authorization. This form is due back in our office as soon as possible, but no later than November 15, 2012 No tax is payable with the filing of this return
Enclosed is your 2011 California Exempt Orgamzation Annual Information Return. The original should be signed at the bottom of page one. No tax is payable with the filing of this return. Mail
-- the California return on or before November 15,2012 to
FRANCHISE TAX BOARD P.O. BOX 942857
SACRAMENTO, CA 94257-Q700
Enclosed is your California Registration/Renewal Fee Report to the Attorney General. The ongmal should be signed at the bottom of page one. A copy of your Federal Return of Organization Exempt from Income Tax should be signed and enclosed with your California Registration/Renewal Fee Report. There is a fee due of $75 payable by November 15,2012 Make the check or money order payable to "Department of
Justice and mail your Califorma
report on or before November 15, 2012 to
REGISTRY OF CHARITABLE TRUSTS P0. BOX 903447
SACRAMENTO, CA 94203-4470
Please be sure to call us if you have any questions.
Sincerel
Mike Nolan Certified Public Accountant
IRS e-file Signature Authorization Form 8879E0 I for an Exempt Organization
For calendar year I. or i cai year bg,nning - 1/01 - 2011 an ending 6 LP_ - 2P 2?_ Department of ( Treosu Do not send to the IRS. Keep for your records. Internal Revenue Service I See instructions.
0MB No 1545-Isle
2011
GORDON A. RtJBBO PRESIDENT IPart I I Type of Return and Return Information hoIe Dollars Only)
Check the box for the return for which you are using thts Form 8879-EO and enter the applicable amount, if any, from the return If you check the box on line la 2a, 3a, 4a, or Se, below, and the amount on that line for the return being filed wrth this forni was blank, then leave line lb, 2b, 3b, 4b, or 5b whichever is applicable, blank (do not enter -0-) But, if you entered -0- on the return, then enter -0- on the applicable line below Do not complete more than 1 line in Part I
1 a Form 990 check here b Total revenue, if any (Form 990, Part VIII, column (A) line 12) lb 894,916. 2a Form 990-EZ check here • b Total revenue, if any (Form 990-EZ, line 9) 2b ____________________ 3a Form 1 120-POL check here b Total tax (Form 1 12C-POL, line 22) 3b ____________________ 4a Form 9O-PF check here • b Tax basod on investment income (Form 990-PF Part VI, line 5) 4 b ____________________ Sa Form 8868 check here b Balance Due (Form 8868, Part I, line 3 or Part II, line So) Sb ____________________
Ipart ii I Declaration and Signature Authorization of Officer Under penalties of perjury, I declare that I am an officer of the above organization and that I have examined a copy of the organizations 2011 electronic return and accompanying schedules and statements and to the best of my knowledge and belief, they are true, correct, and complete I further declare that he amount in Part L above is the amount shown on the copy of the organizations 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 at receipt or reason for rejection of the transmission, (b) the reason for any delay in processing the return or refund, and (c) the date of any refund If applicable, I authorize the U S Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (direct debit) entry to the financial institution account indicated in the tax preparation software foi payment of the organizations federal taxes owed on this return, and the financial institution to debit the entry to this account To revoke a payment, must contact the U S Treasury Financial Agent at 1 -888-353-4537 no later than 2 business days prior to the payment (settlement) date I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment I have selected a personal identification number (PIN) as my signature for the organization's electronic return and, if applicable, the organization's consent to electronic funds withdrawal
Officers PIN: check one box only _______________________ I authorize }IAYASHI & WAYLAND, CPA' S to enter my PIN I 75367 las my signature
ERO 'm u nemo Fnlertve numbers, but do fbi ei,t,r 0 zeros
on the organiza tLons tax year 201' electronically filed return Ill have indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program. I also authorize the aforementioned ERO to enter my PIN on the return's disclosure consent screen
[Ps an officer of the organization I will enter my PIN as my sinature on the organization's tax year 2011 electronically filed return III have indicated within this return that a copy of the return is being tiled with a state agency(ies) regulating charities as part of the IRS Fed/State program, I will enter my PIN on the return's disclosure consent screen
Otlicers signaiurc Date
Part Ill Certification and Authentication
EROs EFIN!PIN. Enter your siy -digit electronic tiling identification number (EFIN) followed by your five-digit self-selected PIN I 77154556135 I
do not ether au zeros
I certify that the above numeric entry is my PIN. which is my signature an the 2011 electronically filed return for the organization indicated above I confirm that I am submitting this return in accordance with the requirements of Pub 4163, Modernized e-Fi!e (MeF) Information for Authorized IRS elite Providers for Business Returns
signature /t.(&.0 Date // //'zo / 2__ ERO Must Retain This Form - See Instructions
Do Not Submit This Form To the IRS Unless Requested To Do So
BAA For Papenvork Reduction Act Notice, see instructions. Form 8879-EO (2011)
TEA740lL 12/01/Il
0MB No 15450047
2011
! fllpejtion -1
2012 Enipoyer idcutilic.tion Number
Form 990
Deprfmenf of the Treasury Inlernat Revonujo Service
A rorthe2oll calmi B Check 'I applicable
IAddress change Name charlge irlitLal return Termina red Amended relurn Applicetiori pending
I Tag-exempt status J Website: •
Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(aXl) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
• The organization may have to use a copy of this return to satisfy state repertin requirements
EALS ON WHEELS OF THE SALINAS VALLEY 40 CLAH< srREET, SUITE C SALINAS, CA 93901-4713
Name end aress or pripic,pal office, is this a group return for affiliales' ye X No
Are all affiiiates irciuded ys No 'NO; atlacir a list (see inskiictions)
1 Briefly describe the organizations mission or most significant activities NO SENIOR SHOULD GD HUNGRY.
fl iDE V P CWNG SQLUI1flR P3i fl BTJL4ND JCcBEfli _QF_ EEDPLE 2UQ EL BQP QUD - £LflEBLL DR JDI SJSL Eli ND BELP_ DIEFi EENAUt JII_tHEILBOM& 1WJ1
AfliTM& 1liEILThDEEENDENCE ____________________________ 2 Check this box - H if the organization discontinued its operations or disposed of more than 25% ot its net assets 3 Number of voting members of the governing body (Part VI, line a) 3 14 4 Number of independent voting members at the governing body (Part VI, line 1 b) 4 U
Total number of individuals employed in calendar year 2011 (Fart V, line 2a) 5 6 6 Total number of volunteers (estimate if necessary) 6 125 7a Total unrelated business revenue from Part VIII, column (C), line 12 7a 0
Net unrelated business taxable income from Form 990-f Line 34 7b 0
8 Contributions and grants (Part VIII line 1 h) 9 Program service revenue (Part VIII, line 2g)
10 Investment income (Part VIII, column (A), lines a, 4, and 7d) 11 Other revenue (Part VIII, column (A), lines 5, Sd, Sc! 9c, 1 Oc, and lie) 12 Total revenue - add lines S through ii (must equal Part VIII, column (A). line 12) 13 Grants and sLmilar amounts paid (Part IX. column (A), lines 1-3) 14 Benefits paid to or for members (Part IX, column (A), line 4) 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
I 16a Protessional fundraising fees (Part IX, column (A), line lie)
b Total lundraising expenses (Part IX. column CD), line 25) • 75, 576.
17 Other expenses (Part IX, column (A). lines 1 la-lid, 1 lf-24e) 18 Total expenses Add lines 13-17 (must equal Part IX, column (A), li ne 25)
20 Total assets (Part X, line 16) 21 Total liabilities (Part X, line 26)
22 Net assets or fund balances Si
Under penait'es ci peflury. i decLIne Flat i haiie xanhined this return, including accompanying scheduies arili statenierits. and to the best of my knowledge ond behe?. it is irLie. correrl, and complete Declaration of preparer (other than onicer is bztsed on au iniormaiLon of which preparer has any knowledge
Sign biQnatore 01
Here GORDON A. RUBBO PRESIDENT Type or prifli namo IId tifie
I Date I Check flit I Paid MIKE NOLAN
Prinlrrhe preparer's name
seifempioyed I P00930869
Preparer rirmsname HAYASHI & WAY D, CPAS Use Only ffirmsaddress 1188 PADRE DRI, SUITE 101 1FLrmSEiN 20-1939256
0 C w E C 0 0
S C
S C
C
364.
May the IRS discuss this return with the preparer shown above' (see nstructlDns) IAI Yes I I I O
BAA ror Paperwork Reduction Act Notice see the separate instructions. TEEAO113L oensil Form 990 (2011)
Forrr99Q(2011) MEALS ON WHEELS CF THE SALINAS VALLEY 77-0064507 Fage2
I Part Ill I Statement of Program Service Accomplishments Check ii Schedule 0 contains a response Ia any question in this Par! III ri
1 Briefly describe the organizations mission NO SENIOR SHOULD GO HUNGRY. NUTRITIOUS MEALS, WHICH ARE DELIVERED BY CARING VOLUNTEERS, IMPROVE THE HE&LjB_AJp_W & -
pnNp_F_nQPL;2Jliq CR DISABLED AND HELP THEM RENAIN IN THEIR HOMES AND MAINTAIN THEIR INDEPENDENCE.
2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 Or 990-EZ' Yes No If 'Yes, describe these new services on Schedule 0
3 Did the organization cease conducling, or make significant changes in how it conducts, any program Yes No If Yes,' describe these changes on Schedule 0
4 Describe the organization's program service accomp'ishments for each of its three largest program serdices, as measured by expenses Section 501 (c)(3) and 501 (c)(4) organizations and section 4947(aXl) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, Jar each program service reported
4a (Code __________ ) (Expenses S 612, 035. including grants of $___________________) (Revenue $ 304,032. TO DELIVER NUTRITIOUS MEALS TO THE HOMES OF ELDERLY AND DISABLED PERSONS THROUGHOUT SALINAS VALLEY WHO CAN'T SHOP CR COOK FOR THEMSELVES. 98,498 MEALS WERE SERVED THIS YEAR.
db (Code __________) (Expenses $ __________________ including grants of $ ) @evenue $__________________
4c (Code __________ ) (Expenses $__________________ including grants of $___________________) (Revenue S__________________
4d Other program services (Describe in Schedule 0 (Expenses $ including grants of $ (Revenue $
4e Total program service expenses • 612,035. BAA TEEAo1Ot 071051'1 Form 990 (2011)
WHEELS OF THE
1 Is the organization described in section 5D1(c)(3) or 4947(a)(l) (other than a private foundation)
if 'Yes, complete Schedule A
2 Is the organization required to complete Sched&e B, Schedule of Contributors (see instructions)'
3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office' If Yes, 'comp/ete Schedule C, Part I
4 Section 5O1(cX3) organizations Did the organization engage in Lobbying activities, or have a section 501(h) election in effect during the tax year If
Yes complete Schedule C, Part/I
5 Is the organization a section 501 (c)(4), 501 (c)(5) or 501 (c)(6) organization that receives membership dues. assessments, or similar amounts as defined in Revenue Procedure 9819' /1 'Yes, 'complete Schedule C, Part III
6 Did the organization maintain any donor advised funds or any similar tunds or accounts for which donors have the riçbt to provide advice on the distribution or investment of amounts in such funds or If 'Yes,' complete Schedule L', Part I
7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas or historic If Yes, 'complete Schedule 0, Part U
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets' if Yes, complete Schedule D, Part (U
9 Did the organization report an amount in Part X, line 21, serve as a custodian br amounts not listed in Part X, or provide credit counseling, debt management, credit repair, or debt negotiation If Yes, complete Schedule 0, Part/V
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or
quasi.endowments If 'Yes, complete Schedule 0, Part V
11 If the organizations
answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable
a Did the organization report an amount for land, buildings and equipment in Part K li ne 10' If 'Yes, complete Schedule D, Part VI
b Did the organization report an amount for investments— other securities in Fart K, line 12 that is 5% or more of its total assets reported in Part K line 16' It 'Yes,' complete Schedule 11', Part VU
Did the organization report an amount for investments— program related in Pad X, line 13 that isb% or more of its total assets reported in Part K, line 16' If Yes,'complete ScheduleD, Part VIII
d Did the organization report an amount for other assets in Fart X, line 15 that is 5% or more of its total assets reported in Part X, line 16' If Yes,' complete Schedule 0, Part IX
e Did the organization report an amount for other liabilities in Part X, line 25
If Yes cornpfete Schedule 0, Part X
I Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organizations liability for uncertain tax positions under FIN 42 (ASC
74Q) It Yes,' complete ScheduleD, Part X
12a Did the organization obtain separate, independent audited financial statements for the tax year
If 'Yes, 'complete Schedufe 0, Parts XI, XII, aS XIII
b Was the organization included in consolidated, independent audited financial statements for the tax year' If Yes and it the organization answered 'No' to line 12a, then completing Schedule 0, Pails XI, XII, and XII! s cptiona(
13 Is the organization a school described in section I 7O(bXl )(A)(ii)' If 'Yes, complete Schedule £
14a Did the organization maintain an office, employees. or agents outside of the United States'
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $ioa,oao or nore If Yes, complete Schedule F, Parts land IV
15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United Slates' if Yes, ' complete Schedule F, Parts II and IV
16 Did the organization report on Part IX, column (A), line 3, more than $5000 of aggregate grants or assistance to individuals located outside the United States' /t Yes, 'complete Schedule F, ParIs Ill and IV
17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and lie' If Yes.' complete Schedule G, Part I (see nstruchons)
18 Did the organization report more than $15,000 total ot fijndraising event gross income and contributions on Part VIII, li nes 1 c and 8a' If Yes, complete Schedule G, Part II
19 Did the orqanization report more than $15,000 of gross income from gaming activities on Part VIII, line It Yes,' complete Schedule G, Pan 11,
20 aDid the organization operate one or more hospital facilities' if Yes. 'complete Schedule H
bIt 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this ret u rn
1tEAOI OZL i23I12 Eorm 990 (2011)
No
990
21 Did the organization report more than $5000 of grants and other assistance to governments and organizations in the United States on Fart IX, column (A), line 1' If 'Ys,'complete Schedule!, Parts land/f
22 Did the organization report more than $5,D00 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2' If Yes, complete Schedule I, Pans land//I
23 Did the organization answer 'Yes to Part VU, Section A, line 3, 4, or 5 about compenstion of the organization's current and lormer officers, directors, trustees, key employees, and highest compensated employees If 'Yes, complete Schedule J
24a Did the organization have a tax-exempt bond issue with an outstanding principal amount at more than $100000 as of the last day of the year. and that was issued after December 31, 20C2' If Yes, answer lines 24b through 24d and complete Schedule K If No, jo to line 25
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception'
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds'
d Did the organization act as an on
behalf of issuer for bonds outstanding at any time during the year
25a Section S01(cX3) and
5O1(cX4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the
year If Yes, complete Schedule 1, Part!
b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year. and that the transaction has not been reported on any of the organizations prior Forms 990 or 990-EZ' If 'Yes,' complete Schedule I., Part /
26 Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or drsqualilied person outstanding as of the end of the organizations tax year' if Yes, complete Schedule L, Part!!
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or Jamily member of any of these
persons It 'Yes,' complete Schedule L, Part!!!
2$ Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions)
a A current or former officer, director, trustee, or key employee' If 'Yes, complete Schedule L, Part IV
b A family member of a current or former officer, director, trustee, or key employee' If Yes, complete Schedule L, Part IV
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereofl was an officer, director, trustee, or direct or indirect owner' If Yes'conpIete Schedule L, Part IV
29 Did the organization receive more than $25,000 in non-cash contributions' If 'Yes,' complete Schedule Al
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation If 'Yes, complete Schedule M
31 Did the organization liquidate, terminate, or dissolve and cease operations' If 'Yes,' complete Schedule N, Patti
32 Did the organization sell, exchange, dispose at, or transfer more than 25% of its net assets 7 If 'Yes, complete Schedule N, Part /1
33 Did the organization own 100% of an entity disregarded as separate from the organizatFon under Regulations sections 301 7701-2 and 301 7701 -3' ff 'Yes,' complete ScheduleR, Pad I
34 Was the organization related to any tax-exempt or taxable entity
If 'Yes, complete Schedule R, Parts II, III, IV, and V, fine
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)
b Did the orQanization receive any payment from or engage in any transaction with a controlled entity within he meaning of section 51 2(bXl 3)' If Yes,' complete Schedule P. Part V, 'ne 2
36 Section 5D1(cX3) organizations. Did the orçanization make any transfers to an exempt non-charitable related organization' if 'Yes,' complete Schedule IR, Part V. line 2
37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that i treated as a partnership for federal income tax
purpose5 If 'Yes,'complete Schedule R, Part VI
38 Did the orgaruzation complete Schedule Oand provide explanations in Schedule 0 for Part VI, lines Ii and 19'
Form 990 (2011)
TEEAO1O4L 07105/11
Form 990 (2011) MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page 5 IPt Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule 0 contains a response to any question in this Part V FT
1 a Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable b Enter the number of Forms W-2G included in line la Enter -0- if not applicable
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners'
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State-ments. tiled for the calendar year ending with or within the year covered by this return 2a
bIt at least one is reported on line 2a, did the organization file all required federal employment tax returns 7
Note. If the sum of lines I a and 2a is greater than 250, you may be required to e-frle (see instructions) 3a Did the organization have unrelated business gross income of $1,000 or more during the yea r
bIt Yes
has it filed a Form 990-T for this year
If No, 'provide an explanation fl Schedule U
4a At any time durinQ the calendar year. did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)'
bIt Yes
enter the name of the foreign country _____________________________________________________________ See instructions for filing requirements for Form it F 9022 1, Report of Foreign Bank and Financial Accounts
Sa Was the organization a party to a prohibited tax shelter transaction at any time during the tax year
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction' If !Yes to line Sa or Sb, did the organization tile Form
Ga Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible'
b If y95
did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible'
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor'
b If !Yes
did the organization noti the donor of the value of the goods or services provided' Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282'
d If Yes, indicate the number of Forms 6282 bled during the year I 7dI Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit
I Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract' g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899
as required
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C'
8 Sponsoring organizations maintaining donor advIsed funds and section 509(aX3) supporting organizations. Did the LL E supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year' S - -
9 Sponsoring organizations maintaining donor advised tunds. a Did the organization make any taxable distributons under section 4956 Sa - - b Did the organization make a distribution to a donor, donor advisor, or related person' Sb -
10 Section 501(cX7) organizations. Enter a Initiation lees and capital contributions included on Part VIII, line 12 b a b Gross receipts, included on Form 99D, Part VIII, line 12, for public use ol club facilities lOb
11 Section S01(cXl2) organizations. Enter a Gross income from members or shareholders 11 a
b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them ) 11 b _) _.
