8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
1/56
Form
CT-12
ForOregon
Charities
Charitable Activit ies Section
Oregon DepartmentofJustice
1515 SW
5 th Avenu e, S u i te
410
P or t l and ,
OR
9 7 2 0 1 - 5 4 5 1
Em a i l : charitable.activ it ies@doj .state.or.us
Webs i t e : h t t p : / /w w w .do j . s t a te .o r .us
VOICE
( 9 7 1 ) 6 7 3 - 1 8 8 0
TTY (800)735-2900
FAX
( 9 7 1 ) 6 7 3 - 1 8 8 2
For
Accounting Periods Beginn
2013
SectionI.
General
Information
1.
Cross
Through Incorrect
Itemsand
CorrectHere:
(See
instructions
for
change
of
name or accounting period.)
1411
Registration
:
The
F a m i l y Young
Men's C h r i s t i a n
Assoc i a t i o r j r g an i za t i o nName:
o f
M a r i o n andP o l k C o u n t i e s Address:
685
C o u r t
St NE,Salem, OR
9 7 3 0 1
City, State, Zip:
01/01/2013 12/31/2013
p
h0
ne:
Email:
503-399-2757 Period Beginning:
Fax:
Period
Ending:
Am
R
Didacertif ied public accountant audit your financial records?- Ifyes, attach a copy of the auditor's report, financial statements,
accompanying notes, schedules,
or
other d ocum ents supplem enting the report or financial statements.
Isthe organization
a
party
to a
contrac t involving perso n-to-pe rson, advertising, vending machine or telephone fund-raisingin
Oregon?
If
yes, write the name
of
the fu nd-raising firm(s) who conducts the campaign(s):
Has
the o rganization
or
any
ofts
officer s, directo rs, trustees, or key employees ever signed a voluntary agreement with any
government
agency, such
as
a state attorney general, secretary
of
state, or local district attorney,
or
been a party to legal action
inany court
or
administrative agency regarding charitable solicitation, administration, management, or fiduciary practices?If
yes, attach explanation
of
each such agreement or action. See instructions.
During this reporting period, did the organization amend
its
articlesofincorporation, bylaws, or trust documents, OR did the
organizationreceive a determin ation letter from the Internal Revenue Service relating to its tax-exempt status?
If
yes, attach
a
copy
of
the amended document
or
letter.
Is
the organization ceasing operations and
is
this the final report?
(If
yes, see instructions on how to close your registration.)
Provide
contact information
for
the person respon sible for retaining the organization's records.
ve s
Yes
Z ] Yes
I I Yes
Name
Position Phone
MailingAddress
&
Email Address
F r e d
N a i m y VP
o f Ops
5 0 3 - 3 9 9 - 2 7 5 7 Same
as
a b o v e
8.
ListofOfficers, Directors, Trustees and Key Employees- List each person who held one of these positions
at
any time during the year evenifthey
not
receive compensa tion. Attach additional sheets
if
necessary.
If
an a ttached IRS form includes substantially the same compensation informat
the
phrase See IRS Form may be entered
in
lieu
of
completing that section. (Oregon law requires a minimum of three directors.)
(A)
Name, mailing address, daytime phone number
and
em ail address
(B) Title &
averageweekly
hours
devoted
to
position
(C)
Compensa
(enter $0
position un
Name:
Address:
Phone:
Email:
SeeIRS
F o r m
990
Name:
Address:
Phone:
Email:
RECEIVED
Name:
Address:
Phone:
Email:
MOV 0
DEPAHTMEIT
7
ZOH
Form
Continued
on
Reverse Side
THO
3J4460
1.000
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
2/56
Sec t ion
II. Fe e Calc ulat ion
11.
12.
13.
14.
16.
17.
Total Revenue
( F r o m L i n e
12
( c u r f e n t y e a r ) o n F o r m 9 9 0 ; L i n e 9 o n F o r m 9 9 0 - E Z ; P a r tI Line 12a on Form 990-PF; Line 9 on Form
1041;
or see p age 3 o f the instru ct ions i f no federal tax
return
w a s p r e p a r e d . A t t a c h e x p l a n a t i o n i f T o t a l R e v e n u e i s $ 0 . )
4 , 8 5 3 , 2 5 1
10 . Revenue Fee
( S e e c h a r t b e l o w .
Minimum
fee is $10, even i f
total
revenue is a negative amount.)
Amount o n L i n e 9
R e v e n u e F e e
0
24,999 10
25,000
49,999
25
50,000 99,999
45
100,000 249,999
75
250,000
499,999
100
500,000
749,999 135
750,000
999,999 170
1,000,000
or
m o r e 200
Net
Assets or Fund Balances at End of the Reporting
Period.
( F r o m
L i n e 22 ( en d of yea r) on Form990, Line 21 on Form 99 0-E Z, or Part I II ,
L i n e
6 o n Form 990 -PF ; or s ee pa ge 3 of CT-12 i ns truct i ons to ca lcula te . )
Net Fixed Asse ts U sed to Cond uct Charitable Activities . . .
( G e n e r a l l y ,
from
Pa rt X . L i ne 10c on Form 990, L i ne 23B on Form 99 0-EZ or Pa rt
II, L i n e
14b
on Form 990 -PF; or s ee pa ge 4 of CT- 12 i ns truct ions to ca lcula te . S e e
i ns truct i ons i f orga ni z a t i on owns i ncome-produci ng. )
Am oun t Subject to Net Assets or Fund Balances Fee . . . .
( L i ne 11 m i nus L i n e 12 . I f L i ne 11 mi nu s L i ne 12 i s le ss than
50,000, write
$0.)
Net
Assets or Fund Balances Fee
( L i n e 1 3 multip lied by .0001. I f
the
fee is le ss than $5, enter $0. N ot to ex ce ed 1,000. R ou nd cents to the nea res t whole dol lar
)
15. Are you filin g this report late? Yes No
(If
y e s ,
th e
late
fee is a minimumof $20. Yo u ma y owe more dependi ng on how
late
t he report is. S ee instruction 15 for additional
information
or conta ct
the
Cha r i ta ble A ct i v i t i es S ect i on a t ( 971)
673-1880
t oobtain
late
f ee amount)
10.
200
14.
0
15.
0
16.
200
otal Amount Due
(Add L i n e s 10, 14, a nd 15.
Makec h e c k
pa ya ble to the Oregon Department of Ju st ic e . )
Attach a copy of the organization's federal 990 or other return and all supporting schedules and attachments that were filed with the IRS with
the exception that Form 990 & 990EZ filers do not need to attach a copy of their Schedule B. Also, if the organization did not file with the IRS
or filed a 990-N, but had Total Revenue of $25,000 or more, or Net Assets or Fund Balances of $50,000 or more, see the instructions as the
organization
may be requ ired to c omple te ce rtain IRS For ms fo r O regon purposes only. If the attached return was not filed with the IRS, then
mark
any such return as For O regon P urposes Only. If your organization files IRS Form 990-N (e-Postcard) please attach a copy or confirmation
of its filing.
Please
Sign
Here
U nder penalties of perjury, I declare^that I have examined this return, including all accompanying forms, schedules, and attachments, and
to
the
bes
^ f
/ fny|
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
3/56
Form
990
Department
of the T r e a s u r y
Intemai R e v e n u e S e r v i c e
Return
of Organization Exempt From Income Tax
Undersection501
(c),
527, or4947(a)(1)of the Internal RevenueCode(except private foundations)
Do notenter
Socia l
Security numbers on this
form
as i t may bemadepublic.
Informationabout Form 990 and its instructions is at www.irs.gov/form990.
OM B
No . 1545-004
2013
Open to Public
Inspection
A
For the
2013
calendar year, or tax year beginning
and ending
B
C h e c k if
a ppl i ca ble :
A d d r e s s
c h a n g e
Name
c h a n g e
Initial
retum
T e r m i n
ated
A m e n d e d
return
A p p l i c a
tion
pending
C
Name of organization
THE
FAMILY
YOUNGMEN'S
C H R I S T I A N
ASSOCIATION OF
MARION
AND
POLK
COUNTIES
Doing
Business As
D
Emplo yer identification number
9 3 - 0 3 8 6 9 8 2
Numbera nd stre et (or P.O. box if mail is not delivered to street address)
6 8 5
COURT
ST NE
Cityor tow n, state or province, country, and ZIP or foreign postal c ode
Room/suite
Telephone number
5 0 3 - 3 9 9 - 2 7 5 7
SALEM,
OR 97 30 1
G G r o s s
rece ip t s $
4,856,892
F Name and address of principal officer:CHUCK HUDKINS
SAME AS C
ABOVE
I Tax-exempt status: [ X ]501(c)(3)
501(c)
( )
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
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THE F A M I L Y
YOUNG
MEN'S C H R I S T I A N
Form990
(2013) A S S O C I A T I O N O F MARION AND POLK C O U N T I E S 9 3 - 0 3 8 6 9 8 2
p
a
g
Part
HI1
Statement of Program
Service
A ccompl ishments
Check
if Schedule
O
contains a response or note to any line in this Part III
1
Briefly describe the organization's mission:
THE
Y I SCOMMITTED TO
STRENGTHENING
OUR
COMMUNITY.
OUR
FOCUS
I SYOUTH
DEVELOPMENT,
HEALTHY L I V I N G
AND SO CI AL R E S P O N S I B I L I T Y . OUR MIS SIO N I S
TO P UT C H R I S T I A N P R I N C I P L E S I N T O P R A C T I C ETHROUGH PROGRAMSTHAT B U I L D
A HEALTHY S P I R I T , MIND
AND
BODY
FOR A L L . WE
HAVE
BE EN S ER V IN G OUR
2
Did the organization undertake any significant program services during the year which were not l isted on
the
prior Form 99 0 or 990-EZ?
L Z j Y e s E E ] N
If
Yes, descr ibe these new services on Schedule
O.
3 Did the organization cease con duc ting, or make significant change s in how it con du cts, any program services?
I I
Ye s
IXI
If
Yes, descr ibe these changes on Schedule O.
4
Describe the organization's program service acco mplishm ents for each of its three largest program services, as measured by expense s.
Section501(c)(3) and 501(c)(4) organizations are required to report the a mount of grants an d allocations to oth ers, the total expenses , and
revenue, if any, for each program service reported.
4a ( C o d e :
) ( E x p e n s e s
2 , 7 0 1 , 3 7 9 . inc lud ing grant s of
$ )
( R e v e n u e s 1 , 7 6 3 , 0 1 0
THE
A S S O C I A T I O N P R O V I D E S E A R L Y
CHILDHOOD
EDUCATION FOR K I D S AGE S I X
WEEKS
THROUGH KINDERGARTEN,
INCLUDI NG OPPO RT UN ITI ES TO EXPL ORE AND
LEARNTHROUGH
DEVELOPMENTALLY A P P R O P R I A T E A C T I V I T I E S . THE
ASSOCIATION'S SCHOOL A G E C H I L D CARE
PROGRAM
P R O V I D E S A UNIQUE BALANCE
OF
FUN, LEARNING, AND P HY SI CA LDEVELOPMENTTHROUGHPLANNED, S A F E
A C T I V I T I E S
S E T TO B I - W E E K L Y
THEMES.
4b ( c o d e :
)
( E x p e n s e s $ 1 8 0 , 0 9 9 . i n c l u d i n g
g rant s of
$ ) ( R e v e n u e $
1 , 4 0 1 , 3 1 0
THE Y P R O V I D E S
MEMBERSHIP
AND PROGRAM O P P O R T U N I T I E S THATPROMOTE
YOUTH
DEVELOPMENT,
HEALTHY L I V I N G
AND S OC IA L
R E S P O N S I B I L I T Y . PROGRAMS
INCLUDE BUT ARE NOT
L I M I T E D
TO E X E R C I S E
PROGRAMS, YMCA
D I A B E T E S
PROGRAM,
B I C Y C L E R E C Y C L I N G
PROGRAM
AND ARE FOR A L L L E V E L S OF E X E R C I S E
AND
AGES.