12a Section 4947(aXl) non-exempt chantable trusts. Is the organization tiling Form 990 in lieu of Form 14J 12a - - b If "ics, enter the amount of tax-exempt interest received or accrued during Ihe year I 12b1
13 Section 501(cX29) qualified nonprofit health insurance issuers. - - a Is the organization licensed to issue qualified health plans in more than one 13a
Note. See the instructions for additional information the organization must report on Schedule 0 b Enter the amount of reserves the organization is required to maintain by the states in -
which the organization is licensed to issue qualified health plans 13b Enter the amount of reserves on hand 13c - -
14a Did the organization receive any payments for indoor tanning services during the tax yea r 14a - X
TEEAO1O5i 07/O&fl Form 990 (2011)
Form 990 (2011) MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507
Governance, Management and Disclosure For each 'Yes' response to lines 2 through 7b below, and for a No response to line Ba, Sb, or JOb below, describe the circumstances, processes, or changes in Schedule 0. See instructions.
1 a Enter the number ot voting members of the governing body at the end of the tax year 1 a 1 If there are material differences in voting rights among members of the governing body, or the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule 0
b Enter the number of voting members included in line la, above, who are independent lb 1
2 Did any officer, director trustee, or key employee have a family relationship or a business relationship with any other oftcer, director, trustee or key employee'
3 Did the organization delegate control over management duties customarily performed by or under the direci supervision of officers, directors or trustees. or key employees to a management company or other per5on
4 Did the organization make any significant changes to its governing documents since the prior Forni 990 was
S Did the organization become aware during the year of a significant diversion of the organizations S 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 bod y
b Are any governance decisions of the organization reserved to (or sublect to approval by) members, stockholders, or other persons other than the governing body
B Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following
a The governing body' bEach committee with authority to act on behoff ot the governing body'
9 Is there any officer, director or trustee, or key employee listed in Part VII, Section A, who cannot be reached at the omnanl7atinns mailino address' if 'Yes. nrnvide the names amd addresses In Schedule 0
b a Did the organization have local chapters, branches, or
b If did the organization have written pohcies and proc ures governing the activities of such chapters, afIiIiate, and brancha to ensule their operations are consistent wiTh the organizaJons exempt purposes'
11 a Has The organization provided a complete copy of this Form 9 to all members of its governing body before tiling the b Describe in Schedule C the process, if any, used by the organization to review this Form 990 SEE SCHEDULE
12a Did the organization have a written conflict of interest policy' If No,!
go to ,ne 73 b Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise
to
Did the organization regularly and consistently monitor and enlorce compliance with the poEicy
if 'Yes, 'describe In Schedvie 0 how this is done SEE SCHEDULE U
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 compensation of the fotlowing persons include a review and approval by independent persons, coniparability data! and contemporaneous substantiation of the deliberation and
a The organizations
CEO, Executive Director, or top management official SEE SCHEDULE 0 b Other officers of key employees of the organization SEE SCHEDULE 0
f Yes to line 15a or 15b, describe the process in Schedule C (See instructions)
l6a Did the organization invest in, contribute assets to, or pariLcipate in a joint venture or similar arrangement with a taxable entity during the yea r
b If !Yes ! did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard The
17 ListthestateswithwhichacopyofthisForm99Oisrequiredtobefiled
18 Section 6104 requires an organization to make its Forms W23 (or 1024 if applicabte), 990, and 990-T (501(c)(3)s only) available br public inspection Indicate how you make these available Check all that apply
Own website El Another's website Upon request
19 Describe in Schiule 0 whethei (and so, low) the organization makes its governing documents, conflict of interest policy, and financial statements vai lable to the public during The tax year SEE SCHEDULE 0
20 State the name, physical address, and telephone number ot the person who possesses the books and records of the organization BUSINESS OFFICE 40 CLARK STREET, SUITE C SALINAS CA 93901 831-758-6325
BAA 'WEAOI 05L 01(23/12 Form 990 (2011)
Form
Check Schedule 0 contains a response to any question in this Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1 a Complete this table for all persons required to be listed Report compensation for the calendar year ending with Or wLthin the organizations tax year
• List all of the organizations current officers directors, trustees (whether individuals or organizations), regardless of amount of compensation Enter -0- in columns CD), CE), and (F5 if no compensation was paid
• List all of the organizations current key employees, if any See instructions for definition of key employee • List the organizations live current highest compensated employees (other than an officer, director, trustee, or key employee) who
received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations
• List all of the organizations lomier officers, key employees, and highest compensated employees who received more than $100000 of reportable compensation from the organization and any related organizations
• List all at the organizations fomier directors orirustees that received, in the capacity as a former director or trustee of the organization, more than $10000 of reportable compensation from the organization and any related organizations List persons in the following order individual trustees or directors, institutional trustees, officers, key employees, highest compensated employees, and former such persons
(A) I (B) ((10 noi check more than one box. (0) I (E) I Name and title I Average uniess person both n officer Reportabie I Re0rtabie I Estimaled
describe r 5 0 I " (W 2fiOS Misc) W 211090-MiSC) I from the I hours and a direcior/trustee) compensetion tram compensation from I amount of other
per week — — — — — the oraruzation reieted organizatiors I compensation iours or a - organization related a -
r' and related organize
Lons ri 0
Sciieduie - oroanizations
0)
_cm 9_ IQL1 _____ DIRECTOR 1 X -- 0. 0. 0.
JL VICE PRESIDENT 1 X X 0. 0. 0.
--------------- PRESIDENT 1 X X 0. 0. 0.
— ( . T SALTAY -
SECRETARY 1 X X - 0. 0. 0. ®CARYGERBRANDT ----
DIRECTOR 1 K — 0. 3. 0,
------ - DIRECTOR 1 K - 0. 0. 0,
DIRECTOR
DIRECTOR
TREASURER
112L I Q .—$!Th DIRECTOR
a P&_ DES ROCHES — - - DIRECTOR
j14) JA}E RUSSO
BAA TEEADIO7L 07106/il Form 990 (2011)
(C) Position
(A) (B) (do not check more than one Name and title Acerage box, unless person is both ar
hours officer arid a director/trustee) per
week I11'1H' (clescrib a I - I Feal ,, e hoLs UI or
relaleti r I 'c1 21 oranI
ml 'i zations In i'i I I
(D) (E) (I') Reporlabie Reportable Eslimated
comperisation from compensation [Tom amount of other be organization r&ated organizations compensation
CN 211099 MISC) CM fl1099 MISC) tram the oroanalion and raIaed
organizations
EXECUTIVE DIREC
(16)
(17)
ji)
112) ______________ j2)
121)
in)
i2!)
(24)
c)------------------------- ibsub-total 97,134. 0. 1/,a59,
Total trom continuation sheets to Part VII, Section A 0. 0. 0.
dTotal(addlineslbandlc) • 97,134, 0. 17,359. 2 Total number of individuals (including but not limited to those listed above) who received mare than $100,000 of repartabre compensation
from the organization 0 - -
Yes 110
3 Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1 a' ff 'Yes, compete Schedule J for such endivduaI - X
4 For any individual listed on line la, is the sum oi reportable compensation and other compensation from I ' - the organization and related organizations greater than $15ODQO If Yes' complete Schedule J for such nthv,dual 4 - x Did any person listed on line Ia receive or accrue compensation from any unrelated organization or individual - -
(A) Name and business address
(C) Description ot services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who received more than
$100,000 in compensation from the organization 1
BAA TEEAO1OSL 011%'" Form 999 (2011)
(A) (B) (C) (D) Total revenue Related or Unrelated evenue
exempt business excluded from tax function revenue under sections
1 a Federated campaigns la b Membership dues lb ____________ C Fundraising evenis le 3, 9 d Related organizations ld e Guverment raflts (conThbuions) le
f All oilier contribujons. gifts, 9rans, and si milar amount3 not included abcve 11 573, 7
g Noncash oontribflons included Ins I If $ 1 . 9
Business Code 2a TITLE III - MEAL REIMBURS
b NSIP - MEAL REIMBURSEMENT TITLE III - ONE-TIME ONLY
d e
All other program service revenue
3 Investment ncome (includEng dividends, interest and other similar amounts)
4 Income from investment of tax-exempt bond proceeds 5 RoyaLties _____________ ___________
(0 Aeai (H) Persanai 6a Gross rents.
b Less rental expenses _____________ ___________ Rental income or (loss) ____________________ _________________
d Net rental income or (loss) ___________ (0 sec r ities (ii) Other 7 a Gross amount tram sales of
assets other than inventory ____________________ _________________ b Less cost or other basis
and sales expenses ____________________ 5. 0 9 Gain or (loss) _____________ -5, 09
d Net gain or (loss) ____________
Ba Gross income from fundratsing events (not including $ 3 995. of contributions reported on line ic) See Fart IV, line 18 a Less direct expenses ____________ Net income or (loss) from fundraising events
9a Gross income from gaming activities See Fart LV, line 19 a 12, 14(
bLess direct expenses b 71 Net income or (loss) 1mm gaming activities
b a Gross sales of inventory, less returns arid allowances a
b Less cost of goods sold b ______________ Net income or (loss) from sales of inventory
M'sceiianeous Revenue Business Code 11 a _____________
b _____________ C _________________ d All other revenue _____________
Total. Add lines ha-lid
T 1, - 4. - :s_' -{± '1 _a . - L ___________ __________
! - -- .- - .; : .' C-; - - - b-
-
BAA TEEAO1 09i 07/06(1' Form 999 (201')
Section 5O (c)(3) and 5O (c)(4) organizations must complete alt columns 411 other organ,zaf:ons must complete column (A) but are not required to complete columns (B), (C), and
Check if Schedule U contains a resoonse to any auestion in this Part IX (A) I
2o not include amounts reported on lines Total expenses Program service I Management and h, 7k, Sb Sb. and lOb of Part VIII. ____________________ expenses I general expenseE
1 Grants and other assistance to uovernments I and organizations in the United states See iEI__ Part IV; line 21 I __________
2 Grants and other assistance to individuals in I _________________ the United States See Fart IV, line 22 __________________ I
3 Grants and other assistance to governments, I organizations, and individuals outside the United States See Part IV, lines 15 and 15 __________________ I
4 Benefits paid to or for members ___________________ ____________________________________ Compensation of current officers, directors, trustees, and key employees 119,477. 47,791. 23, 89
6 Compensation not included above, to disqualified persons (as defined under section 4958(00)) and persons described in section 4958(c)(3)(B) 0 0 ________________
7 Other salanes and wages 148, 604. 135,314. 948 8 Pension plan accruals and contributions
(include section 401(k) and section 403(b) employer contributions) ___________________ ___________________ ________________
9 Other employee benefits 18,774. 16, 982. 1,00 1Q Payrolltaxes 22,709. 16,477. 2,63 11 Fees for services (non-employees)
a Management ___________________ ___________________ ________________ bLegal _____________________ _____________________ __________________ cAccounting 20,843. 2,084. 18,75 d Lobbying ___________________ ___________________ ________________
Professional tundraising sen,ices See Part iV, line I] _____________________ Investment management fees ___________________ ___________________ ________________
gOtber 477. 1. 47 12 Advertising and promotion 13,249. 13,249. ________________ 13 Officeexpenses 29,697. 16,244. 6,51 14 Information technology 25,901. 16, 836. 3.88 15 Royalties ___________________ ___________________ ________________ 16 Occupancy 32,790. 21,314. 5,57 17 Travet 12,972. 12,798. 17 18 Payments of ftavel or entertainment
expenses for any federal, state, or local public officials ____________________ _____________________ __________________
19 Conferences, conventions, and meetings 3,456. 2,221 29 20 Interest ____________________ _____________________ __________________ 21 Payments to afiLliates __________________ ___________________ ________________ 22 Depreciation, depletion, and amortization 12,345. 6, 173. 6, 17 23 Insurance 4,161. 2,913. 1,24 24 Other expenses Itemize expenses not *tk •7
covered above (List miscellaneous expenses in line 24e It line 24e amount exceeds 10% _'list of line 25. column (A amounL list line 24e expenses on Schedule C __________________ ___________________ ________________
a FOOD PURCHASES -. 292,779. 292,779. ___________ LOSS ON DISPOSAL OF PROPERTY 5,097. 5,097. _________
- 3.679. 3,679. __________ dMISCELLANEOIJS - 1,267. ___________ 63
All other expenses 87. 83. ________________ 25 Total functional expenses Add lines 1 Through 24s 768, 364 . 612, 035. 80, 75 26 Joint costs. Complete this line only it
the organization reported in coLumn (B) joint costs from a combined educational campaign and tundraising solicitation Check here if Jollowing
BAA Form 990 (2011)
WEAOI I Or O1i2I12
(A) (B) Beginning of year End of year
1 Cash - non-interest-bearing 2 Savings and temporary cash investments 3 Pledges and grants receivable, net 4 Accounts receivable, net
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees Complete Fart II of Schedule
6 Receivables from other disqualified persons (as defined under section 4958(0(1)), persons described in section 4958(c)(3XB), and contributing employers and sponsoring organizations at section 5D1(c)(9) voluntary employees beneticiary
A organizations (see instructions)
7 Notes and Loans receivable) net B Inventories for sale or use 9 Prepaid expenses and deterred charges
b a Land, buildings, and equipment castor other basis Complete Part VI of Schedule D
b Less accumulated depreciatioR 11 Investments - publicly traded securities 12 Investments - other securities See Part IV, line 11 13 Investments— program-related See Part IV! line 1 14 Intangible assets 15 Other assets See Part IV! line 11
17 Accounts payable and accrued expenses 1 B Grants payable 19 Deterred revenue 20 Tax-exempt bond liabilities 21 Escrow or custodial account liability Complete Part IV of Schedule 0 22 Payables to current and former officers, directors, trustees ! key employees,
highest compensated employees, and disqualified persons Complete Part II of Schedule
23 Secured mortgages and notes payable to unrelated third parties 24 Unsecured notes and loans payable to unrelated third parties 25 Other liabilities (including federal income tax, payahles to related third parties !
and other liabilities not included on lines 17-24) Complete Part X of Schedule D
112.827.
Organizations that follow SEAS 117, check here and complete lines -i - J '
27 through 29 and lines 33 and 34. - 27 Unrestricted net assets - 88 28 Temporarily restricted net assets ____________ 29 Permanently restricted net assets ______________
Organizations that do not follow SFAS 117, check here and complete -- ' -
lines 30 through 34. ! -
30 Capital stock or trust principal, or current funds 31 Paid-in or capital surplus, or land ! building, or equipment fund 32 Retained earnings, endowment, accumulated income! or other funds 33 Total net assets or fund balances
BAA Form 990 (2011)
rEEAO111L O7O6/11
Form 990 (2011) MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page 12 IIP t)XILI Reconciliation of Net Assets
Check ii Schedule 0 contains a response to any question in this Part Xl [ki
1 Total revenue (must equal Part VIII, column (A), line 12) 2 Total expenses (must equal Part IX, coLumn (A), line 25) 3 Revenue less expenses Subtract line 2 from line I 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
Other changes ri net assets or fund balances (explain in Schedule 0) SEE SCHEDULE 0
6 Net assets or fund balances at end of pear Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B
1 Accounting method used to prepare the Form 99D Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked 'Other,' explain in Schedule 0
2a Were the organizations financial statements compiled or reviewed by an independent bwere the ornanization's financial statements audited by an independent accountant'
c If 'Yes' to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant' It the organLzation changed either its oversight process or selection process during the tax year, explain in Schedule 0
d If Yes to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both
Separate basis flConsolidated basis Both consolidated and separate basis
3a As a result of a federal award! was the organization required to undergo an auditor audits as set forth in the Single Audit Act and 0MB Circular A-133'
Ii Yes, did the organizahon undergo the requred aud!toraudds' Ii (be organizationddnot undergo the required audit
BAA
TEEAO1Ia OflQbtII
SCHEDULE A I Public Charity Status and Public Support (Form 990 or 990-fl) Complete if the organization isa section 501(c)Q) organization or a section
4947(aXl) nonexempt chantable tnjst.
2011
Depaibilent 01 the Treasury inlernoi Revenue Service I Attach to Form 990 or Form 990EZ. - See separate instructions.
Hen,, 01 m. orgen'nh'on
he organization is not a private foundation because it is (For lines 1 through 11, check only one box 1 A church, convention of churches or association of churches described in section 17OQ,1 AXi).