4c
( c o d e : )
( E x p e n s e s
1 , 2 8 8 , 6 3 1 . inc lud ing grant s of
$
)
( R e v e n u e $
1 , 0 5 1 , 8 7 2
YOUTH
SPORT
PROGRAMS
I N C L U D E : LEARNABOUTSPROGRAM (DESI GNE D TO IN V O L V
PARENTS
I N THE
LEARNING PROCESS
OF THE
SPORT
ALONGWITH
T H E I R C H I L D ) ,
YOUTH B A S K E T B A L L,
GYMNASTICS
&
MOVEMENT,DANCE,AQUATICS,
AND
MUCH
MORE. THE
SUMMER
DAY
CAMP
FOR K I D S I NGRADES 1
THROUGH
9 -LOCATED ON
ANOVER
8 0 - ACRE CAMP S I T E - O F F E R S BOATING, F I E L D SPORTS,GROUP GAMES,
ARCHERY,SWIMMING, CRA FTS , HI K I N G AND EXPL ORI NG . THE ASSOCIATION'S
R E S I D E N T
CAMP
I S
LOCATED
I N
S I L V E R F A L L S
S T A T E PARK AND OF FE RS
TRADITIONAL
CAMPPROGRAMSTHAT
B U I L D A
HEALTHY S P I R I T , MIND
AND BODY.
4d
Other program services (Describe in Sched uleO.)
( E x p e n s e s
$ includ ing grants of $
)
( R e v e n u e $
)
4e Total program service expenses
4 , 1 7 0 , 1 0 9 .
332002
Form990
(2
10-29-13
2
1 6 4 0 1 0 3 1
7 8 3 6 7 3 8 5 2 2 2 2 0 1 3 . 0 4 0 3 0 T H E F A M I L Y
YOUNGMEN'S
CHRI 852 22
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
5/56
THE F A M I L Y YOUNG
MEN'S
C H R I S T I A N
Form990(2013) A S S O C I A T I O N OF MARION AND POLK C O U N T I E S
93- 0 386982 Pa
Q
PartIV Checkl istofRequiredSche dules
1
Is the organization described
in
sect ion
501
(c)(3)
or
4947(a)(1) (other tha n
a
private foundation)?
If
Yes, complete ScheduleA
Ye s N
1
X
2
Is the organization requiredtocomplete Schedule B, Scheduleof Contributors
2
X
3 Did the organization engage in directorindirect p olit ical campaign ac tivities on be halfof orin opp ositiontocandidates for
publicoffice?If Yes, com plete Schedule C, Part1
3
4 Section501(c)(3) organizations.Did the organization engage in lobbying ac tivities,
or
have
a
sect ion501(h) election
in
effect
duringthe tax year?If Yes, complete S chedule C, Part II
4
5
Is the organization
a
section
501
(c)(4),
501
(c)(5),
or
501
(c)(6) organization that receives me mbers hip du es, assessm ents,
or
similar
amounts as defined in Revenue Procedure98-19?
If
Yes, complete Schedule C,PartIII
6 Did the organization maintain any dono r advised funds
or
any similar funds
or
accounts
for
which donors have the right
to
provide
advice on the distribution
or
investment
of
amounts in such funds or accounts?
If Yes, complete Schedule D, Part1
7 Did the organization receiveor hold a conservation easement, including easementstopreserve open s pace,
the environment, historic land areas,
or
historic structures ?
If Yes, complete Schedule
D,
Part II
8
Did the organization maintain collections
of
works
of
art, historical treasures,
or
other similar assets?
If
Yes, complete
Schedule D, Part III
5
6
7
8
9 Did the organization report an amountinPart X, line2 1 ,forescroworcustodial a ccou nt liability; serve asacustodianfor
amounts
not listed in Part X;orprovide credit coun seling, debt man agement, credit repair,ordeb t nego tiation services?
If Yes, complete S chedule D, Part IV
9
10 Did the organiza tion, directly or through
a
related organization, hold assets in temporarily restricted endowments, permanent
endowments ,
orquasi-endowments?If Yes, complete ScheduleD,Part V
10
X
11 If the organization's answer to anyofthe fol lowing quest ionsis Yes, then complete Schedule D, Parts
V I,
Vll, Vll l , IX,orX
as
ap pl icable.
a Did the organization report an amount for
land,
bui ld ings, and equipment
in
Part X, line
10?If Yes, complete Schedule D,
PartVI
11 a X
b Did the organization report an amount for investme nts - other securities in Part X, line 12 thatis5%ormoreofits total
assets
reported
in
Part X, line
16?If Yes, complete ScheduleD,PartVll
11b
c
Did the organization report an amount
for
investments
program related in Part X, line
13
that
is
5%
or
more
of
its total
assetsreportedinPart X, iine16?If Yes, complete ScheduleD,Part Vlll
11 c
X
d Did the organiza tion report an amount for other asse ts in Part X, l ine15that is 5%ormoreofits total assets rep ortedin
Part
X, line16?
If Yes, complete Schedule
D,
Part IX
11d
e
Did the organization report an amou nt for other liabilities in Part X, l ine 25?
If Yes, complete Schedule
D,
Part X
f
Did the organiza tion's separate
or
cons olidated financial stateme nts for the tax year include a footno te that add resses
the
organization's liability for uncertain ta x pos itions under FIN 48 (ASC 740)?
If
Yes, complete ScheduleD, PartX
12 a Did the organization obtain separate, independen t audited financial stateme nts for the tax year?
If
Yes, complete
Schedule D,Parts XI and Xll
11e
Hf
X
12 a X
b
Was the organization included in con solida ted, indepe ndent au dited financial statem ents for the tax year?
If Yes, andifthe organization answered No foline 12a, then completing Schedule D, Parts XI and Xll is op tional
13 Is the organization
a
school descr ibed in sect ion170(b)(1)(A)(ii)?
If
Yes, complete Schedule
E
14 a
Did the organization maintain an office, employ ees,
or
agents o utside
of
the U nited States?
b Did the organization have aggregate revenues
or
expenses
of
more than$10,000from grantmaking, fundraising, business,
investment,
and program service activities outside the United States,
or
aggregate foreign inves tments va lued
at$100,000
or more?If Yes, complete ScheduleF,Parts1and IV
12b
13
14a
14b
15 Did the organization report on Part IX, column (A), l ine 3, more than $5,000
of
grants or other assistance
to
or for any
foreign
organization?