2 A school described in section 170(bXlXAXii). (Attach Schedule E
3 A hospital or a cooperative hospital service organization described in section 170(bXl$Axiii).
4 A medical research organization operated in conjunction with a hospital described in section llQØXlXAXiii) Enter the hospitals name, city, and state
5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(bXlXAXiv). (Complete Part II)
6 A federal, state, or local government or governmental unit described in section 170(bXlXAXv). 7 X
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 1700,X1XAXvI). (Complete Part II)
8 [A community trust described in section 170(bXlXAXvi). (Complete Part II) 9 [An organization that normally receives (1) more than 334/3% of its support from contributions, membership fees, and gross receipts
from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33-1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975 See section 509(a2). (Complete Part Ill)
10 An organization organized and operated exclusively to test for public safety See section 509(aX4). 11 An organization organized and operated exclusively for the benefit of, to perform the junctions of, or carry out the purposes ot one or
more publicly supported organizations described in section 509(aXl) or section 509(a)(2) See section 509(aX3). Check the box that describes the type of supporting organization and complete lines lie through U a jrype I b [Type II c [Type Ill - Functionally inlegraled d Type ill - Other By checking this box! I certity that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(aXl) or section 509(a)(2) If the organization received a written determination from the IRS that is a Type I, Type II or Type lii supporting organization, check ths box
g Since August 17, 2006, has the organization accepted any gift or contribution from any of the following p ersons __________
Yes No (i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii)
below, the governing body of the supported organiza t uo n 11 g (i)
(ii) A family member of a person described in Ci) above' ii U (ii) (iii) A 35% controlled entity of a person described in 0) or (ii) above' lip (in Provide the following inlormation about the supported organization(s) (i) Name of supported (ii) EIN (III) Type of organization (iv) is lie (IF) Did you notify (' O is the (vii) Amouptl of support
organizalion (described on hria 19 organization in the oroanization in orQsnizatn in abe or iRc section coiumn (i) listed in coiumn (Oar coiumn (I) (see ntr.ictions)) your govern,ng your support' OtQanl7.ed iii Ihe
BAA ror see 990 or 990-EZ) 2011
TEEAO4OIr O9/2a/l1
Schedule A (Form 990 or 990-E2) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page 2
I Partil Support Schedule for Organizations Described in Sections 170(bXlXAXiv) and 170(bXlXAXvi) (Complete only if you checked the box on line 5, 7, or B of Part I or if the organization failed to qualify under Fart Ill If the organization fails to qualify under the tests listed below, please complete Part Ill
Calendar year (or fiscal year beginning in)
1 Gifts, grants, coritributLens, and membership fees received coo not include any unusual gran
2 Tax revenues levied for the organizations benefit and either paid lo or expended on its behatf
3 The value of services or facilities furnished by a governmenta' unit to the organization without charge
4 Total. Add lines 1 through 3 5 The portion of total
contributions by each person (other than a governmental unit or public'y supported organization) included on line 1 that exceeds 2% at the amount shown on line 11, column (V
6 Public support. Subtract line 5
Calendar year (or fiscal year beginning in)
7 Amounts from line 4
8 Gross income from interest, dividends, payments received on securities loans! rents, royalties and income from similar sources
9 Net income from unrelated business activities, whether or not the business is regularly carried on
10 Other income Do not include gain or loss from the sale of capital assets (Explain in Part IV) SEE PART IV
(a) 2007 I (b) 2D08 I (c) 2009 I (d) 2010 I (e) 2011 (f) Total
847.1 577786.1 2.774.285.
(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (Q Total
554,782. 548,611. 614,259. 478,847. 577,786
7q417 174A1 13.009 8.570. 6.765 262.
11 Total su ort. Add lines 7 - T. 'C Y P : 4 Y - - through ! !: . ! 2,897,81
12 Gross receipts from related activities, etc (see instructions) 12 1, 131, 10
13 First fiveyears. If the Form 990 is for the organizations first, second third, fourth! or fifth tax year as a section 501(c)(3) II,,, k .
14 Public support percentage for 2011 (line 6, column (0 divided by line 11 column (0) 14 95.74% 15 Public support percentage from 2010 Schedule A. Part II, line 14 15 96 03 %
16a 33-1/3% support test —2011. If the organization did not check the box on line 13, and the tine 14 is 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization
b 33-1/3% support test —2010.1 the organization did not check a box on line 13 or 16a, and line this 33-1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization •
h a 10%-facts-and-circumstances test —2011. lIthe organization did not check a box on line 13, iSa, or 16b, and line 14 is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain in Fart IV how the organization meets the facts-and-circumstances test The organization qualifies as a publicly supported organization
b 10%-lacts-and-circunstances test —2010. If the organization did not check a box on line 13, 16a, 1 Sb, or lJa, and line 15 is 10% or more, and if the organization meets the 'facts-and-circumstances test, check this box and stop here, Explain in Part IV how the organization meets the
facts and circumstances' test The organization qualifies as a publicly supported organization
18 Private foundation. If the organization did not check a box on line 3, 16a, 16b. 17a, or 17b. check this box and see instructions BAA Schedule A (Form 990 or 990-EZ) 2011
rEEAO4O2L 05/25/Il
Schedule A Forni 990 or 990-EZ) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064537 Page 3
I Part III -_I Support Schedule for Organizations Described in Section 509(aX2) (Complete only you checked the box on line 9 of Fart I or if the organization failed to qualify under Part II If the organization fails to qualify under the tests listed below, please complete Part
rtinn A P"hlir C,,nn.,.4
Calendar year (or fiscal yr beginning in) 1 Gifts! grants! contributions
and membership fees received (Do not include any unusual grants)
2 Gross receipts from admis-sions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organizations tax-exempt purpose
3 Gross receipts from activities that are not an unrelated trade or business under section 513
4 Tax revenues levied for the organizations benefit and either paid to or expended on its behalf
5 The value of services or facilities furnished by a governmental unit to the organization without charge
6 Total. Add lines 1 through 5 7a Amounts included on lines 1,
2, and 3 received from disqualified persons
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1 % of the amount on line 13 for the year Add lines 7a and 7b
S Public support (Subtract line
Calendar year (or tiscal yr beginning in) • (a) 2007 (b) 2008 (C) 2009 Cd) 2010 (e) 2011 — 9 Amounts from line 6 _____________ ______________ ______________ ______________ ______________ -
b a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources _______________ _______________ _______________ _______________ _______________ - Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 _____________ _____________ ______________ ______________ ______________ - Add lines Wa and lOb _____________ _____________ ______________ ______________ ______________ -
11 Net income from unrelated business activiti not included ri line lOb, whether or not the business is reguldrlyC4rried on _________________ _________________ __________________ __________________ __________________ -
12 Other income Do not include gain or toss from the sale of capital assets (Explain in Partly) _________ _________ _________ _________ _________ -
13 Total support. (Add ins, i Ii, and 11) _____________ _____________ ______________ ______________ ______________ - 14 First flveyears. If the Fqrm 990 is for he
organizations first, second, third, fourth, Or fifth tax year as a section 501(cX3)
15 Public support percentage for 2011 (line 8, column (fl divided by line 13 column (U) 16 Public suoDort nercentane from 2010 Schedule A. Part It. line 15
17 Investment income percentage for 2011 (line bc, column (fl divided by line 13, column (0) 'I I 18 Inveslment income percentage from 2010 Schedule A, Part III, line 17 18 19a 33-1/3% support tests —2011 If the organization did not check the box on line 14, and line 15 is more than 33-1/3%, and line 17
is not more than 33.1/3%. check this box and stop here. The organization qualifies as a publicly supported organization b 33-1/3% supDort tests —2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33-1/3%. and
li ne l8is nof more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization 20 Pdvate foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
BAA TEEAO4QSL U525Ii i Schedule A (Form ggo or 990-EZ) 2011
Schedule B (Form 990,990-fl, or 990-Pr) Schedule of Contributors
Attach to Form 990, Form 990.EZ, or Form 990-Pr
OMSNO 15450047
2011
Organization type (check one) Filers of: Form 990 or 990-EZ
Form 990-PF
Section: X 501 (c)( 3) (enter number) organization
4947(aXl) noneempt charLtable trust not treated as a private foundation 527 political organization
501 (C(3) exempt private foundation 4947(aXl) nonexempt charitab'e trust treated as a private foundation 501 (c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule Note. Only a section 501 (c)(7), (8), or (IC) organization can check boxes for both the General Rule and a Special Rule See instructions
General Role For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, ¶5.000 or more (in money or property) from any one contributor (Complete Parts I and II)
Special Rules
For seclion 501 (c)(3) organization tiling Form 990 or 990-EZ that met thc 33-1/3% support test of the reguLations under sections 509(aXl) and 7U(b)(1)(A)(vj). and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line lh or (ii) Form 990•EZ line I Complete Parts I and II
For a section 501 (cM7), (A), or (10) organization filing Form 990 or 990•EIZ that received from any one contributor, during the year. total contributions ot more than $1 .000 far use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals Complete Parts I, II, and Ill
E For a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year. contributions for use exciusivefy tor religious! charitable, etc purposes, but these contributions did not total to more than $1000 II this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable. etc, purpose Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusrvely religious, charitable. etc, contributions of $5,000 or more during the year . $____________________
Caution: An organization that is not covered by the General Rule and/cr the Special Rules does not file Schedule B (Form 990, 99C-EZ, or 990-PF) but it must answer 'No on Part IV, line 2, of its Form 990, or check the box online Hot its Form 990-EZ or on Part I, line 2. of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990! 990-EZ. or 990-PF)
BAA For Paperwork Reduction Aol Notice, see the Instructions for Form 990, Schedule B (Form 990, 990-EZ, or 990-PF) (2011) 990EZ, or 990-Pr.
TEEAO7O1L 01116fl2
Nan'. of organinton Ei
MEALS ON WHEELS Of THE SALINAS VALLEY 7'
I Part I I Contributors (see instructions) Use duplicate copies of Part I if additional space is needed
(a) (b) K) Number Name, address, and ZIP + 4 Total Type ot contribution
contributions
1 COMMUNITY FND OF )IONTEREY COUNTY Person X Payroll
2354 GARDEN ROAD $ 31.180. Noncash
(Complete Part II if there MONTEREY, CA 93940 is a noncash contribution)
(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type ol contribution
contributions
2 MONTEREY PENINSULA FOUNDATION
1 LOWER RAGSDALE DRIVE $ 41,4
MONTEREY, CA 93940
(a) 0') (C)
Number Name, address, and ZIP + 4
3 CITY OF SALINAS
200 LINCOLN AVENUE
SALINAS, CA 93901
(a) 0') lumber Name, address, and ZIP + 4 Total
contributions
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution
(d) Type of contnbution
Person X Payroll Nonca sli
(Comp!ete Part II if there is a noncash contribution)
(d) Type of contnbution
4
Number
5 LH
Number
6
BAA
CANOGA AVENUE, SUITE 1700 $ 150,
AND HILLS, CA 91367
(b) (c) Name, address, and ZIP t 4 Total
contnbutior
N FOUNDATION
BOX 779 $ 50,
AS, CA 93902
0') (c Name, address, and ZIP 4 4 Total
to ntri butic r
STANLEY SMITH CHARITABLE ThUS
1!F L P!k ------------------ $ -2_Os
IlTO, CA 94965
TEEAO7O2L 08130/11 Schedule B (Ec
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution
(d) Type of contribution
Person X Payroll Non cash
(Complete Part II if there is a noncash contribution
Cd) Type of coritnbution
Person X Payroll Noncash
(Complete Fart lIt there isa noncash contribution)
990.EZ. or 990-Rn (201
2 of Parti
I Pert I Contributors (see Enstructions) Use duplicate copies of Part I if additional space is needed
(a) (b) (C)
Number Name, address, and ZIP + 4 Total contn butio ns
7 UNITED WAY
60 GARDEN COURT STE 350 $
MONTEREY. CA 93940
(a) (b) - lumber Name, address, and ZIP + 4
L_ M?cQSLj!cL ____________________ 860 S. WHflE ROAD $
SAN JOSE, CA 95127
(a) (b) - lumber Name, address, and ZIP + 4
to) Type oF contribution
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution)
(d) Type of contribution
Person K Payroll
15,112. Noncash
(Complete Part If there is a noncash contribution
Cc) Cd) rotal Type of contnbution ributions
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
P erg on Payroll N oncas h
(Complete Part 'lit there is a noncash contribution)
(c) (d) Total Type of contnbution
ntributions
Person Payroll No ncash
(Complete Part II if there is a rioncash contribution
(c) (d) Total Type of contnbution
contnbutions
Person Payroll No ncash
(Complete Part II it there is a noncash contribution
(d) Type of contribution
"Is
EIEEIIIIIEEIEIEH BAA TLEAOZQ2L 08130/I Schedule B
Person Payroll Non cash
(Complete Part II if there is a noncash contribution
990-EZ. or 990-PF (2011
II Name ci orgarizition Empioyeriduntlic.tion number
MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507
I pait:u Noncash Property (see instructions) Use duplicate copies of Part II if additional space is needed
(a) (b) (c) (d) No. from Description of noncash property given FMV (or estimate) Date received
Part I (see instructions)
(a) No. from
Part I
(b) Descnption ot noncash property given
(C) (d) FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(c) (d) FIVIV (or estimate) Dale received (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(c) (d) FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Descnption of noncasli property given
(c) (C FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(c) (d) rMv (or estimate) Date received (see instructions)
BAA Schedule B (Form 990 990.EZ or 990PF) (2011)
TEEAO?031 08130/Il
Exc/us/velyreligious, charitable, etc, individual contributions to section 501(cXl), (8), or (10) organizations that total more than $1 ,000 for the year.Complete cols (a) through (e) and the following line entry For organzations completing Part Ill, enter total of exclusively religious, charitable, etc, contributions of $1000 or less for the year (Enter this information once See instructions) • $ N/A Use dupFicale copies of Part Ill if additiona space is needed
(b) (c) (d) Purpose of gift Use of gift Description of how gilt is held
No. from Part I
Purpose of gift
(e) Transfer of gift
and ZIP + 4
Use of gift Description of how gilt is held
Transfer of gift and ZIP +4 of transferor to transferee
Purpose of gift Use of gift Descnption of how gift is held
Transfer of gift Transferee s ZIP +4 of transferor to transferee
Purpose of gift Use of gift Description of how gilt is held
(e) Transfer of gilt
Trail sferee and ZIP + 4
BAA Schedule B (Form 990, 99D-EZ, or 990PF) (2011) ILAO704L 08)30/li
SCHEDULED (Form 990) Supplemental Financial Statements 2011
Part or
or Other Similar Funds or IV, lineS
1 Total number at end at year 2 Aggregate contributions to (during year) 3 Aggregate grants from (during year) 4 Aggregate value at end of year
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organizations property, subject to the organizations exclusive legal El Yes No
6 Did the organization inform all granlees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or br any other ouroose conferrinu impermissible private r]Yes fl] No
1 Purpose(s) of conservation easements heid by the organization (check all that apply) Preservation of land for public use (eq recreation or education) Preservation of an historically important land area Protection of natural habitat Preservation of a certified historLc structure Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year -
— Held at the End of the Tax Year a fatal number of conservation easements 2a _______________________________ b Total acreage restricted by conservation easements 2b
Number of conservation easements on a certified historic structure included in (a) 2c
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register 2d _______________________________
3 Number of conservaton easements modified, transferred, released, extinguished, or terminated by the organization during the tax year
4 Number of states where property subject to conservation easement is located 5 Does the organization have a writlen policy regarding the periodic monitoring, inspection, handling ot violalions,
and enforcement ob the conservation easements it Li ves fl No 6 Staft and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
8 Does each conservation easement reported on line 2(d) above satisj the requirements of section 1 70(h)(4XB)(i) and section 1 70(hX4)(B)(u)' Yes No
9 In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organiza t ions accounting for conservation easements
art iii I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Comolete if the orcanization answered 'Yes' to Form 990, Part IV. li ne S
1 a If the organization elected, as permrtted under SEAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIV, the text ob the footnote to its financial statements that describes these items
bit the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and bafance sheet works of art, hrstoricai treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items (i) Revenues included ni Form 990, Part Viii, line 1 ____________________ (ii) Assets included in Form 990. Part X ____________________
2 If the organization received or held works ot art ! historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items
a Revenues included in Form 990. Part VIII, line 1 • $ ____________________ b Assets included in Form 990, Part X $
BAA ror Paperwork Reduction Act Notice, see the Instructions br Form 990. TEEA3S0R cSf2Sfll ScheduleD (Form 990) 2011
ScheduleD orm 990) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Pa9e 2
I Part IlL. Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3 Using the organizations acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply)
a Public exhibition d Loan or exchange programs b Scholarly research e Other C PreservatLon for future generations
4 Provide a description of the organizations
coFlections and explain how they further the organizations exempt purpose in Part XIV
5 Ourina the year, did the oreanization solicit or receive donations of art, historical treasures, or other similar
He 9, or reported an amount on Form 990, Fan X, line
1 a Is the organization an agent, trustee! custodian, or other intermediary for contributions or other assets not included on Form 990, Part X' Yes No II 'Yes,' explain the arrangement in Part XIV and complete the following table _______________________________
Amount Beginning balance ic Additions during the year id ___________________________________ Distributions during the year le _______________________________ Ending balance if _______________________________
Za Did the organization include n amount or, Form 990, Part X, line flYes fl No
1 a Beginning of year balanca Contributions
Net investment earnings, gains, and losses _________________ _________________ _________________ __________
d Grants or scholarships ___________________ ___________________ ___________________ ___________ Other expenditures for facilities and programs _________________ _________________ _________________ __________ Administrative expenses ___________________ ___________________ ___________________ ___________ End of year balance _________________ _________________ _________________ __________
2 Provide the estimated percentage of the current year end balance (line 1 g, column (a)) held as a Board designated or quasi-endowment • b Permanent endowment
Temporarily restricted endowment • The percentages in lines 2a, 2b, and 2c should equal 100%
3a Are there endowment funds not in the possession of the organization that are held and administered br the organization by 0) unrelated organizations (ii) related organizations
b if Yes to 3a(ii), are the related organizations listed as required on Schedule
of property 1(a) Cost or other basisi Q) Cost
1 a Land b Buildings
Leasehold improvements d Equipment
Yes No 3a(l) 3a(ii)
3b I
(d)Book value
Schedule 0 (Form 990) 2011
TEEA33O2L 0111 €112
2 FIN 4S (ASC 740) Footnote In Part XIV, provide the text of the footnote to the organizations financial statements that reports the organiza lporis liabitity for uncertain tax positions under FIN 48 (ASC 740) SEE PARI XIV BAA TEEAS3O3L 01i23fl2 ScheduleD (Form 990) 2011
VALLEY
Total revenue (Form 990, Fart VIII! column (A), line 12) Total expenses (Form 990. Part IX, column (A), line 25) Excess or (deficit) for the year Subtract line 2 from line 1 Net unrealized gains (losses) on investments Donated services and use of facilities Investment expenses Prior period adjustments Other (Describe in Part XIV ) SEE PART XIV Total adjustments (net) Add ines 4 through S
Total revenue gains! and other support per audited financial statements Amounts included on line 1 but not on Form YYD, Part VIII, me 12
a Net unrealized gains on irivesimerils b Donated services and use of facilities c Recoveries 01 prior year grants d Other (Describe in Part XIV) SEE PART XIV
Add lines 2a through 2d Subiract line 2e from line I Amounts included on Form 990, Pad VIII ILne 12, but not on line 1
a Invesimeni expenses not included on Form 930, Part VIII, line 7b
b Other (Describe in Part XIV) Add lines 4a and 4b
1 Total expenses and losses per aurj,ted financial statemenis 2 Amounts included on line 1 hul no! on Form 990, Part jX, line 25
a Donated services and use of faolites b Prior year adjustments
Other losses d Other (Describe in Part XIV) SEE PART XIV
Add lines 2a through 2d 3 Subtracl line 2e from line 1 4 Amounts included on Form 990, Fart IX, line 25, but not cr1 line 1:
a Investment expenses not ineFuded on Form 990, Part VIII, line 7h Other (Describe in Part XIV Add lines 4a and 4b
Complete this pad to provide the descuptions required for Part II, lines 3, 5, and 9, Part LII, lines la and 4, Part LV, lines lb and 2b, Part V, kne 4, Part X, line 2. Part Xl, lineS, Part XII, lines 2d and 4b, and Pail XIII, lines 2d and 4b Also compctc this part to provide any additional information
_ YARfl(_-flNA&FODItIQTE _____________________________________________
___ yjnaiwia -- JQ_TJ(Q!1t1A?( SrATE c CCALTAAUIIQRJI EQ&_ -
-- JflRQ ZP 2DQt Ear B&L F a_aNP_ZQO2flSSfltMP_ LQQ1L_JflQRnIfl
BAA TEEA3SO4L 05125/li Schedule D (Form
Schedule D (Form 990) 2011 }IEALS ON WHEELS OF THE SALINAS VALLEY 77-0364507 Page 5 IPittXIVI Supplemental Information (continued)
TEEA3aO5L 05125/11 Schedule D (Form 990) 2011
2011 SCHEDULE D, PART XIV - SUPPLEMENTAL INFORMATIONPAGE
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY 07
SCHEDULE D, PART XI, LINE 8 OTHER CHANGES IN NET ASSETS OR FUND BALANCES
LOSS ON DISPOSAL OF PROPERTY 5,097. TOTAL $ 5,097.
SCHEDULED, PART XII, LINE 2D OTHER REVENUE INCLUDED IN Ff5 BUT NOT INCLUDED ON FORM 990
INVESTMENT EXPENSES LOSS ON DISPOSAL OF PROPERTY
$ -467. 5,097
TOTAL S 4,630.
SCHEDULE D, PART XIII, LINE 2D OTHER EXPENSES AND LOSSES PER AUDITED F/S
INVESTMENT EXPENSES $ -467. TOTAL $ -467.
OMENo 15450047 SCHEDULE 0 I Supplemental Information to Form 990 or 990-EZ (FonnS9Oor99D-EZ) I I 2011
Complete to provide information for responses to specific questions on I . - DSadmefltO the Trea5u Allach to Fo 9 or EZ. : ,lns diOñ
Form S or 990-a or to provide any additional inlormation. Ir 9° toPublic
AUDIT COMMITTEE WILL REVIEW THE 990 BEFORE IT IS FILED. UPON AUDIT COMMITTEE'S
-- ?_L_2LJJ_L__ JO ALL VOTING MEMBERS OFIU Q&RP__...
- - fP!!kQ1 f L!kkNEJc L b AJJOffi Q QNR0FNPANPPIf9RQE14P 1I 9! P9!F.LICn
BOARD MEMBERS AND STAFF SHOULD AVOID ANY PERSONAL OR BUSINESS RELATIONSHIP THAT
PLACES HIS OR HER INTERESTS IN DIRECT CONFLICT WITH THE ORGANIZATION. BOARD MEMBERS
AND STAFF ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEFENT ANNUALLY,
NOT BECOME INVOLVED WITH DELIBERATIONS OR DECISION—MAKING IF A CONFLICT OF INTEREST
EXISTS AND DOCUMENT VOTE ABSTENTIONS IN THE MINUTES OF THE MEETINGS, AND MAKE SURE
THAT MEETING MINUTES REPORT ANY CONFLICT OF INTEREST SITUATION.
FORM 990, PART VI, LINE 15A - COMPENSATION REVIEW & APPROVAL PROCESS FOR CEO, EXEC. DIR., OR TOP MGT
PRESIDENT OF THE BOARD OF DIRECTORS IS RESPONSIBLE, ON MI ANNUAL BASIS, TO PREPARE
AN APPRAISAL OF THE EXECUTIVE DIRECTOR. THE BOARD OF DIRECTORS SHALL ESTABLISH A
SALARY SCHEDULE FOR STAFF POSITIONS WHICH INCLUDES A SALARY RANGE. THIS SALARY
SCHEDULE FOR STAFF POSITIONS SHALL BE REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF
DIRECTORS IN THE SAI1E MANNER AND AT THE SM1E TIME AS THE BUDGET. CURRENT SALARY
COMPARISONS ARE DONE USING THE WAGE AND SALARY SURVEY OF NORTHERN CALIFORNIA
NONPROFIT ORGANIZATIONS.
FORM 990, PART VI, LINE 15B - COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES
CURRENT SALARY CONPARISONS ARE DONE USING THE WAGE AND SALARY SURVEY OF NORTHERN
CALIFORNIA NONPROFIT ORGANIZATIONS. THE AGENCY OPERATIONS COMMITTEE THEN REVIEWS THE
SALARY SCHEDULE FOR THE EXECUTIVE DIRECTOR AND APPROVES ANY SALARY INCREASES.
FORM 990, PART VI, LINE 19- OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE
A FORMAL REQUEST MUST BE MALE AT THE BUSINESS OFFICE.
BAA For Paperwork Reduction Act Notice, see the ln5tructiDns for Form 990 or 990-EZ TEEA49O1L 07114/11 Schedule 0 (Form 990 or 990-EZ) 2011
6/30/12 2011 FEDERAL BOOK DEPRECIATION SCHEDULE PAGE 1
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY
11/05/12 07
PRIOR CUR SPECIAt. 179/ PRIOR SALVAG
DATE DATE COSTf BUS 179 DEN RONUS/ DEC BAL /BASIS DEPR PRIOR rwcr'vT1nN r.olIIRfI) cnl 11 RA 1iL QJj1 •I I (1W FWPR DFFR REDUCL BASIS flPPR IIFTWII) .UEL SIL
FORM 990/SSO-PF
AUTO / TRANSPORT EQUIPMENT
I FORD VAN 5/23/05 7/22/lI 40,771 40,771 35,108 S/L 6 566
8 2011 FORD VAN/TRUCK 5/IS/li 50,194 50,194 697 S/L 6 L356
TOTAL AUTO / TRANSPORT EQUIP 90,955 0 0 0 0 0 90,%5 25,805 8!932
FURNITURE AND FIXTURES
2 FURNITURE 1/19/92 1,413 1.413 1,413 S/L ID 0
3 ACCESS SYSTEM FOR W 4/01/98 6,XL 6,000 6,0 S/L 5 0
6 FURNITURE 9/17/92 922 922 922 S/L 3 0
TOTAL FURNITURE AND FIXTURE 8,335 0 U 0 0 0 8,335 8,335 0
MACHINERY AND EQUIPMENT
4 COPIER 6/07/ID 7!633 7,633 1,654 S/L 5 1,527
5 ABSOCOLD REFRIGERATOR 3/09/% 298 298 2S S/L 10 a
/ FREEZER 5/21/02 13201 3.201 5,815 S/L 7 1,886
TOTAL MACHINERY MID EQUIPME 21132 0 0 0 0 0 21,132 7.767 3,413
TOTAL DEPRECIATION 20432 0 0 0 0 0 120,432 51.901
GRAND TOTAL DEPRECIATION 120,432 0 0 0 0 0 120,432 51,907
MEALS ON WHEELS OF THE SALINAS VALLEY 40 CLARK STREET, SUITE C SALINAS, CA 93901-4713
199
Franchise Tax Board P.O. Box 942857 Sacramento, CA 94257-0700
FORM
199 TAXABLE YEAR California Exempt Organization
2011 Annual Information Return
room. Or
C
A First Return Yes No
B Aanded Return • Yes No
C IRC Se€tion 4941(aXl) trust Yes No
D Final Return [Yes No
• [ Dissolved • [ Surrendered (Withdrawn)
• fl Merged/Reorganized Enter date • _____________________ E Check accounting method
1 Cash 2 AccruaI 3 [Other F Federal return filed'
1 • [990T 2 • [990(PF) 3 I [SchH(990) (3 Is this a group filing for the subordinates/affiliates' [ Yes Mo
II Yes
attach a roster See instruc'ons H Is this organization in a group exemption' I [ Yes No
II Yes!
Whats the parents name 2
I Did the organization have any chan s in its activibes, governing insfrumen articles of incorporation, or bylaws that have not been reported to The Franchise Ta Board' I Yes No
If exempt under R&TC Section 23/Old, has the organization dun g the year (I) participated in any political campaign, or (2) attempted to influence legislation or any ballot measure, or (3) made an electron under R&TC Sechon 23704 5 (relating to lobbying by public charities)' I [Yes j No If complete and attach form E SSc
K Is lie organization exempt under R&TC Section 23101g' • [Yes If Yes,' enter gross reteipts from nonmember sources $ ________________
L If organization is exempt under R&TC Section 23701d and is exclusively religious, educational, or charitable, and is supported pnrnanly (50% or more) by public contributions, cheek box No filing fee is required •
M Is the organization a Limited babilily Company' • [Yes
N Did the organization tile Form 1W or Form '09 to report taxable income' • [Yes
0 Is the organizalion under audit by the IRS or has the IRS audited in a prior year • [Yes
jNo
No
No
No
1 Gross sales or receipts from other sources From Side 2. Fart II, lineS I 2 Gross dues and assessments from members and affiliates
Receçts 3 Gross contributions, gifts, grants, and similar amounts received SEE SC!!. B • Revenues 4 Total gross receipts for filing requirement test Add line 1 through line 3
This line must be completed. If the result is less than $25,000. see General Insiruction B •
5 Cost of goods sold I 5 6 Cost or other basis! and sales expenses of assets sold • 6 5,097 7 Total costs Add line Sand line 6 B Total gross income Subtract line 7 from line 4 9 Total expenses and disbursements From Side 2! Part II, line 18 I
Expenses , . -.• -
11 Filing fee $10 or $25 See Genera' Instruction F
riling 12 Total payments Fee 13 Penalties and lnteres See General InstructLon
14 Use tax See General Instruction K 15 Balance due. Add line 11, line 13, and line 14
Then subtract line 12 from the result under penailies of penury, I declare that I have examined this return. inciL,flg s000rlIpan correct, and compiele Daciarabon ci preparer (othEr Than taxpayer) is based on di 'niorn
Sign Here Title
______ PRESIDENT
Paid &L MZ_ P FErets name HAYASHI & WAYLMm, CPA' S
eifempioyed) 1188 PADRE DRIVE, SUITE 101 andaddress SALINAS, CA 93901
_________ May the FTB discuss this return with the preparer shown b ove
ForPrivacyNotice,getforrn FTB1131. 059 I 3651114
.
knowied9e and Leiief, ii is true !
• Telephone
831-758- 6 325 • PaidPTiN P00930 869 • FEiN
20-1939256 • Teiephorie
I CAOA1II2L 01105/12 Form 199 Cl 2011 Sidel
MEALS ON WHEELS OP THE SALINAS VALLEY 77-0064507
Part II Organizations with gross receipts of more than $25,000 and private foundations regardless ot amount of gross receipts -
1 Gross sales or receipts from all business activibes See instructions 2 Interest 3 Dividends 4 Gross rents S Grass royalties 6 Gross amount received from sale of assets (See instructions) S
7 Other income Attach schedule SEE. STATEMENT a • S Total gross sales or receipts from other sources Add line I through line 7
Enter here and on Side 1, Part I, line 1 9 Contributions, gifts, grants, and similar amounts paid Attach schedule S
10 Disbursements to or far members 11 Compensation at officers, directors, and trustees Attach schedule 12 Other salaries and wages S
13 Interest 14 Taxes S
15 Rents S
16 Depreciation and depletion (See instructions) 17 Other Expenses and Disbursements Attach schedule SEE STATEMEIT 2 •
Receipts Iron Other Sources
Expenses nd
Disburse-ments
477.
76
1 Cash 2 Net accounts receivable 3 Net notes receivabLe 4 nventories S Federal and state government obl igalions 6 I nvesttnents in other bonds I I nvestnients in stock 8 Mortgage loans 9 Other investments Attach schedule ST
10 a Depreziable assets b Less accumulated depriat,on
11 Land 12 Other assets Attach schedule Sm 13 Totalassets
Liabilities and net worth 14 Accounts payable 15 Contributions, oifts, or grants payable 16 Bonds and notes payable 17 Mortgages payable 18 Other liabilities Attach schedule 19 Capital stock or principle fund 745.
20 Paid-in or capital surplus Attach reconci liatic 21 Retained earnings or income fund
Schedule M-1 Reconciliahon of Income per books with income per return Do not complete this schedule if the amount on Schedule L,
1 Net income per books 7 Income recorded on books this year 2 Federal income tax not included in this return 3 Excess of capital losses over capital gains Attach schedule 4 Income not recorded on books This year 8 Deductions in This return not charged
Attach schflle against book income This year 5 Egpenses recorded on bxks This year ot deducted Attach schedule
in this return Attach schedule 9 Total Add line 7 and tine 8 6 Total 10 Net income per return
Side 2 Form 199 Cl 2011 059 I 3652114 I cc*iii2r 01105'r2
Schedule B (Fern, 990, 990-EZ, or 990-PF)
CALIFORNIA COPY
Schedule of Contributors - Attach to ram, 990, rorm 990.EZ, or Form 990-PF
0MB No 1545 0047
2011
Organization type (check one) Filers of: Form 990 or 990-EZ
Form 990-PF
Section: X 501(cX 3) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization
501 (c)(3) exempt private foundation 4947(aXl) nonexempi charitable trust treated as a private foundation 501 (c)(3) taxable private foundation
Check it your organization is covered by the General Rule or a Special Rule Note. Only a section 501(c)ç7), (8), or (10) organization can check boxes br both the General Rule and a Special Rule See instructions
General Rule For an organization filing Form 990, 990-EZ, or 990FF that received! during the year, $5,000 or more (in money Or property) from any one contributor (Complete Paris I and II)
Special Rules For a section 501 (c)(3) organization filing Form 990 or 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2)2% of the amount on (i) Form 990, Part VII!, line 1 h or (ii) Form 990-EZ, line 1 Complete Parts I and II
For a section 501 (c)(7), (8), or (10) organization filLng Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 for use exclusively for religious ! charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals Complete Parts I, II, and Ill
For a section 50! (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for use exciusive?y for religious, charitable, etc, purposes, but these contributions did not total to more than $1,000 If this box is checked, enter here the total contributions that were received during the year far an exc/usively religious, charitable, etc, purpose Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc, contributions of $5,000 or more during the year $____________________
Caution; An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EL, or 990-PF) but ii must answer 'No on Part IV. line 2, of its Form 990, or check the box on line H of its Form 990-EZ or on Part I. line 2, of its Form 990-PF, to certify that it does not meet the filing requirements ot Schedule B (Form 990, 990-EZ, or 990-PF)
BM Fur Paperwork Reduction Act Notice, see the Instructions tor Form 990, Schedule B (Form 990, 990•E2 or 990-PF) (2011) 990, or 990-PF.