If Yes, com plete Schedule F, PartsIIand IV
15
16
Did the organization report on Part IX, colum n (A), l ine 3, more than $5,000
of
aggregate grants
or
other a ssistance
to
orfor foreign individuals?If Yes, complete ScheduleF,Parts III and IV
16
17 Did the organization report a totalofmore than$15,000ofexpenses for professional fund raising services on PartIX,
column
(A), lines
6
and
11e?If Yes, complete Schedule G, Part
1
17
18 Did the organization report more than $15,000 total
of
fundraising event gross income an d contribu tions on PartVl l l , lines
1
c and 8a?
If Y es, complete ScheduleG,Part II
18
19 Did the organization report more than $15,000
of
gross income from gaming activities on PartVl l l , line 9a?
If Yes,
complete Schedule G,Part III
19
20 a Did the organization operate one
or
more hos pital facil it ies?
If Yes, complete Schedule H
b
If
Yes
to
line 20a, did the orqanization atta ch
a
copy
of
its audited financial statements
to
this return?
20 a
20b
Form990 (20
332003
10-29-13
3
16401031
783673 85222 2013 .04 030
THE F A M I L Y YOUNG
MEN'S
CHRI
85222
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6/56
THE F A M I L Y YOUNGMEN'S C H R I S T I A N
Form990 (2013)
A S S O C I A T I O N OF MARION AND
POLK
C O U N T I E S
93-0386982 p
a q
PartIV
Checkl istof
Required
Schedules(continued)
21
Did the organization report more than $5,000
of
grants
or
other assistance to any domestic organization
or
government
on Part IX, column (A), line 1?
If Yes, complete Schedule1, Parts1 andII
Ye
21
s
N
X
22 Did the organization report more than $5,000
of
grants
or
other assistance to individuals in the U nited States on Part
IX,
column(A), line 2?If Yes, complete Schedule1, Parts1and III
22
X
23
Did the organization answer Yes
to
Part
Vll,
Section A, l ine 3, 4,
or
5 about compensat ion
of
the orga nization's curren t
andformer off icers, d irectors, t rustees, key employees, and highest compensated employees?
If Yes, complete
ScheduleJ
23
X
24 a Did the organization have a tax-exempt bon d issue with an outsta nding principal amount
of
more than
$100,000
as
of
the
lastd ayofthe year, that was issued after Decembe r 3 1 , 2002?If Yes, answer lines 24b through24dand complete
Schedule
K .If No ,go toline 25a
24a
X
b Did the organization invest any procee ds
of
tax-exempt bo nds beyond a temporary p er iod except ion?
c Did the organization maintain an escrow accou nt other thanarefunding escrowatany time durin g the year to defease
any tax-exempt bonds?
24b
24c
d Did the organization
act
as an on behalf of issuer for bonds outstand ing
at
any time du ring the year?
25 a Section501(c)(3)
a nd
501(c)(4)
organizations.
Did the organization engage in an excess benefit transaction with
a
disqualified
person during the year?
If Yes, complete Schedule L, Part1
24d
25a
X
b Is the organization aware thatitengaged in an excess benefit transaction withadisqualif ied personin aprior year, and
that
the transaction has not been reported on anyofthe orga nization's prior Forms 990or990-EZ?If Yes, complete
Schedule
L, Part
1 25b
X
26
Did the organization report any amou nt on Part X, l ine
5,6,
or 22
for
receivables from
or
payables
to
any current
or
formeroff icers, d irectors, t rustees, key em ployees, highest compen sated employees, or disqual i fied persons?Ifso,
completeScheduleL,PartII 26 y-
27 Did the organization provide
a
grant
or
other ass istance
to
an officer, director, trustee, key employee, substantial
contributoror
employee thereof,
a
grant selection c omm ittee mem ber, or to
a
35% control led ent i ty or family member
of
a ny
of
these persons?
If Yes, complete S chedule L, Part III
27
X
28 Was the organizationapartyto abusiness transact ion with oneofthe following pa rties (see ScheduleL,PartIV
instructions
for applicable fil ing thresholds, conditions, and exceptions):
a
A
current or forme r officer, director, trustee,
or
key employee?
If Yes, complete Schedu le L, Part IV
b
A
family mem ber
of a
current or former officer, director, truste e,
or
key employee?
If Yes, complete S chedule L, Part IV
c
An entity
of
which
a
current or former officer, director, truste e,
or
key employee (or a family m ember thereof) w as an officer,
director,trustee,ordirectorindirect ow ner?If Yes, complete Sch edule L, Part IV ...
28a
28b
28c
X
X
X
29 Did the organization receive more than $25,000innon-cash contributions?
If
Yes, complete Schedule
M
30
Did the organization receive contribution s
of
art, historical treasures ,
or
other similar asse ts,
or
qualif ied conservation
contributions?If Yes, complete ScheduleM
29
30
X
X
31 Did the organization liquidate, terminate ,ordissolve and cease operations?
If Yes, com plete Schedule N, Part1
31
X
32 Did the organization sell,exchange, dispose of, or transfer more than 25 %
of
its net assets?/^ Ves,
complete
ScheduleN, Part II
32
X
33 Did the organization own 100%ofan entity disregarded as separate from the organiza tion under Regulations
sections
301.7701-2a nd301.7701-3?
If
Yes, complete ScheduleR,Part1 33
X
34 Was the organization related
to
any tax-exempt or taxable entity?
If
Yes, complete Schedule R,Part II, III, orIV,and
Part V, line
1
34
X
35 a Did the organization have
a
controlled entity within the meaning
of
section 512(b)(13)? 35a
X
b If
Yes
to
line 35a, did the organization receive any payment from or engage in any transaction with
a
contro lled en tity
within
the meaning
of
section
512(b)(13)?If
Y es, complete ScheduleR,PartV, line
2 35b
36 Section501(c)(3) organizations.Did the organization make any transfers
to
an exempt non-charitable related organization?