TFEAO7O1 L 01116112
I RátIf Contributors (see instructions) Use duplicate copies ot Part ft additional space is needed
(a) (b) (c) Number Name, address, and ZIP + 4 Total
contri bulions
1 COMMUNITY FND OF MONTEREY COUNTY
? ± PP! AD -$ -31L 1
- a .2 Pi9 (a) (b) (c)
Number Name address, and ZIP + 4 Total contributions
2 MONIEREY PENINSULA FOUNDATION
1 LOWER RAGSDALE DRIVE $ 41,4
M2it X1 - a 2 & ----------------------- - (a) (b) (c)
Number Name, address, and ZIP + 4 foal
Type of contribution
Person X Payroll Noncash
(Complete Part (I if there isa noncash contribution)
(d) Type of contribution
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution
(d) Type of contnbution
3 CITY OF SALINAS
200 LINCOLN AVENUE
SALINAS, CA 93901
(a) (b) dumber Name, address, and ZIP + 4
4 CALIFOR1IIA WELLNESS FOUNDATION
6320 CAIIOGA AVENUE. SUflE 1700
QQQ Q S 7___________________
(a) U,) lumber Name, address, and ZIP + 4
Person X Payroll
14,196. Noncash
(Complete Part II if there is a noncash contribution)
(c) (d) Total Type of contribution
contributions
Person X Payroll
- - L5PLQPP Noncash
(Complete Part II if there is a noncash contribution
Cc) (d) Total Type of contributon
contributions
5
Number
6
BAA
0 BOX 779 $
J_ cA 2
(b) (c) Name, address, and ZIP + 4 Tob
contnbL
:FS NATL BRD PRG AWRD INSIL
$
__________________________ TLEAOZO2L. 08)30/Il Schedule
Person X Payroll No ncash
(Complete Part II if there is a noncash contribution)
(d) Type of contribution
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution)
990-EZ, or9BO-PF) (2011)
I Part I I Contributors (see instructions) Use duplicate copies of Fart I it additional space is needed
(a) (b) K) (d) Number Name, address, and ZIP + 4 Total Type of contnbution
contributions
7 BIRNET SEGAL CHARITABLE TRUST Person X Payroll
-------------------------------------$ -1O L 000. Noncash
(Complete Part II if there CARNEL, CA 93921 is a noncash contribution
(a) (b) (C) (d) Number Name, address, and ZIP + 4 Total Type of contnbution
contnbutions
8 MAY & STANLEY SMITH CHARITABLE TRUS Person X Payroll
--- ----------------------------$ -2PLQQPL Noncash
(Complete Part II if there SAUSALITOJ CA 94965 - is a noncash contribulion
(a) (b) (c) (d) Number Name, address, and ZIP + 4 Total Type of contribution
contnbutions
9 UNITED WAY
60 GARDEN COURT STE 350 -$
MONTEREY, CA 93940
(a) (b) (c) Number Name, address and ZIP + 4 Total
contributior
10 DARRIGO BROS.
P.O. BOX 850 -- $ 5,
SALINAS, CA 93902
(a) 0) (C) Number Name address, and ZIP + 4 Total
contnbutior
11 SANTA FE MERCADOS, INC.
860 S. WHITE ROAD - $ 16,
SAN JOSE, CA 95127
(a) (b) (c) Number Name, address, and ZIP + 4 Total
coritributior
12 CITY OF KING CITY Person X Payroll
212 S. VANOERHURST AVENUE $ G OOD. Noncash
(Complete Part II if there KING CITY, CA 93930 is a noncash contribution)
BAA TEEADYD2L o83o1 1 Schedule B (Form 990, 990EZ, or 990-FF) (2O I)
Person X Payroll Noncash
(Complete Part II it there is a noncash contribution
Type of contribution
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution
(ci) Type of contribution
Person X Payroll Noncasli
(Complete Part lit there is a noncasli contribution
(d) Type of contribution
1 to 1 of N.meof organintion EmpIoyeridenttictiD,. number
MEALS ON WhEELS OF HE SALINAS VALLEY 77-0064507
I Part II I Noncash Property (see instructions) Use duplicate copies of Part LI if additional space is needed
(a) (b) (c) (d) No. from Descnption of noncash property given FMV (or estimate) Date received
Part I (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(0) (cU FIVIV (or estimate) Date received (see instructions)
(a) No from
Part I
(b) Descnption of noncash property given
(c) (ci) VMV(or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncasli property given
(c) (d) FIYIV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(c) ('0 FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncasli property given
(c) (d) FMV (or estimate) Date received (see instructions)
990-EZ, or990PF) (2011)
TEEAVOSL 08130fl 1
Nime of
'art Ill 1 Exclusively religious, charitable, etc individual contributions to section 501(cXl), (8), or (10) Organi2atiOnS that total more than $1000 for the year.Complete cols (a) through Ce) and the following line entry For organizations completing Part III, enter total of exc/us/ve/y relLgLous oharilabte, etc. contributions of $1000 or less for the year (Enter this information once See instructions) • $ N/A Use duplicate capies of Part III if additional space is needed
(a) (b) (c) No. from Purpose of gift Use of gift Descnption of how gift is held
Tram ste rees
(a) (b) No. from Purpose of gift
Part_I ______________________
Transferee s
(a) (b) No. f!Cm Purpose of gift
ZIP +4
Use of gift
(e) Transfer of gift
and ZIP + 4
Use of gift
of transferor to transferee
Description of how gift is held
of transferor to transferee
Descnptiun of how gift is held
No. from Part I
Purpose of gift
(e) Transfer nf gilt
and ZIP + 4
Use of gift Description of how gift is held
Transfer of gilt Iransferees name, address, and ZIP + 4
BAA Schedule B orm 990, 990-EZ, or 990-PE) (2011) IEEAOIO4L. DSI3D/I I
TAXABLE YEAR CALIFORNIA FORM
2011 Corporation Depreciation and Amortization 3885
•"&I•!!•
1 Maximum deduction unuer PhIL bedpan i , tar Uaiitornia 2 Total cost of IRC Section 179 proper' placed in service 3 Threshold cost of IRC Section 179 property before reduction in limitation 4 Reduction in limitation Subtract line 3 from line 2 Il zero or less, enter -0-
7 Listed property (elected IRC Section 179 cost) I 7 I
8 Total elected cost of IRC Section 179 property Add amounts in column (c). line 6 and line 7 9 Tentative deduction Enter the smaller of line 5 or line 8
10 Carryover of disallowed deduction from prior taxable years 11 Business income limitation Enter the smaller of business income (not less than zero) or line 5 12 IRC Section 179 expense deduction Add line 9 and line 10, but do not enter more than line ii
14 (a) (h) (c) Descript;on Date Cost or of property acquired other basis
hue I i Ia i rv -- -
luction Under R&TC Section 24356
(e) (0 (g) (h) ion DeprecLa- Lile Depreciation for Additional first or lion or rate this year year
in method depreciation
15 The talal of column (h) may not exceed
16 Total If the corporation is electing IRC Section 179 expense, add the amount on line 12 and line 15. column (g) or Additional first year depreciation under Rate Section 24355. add the amounts an line 15, columns (g) and (hi) or Depreciation (it no election is made), enter the amount from line 15, column (g)
17 Total depreciation claimed for federal purposes from federal Form 4562, line 22 18 Depreciation adjustment If line l7is greater than line 16, enter the difference here and on Form 100 or
Form 100W, side i, line S If line 17 is less than line 16, enter the difference here and on Form 100 or Form 100W, Side 1, line 12 (If California depreciation amounts are used to determine net Income before state ad1uslments an Form 100 or Form 100W, no adjustment is necessary)
'art IV Amortization 19 (a) (b) (c) (d) (e) (9
Description Date Cost or Amortization R&TC Period or of property acquired other basis allowed or allowable section percentage
in earlier years (see instr)
20 Total Add the amounts in column (g) 21 Total amortization claimed for federal purposes from federal Form 4562, line 44
22 Amortization adjustment If line 21 is greater than line 20, enter the difference here and on Form DOor Form 100W, Side I, line 6 Il line 21 is less than line 20. enter the difference here and on Form 100 or Fnrm 100W Sicl 1 Imp 12
for this year
CAcA3EOIL 08/01/lI 059 I 7621114 I FIB 3885 2011
TAXADLE YEAF CALIFORNIA FORM
2011 and Amortization 3885
krorn'a corporation
282277
art I Election to Expense Certain Properly Under IRC Section 179 1 Maximum deduction under IRC Section 179 tar California 2 Total cost of IRC Section 179 property placed in servica 3 Threshold cost of IRC Section 179 property before reduction in limitation 4 Reduction in limitation Subtract line 3 from line 2 If zero or less, enter -0-
Elected
7 Listed property (elected IRC Section 179 cost) I 7 8 Total elected cost of IRC Sechon 179 property Add amounts in column (c), line Band line 7 9 Tentative deduction Enter the smaller of line 5 or line S
10 Carryover of disallowed deduction from prior taxable years 11 Business Income limitation Enter the smaller of business income (not less than zero) or line S 12 IRC Section 179 expense deduction Add line 9 and line 10, but do not enter more than line 11
14 (a) (b) K) Cd) (e) (0 (g) (11) Description Date Cost or Depreciation Deprecia- Life Depreciation for Additional first of property acquired other basis allowed or tion or rate this year year
allowable in method depreciation
15 Add the amounts in column (g) and column (h) The total at column Ji) may not exceed $2,000 See instructions for line 14, column (h) 15
'art Ill Summary 16 Total If the corporation is electing
IRC Section 179 expense, add the amount on line 12 and line 15, column (g) or Additional first year depreciation under R&TC Section 24356, add the amounts on line 15, columns (g) and (h) 0, Depreciation (if no election is made), enter the amaunt from line 15, column (g)
17 Total depreciation claimed for federal purposes from federal Form 4562, line 22 18 Depreciation adjustment If line 17 is greater than line 16, enter the difference here and on Form 100 or
Form 100W, Side 1 line 5 If line 17 is less than line 16, enter the difference here and on Form 100 or Form 100W! Side 1 line 12 (If California depreciation amounts are used to determine net income before
19 (a) (b) (c) Description Date Cost or of property acquired other basis
(9) Period or Amortization
percentage b r this year
I I I I I 20 Total Add the amounts in column (g) 2? Total amortization claimed for federal purposes from federal Form 4562, line 44
22 Amortization adjustment If line 21 is greater than line 20, enter the difference here and on Form 100 Or Form 100W, Side 1, line 6 If line 21 is less than line 20, enter the difference here and on Form 100 or Fnrm 100W Side 1. line 12
OAGM5DIL 1fOlfll 059 I 7621114 I FTB38852011
2011 CALIFORNIA STATEMENTS PAGE ii
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY 07
STATEMENT 1 FORM 199, PART II, LINE 7 OTHER INCOME
INCOME FROM SPECIAL EVENTS OTHER INVESTMENT INCOME PROGRAM SERVICE REVENUE
$ 12,140. 6,765.
304,032. TOTAL $ 322,937.
STATEMENT 2 FORM 199, PART II, LINE 17 OTHER EXPENSES
ACCOUNTING FEES ADVERTISING AND PROMOTION AWARDS CONFERENCES, CONVENTIONS, AND MEETINGS FOOD PURCHASES INFORMATION TECHNOLOGY INSURANCE LOSS ON DISPOSAL OF PROPERTY MISCELLANEOUS OFFICE EXPENSES OTHER EMPLOYEE BENEFIT OTHER FEES SPECIAL EVENT EXPENSES TRAINING & RETENTION TRAVEL
$ 20,843. 13, 249.
87. 3,456.
292,779. 25,901. 4,161. 5,097. 1,267.
29, 697. 18,774.
477. 710.
3,579. 12, 972.
TOTAL $ 433,149.
STATEMENTS FORM 199, SCHEDULE L, LINE 9 OTHER INVESTMENTS
MUTUAL FUNDS & MONEY MAREET FUNDS $ 35,706. TOTAL $ 35,706.
STATEMENT 4 FORM 199, SCHEDULE 1, LINE 12 OTHER ASSETS
DEPOSITS INVESTMENTS HELD AT COMMUNITY FOUNDATION PREPAID EXPENSES AND DEFERRED CHARGES
5,912. 70,051. 5,872.
TOTAL $ 81,835.
RRF-I MEALS ON WHEELS OF THE SALINAS VALLEY 40 CLARK STREET, SUITE C SALINAS, CA 93901-4713
Registry of Chantable Trusts P.O. Box 903447 Sacramento, CA 94203-4470
IN
MAIL TO: Registry of Charitable Trusts P.O. Box 903447 Sacramento CA 94203-4470 Telephone: (916) 445-2021
WEBSITE ADDRESS; http:ilag.ca.gov(chantiesl
ANNUAL REGISTRATION RENEWAL FEE REPORT
TO ATTORNEY GENERAL OF CALIFORNIA Sections 12586 and 12587, California Government Code
11 Cal. Code Regs. sections 301-307, 311 and 312 Faiiurs to seibmit this report annnaily no ialer than icur months and lilian days after lie end dlii. OFq,nIaIJOn'S accounting pitied may iosialt ti the icc. oftax exemption end the assessment ci a mininium tax of S200, iu. interest, andfor lines or filing penaltiet as detined in Govaniment cod. Section I 1 iRS fltOnSions wili be honored
State Charity Registration Number 059716 ut address d report
MEALS ON WHEELS OF THE SALINAS
Organization No.
SALINAS. CA 93901-4713 FederalEmployerlDNo. 77-0054507 Cil or Town state ZiP Code
ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal, Code Regs sections 301-307, 311 and 312) Make Check Payable to Attorney Generals Registry of Chantable Trusts
Gross Annual Revenue Fee Gross Annual Revenue Fee Gross Annual Revenue Fee
Less than $25000 0 Between $100,001 and $250000 $50 Between $1,000,001 and $10 million $150 Between $25000 and $100,000 $25 Between $250,001 and $1 million $75 Between $10000001 and $50 million $225
Greater than $50 million $300
PART A - ACTIVITIES For your most recent tuli accounting period (beginning 7 / 01/11 ending 6 / 30/12 ) iist:
Grossannual revenue $ 894,916. Total assets $ 1,050,620.
PART B - STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT
Note: It you answer yes to any of the questions below, you must attach a separate sheet providing an explanation and details for each yes response. Please review RRr-1 instructions tor Information required.
Yes N. 1 Durin this reporting period, were there any contracts, loans, leases or other tinancial transactions between the
organization and any officer, director or trustee thereof either dtrectly or with an entity in which any such officer, director or lrustee had any financial inferesf 1-I Ii
2 During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable ri rz
4 During thu Form 472(
5 During thu purposes service Pr!
6 Durina thi
7 During #1 indicatinç
8 Does the
9 Did
did non-program expenditures exceed 50% of gross revenues'
were any organization funds used to pay any penalty, fine or udgment
It you filed a Revenue Service, attach a copy
were the services of a commercial fundraiser or lundraising counsel for charitable ri de an attachment listing the name, address, and telephone number of the
reporting period, did the organization receive any governmental funding
It so, provide an attachment listing of the agency! mailing address! contact person, and telephone number SEE STATffiNT 1 JJ j
reporting period, did the organization hold a raffle for charitable purposes
If yes, provide an attachment the number of raffles and the date(s) they occurred SEE STATEMENT 2 .J J .1 Drganization conduct a vehicle donation program' It yes provide an attachment indicating whether rn is operated by the charity or whether the organization contracts with a commercial fundraiser for purposes .L1 I
'rganization have prepared an audited financial statement in accordance with generally accepted accounting for this reporting period JL I area code and telephone number 831-758-6325
e-mail address
• penalty ot perjury that I have examined this report, including accompanying documents, and to the best of my knowledge tnje, correct and complete.
CAVA9BOTh oeIi&o5 RRF-1 (3-05)
2011 CALIFORNIA STATEMENTS PAGE 1
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY
STATEMENT 1 FORM RRF-1, PART B, LINE 6 GOVERNMENT AGENCY THAT PROVIDED FUNDING
CITY OF SALINAS, HOUSING AND CONNUNITY DEVELOPMENT - 200 LINCOLN STREEt SALINAS, CA 93901, ARNANDO BARRAGAN, 831-758-7229
CITY OF GONZALES - P.O. BOX 647, GONZALES, CA 93926, RENEE NENDEZ, 831-675-5000
COUNTY OF NONTEREY, AREA AGENCY ON AGING - 1000 SOUTH MAIN STREET, STE. 301, SALINAS, CA 93901 SAN TREVINO, 831-755-4447
CITY OF KING CITY - 212 S. VANDERHURST AVENUE, KING CITY, CA 93930, MICHAEL POWERS, 831-385-3281
STATEMENT 2 FORM RRF-1, PART B, LINE 7 NUMBER AND DATES OF RAFFLES
ONE RAFFLE HELD 3/30/2012.
07 1
Form 990
reni of the Treasun1 Revenue Service
r the 2011 cali
eck ii ppi'cahIe
Address change Name change
Initial reLIrn
Term' ated Amended return
Applicalion pend'
lax-exRrttpt status
Website: I
Return of Organization Exempt From Income Tax Under section 501(c), 527, or4947(aXl) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
The uroarnzation may have to use a cco of This return to satisfy state renortino reouiiements
E.,'pioyer identification Nubiher
WHEELS OF THE SALINAS VALLEY STREEt SUITE C CA 93901-4713
Narie arid address of principal oIl,cer is 01's a group relurn tar affiliates' H(b) Are all aff,L,aies niuded
if !ND.! attach a iisl see instructions)
LU_ fl._. __i,__...._.r..
OMU No 1545 0047
2011
0 U
1 Briefly describe the organization's mission or most significant activities NO SENIOR SHOULD GO HUNGRY. JL'Tm LQ!JE J4 J — w'uca JI8Fa PEkLVZRZfl ay cMn 31NR. JERQY JH REMJB J}!D — JELL-flIJ_QF_LWTLL MIQ BL 1IQMEBQUND .ELURL1,_ DR flABLE 1N lrnLp_ 13 NREIiaDL — JtHEI1BOJ4.XJMNtMK1HE1&I1WEEENDENCE ____________________________
2 Check this box • H if the organization discontinued its operations or disposed of more Han 25% of its net assets 3 Number of voting members of the governing body (Part VI, line la) a 14 4 Number of independent voting members ol the governing body (Part VI. line ib) 4 14 5 Total number of individuals employed in calendar year 2011 (Part V. line 2a) 5 6 6 Total number of volunteers (estimate if necessary) 6 125 la Total unrelated business revenue from Part VIII, column (C), line 12 7a 0.
8 Contributions and grants @:art VIII, line 1 h) 9 Program service revenue (Part VIII, line 29)
10 Investment income (Part VIII, column (A), lines 3,4, and Id) & 11 Other revenue (Part VIM, column (A), lines 5, Gd. Bc, 9c, bc, and lie)
1' T,fi hnac Kr,,, !nh •} 1 fm,,c4 n,,,i Pri Viii rnhilnnn
13 Grants and similar amounts paid (Fart IX, column (A). lines 1 3)
14 Benefits paid to or for members (Part IX, column (A)! line 4)
15 Salaries, other compensation, employee benefits (Par! IX, column (A), lines 5-10)
16a Prolessional fundraising fees Fart IX, column (A), line 11 e)
& b Total fundraising expenses (Part IX. column (D), line 25) 75, 576. 17 Other expenses (Part IX, column (A), lines 1 1a- id, ii f-24e) 18 Total expenses Add lines 13-17 (must equal Part IX column (A), line 25)
End of 20 TotaL assets (Part X. line 6) 21 Total liabiltties (Part X, line 26)
Under penaii,es ci penury, i deciare that i have eammed this return, ,ciuding acccn ar1y,ng sci1eLsies artØ statemeills. and to the best or my knowielqe arid boi,et, d is rue, correct, and complete Declaration of preparer (other than officer) is hased an all intormalion or which preparer nas any nowiedge
Sign Signature or once vote
Kere GORDON A. RUBBO PRESIDENT Type or print name ar title
Date PrinVType preparers
name
Paid NIKE NOL1N ,t/e (2w2 cec flit I PUN
sail employed I P00930869 Preparer F,rni'snarre HAYASHI & WAYLAND, CPA' S Use Only Frrm'saddress 1188 PADRE DRIVE. SUITE 101 r,rrnsEiN 20-1939256
May the IRS discuss this return with the preparer shown (see instructions)
BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEAOISL 08118)11
FormDSO(2011) MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page2 I Part Ill 1 Statement of Program Service Accomplishments
Check if Schedule 0 contains a response to any question in this Part III P1 1 Briefly describe the organizations mission
NO SENIOR SHOULD GO HUNGRY. NUTRITIOUS MEALS, WHICH ARE DELIVERED BY CARING VOLQNTEERS L IMPROVE J J LJ_AJf_W &-flN_QF EQP GAREHOtEOUN, _E RJ3L__ OR DISABLED AND HELP THEM REMAIN IN THEIR HOMES AND MAINIAIN THEIR INDEPENDENCE.