If
Yes, co mplete Schedule R, Part
V,
line2
36
37 Did the organization cond uct more than 5%
of
its activities through an entity that
is
no t
a
related organization
and
that
is
treated as
a
partnership for federal income tax purposes?
If Yes, complete Schedule R,Part VI
38 Did the organization com plete Schedule
O
and provide explanations in Schedule
Ofor
Part VI , lines
11b
and
19?
Note.All Form 990 filers are required
to
complete Schedule
O
37
38
>
i
Form
990
(20
332004
10-29-13
4
16401031 783673 85222 201 3. 0403 0 THE
F A M I L Y
YOUNGMEN'SCHRI 85222
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
7/56
Form
990
(2013)
T H E F A M I L Y Y O U N G M E N ' S C H R I S T I A N
A S S O C I A T I O N
O F M A R I O N A N D P O L K C O U N T I E S
9 3 - 0 3 8 6 9 8 2
p
a
qe
Part
V]
Statemen ts Regarding Other IRS
Filings
and Tax Com pliance
Check
if Schedule
O
contains a resp onse or n ote to any line in this Part V
1a
b
c
2a
3a
b
4a
1a
1b
2a
Enter
the num ber re ported in Box 3 of Form 109 6. Enter -0- if not applicable
Enter
the numb er of Forms W-2G included in line
1a.
Enter
-0 -
if not applicable
Didthe organization com ply with backu p withholdin g rules for reportable payments to vendors an d reportable gaming
(gambling)
winnings to prize winners?
Enter
the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
filed
for the calendar year ending with or within the year covered by this return
If
at least one is reported o n line 2a, did the organization file all required federal employment t ax returns?
Note.If the s um o f l ines
1
a and 2a is greater than 2 50, you m ay be required toe-file(see instructions)
Did the organization have unrelated business gross income of$1,000or more during the year?
If
Yes, has it f i led a Form 990-T for this year?
If No,
fo
line 3b, provide an explanation in Schedule
O
Atany time during the ca lendar year, did the organization have an interest in, or a signature or other autho rity over, a
financialaccount in a foreign country (such as a bank account, securities account, or other financial account)?
If
Yes, enter the name of the foreign country:
5 0 5
See
instructions for fi l ing requirements for Form TD F90-22.1,Report of Foreign Bank and Financial Accounts.
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
b Did any taxable party n otify the organization that it was or is a party to a prohibited tax shelter transaction?
c
If Yes, to line 5a or 5b, did the organization file Form8886-T?
6a
Does the organization have annua l gross receipts that are normally greater than $100 ,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions?
b If Yes, did the organization include with every solicitation an express statement that such contribution s or gifts
werenot tax deduct ible?
7
Organizat ions
that
may receive deductible contributions under
section
170(c).
a
Did the organization receive a payment in excess of $75 made partly asacontribution and partly for goods and services provided to the payor?
b If Yes, did the organization notify the donor of the value of the goods or services provided?
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
tofi le Form 828 2?
d If Yes, indicate the number of Forms 8282 filed duringtheyear
I
7d
I
8
9
10
11
e
Did the organization receive any fun ds, directly or indirectly, to pay premiums on a personal benefit contrac t?
f
Did the organiza tion, during the year, pay premium s, directly or indirectly, on a personal benefit contra ct?
g If the organization received a contribution of qualif ied intellectual property, did the organization file Form 8899 as requ ired?. .
h
If the organization received a contribu tion of cars , boa ts, airplanes, or other vehicles, did the organization file a Form1098-C?
Sponsoring
organizations maintaining donor
advised
funds andsection
509(a)(3)
supporting organizations.Did the supporting
organization, or
a
donor
advised
fund maintained by
a
sponsoring organization, have excess business holdings at any time during the year?
Sponsoring organizations maintaining donor advisedfunds.
Did the organization make any taxable distributions under section 4966?
Did the organiza tion make a distribution to a donor, dono r advisor, or related person?
Section
501
(c)(7)
o rganizat ions.
Enter:
Initiation
fees and capital contributions included on PartVll l , line 12
10a
Gross receipts, included on Form 990, Part
Vl l l ,
line 12, for public use o f club facilit ies I10b
Section501(c)(12)organizat ions.Enter:
Gross
income from members or shareholders 11a
Gross
income from other sources (Do not net amounts due or paid to other sources against
amounts
due or received from them.)
I11b
12 a Section4947(a)(1) non-exempt charitabletrusts. Is the organization filing Form 990 in lieu of Form1041?
b If Yes, entertheamount of tax-exempt interest received or accrued during the year
I
1 2b
I
13 Section501(c)(29) qualified nonprofit healthinsurance
issuers.
a Is the organization licensed to issue qualif ied health plans in more than one state?
Note.See the instructions for additional information the organization must report on Schedule O.
b Enter the amou nt of reserves the organization is required to maintain by the states in which th e
organization is l icensed to issue qualif ied health plans 13b
c
Enter the amount of reserves on hand
I13c
14 a Did the organization receive any payme nts for indoor tanning services during the tax year?
b If Yes, has it f i led a Form 720 to report these paymen ts? If No, provide an explanation in Schedule
O
..
1c
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
7h
9a
9b
Yes N
12a
13a
X
14a
14b
Form 990
(2
332005
10-29-13
1 6 4 0 1 0 3 1 7 8 3 6 7 3 8 5 2 2 2
2 0 1 3 . 0 4 0 3 0
T H E F A M I L Y Y O U N G M E N ' S
C H R I
8 5 2 2 2
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
8/56
Form 990 (2013)
THE
F A M I L Y
YOUNG MEN'S
C H R I S T I A N
A S S O C I A T I O N OF MARION AND
POLK C O U N T I E S
93-0386982 p
a
q e
iRartVij
Governance,
Management, and
DisclosureFor each Yes response to lines 2 through 7b below,andfora No response
toline8a,8b ,
or
10bbelow, describe the circumstances, processes, or changes in Schedule O.See instructions.
Check
if
ScheduleOcontains a response or note
to
anv line in this Part VI LK
Sect ionA. Governing Body and Management
1a
1a
1b
Enter
the number
of
vot ing members
of
the governing body at the end of the tax year
Ifthere are material differences in voting rights among members ofthegoverning body, or if the governing
bodydelegated broad authority to an executive committee or similar committee, explain in Schedule
0.
b Enter the number
of
voting m embers included in line
1 a,
above, who are independent
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other
officer,director, trustee,
or
key em ployee?