2 Did the organization undertake any sLgnificanl program services during the year which were not listed on the prior FormggOorggO-EZ' Yes No If
Yes, describe these new services on Schedule 0
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services' Yes No If 'Yes,' describe these changes on Schedule 0
4 Describe the organizations
program service accomplishments for each of its three largest program services, as measured by expenses Section 501 (c)(3) and 501 (c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocatLons to others, the total expenses! and revenue, if any, for each program service reported
4a (Code __________) (Expenses $ 612, 035 including grants of $___________________) (Revenue $ 304,032. TO DELIVER NUTRITIOUS NEALS TO THE HOMES OF ELDERLY AND DISABLED PERSONS THROUGHOUT SALINAS VALLEY WIfl CAN'T SHOP OR COOK FOR THEMSELVES. 98,498 )IEALS WERE SERVED THIS YEAR.
4b (Code __________ ) (Expenses $ __________________ including grants of S___________________) ( Revenue S__________________
4€ (Code __________ ) (Expenses $ __________________ including grants of $__________________ ) (Revenue $__________________
4d Other program services (Describe in Schedule 0) (Expenses $ ncluding grants at $ ) (Revenue $
4e Total proqram service expenses 612, 035. BAA TEEAU1O2L 07105111 Form 990 (2011)
1 Is the organization described in section 501 (cX3) Or 4947(a)(1) (other than a private loundation)
it Yes, complete Schedule A
2 Is the organization required to complete Schedule 8, Schedule of Contributors (see instructions)
3 Did the organization engage in direct or indirect political campaign activities on behalf at or in opposition to candidates for public It Yes, complete Schedule C, Part!
4 Section 5O1(cX3) organizations Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year' If Yes, complete Schedule C, Part II
S Is the organization a section 501 (cX4), 501 (c)15), or 501 (ç)(&) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19' If
Yes complete Schedule C, Patti!!
6 Did the organization maintain any donor advised funds or any similar funds or accounts for which to provide advice on the distribution or investment of amounts in such funds or If Yes, Part I
7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas or historic If Yes.'complete ScheduleD, Part!!
S Did the organization maintain collections of works of art, historical treasures, or other similar assets' if 'Yes,' complete ScheduleD, Part III
9 Did the organization report an amount in Part X, line 21, serve as a custodian for amounts not listed in Part X, or provide credit counseling, debt management, credit repair. or debt negotiation If Y es, complete Schedule 0, Part IV 9 X
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments! permanent endowments, or quasi-endowments' If Yes,'complete ScheduleD. Part V 10
! X
11 lithe organ'zations answer to any of the following questions is Yes,
then complete Schedule D, Parts VI, VII, VIII, IX. '. or X as applicable -
a Did the organization report an amount for land, buildings and equipment in Pad X, line If ! (5 complete Schedule Part VI Ba X
b Did the organization report an amount for investments— other securities in Part X. line 12 that is5% or more ot its total assets reported in Part X, line 16' If Yes, 'complete ScheduleD, Part VII lit X
c Did the organization report an amount for investments— program related in Fart X, line 13 that is 5% or more of its total assets reported in Part X, line 16' If 'Yes, ' complete Schedule D. Part VIII 11 C X
d Did the organization report an amount for other assets in Part X. line 15 that is 5% or more of its total assets reported in Fart X, line 16' If 'Yes,'compfete Schedule D, Part IX lid X
e Did the organization report an amount for other liabilities in Fart X, line 25
if 'Yes,' complete ScheduleD, Part X 11 e X
I Did the organizations separate or consolidated financial statements for the tax year include a footnote that addresses the organizations liability tar uncertain tax positions under FIN 48 (ASC 74O) If 'Yes complete ScheduleD, Part X ill X
12a Did the organization obtain separate, independent audited financial statements for the tax year' if 'Yes! complete Schedule D, Parts Xl, XII, and XIII lZa X
Was the organization included in consolidated, independent audited financial statements for the tax year' If Yes, and if the organization answered
No to line 72a, then completing ScheduleD, Parts XI, XII, and XIII is optional lZb X
13 Is the organization a school described in section 1 /0(b1)(A)i) If Yes
complete Schedule E 13 X
14a Did the organization maintain an office, employees, or agents outside of the United States' 14a X
b Did the organization have aggregate revenues or expenses of more than $10000 from grantrnaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more7 If Yes,'complele Schedule F, Parts and IV 1db X
15 Did the organization report on Part IX, column (A), line 3, more than ¶5000 of grants or assistance to any organization or entity located outside the United States' If
Yes, complete Schedule F, Parts ii and/V 15 X
16 Did the organization report on Part IX, column (A), line 3, more than $5000 of aggregate grants or assistance to individuals located outside the United if Yes,' complete Schedule F, Parts III and IV 16 X
17 Did the orqanization report a total of more than $15,000 of expenses for professional fundraising services on Fart IX, column (A), lines 6 and 1 If Yes, 'complete Schedule 0, Part I (see instructions) 17 X
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, li nes ic and Ba' It 'Yes,' complete Schedule G, Part II 18 X
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line If Y es complete Schedule C, Part III 19 X
20 aDid the organization operate one or more hospital facilities' If Yes
complete Schedule H 20 X
If Yes
to line 20a, did the organization attach a copy of its audited financial statements to this 20b
BAA TEEAO1 031 01123112 Form 990 (2011)
VALLEY 77-0064507
No
21 Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1' It 'Yes,' complete Schedule I, Parts I end II
22 Did the organization report more than $5000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2' if Yes, 'complete Schedule I, Parts / and III
23 Did the organization answer Yes
to Part VII, Section A, line 3. 4. or 5 about compensation of the organization's current and former officers, directors ! trustees, key employees, and highest compensated
empioyees /f 'Yes, complete
Schedule J 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100000 as of
the last day of the year, and that was issued after December31 2002' If 'Yes,'answer lines 24b through 241 and complete Schedule K If No, 'go to line 25
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exce pt ion
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt
d Did the organization act as an 'on behalf of issuer for bonds outstanding at any time during the year
25a Section 501(cX3) and 501(cX4) organizations. Did the organization engage in an excess benefit transaction with a disquari1ed person during the year' It Yes, complete Schedule L, Part!
bIt the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and hat the transaction has not been reported on any of the organizations prior Forms 990 Dr If 'Yes, complete
Schedule L, Part
26 Was a loan to or by a current or former officer, director ! trustee! key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization's tax year' If Yes, complete Schedule L, Part (I
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons 7 If 'Yes, ' complete Schedule L, Part III
28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Fart IV instructions for applicable filing thresholds, conditions, and exceptions)
a A current or former officer, director, trustee, or key emplo yee If 'Yes, complete Schedule L, Part IV
b A family member of a current or former officer, director, trustee, or key employee
If 'Yes, complete ScheduleL, Part/V
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee! or director indirect owner' If 'Yes,' complete Schedule L, Part/V
29 Did the organization receive more than $25,000 in non-cash contributions' If 'Yes,' complete Schedule M
30 Did he organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation If 'Yes, ' complete Schedule M
31 Did the organization liquidate, terminate, or dissolve and cease operations' If 'Yes,' complete Schedule N. Part
32 Did the organization sell, exchange, dispose at, or transfer more than 25% of its net assets' /f 'Yes,' complete Schedule N, Part II
33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301 7701 -2 and 301 7701 -3' If 'Yes, ' complete Schedule P, Part /
34 Was the organization related to any tax-exempt or taxable enIity
If Yes,
complete ScheduleR, Parts II, III. IV, and V, Irne I
35a Did the organization have a controlled entity within the meaning of section 5)2(bXlB)'
b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(bXlS)' If Yes, 'complete ScheduleR, Part V, line 2
36 Section 501(cX3) organizations. Did the organization make any transfers to an exempt non-charitable related organization' If 'Yes,' complete Schedule R, Part V, line 2
37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that treated as a partnership for federal income tax
purposes If 'Yes, complete Schedule R, Part VI
38 Didtheorganizationcomplete Schedule C and provide explanations in Schedule C for Part VI, lines 11 and 19'
BAA Form 990 (2011)
TEEAO1O*L 07/05/11
Form9gO(2011) MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page5 rPaitWI Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule 0 contains a response to any question in this Part V - P1
1 a Enter the number reported in Box 3 of Form 1096 Enter -0- nat applicable 1a b Enter the number of Forms W-20 included in line la Enter -0- if not applicable lb
C Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners 7
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State-ments. filed for the calendar year ending with or within the year covered by this return 2a
bIt at least one is reported on line 2a, did the organization file all required federal employment tax returns' Note. If the sum at lines la and 2a is greater than 250, you may be required to e-file (see instructions)
Ba Did the organization have unrelated business gross income of $1 .000 or more during the year
b If Yes
has it filed a Form 990-T for this year ( No, provide an explanation n Schedule 0
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial accaunt) It
Yes, enter the name of the foreign country ____________________________________________________________
See instructions for filing requirements for Form TO F 90-22 1 Report of Foreign Bank and Financial Accounts Sa Was the organization a parflt to a prohibited tax shelter transaction at any time during the tax year'
Did any taxable party notity the organization that it was or is a party to a prohibited tax shelter If 'Yes, to line 5a or 5b, did the organization file Form 3886-f'
6a Does the organization have annual gross receipts that are normally greater than $100000, and did the organization solicit any contributions that were not tax
If Yes did the organization include with every solicitation an express statement that such contributions or gifts were
not tax deductible' 7 Organizations tIat may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor'
b If 'Yes, did the organization notify the donor cf the value of the goods or services provided' Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282'
d If Yes
indicate the number of Forms &282 filed during the year I_7d( Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract' Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
g If the organization received a contribution of qualified intellectual properly, did the organization file Form 8899 as re q ui red
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C'
B Sponsor!ng organizations maintaining donor advised funds and section 509(aXB) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year'
9 Sponsoring organizations maintaining donor advised funds. a Did the organization make any taxable distributions under section 4966' b Did the organization make a distribution to a donor, donor advisor, or related person
10 Section 501(cX7) organizations. Enter a Initiation fees and capital contributions included on Part VIII, line 12 b a b Gross receipts, Lncluded on Forni 990, Part VIII, line 12, for public use of club facilities lOb
11 Section SO1(cX12) organizations. Enter a Gross income from members or shareholders 11a
b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) 11
12a Section 4947(aXl) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 104V' b If Yes' enter the amount of tax-exempt interest received or accrued during the year I_12b1
13 Section 5O1(cX29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one
Note. See the instructions for additional information the organization must report on Schedule 0 b Enter the amount of reserves the organization is required to maintain by the states in
which the organization is licensed to issue qualified health plans 13b
cEnter the amount of reserves on hand 13c 14a Did the organization receive any payments for indoor tanning services during the tax yea r
BAA TEEAO1O5L O7IO51 1 Form 990 (2011)
Form 990 (2011) MEALS ON WI1EELS OF THE SALINAS VALLEY 77-0064507 Page 6
I PãriVII I Governance, Management and Disclosure For each Yes' response to lines 2 through 7b below, and for a No response to !,ne Ba, Sb, or / Ob below, describe the circumstances, processes, or changes en Schedule 0 See instructions Check if Schedule 0 contains a response to any question in this Part VI
1 a Enter the number of voting members of the governing body at the end of the tax year 1 a 1 If there are materiai differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule 0
b Enter the number of voting members included in line la, above, who are independent lb 1
2 Did any officer, director, trustee or key employee have a family relationship or a business relationship with any othei officer, director, trustee or key employee
3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other p erson
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 organizations ge t s
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 bod y
bAre any governance decisions of the organization reserved to (or sublect to approval by) members, stockholders, or other persons other than the governing bod y
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following
a The governing body' bEach committee with authority to act on behalf of tile governing b ody
9 Is there any officer, director or trustee! or key employee listed in Part VII, Section A, who cannot be reached at the
b a Did the organization have local chapters. branches, or
If !yes!
did the organization have written policies and pr edures governing The activies of such chapters, atfi I iates, and bianches to ensure their operations are consistent with the organiza t ion !s exempt purposes'
11 a Hs he organization provided a complete copy of this Form 990 to all members at t governing body before filing the form' Describe in Schedule 0 the process, it any, used by the organization to review this Form 990 SEE SCHEDULE
'1 2a Did the organization have a written conflict of interest policy
Ii No, go to inc 73 Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to
Did the organization regularly and consistently monitor and enforce compliance with the policy
if 'Yes, describe In Schedule C how th,s is done SEE SCHEDULE 0
13 Did the organization have a written whistleblower policy' 14 Did the organization have a written document retention and destruction pol i cy
15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision'
a The organizations
CEO, Executive Director, or top management official SEE SCHEDULE 0 bOther officers of key employees of the organization SEE SCHEDULE 0
If !Yes
to line ISa or 15b, describe the process in Schedule 0 (See instructions)
iGa 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 If 'Yes, did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the
17 ListthestateswithwhichacopyofthisFornl99Oisrequiredtobefiled
18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (501 (c)(3)s only) available for public inspection Indicate how you make these available Check all that apply
Own website Another's website J Upon request
19 Describe in Schedule C whether (and if so, w) the organization makes its governing docurrients, conflict of interest policy, and financial statements available to the public during the taA year SEE SCHEDULE 0
20 State the name. physical address, and telephone number of the person who possesses the books and records of the organization •BUSINESS OFFICE 40 ClARK STREEr, SUITE C SALINAS CA 93901 831-758-6325
BAA TEEAO1O€, 01/23112 Form 990 (2Q11)
Form
Section A. Otficers, Directors. Trustees. Key Employees, and Highest compensated tmpioyees 1 a Complete this table for aM persons required to be listed Report compensation for the calendar year ending with or within the
organizations tax year
• List all of the organiza tions current officers directors, trustees (whether individuals or organizations), regardless of amount of compensation Enter -0- in columns (D), (E), and CF if no compensation was paid
• List all of the organizations
current key employees, if any See instructions far definition of 'key employee!
• List the organizations live cunent highest compensated employees (other than an officer, director, trustee, or key employee) who
received reportable compensation (Box 5 of Form W-2 andlor Box 7 of Form 1099-MISC) of more than $100000 from the organization and any related organizations
• List all of the organizations former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations
• List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reporlable compensation from the organization and any related organizations
List persons in the following order individual trustees or directors, institutional trustees, officers, key employees, highest compensated employees, and former such persons
(C) Pos pile it
(A) (B) (do not ctrecic more than one box, (D) (E) (F) Name arid title Average uniess person is Mth an officer Reporlabie Reportable Estiniated
hours and a drcctorttrL,stee) compensation Irom conipensalion from amount of other per week c oroanizalion reialed ornanjlallons compensation (decribv 5l ,
r -n v-2I1O99 MISC) N 2jio4a Misc) from the ,aurstor o reiaierJ I .
organization and reiated
organiza -, I organizations loris III -
Sctieduie - a 0) a
MJQ_ 2Q _____ DIRECTOR 1 X - _________ 0. 0.
S LtbLE_ IL iQik - VICE PRESIDENT 1 X X - 0. 0. 0.
---------------- PRESIDENT 1 X - X - - 0. 0. 0.
---------------- SECRETARY 1 X X - 0. 0. C.
---------------- DIRECTOR 1 X - 0. 0. 0.
L6Lft?XI±fficWN-------- DIRECTOR 1 X - 0. 0. 0.
Q) HsgE BRESHE-- DIRECTOR 1 X 0. 0. 0.
- ® DIRECTOR 1 X 0. 0. 0.
DIRECTOR 1 X 0. 0. 0. j1p)MA( ORRES?OQJ _
DIRECTOR 1 X 0. 0. 0.
JUL - TREASURER 1 X X 0. 0. 0.
- DIRECTOR 1 X 0. 0. 0. CHARLES DES ROCHES - - - - DIRECTOR 1 X 0. 0. 0.
-- -
BAA TEEAO1 07L O7,U61 I Form 990 (2011)
77 —0064 507
(C) Positn
(A) (B) (do not check more han one Name and 'tie Average unless person is both an
hours oItcer and a director/trtjstea) per
weelc 2 Q ax (describn4
e R hours or
relaled Drani 2 a zAtions '
In a
(D) (E) 0') Reportable Reportahie Estimaied
compensation trom compensation horn amount Oh Other the organizahon related organizations compensation 1W 211099 MISC) (Vd-211099 MISC) from the
orgaIi]2aIion and related
orga flint' ons
AlL LWi 1 _ ! r!E EXECUTIVE DIREC 97,134. 0. 17,359.
c2)
----------------------
----------------------
j2ç) 12D ____________
---------------------- j2)
j2 j2
ibsub-total
-
-97,134. 0. 17.359.
Total from continuation sheets to Part VII, Section A 0 0. C.
dlotal(addlineslbandlc) 97,134. 0. 17,359.
2 Total number of individuals (including bu not limited to those ltsted above) who received more than $100,000 of reportable compensation
from the organization • 0 - - Yes 14o
3 Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1 If Yes, comp?ete Sched&e J for such uidviduaI 3 -
4 For any individual listed on line la, is the sum ci reportable compensation and other compensation from 3f the organization and relaled organizations greater than $150,000' f Yes' complete Schedule J for such individual 4 - X
5 Did any person listed on line la receive or accrue compensation from any unrelated orqanization or individual _i'--Y
(A) (C) Name and business address services Compensation
2 Total number of independent contractors (including but not linited to those listed above) who received more than - - -- -
$900,000 in compensation from the organization 1 -
BAA TEEAC I osL 07106(11 Form 990 (2011)
THE SALINAS VALLEY
1 a Federated campaIQns - b Membership dues - C Fundraising evenk - d Related organizations - e Government grants (contributions)
I All other contributions, gifts, grants, and si riiilar amounts not included above -
9 Noncash contributions included in Ins la-it
(A) Total revenue
(B) Related or
exempt function
(C) (D) Unrelated Revenue business excluded from tax revenue under sections
Bjsiness Coda 2a IIILE III - MEAL REINBURS 624210
b NSTP - MEAL REIMBURSEMENT 624210 CTITLE TTI-ONETIME ONLY 624210 d __________ e __________ F All other program service revenue g Total. Add lines 2a-2t
3 Investment income (including dividends, interest and other similar amounts)
4 Income from investment of tax-exempt bond proceeds 5 Royallies _______________ ____________
(I) Real (Ii) Personal Ga Gross rents. _____________ ___________
Less rental expenses _____________ ___________ Rental income or (loss) _________________ ______________
d Net rental income or (loss) ___________ (I) Securities (II) Ci h Sr 7 a Grass amount from sales ci
assets oilier than iriventor ____________________ _________________ Less cost or other basis and sales expenses ____________________ 5 09 Gain or (loss) _____________ -5,09
d Net gain or (loss) ______________
Ba Gross income trom tundraising events (not inctuding $ 3, 995. of contributions reported on line C) See Part IV, line 18 a ____________
b Less direct expenses b Net income or (loss) from fundraising events
9a Gross income from gaming activities See Part IV. line 19 a 32,14
b Less direct expenses b 71 Net income or (loss) from gaming activities
b a Gross sales of inventory, less returns and allowances a
b Less cost ot goods sold ____________
-5. 097 097.
: ;t1- C
- - -- - ,- l__ - 11,430 S.
--
b C d All other revenue e Total, Add lines Pa-lid
BAA ThEAOIO9L 07/06/I Form 990 (2011)
organizations must comp(ete all columns 7plate column (A) but are not required to complete co/umns
(A) Total expenses
(B) Program service
1 Grants and other assistance to governments and organizations in the United Slates See Fart IV, line 21
2 Grants and other assistance to individuals in tile United States See Part IV, line 22
3 Grants and other assistance to governments ! organizations, and individuals outside the United Stales See Part IV, lines 15 and 16
4 Benefits paid to or for members 5 Compensation of current officers, directors,
trustees, and key employees 6 Compensation not included above, to
disqualified persons (as defined under section 4958(U(1)) and persons described in section 495B(cXB)(B)
7 Olher salaries and wages a Pension plan accruals and contributtons (include section 401(k) and section 403(b) employer contributions)
9 Olher employee benefits 10 Payroll taxes 11 Fees for services (non-employees)
a Management Legal Accounting Lobbying ProFessional fundraisi g services See Part IV, line 17 Investment management fees Other
12 Advertising and promotion 13 Office expenses 14 Information technology 15 Royalties 16 Occupancy 17 TraveL 18 Payments of travel or entertainment
expenses for any federal, state, or local public officials
19 Conferences. convenlions, and meetings 20 Interest 21 Payments to affiliates 22 Deprecialion, depletion, and arnorti2ation 23 Insurance 24 Other expenses Itemize expenses not
covered above (List miscellaneous expenses in line 24e If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule C
477
0 0.
r -c
d MISCELLANECUS cAll other expenses
25 Total functional expenses Add lines I Through 24e 26 Joint costs. Complete this line only if
the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation Check here • if following
BAA Form 990 (2011)
TEEAO11OL OU2bII2
(A) (B) BegFnrllng of year End of year
1 Cash - non-interest-bearing 2 Savings and temporary cash investments 3 Pledges and grants receivable, net 4 Accounts receivable, net
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees Complete Part II of Schedule
6 Receivables from other disqualified persons (as defined under section 4958(fl( 1 )), persons described in section 4958(c)(3)(8), and contributing employers and sponsoring organizations of section 501 (c)(9) voluntary
employees! beneficiary
organizations (see instructions) 7 Notes and loans receivable, ne 8 Inventories for sale or use 9 Prepaid expenses and deferred charges
iDa Land, buildings, and equipment cost or other basis Complete Part VI of Schedule D
b Less accumulated depreciation 11 Investments - publicly traded securities. 12 Investments - other securities See Part IV. line 11 13 Investments - program-related See Part IV, line 11 14 Intangible assets 15 Other assets See Part fV, line 11
17 Accounts payable and accrued expenses 18 Grants payable 19 Deferred revenue 20 Tax-exempt bond liabilities 21 Escrow or custodial account liability Complete Part IV of Schedule D 22 Payables to current and former officers, directors, trustees, key employees,
highest compensated employees, and disqualified persons Complete Part II of Schedule
23 Secured mortgages and notes payable to unrelated third parties 24 Unsecured notes and loans payable to unrelated third parties 25 Other liabilities (including federal income tax, paysbles to related third parties,
and other liabilities not included on lines 17-24) Complete Part X of Schedule D
Organizations that follow SFAS 117, check here • and complete lines 27 through 29 and lines 33 and 34.
A 27 Unrestrided net assets 28 Temporarily restricted net assets 29 Permanently restricted net assets
Organizations that do not follow SFAS 117, check here • and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds 31 Pard-in or capital surplus, or land, building! or equipment fund 32 Retained earnings. endowment, accumulated income, or other funds 33 Total net assets or fund balances
d Tnti i'h'i'Iup rid wi nccøtclfuinrl hninnrpc
Form 990 (2011)
TEEAO11 IL 07IO5!l1
Form 990 (2Q11) MEALS ON WHEELS OF TEE SALINAS VALLEY 77-0064507 Page 12
IPa?tItI Reconciliation of Net Assets Check if Schedule 0 contains a response to any question in this Part Xl III
1 Total revenue (must equal Part VIII, column (A), line 12) 2 Total expenses (must equal Part IX, column (A), line 25) 3 Revenue less expenses Subtract line 2 from ILne 1 4 Net assets or fund balances at beginning of year (musf equal Part X, line 33, column (AXt 5 Other changes in net assets or fund balances (explain in Schedule 0) SEE SCHEDULE 0
6 Net assets or fund balances at end of year Combine lines 3, 4, and 5 (must equal Fad X, line 33,
1 Accounting method used to prepare the Form 990 Cash Accrual Other ______
If the organization changed its method of accounting from a prior year or checked 'Other, explain in Schedule 0
2a Were the organizations financial statements compiled or reviewed by an independent bWere the organization's financial statements audited by an independent
If 'Yes to line 2a or 2b, does the organization have a committee that assumes responsibildy for oversight of the audit, review, or compilation of its financial statements and selection of an independent If the organization changed either its oversight process or selection process during the tax year. explain in Schedule 0
d If 'Yes to Fine 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both
Separate basis Consolidated basis Both consolidated and separate basis
3a As a result of a federal award, was the organization required to undergo an audit Or audits as set forth in the Single Audit Act and 0MB Circular A-133'
bIt Yes,
did the organization undergo the required audit or audits' If the organization did not undergo the requLred audit or audits, explain why in Schedule 0 and describe any steps taken to undergo such audits
BAA
TEEAO112L 07106111
SCHEDULE A (Form 990 Or 990-EZ)
DeprUi,enl of the IresLy Internal Revenue Sconce Nan'. 0111. organintion
Public Charity Status and Public Support Complete if the organization is a section 501(cX3) organization or a section
4947(axl) nonexempt charitable trust.
Attach to Form 990 or Form 990-Q. 1 See separate instructions.
2011
THE SALINAS VALLEY
The organization is nol a private foundation because it is (For lines 1 through 11 check only one box 1 A church, convention of churches or association of churches described in section 170(bXlXAXi). 2 A schoor described in section 17Q(bXlXA)Oi). (Attach Schedule E 3 A hospital or a cooperative hospital service organization described in section 170(b$lRAXni). 4 A medical research organization operated in conjunction with a hospital described in section 170(bXlXAXiil) Enter the hospital's
name, city, and state - 5
An organization operated for the benelit of a college or university owned or operated by a governmental unif described in section 170(bXlXA)Qv). (Complete Part II)
6 A federal, state, or local government or governmental unit described in section 170(b)(lXAXv). 7 x An organization that normally receives a substantial part of its support from a governmental unit or from the general public described
in section 170Ø,XlXAXvi). (Complete Part II) 8 A community trust described in section 170(bXtXAXvi). (Complete Part 9 An organization that normally receives (1) more than 33-1/3% of its support from contributions, membership tees, and gross receipts
from activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33-113% of its support from grass investment income and unrelated business taxable income Qess section 511 tax) from businesses acquired by the organization after June 30, 1975 See section S09(a)(2). (Complete Part Ill)
10 An organization organized and operated exclusively to test for public safety See section 509(4(4). 11 An organization organized and operated exclusively for the benefit of, to perform the hnctions of, or carry out the purposes of one or
more publicly supported organizations described in section 509(aXl) or section 509(a)(2) See section 509(aX3). Check the box that describes the type of supporting organization and complete lines lie through 11 a flType I b Jrype Li C fl Type Ill - Functionally integrated d Type Ill - Other
e By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)
I If the organization received a written determination from the IRS that isa Type I, Type It or Type Ill supporting organization. check this box Since August 1], 2006. has the organization accepted any gift or contribution from any of the following p ersons __________
Yes No (i) A person who directly or indirectly controls either alone or together with persons described in (ii) and (iii)
below, the governing body of the supported organization 11 g ® (ii) A family member ot a person described in (i) above' 11 g (ii) (iii) A 35% controlled entity of a person described in (i) or (u) above' 11 g Øii Provide the following information about the supported organization(s) (I) Name of rijpporled (ii) Liii (Iii) Type of organization (iv) is the (v) Did you nohry (vi) is the vii mcunt 01 suppOd
organization (described on lines 1 9 organization in the organization in organizahon in abce or iRC section column (I) hsled in column 0) ci coiumn (') (S.. instrudion)) your governing your support' organized in the
see A (Form 990 or 990-EZ) 2011
TEEAO4OIL 09/2811
Schedule A (Form 990 or 990 - EZ) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Pace 2
I Part'lI Support Schedule for Organizations Described in Sections 170(bXlXAXiv) and 170(bXlXAXvi) (Complete only you checked the box on line 5, 7, or S of Part I or if the orgenization failed to quah, under Part Ill If the organization fails to qualify under the tests listed below! please complete Part (LI
Calendar year (or fiscal year beginning in)
1 Gifts, grants, contributions, and niem ship fBe received not includR any
unusual grants
2 Tax revenues levied for the organizations benefit and either paid to or expended on its beharf
3 The value of services or facilities furnished by a governmental unit to the organization without charge
4 Total. Add lines 1 through 3 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (fl
6 Public support Subtract line
Calendar year (or fiscal year beginning in)
7 Amounts from line 4
(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (fl Total
s4.1R2. 54R.611. 14.259 478.547. 577.786. 2.7742
(a) 200? (b) 2008 Cc) 2009 (d) 2010 (e) 2011 (0 Total
554.782. 548.611. 614.259. 478.847. 577.786. 2,774.
B Gross income from interest dividends, payments received on securities loans, rents, royalties and income from similarsources 29,437. 17,481. 13,009. 8,570. 6,765. 75,2
9 Net income from unretated business activities! whether or not the business is regularly carried on
10 Other income Do not nclude gain or loss from the sale of capital assets (Exolain in Partly) SEE PART IV __________ 12,290. 13,061. 10,775. 12,140. 48,2E -, - Pt .
11 l i gort Add lines? ' ~ - . 4. 4 4r
'- 2,897, 8 12 Gross receipts from related activities, etc (see instructions) Lj._ 1, 131, 1
13 First live years. It the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) n,c, nri,nn rhori' Ib!c hny nri ctnn hArA
14 Public support percentage for 2011 (line 6, column Ct) divided by line 11 column (t)) 14 95. / ~ 15 Public support percentage from 2010 Schedule A, Part II, tine 14 15 96. C3 %
16a 33-1)3% support test - 2011. It the organization did not check the box on line 13, and the line 14 is 33-113% or more, check this box and stop here. The organization qualifies as a publicly supported organization
l 33-1/3% supporttesl - 2010. lithe organization did not check a box on line 13 or iSa, and line 15 is 33-113% or more, check this box and stop here. The organization qualifies as a publicly supported organization
17a 10%.iacts-and-circumstances test —2011. lithe organization did not check a box on line 13, iSa, or 1Gb, and line 14 is 10% or more, and it the organization meets the
facts and circurrstances test, check this box and stop here. Explain in Part IV bow
the organization meets the iacts.and.circumstances' test The organization qualifies as a publicly supported organization
10%.Iacts-and-circumstances test —2010. If the organization did not check a box on line 13, 1 Sa, 1Gb, or 17a, and lIne 15 is 10% or more, and if the organization meets the factsandcircumstances' test, check this box and stop here. Explain in Part IV how the organization meets the 'tacts.and-circumstances' test The organization qualities as a publicly supported organization
18 Pnvate foundation. If the organization did not check a box on line 13! 1 Ga, 1 Gb, 1 7a. or 1 7b, check this box and see instiuctions BAA Schedule A (Form 990 or 990-EZ) 2011
'TEEAG4O2L 05125111
Schedule A (Form 990 or 990-EZ) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77-0064507 Page 3
I Part'lIl I Support Schedule br Organizations Described in Section 509(aX2) (Complete only it you checked the box on line 9 of Part I or if the organization failed to quality under Part II lithe organization fails to qualify under the tests listed below, please complete Fart II)
Sprtinn A Piihlir Siinnnrt
(or fiscal yr beginning in)
any u 2 Gross
3 Gross receipts from activities that are not an unrelated trade or business under section 513
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf
5 The value of services or facilities furnished by a governmental unit to the organization without charge
6 Total. Add lines 1 through 5 7a Amounts included on lines 1,
2, and 3 received from disqualified persons Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5000 or 1 % ot the amount on line 13 for the year Add lines 7a and 7b !li support (Subtract line
Calendar year (or fiscal yr beginning in) • (a) 2007 (b) 2008 K) 2009 (d) 2010 (e) 2011 - 9 Amounts from line 6 ______________ ______________ ______________ ______________ _____________ -
b a Gross income from interest, dividends, payments received on securities loans, rents! royalties and income from similar sources ______________ ______________ ______________ ______________ _____________ -
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 ______________ ______________ ______________ ______________ ______________ -
cAdd lines ba and lOb ____________ ____________ ____________ ____________ ____________ - 11 Net 'nccme tram unrelated business
activities not included fl li ne lob, whether or ot the husines is regularly carried on _____________________ _____________________ _____________________ _____________________ ____________________ -
12 Other income Do not include gain or loss from the sale of capital assets (Explain in Partly) _________ _________ _________ _________ _________ -
13 Total support. (Add ins U. ai1 I?) ______________ ______________ ______________ ______________ ______________ - .' the organizations first, second, third, fourth, or fifth tax year as a section 501c)(3)
15 Public support percentage for 2011 (lineS, column (f) divided by line 13, column (0)
17 Investment income percentage for 2011 (line bc, column (f) divided by line 13, column (0) 17 18 Investment income percentage from 2010 Schedule A, Part Ill, line 17 18 iSa 33-113% support tests —2011. It the organization did not check the box on line 14, and line ibis more than 33-113%, and line 17
is not more than 33-1(3%, check this box and stop here. The organization qualifies as a publicly supported organization b 33-113% support tests —2010. It the organization did not check a box online 14 or line 1%, and line 16 is more than 33-113%, and
li ne IBis not more than 33.1/3%. check this bcx and stop here. The organization qualifies as a publicly supported organization 20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
BAA TEEAO4OSL 05/25)11 Schedule A (Form 990 or 990-EZ) 2011
Schedule B (Form 990,990-El or 990-PF)
Department of the TieasLiry Internal Revenue Service
Schedule of Contributors Attach to Form 990, Form 990-EZ, or Form 990-Pr
OMA No 1545 0047
2011
THE Organization type (check one) Filers of; Form ggo or 990-EZ
Form 990.PE
Section: X 501 (c)( 3) (enter number) organization
4947(aXl) nonexempt charitable trust not treated as a private foundation 527 political organization
501 (cX3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501 (c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule Note. Only a section 501 (cX7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule See instructions
General Rule For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5000 or more (in money or property) from any one contributor (Complete Parts I and II)
Special Rules jFor a section 501 (c)(3) organization filing Form 990cr 990-EZ that met the 33-1/3% support test of the reguiatiDns under sections
509(aRI) and 170(bXl)(A)(vi), and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Fart VIII, line lb or (u) Form 990-EZ, line I Complete Parts I and II
For a section 501 (c)(7). (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 for use exc/usve/y for religious, charitable, scientific, literary, or educalional purposes, or the prevention of cruelty to children or animals C mpIete Parts I, II, and III
For a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for use exclus,vc/ytor religious, charitable, etc, purposes, but these conlrLbutions did not total to more than $1,000 If this box is checked, enter here the total contributions that were received durin the year for an exclusively religious, charitable, etc, purpose Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc, contributions of $5.000 or more during the year $____________________
Caution: An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF) but it must answer 'No' on Part IV, Fine 2, of its Form 990, or check the box on line H of its Form 990-EZ or on Fart I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule 8 worm 990. 990-EZ, or 990-RE)
BAA For Paperwork Reduction Act Notice, see the Instructions br Form 990, Schedule B (Form 990, 990-El or 990-FE) (2011) 990E2, or990-PF.