3 Did the organization delegate control over managem ent duties customarily performed by or under the direct supervision
of
officers, directors, or trustees, or key employees
to a
management company or other person?
4 Did the organization make any significant chang es
to
its governing docum ents s ince the prior Form 990 was filed?
5 Did the organization becom e aware during the year of a significant diversion
of
the organization's assets?
6 Did the organization have mem bers or stockho lders?
7a
Did the organization have members, stockho lders, or other persons who had the power to elect or appo int one
or
moremembers
of
the governing body?
b Are any governan ce decisions of the organization reserved
to
(or sub ject
to
approval by) members, stockholders,
or
persons
other than the governing body?
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following :
a The governing body?
b Each com mittee with authority
to
act on behalf
of
the governing body?
Isthere any officer, director, trustee, or key employe e listed in PartVll,Sect ion A, who cannot be reached at the
organization's
mailing address?
If Yes, provide the names and addresses in ScheduleO
22
22
9
7a
7b
8a
8b
Yes
X
N
Section B .
Policies(This Section B requests information about policies not required by the Internal Revenue Code.)
Yes N
10a
X
10b
X
11a
X
12a
X
12b
X
12c
X
13
X
14
X
15a
X
15b
X
16a
X
16b
10a
b
11a
b
12a
b
c
13
14
15
16a
Did the organization have local chapters, branches, or affil iates?
If
Yes, did the organization have written policies and proced ures governing the activities
of
such chap ters, affil iates,
and branches to ensure their operations are consistent with the organization's exempt purposes?
Has
the organization provided
a
complete copy
of
this Form 990
to
all mem bers
of
its governing b ody b efore fil ing the form?
Describein ScheduleOthe process,
if
any, used by the o rganization
to
review this Form 99 0.
Didthe organization have a written conflict
of
interest policy?// No , go foline 13
Wereofficers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
Did
the organization regularly and consistently monitor and enforce compliance with the policy?
If
Yes, describe
in ScheduleOhow this was done
Didthe organization have
a
written whistleblow er policy?
Did the organization have
a
written docum ent retention and destruction policy?
Didthe process for de termining compen sat ion
of
the following persons include
a
review and approval by independent
persons, comparabi li ty data, and contemp oraneous
substantiation
of the deliberation and decision?
a
The organization's CEO, Executive Director, or top m anagement official
b Other officers
or
key employee s
of
the organization
If
Yes
to
line15a or 15b, describe the process in Schedule
O
(see instructions).
Didthe organization invest in, contrib ute a ssets to , or participate in a joint ventu re or similar arrangement with
a
taxable
entity during the year?
If
Yes, did the organization follow
a
written po licy or procedure requiring the organ ization
to
evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps
to
safeguard the organization's
exempt
status with respect
to
such arrangements?
Sect ionC .Disclosure
17
18
List
the states with which
a
copy
of
this Form 990 is required
to
be filed OR
Section 6104
requires an organization
to
make its Forms
1023
(or
1024if
applicable), 990 , and 990-T (Section 501(c)(3)s only) available
fo r
public inspection. Indicate how you made these available. Check all that apply.
Own website Another 's website U pon request Other(explain in Schedule O)
Describein ScheduleOwhether (and
if
so, how), the organization made its governing documents, conflict
of
interest policy, a nd financial
statementsavailable to the public during the tax year.
State
the name, physical address, and telephone number
of
the person who possesses the books and records of the organizat ion:
THE ORGANIZATION-
5 0 3 - 3 9 9 - 2 7 5 7
6 8 5 COURT ST NE,SALEM,OR 97 301
332006 10-29-13
19
20
Form990 (20
1 6 4 0 1 0 3 1 7 8 3 6 7 3 8 5 2 2 2 2 0 1 3 . 0 4 0 3 0 THEF A M I L Y YOUNG MEN'S CHRI 8 5 2 2 2
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
9/56
Form
990
(2013)
THE F A M I L Y YOUNG MEN'S C H R I S T I A N
A S S O C I A T I O N OF MARION AND POLK COUNTIES
9 3 - 0 3 8 6 9 8 2
P a
qe
PartVHjCompen sation ofOfficers, Directors,
Trustees,
K ey
Employees,
Highest Compensated
Employees,
and Independent Contractors
Checkif
Schedule
O
contains
a
response
or
note to any line in this PartVll
Section
A .
Off icers,
Directors,Trustees,K eyEmployees,and Highest Compensated
Employees
1a Com plete this table for all persons required
to
be listed. Report compensation for the calendar year ending with
or
within the o rganization's tax
List all
of
the o rganization's
current
officers, directors, trustees (whether individuals
or
organizations), regardless
of
amount
of
compensat ion
Enter-0-in
columns (D), (E), and (F)
if
no compensat ion was
paid.
List all of the organization's
current
key employees,
if
any. See instructions for de finition
of
key employee.
List the organization's five current highest com pen sated e mployees (other than an officer, director, trustee,
or
key employee) who received rep
able
compensat ion (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 organization
List all
of
the o rganization's
former
off icers, key employees, and highest compen sated employees who received more than
$100,000
of
reportable compensation from the organization and any related organizations.
List all of the organization's
formerdirectors or trustees
that received, in the capa city as a former director o r trustee of the organization,
morethan$10,000
of
reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees-
andformer such persons.
Check this box
if
neither the organization nor any related
(A)
Nameand Title
( 1 )
RICHARDBERGER
P R E S I D E N T
organization compensated any current officer, director, or trustee.
(B)
Average
hours
per
week
(listany
hoursfor
related
organizations
below
line)
1.00
(C)
Position
(do
notc h e c k
more
thanone
box.
u n l e s s
p e r s o nisbothan
officer
a nd
a
d i rec t or / t rust ee )
X
(D)
Reportable
compensation
from
the
organization
(W-2/1099-MISC)
(E)
Reportable
compensation
from
related
organizations
(W-2/1099-MISC)
0.