TEEAO7OIi 01/16t12
I P4I
I Contributors (see instructions) Use duplicate coptes of Part I if add%tional space rs needed
(a) Q,) (c) Number Name, address, and ZIP + 4 Total
cont n b uti on s
1 COMMUNITY FND OF MONTEREY COUNTY
? t Pfl frQ ---------------------------$
_____________________________________
(a) (b) (C)
Number Name, address, and ZIP + 4 Total contobutions
2 MONTEREY PENINSULA FOUNDATION
1 LOWER RAGSDALE DRIVE $ 41,4
- Qa . a 2 (a) (b) (c)
Number Name, address, and ZIP + 4 Total contnbutions
3
Number
4
ITY OF SALINAS
00 LINCOLN AVENUE $ 14,1
ALINAS, CA 93901
(b) Cc) Name, address, and ZIP + 4 Total
contributions
ALIFORNIA WELLNESS FOUNDATION
-------------------------- $ rOODLAND HILLS, CA 91367
(b) (C)
Name, address, and ZIP + 4 Total contnbutions
Type of contribution
Person X Payroll Noncash
(Complete Part II if there is a noncash contribution
Cd) Type of contribution
Person X Payroll Noncash (Complete Part lIt there
is a noncash contribution
(d) Type of contribution
Person X Payroll Iloncash (Complete Fart Iii there
isa noncash contribution)
(d) Type of contribution
Person X Payroll Noncash (Complete Part Ill there
is a noncash contribution
(d) Type of contnbution
S
6
BAA
___________________________$
ALINAS, CA 93902
(b) (c) Name, address, and ZIP + 4 Total
contjibutior
lAY & STANLEY SMITH CH1RITABLE TRUS
_____ _________________ - $ -22L
;AUSAIITp1 CA 94965 -
TFEAO7O2L 0BJ3011 i Schedule B (Fr
Person X Payroll Non cash (Complete Part II if there
is a noncash contribution
(d) Type of contribution
Person X Payroll Noncash (Complete Pad lit there
is a noncash contribution
990-EZ, or990-PF) (2011)
I I I Contributors (see instructions) Use duplicate copies of Part lit additional space is needed
(a) (c) (d) Number Name, address and ZIP + 4 Total iype of contribution
contnbutions
7 UNITED WAY
60 GARDEN COURT STE 350
MONTEREY, CA 93940
(a) (b) lumber Name, address, and ZIP + 4
8 SANIAFEMERCADQSL INC.
860 S. WHITE ROAD
P P1_4 25'32 ______________________
(a) 0,) lumber Name, address, and ZIP + 4
(b) Name, address, and ZIP + 4
$
(b) Name, address, and ZIP + 4
Person X Payroll
_3LQ52L Noncash
(Complete Part II if there is a noncash contribution
Cd) FbI Type of contribution butions
Person X Payroll
16,112. Noncash (Complete Fart lId there
is a noncash contribution)
(C) (d) Total Type of contribution
ntributions
Person Payroll Noncash
(Complete Part lit there is a noncash contribution
(c) (d) Total Type of contribution
contnbutions
Person Payroll Non cash
(Complete Part II if there is a noncash contribution)
(d) Type of contribution
S
Number
Person Payroll
$ Noncash
(Complete Part lit there is a noncash contribution)
(b) (0) (d) Name, address, and ZIP + 4 Total Type of contribution
contnbutions
HEEEEEEEIEEII BAA TEEAO7O2L O$/3O1 1
Pets on Payroll Noncash
(Complete Part lIt there is a noncash contribution
Schedule B (Form 990 990.FZ, or 990-PF) (2011)
Name of organization bitipiover identiuication number
MEALS ON WHEELS OF THE SALINAS VALLEY 77-D064507
I Part II I Noncash Property (see instructions) Use duplicate copies of Fart lit addiltonal space is needed
(a) (b) (C) (d) No. from Description of nor,cash property given FMV (or estimate) Date received
Part I (see instructions)
(a) No. from
Part I
(b) Description of nuncash property given
(c) (d) rMV (or estimate) Date received (see instruclions)
(a) No. from
Part I
0') Descnption of rioncash property given
(c) (d) MV (or estimate) Date received
(see Instructions)
(a) No. from
Part I
(b) Description of noncash property given
(c) (d) FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Description of noncash property given
(C) (d) FMV (or estimate) Date received (see instructions)
(a) No. from
Part I
(b) Descnption of noncash property given
(c) Cd) FMV (or estimate) Date received (see instructions)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
TEEAO7O3L 0313011
Exc/usive/yrcligious, charitable, etc, individual contributions to section 501(c)Q), (8), or (10) organizations that total more than $1,000 for the year.Coniplete cois (a)through (e) and the lollowing line entry For organizations completing Part Ill, enter total of exclus've(y religious, charitable, etc, contributions of $1,000 or less for the year (Enter this informatcon once See instructions) $ N/A Use duplicate copies of Fart lit if additional space is needed
(b) (c) (d) Purpose of gilt Use of gift Descnption of how gift is held
(e) Transfer of gift
Ira nsfere s and ZIP ~ 4 of transferor to transferee
Purposc of gift Use of gift Descoption ol how gift is held
Transfer of gift address, and ZIP + 4
Purpose of gift Use of gift Description ol how gift is held
(e) Transfer of gift
TransFeree's and ZIP + 4 of transferor to transferee
Purpose of gift Use of gilt Descnption of how gilt is held
(e) Transfer of gift
Iranslerees ZIP 1- 4 of transferor to transferee
BAA Schedule B (Form 9S0. 990-EL, Or TEFAOYO4L OI3OI1
SCHEDULED (Form 990) Supplemental Financial Statements 2011
Complete if the orqaniration answered Yes,' to Form 990. Departni&nlortbeTeasjrv Part IV, lines 6,7,8,9,10, ha, lib, 11, lid, lie, ill, 12a, or iTh. 2 OpILto.ut interrei Revenue Service Attach to Form 990. See separate instructions. 4'lnpection Name at the orgn'ntien Employer 'dentilication numb.,
MEALS ON WHEELS OF THE SAlINAS VAlLEY 77-0064507 Part I I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if
the organIzation answered Yes to Form 990, Part IV, line 6 (a) Donor advised funds b) Funds and other accounts
i Total number at end of year _______________________________________ _________________________________ 2 Aggregate contributions to (during year _______________________________________ _________________________________ 3 Aggregate grants from (during year) _______________________________________ _________________________________ 4 Aggregate value at end of year _______________________________________ _________________________________ 5 Did the organization inform all donors and donor advisors in writing that the assets heLd Ln donor advised
hinds are the organiza t ions property, subject to the organizations exclusive legal control' TJYes El No
6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit' Yes No
I Part II I Conservation Easements. Complete if the organization answered 'Yes' to Form 990, Part IV, line 7 1 Purpose(s) of conservation easements held by the organization (check all that apply)
Preservation of Land for public use Ce g , recreation or education) Preservation of an historically important land area Protection of natural habitat Preservation of a certified historic structure Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the iast day of Pie lax year - ___________________________________
- Held at the End of the Tax Year a Total number of conservation easements 2a b Total acreage restricted by conservation easements 2b
Number of conservalion easements on a certified historic structure included in (a) 2c d Number of conservation easements included in (c) acquired after 8/17f06, and not on a historic
structure listed in the National Register 2d 3 Number of conservation easements modified, transferred! released, extinguished, or terminated by the organization during the
tax year _________________ 4 Number of states where property subject to conservation easement is located • 5 Does the organization have a written policy regarding the periodic monitoring, inspection! handling of violations,
and enforcement at the conservation easements it holds' Elves El No 6 Stan and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year i- s_______________
B Does each conservation easement reported on line 2(d) above satisii the requirements of section 170(h)(4)(B)(i) and section I iO(hX4)(B)(ii)' El Yes No
9 In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organiza t ions accounting for conservation easements
art Ill I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
half the organization elected ! as permitted under SFAS 116 (ASC 958). not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide. in Fart XIV, the text of the footnote to its financial statements that describes these items
b If the organization elected! as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art ! historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items (i) Revenues included in Earn, 990, Part VIII, line 1 • $____________________ (ii) Assets included in Form 990, Part X $____________________
2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the folLowing amounts required to be reported under SEAS 116 (ASC 958) relating to these items
a Revenues inctuded in Form 990, Part VIII. line 1 - $____________________
BAA For Paperwork Reduction Act Notice, see the instructions ror Form 990. TEEABSO1 L O/25rfl Schedule D
ScheduleD form 990) 2011 MEALS ON WHEELS OF THE SALINAS VALLEY 77 - 0064507 Page 2 I Part Ill I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3 Using the organiza tions acquisition. accession, and other records, check any of the following that are a significant use of its collection items (check all that apply)
a Public exhibition ii Loan or exchange programs b Scholarly research e Other __________________________________________________________
Preservation for future generations 4 Provide a description of the organizations collections and explain how they k1rther the organization's exempt purpose in
Part XIV 5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar ,_.
I Part' IV I Escrow and Custodial Arrangements. Complete it the organization answered Yes' to line 9, or reported an amount on Form 990, Fart X, line 21
1 a Is the organization an açent, trustee, custodian, or other intermediary for contributions or other assets not included on Form 990, Part X' Yes No
b If 'Yes, explain the arrangement in Part XIV and complete the following table - Amount
c Beginning balance _______________________________ d Additions during the year id ___________________________________ e Distributions during the year it
I Ending balance if _______________________________ 2a Did the organization include an amount on Form 990, Part X, line 21 Yes JMo
1 a Beginning of year balanca b Contributions
C Net investment earnings, gains, and losses _________________ __________
d Grants or scholarships ___________________ ___________________ -___________________ ___________ o Other expenditures for lacihties
andprograms _________________ _________________ _________________ __________ Administrative expenses _________________ _________________ _________________ __________
g End of year balance ___________________ ___________________ ___________________ ___________ 2 Provide the estimated percentage of the current year end balance (line 1g. column (a)) held as
a Board designated or quasi-endowment - Permanent endowment - Temporarily restricted endowment - The percentages In lines 2a, 2b, and 2c should equal 100%
3a Are there endowment funds not in the possession of the organization that are held and administered for the organizalion by (i) unrelated organizations (ii) related organLzations
b If Yes to 3a(ii), are the related organizations listed as required on Schedule R?
Description of property 1(a) Cost or other
1 a Land b Buildings
Leasehold improvements d Equipment
Yes No 3a0) 3a(ii)
Sb
( Book value
BAA (Form 990) 2011
TrEAaSDa 01 fl 6112
2 FIN 4S (ASC 740) Footnote In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organizations liability for uncertain tax positions under FIN 48 (ASC 740) SEE PART XIV BAA TEEA33D3I. 01/23112 ScheduLe D (Form 990) 2011
Total revenue (Form 990, Part VIII, column (A), line 12) Total expenses (Form 990, Part IX, column (A), line 25
Excess or (deficit) for the year Subtract line 2 from line I Net unrealized gains (losses) on investments Donated services and use of facilities Investment expenses Prior period adjustments Other (Describe in Part XIV) SEE PART XIV fotal adjustments (net) Add lines 4 through 3
1 Total revenue, gains, and other support per audited financial statements 2 Amounts included online 1 but not on Form 990, Part VIII. line 12
a Net unrealized gains on investments Donated services and use of facilities Recoveries of prior year grants
d Other (Describe in Part XIV) SEE PART XIV • Add lines 2a through 2d
3 Subtract line 2e from line 1 4 Amounts included on Form 990, Part VIII, line 12, but not on line 1
a Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIV)
cAdd lines 4a and 4b
1 Total expenses and losses per audited financial statements 2 Amounts included on line 1 but not on Form 990, Part IX. line 25
a Donated services and use of facilities b Prior year adjustments
Other losses Other (Describe in Pad XIV) SEE PART Xi'? Add lines 2a through 2d
3 Subtract line 2e from line 1 4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included an Farm 990. Part VIII, line 7b b Other (Describe in Part XIV
Add lines 4a and 4b
Complete this part to provide the descriptions required br Part II, lines 3, 5, and 9, Part Ill, lines 18 and 4. Fart IV, lines lb and 2b. Part V. line 4. Part X, line 2. Part XI, line 8. Part XII, lines 2d and 4b, and Pad XIII, lines 2d and 4b Also complete this part to provide any additional information
_ 9APTX-IIW4BIVDINQIL ------------------------------------------------
-- JBE _QR?sNjflTjPj EpQutrQ&rcaQQIILQN ______
--
__ic_D X_ ?1INMflNS_at IUB £_EPE -
___\ gp 2DQQ FQR FEDERAL ?Q _NP_21_FR$ThaQLQQJ_APflQB1UL______
BAA TEEA3JO4L 05/25/I I Schedule D (Form 990) 2011
ScheduleD (Form 990) 2011 MEALS ON WhEELS OF THE SALINAS VALLEY 77C064507 Pane 5
I PáttXIVI Supplemental Irifonnatiori (continued)
BAA TLLA3SO5L 05/25/I Schedule D (Form 990) 2011
2011 SCHEDULE D, PART XIV - SUPPLEMENTAL INFORMATIONPAGE 6
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY
11/08/12
SCHEDULED, PART XI, LINES OTHER CHANGES IN NET ASSETS OR FUND BALANCES
LOSS ON DISPOSAL OF PROPERTY
77-0064507
01 1SAM
5,097. TOTAL $ 5,097.
SCHEDULE D, PART XII, LINE 2D OTHER REVENUE INCLUDED IN F!S BUT NOT INCLUDED ON FORM 990
INVESTMENT EXPENSES LOSS ON DISPOSAL OF PROPERTY
$ -467. 5,097.
TOTAL $ 4,630.
SCHEDULED, PART XIII, LINE 2D OTHER EXPENSES AND LOSSES PER AUDITED F!S
INVESTMENT EXPENSES $ -467. TOTAL $ -467.
SCHEDULE 0 I Supplemental Information to Form 990 or 990-EZ 0MB No I4 0C47
(Form 990 or 990-EZ) 2011 Department of Ule Tieasury inIe,nai Revenue Serv,ce Name of he organizabon
Complete to provide information br responses to specific questions on Form 990 or 990-fl orto provide any addihonal information.
Attach to Form 990 or 990-EZ. Empioyvr 'dent'hction number
AUDIT COMMITTEE WILL REVIEW THE 990 BEFORE IT IS FILED. UPON AUDIT COMMITTEE'S
- - _ Y! PA??! Y_VJi_9P L IT IL BE SEN'!
- - fP!!ko f4ITJ(J4N gq
X1bk IQN.Q QNRQRIFLQAJLDJffifQ MP!I OF cot s
BOARD MEMBERS AND STAFF SHOULD AVOID ANY PERSONAL OR BUSINESS RELATIONSHIP THAT
PLACES HIS OR HER INTERESTS IN DIRECT CONFLICT WITH THE ORGANIZATION. BOARD MEMBERS
AND STAFF ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMEN'I ANNUALLY,
NOT BECOME INVOLVED WITH DELIBERATIONS OR DECISION—MAKING IF A CONFLICT OF INTEREST
EXISTS AND DOCUMENT VOTE ABSTENTIONS IN THE MINUTES OF THE MEETINGS, AND MAKE SURE
THAT MEETING MINUTES REPORT ANY CONFLICT OF INTEREST SITUATION.
FORM 990, PART VI, LINE iSA - COMPENSATION REVIEW & APPROVAL PROCESS FOR CEO, EXEC. DIR., OR TOP MGT
PRESIDENT OF THE BOARD OF DIRECTORS IS RESPONSIBLE. ON AN ANNUAL BASIS, TO PREPARE --
AN APPRAISAL OF THE EXECUTIVE DIRECTOR. THE BOARD OF DIRECTORS SHALL ESTABLISH A
SALARY SCHEDULE FOR STAFF POSITIONS WHICH INCLUDES A SALARY RANGE. THIS SALARY
SCHEDULE FOR STAFF POSITIONS SHALL BE REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF
DIRECTORS IN THE SAblE MANNER AND AT THE SAME TINE AS THE BUDGET CURRENT SALARY
COMPARISONS ARE DONE USING THE WAGE AND SALARY SURVEY OF NORTHERN CALIFORNIA
NONPROFIT ORGANIZATIONS.
FORM 990, PART VI, LINE 1SB - COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES
CURRENT SALARY COMPARISONS APE DONE USING THE WAGE AND SALARY SURVEY OF NORTHERN
CALIFORNIA NONPROFIT ORGANIZATIONS. THE AGENCY OPERATIONS COMMITTEE THEN REVIEWS THE
SALARY SCHEDULE FOR THE EXECUTIVE DIRECTOR AND APPROVES ANY SALARY INCREASES.
FORM 990, PART VI, LINE 19- OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE - -
A FORMAL REQUEST MUST BE MADE AT THE BUSINESS OFFICE.
BAA For Paperwork Reduction Act rIIice, see the Instwctions for Form 990 or 9%-El TEEA49O1 L O7I14t Schedule 0 (Form 990 or 990-EZ) 2011
40,//I
50.194
0 0 0 0 0 90,965
1,413
6,000
922
0 0 0 0 0 8,335
35,108 S/L 6
697 S/L 6
35, 5
1,413 S/L 10
6, 0 S/L 5
922 S/L 3
8,335
566
8,366
8,932
0
0
0
0
6/30112 2011 CALIFORNIA BOOK DEPRECIATION SCHEDULE PAGE 1
CLIENT 753670 MEALS ON WHEELS OF THE SALINAS VALLEY 77-006450;
11/08/12 07 18AI
PRIOR CUR SPECIAL 119/ PRIOR SAD/AG
DATE DATE 0051/ BUS 179 DEPR BONUS! DEC BAI JBASIS DEPP PRIOR CURRENT DF IPTION JCQllIE V)Ifl RAcJS 1CL IIS AllOW P FWPP FWPR PfNrr R&SIS RFPR MITHUD LEE PAW rWPR
FORM 199
AUTO! ThANSPORT EQUIPWENT
1 FORD VAN 5/23/05 1/22/11 40,771
8 2011 FORDYAN!TRUCK 5/18/11 50,194
TOTAL AUTO / TRANSPORT EQUIP 90,965
FURNITURE AND FIXTURES
2 FURNIThRE 1/19/92 1,413
3 ACCESS SYSTEM FOR W 4/01/98 6,0w
6 FURNITURE 9/17/92 922
TOTAL FURNITURE AND FIXTURE 8,335
MACHINERY AND EQUIPMENT
4 COPIER 5/07/10 /,633 1,633 1,654 S/L 5 1,527
5 ABSOCOLD REFRIGERATOR 3/09/% 298 298 298 S/L 10 0
7 FREEZER 5/21 / 13,201 13,201 5,815 S/L 7 1,886
tOTAL MACHINERY AND EQUIPME 21.132 0 0 0 0 0 21,132 1,761 3,413
TOTAL DEPRECIATION 20432 0 0 0 0 0 120,432 51,901
GRAND TOTAL DEPRECIATION 20,432 0 0 0 0 0 120,432 51,901