(R
Estimated
amountof
other
compensatio
from
the
organization
and
related
organization
( 2 ) PAUL
CONNOLLY
P R E S I D E N T
ELECT
( 3 ) CHUCK
HUDKINS
PAST P R E S I D E N T
( 4 ) K E V I NPALMER
V I C E
P R E S I D E N T
( 5 ) CORI FRAUENDIENER
SECRETARY
( 6 )
DEB
WILDING
TREASURER
( 7 )
CHUCKADAMS
BOARD MEMBER
( 8 )
B R I A N B L I S S
BOARD MEMBER
( 9 ) S T E VE N HOFFERT
BOARD MEMBER
( 1 0 )
ROBERT
JACKMAN
BOARD MEMBER
( 1 1 )
P H I L
MCCORKLE
BOARD
MEMBER
( 1 2 ) FARIBORZ PAKSERESHT
BOARD MEMBER
( 1 3 )DON
RUSSO
BOARD MEMBER
( 1 4 )
MIKE
SMITH
BOARD MEMBER
( 1 5 )
PHIL
SCHRADLE
BOARD
MEMBER
( 1 6 ) DARIN S I L B E R N A G E L
BOARD
MEMBER
1.00
X
0.
1.00
X
X
0.
1.00
X
X
0.
1.00
X
X
0 .
1.00
X
1.00
X
1.00
0.
1.00
1.00
1.00
X
1.00
0
1.00
0
1.00
X
1.00
X
0
1.00
X 0.
0
( 1 7 ) MIKE
ERDMANN
BOARD MEMBER
1.00
X
0
332007 10-29-13
1 6 4 0 1 0 3 1 7 8 3 6 7 3
8 5 2 2 2
2 0 1 3 . 0 4 0 3 0
7
THE
FAMILYYOUNG MEN'S CHRI
Form990 (20
8 5 2 2 2
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
10/56
THE
F A M I L Y
YOUNG MEN'S
C H R I S T I A N
P a r t VH Sect ionA .Off icers,Directors,Trustees,Ke y E m
sloyees,and Highest Compen satedEmployees (continued)
(A)
Name
and tit le
(B)
Average
hours
per
week
(list
any
hours
for
related
organizations
below
line)
(C)
Position
(do
not
c h e c k more
thanone
box,
u n l e s s
pe rsonisbothan
officer
a nd
a
director/trustee)
(D)
Reportable
compensation
from
the
organization
(W-2/1099-MISC)
(E)
Reportable
compensation
from
related
organizations
(W-2/1099-MISC)
(F)
Estimated
amount
of
other
compensatio
from
the
organization
and related
organizations
(A)
Name
and tit le
(B)
Average
hours
per
week
(list
any
hours
for
related
organizations
below
line)
I
n
v
d
u
e
o
d
e
o
n
u
o
u
e
I
K
e
m
p
o
g
c
m
p
e
e
m
p
o
(D)
Reportable
compensation
from
the
organization
(W-2/1099-MISC)
(E)
Reportable
compensation
from
related
organizations
(W-2/1099-MISC)
(F)
Estimated
amount
of
other
compensatio
from
the
organization
and related
organizations
( 1 8 )
MAUR
HORTON
BOARD MEMBER
1.00
X
0.
0.
0
( 1 8 )
MAUR
HORTON
BOARD MEMBER
X
0.
0.
0
( 1 9 )DANMOORE
BOARD
MEMBER
1.00
X
0.
0.
0
( 1 9 )DANMOORE
BOARD
MEMBER
X
0.
0.
0
( 2 0 )
SHAWN
SELLERS
BOARD MEMBER
1.00
X
0.
0.
0
( 2 0 )
SHAWN
SELLERS
BOARD MEMBER
X
0.
0.
0
( 2 1 )DAN VANOY
BOARD MEMBER
1.00
X
0.
0.
0
( 2 1 )DAN VANOY
BOARD MEMBER
X
0.
0.
0
( 2 2 )DAVIDDECKLEMAN
BOARD MEMBER
1.00
X
0.
0.
0
( 2 2 )DAVIDDECKLEMAN
BOARD MEMBER
X
0.
0.
0
( 2 3 )
PAUL
MANNING
C H I E F E X E C U T I V E OFFICER
4 0 . 0 0
X
1 0 4 , 4 0 8 .
0.
1 4 , 3 4 6
( 2 3 )
PAUL
MANNING
C H I E F E X E C U T I V E OFFICER
X
1 0 4 , 4 0 8 .
0.
1 4 , 3 4 6
( 2 4 ) N I C K Y TIMM (THRUJUN)
DIRECTOR
OF
FINANCE
4 0 . 0 0
X
2 1 , 2 3 7 . 0.
4 , 1 5 3
( 2 4 ) N I C K Y TIMM (THRUJUN)
DIRECTOR
OF
FINANCE
X
2 1 , 2 3 7 . 0.
4 , 1 5 3
( 2 5 )
FREDNAIMY
V I C E
P R E S I D E N T
OFOPERATIONS
4 0 . 0 0
X
6 3 , 0 4 2 .
0. 1 0 , 0 6 0
( 2 5 )
FREDNAIMY
V I C E
P R E S I D E N T
OFOPERATIONS
X
6 3 , 0 4 2 .
0. 1 0 , 0 6 0
( 2 6 ) PEGGYHERMES
(JUN-DEC)
DIRECTOROF
FINANCE
4 0 . 0 0
X
3 3 , 5 3 8 . 0.
3,262
( 2 6 ) PEGGYHERMES
(JUN-DEC)
DIRECTOROF
FINANCE
X
3 3 , 5 3 8 . 0.
3,262
1b Sub-total
2 2 2 , 2 2 5 .
0.
3 1 , 8 2 1
c Total
from
continuation sheetstoPart
VI
d Total (addlines
1
ban d1c)
,Sect ion
A
0.
0.
0
Total
from
continuation sheetstoPart
VI
d Total (addlines
1
ban d1c)
2 2 2 , 2 2 5 .
0. 3 1 , 8 2 1
Total
number
of
individuals (including but not l imited to those listed above) who received more than
$100,000
of
reportable
compensation
from the orqanization
Did
the organization list any
former
officer, director, or trustee, key employee,
or
highest compensated employee on
line1a?If Yes, complete ScheduleJfor such individual
For any individua l l isted on line 1a, is the sum
of
reportable compensation and other compensation from the organization
andrelated organizations greater than
$150,000?
If
Yes, complete Schedule
J
for such individual
Did
any person listed on line
1a
receive or accrue compensation from any unrelated organization
or
individual for services
rendered
to
the organization?
If Yes, complete ScheduleJfor such person
Yes
N
X
X
Section B. Independent Contractors
Complete
this table for your five highest com pensated independent con tractors that received more than $100,000
of
compensat ion from
the organization. Report compensation for the calendar year ending with
or
within the o rganization's tax yea r.
(A)
Name
and business address
NONE
(B)
Description
of
services
(C)
Compensation
Total
number
of
independ ent con tractors (including
but
not limited
to
those listed above) who received mo re than
$100,000
of
compensation from the organization
332008
10-29-13
Form
990
(20
8
1 6 4 0 1 0 3 1
7 8 3 6 7 3 8 5 2 2 2
2 0 1 3 . 0 4 0 3 0 THE
F A M I L Y
YOUNG MEN'S CHRI
8 5 2 2 2
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
11/56
Form990(2013)
THE F A M I L Y
YOUNG MEN'S
C H R I S T I A N
A S S O C I A T I O N
OF MARION AND
POLK C O U N T I E S
9 3 - 0 3 8 6 9 8 2
Pag
Part
Vlll
mm
c
c
2
=
i
OS
J?
I I
= T3
O c
OR
StatementofRevenue
Checkif
Schedule
O
contains
a
respons e or note
to
any line in this Part Vlll
1
a Federated campaigns
b Membership dues
c Fundraising events
d Related organizations
e Governmen t grants (contributions)
f All other contributions, gifts, grants, and
similaramounts not included above
9 N o n c a s h
cont r ibu t ions inc luded
inl i nes
1a-1fi
h
Total.A d d
lines1a-1
f
1f
3 8 , 9 9 3
5 1 3 , 0 8 6
6 1 0 .
(A)
Total
revenue
5 5 2 , 0 7 9
(B)
Relatedor
exempt
funct ion
revenue
(C)
Unrelated
business
revenue
(D)
Revenueexclud
from
tax unde
sections
512-514
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
12/56
Form 990 (2013)
THE FAMILY
YOUNG MEN'S
C H R I S T I A N
A S S O C I A T I O N
OF MARION AND
POLK COUNTIES
9 3 - 0 3 8 6 9 8 2 p
a Q e
1
RjaHIXi
j
StatementofFunctional
Expenses
Section 501(c)(3)a nd501(c)(4) organizations must completea llcolumns.Allother organizations must complete column (A).
Check
if
Schedule
O
contains a response or note to any line in this Part
IX
Do
no t
include amounts reported
on
lines Sb,
7b,8b 9b and 10b ofPart Vlll.
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Grants and other assistance to governments and
organizations
in the U nited States. See Part IV, line 21
Grants and other assistance to individualsn
the
U nited States. See Part IV, line 22
Grants and other assistance to governments,
organizations, and individuals outside the
Uni ted
States. See Part IV, lines
15
a nd
16
Benefits paid to or for members
Compensation
of current officers, directors,
trustees, and key employees
Compensation
not included
above,
to disqualified
persons
(as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Other salaries and w ages
Pension
plan accruals and contributions (include
section 401(k)
and 403(b) employer contributions)
Otheremployee benefits
Payroll
taxes
Fees for services (non-employees):
Management
Legal
Account ing
Lobbying
Professional
fundraising services. See Part IV, line 17
Investment
management fees
g Ot her . (If line
l l g
amount exceeds 10% of line 25,
column(A) amou nt, list line11gexpenses on Sch 0.)
Advertising
and promotion
Office
expenses
Information
technology
Royalties
Occupancy
Travel
Payments of travel or entertainment expenses
for any fed eral, state, or local public officials
Conferences, conventions, and meetings
Interest
Payments to affil iates
Depreciation, depletion, and amortization
Insurance
Other
expenses. Itemize expenses not covered
above.(List
miscellaneous expenses in line 24e.Ifline
24e
amount exceeds 10% of line 25, column (A)
amount, list line 24e expenses on Schedule 0.)
aS U P P L I E S
bSPORTSPROGRAM S U P P L I E S
cALLOCATION
OF
d
I N D I R E C T
e
All other expenses
25 Total functional expenses. Add lines
1
through 24e
(A)
Total
expenses
2 7 1 , 1 7 1
2 , 7 2 7 , 4 0 8 .
6 6 , 5 5 6
1 0 3 , 5 7 0
3 0 8 , 0 3 5
3,458,
2 2 , 1 5 1
1 4 5 , 8 7 5 .
4 6 , 2 2 9 .
1 6 1 , 8 6 4 .
7 , 8 6 8 .
4 5 9 , 2 2 4 .
4 5 , 6 3 7
2 1 , 7 7 8
7 8 , 3 1 7 .
1 1 4 , 3 9 3 .
1 0 0 , 0 8 1
8 4 , 0 9 0 .
3 0 0 , 2 2 0
10,728,
0
5 , 0 7 8 , 6 5 3
(B)
Program service
expenses
1 7 6 , 2 6 1
2 , 0 6 7 , 6 9 2
6 6 , 5 5 6
1 0 3 , 5 7 0
3 0 0 , 4 4 2
1 4 5 , 8 7 5
4 6 , 2 2 9
4 5 9 , 2 2 4
1 1 4 , 3 9 3
3 0 0 , 2 2 0
1 0 , 7 2 8
3 7 8 , 9 1 9
4 , 1 7 0 , 1 0 9
(C)
Management
and
general
expenses
9 2 ,198,
6 5 9 , 7 1 6
7 376
3,458
2 2 , 1 5 1
1 6 1 , 8 6 4
7,868,
4 5 , 6 3 7
21,778,
7 8 , 3 1 7
10 0 ,0 8 1
8 4 , 0 9 0
- 4 2 9 , 7 8 9
8 5 4 , 7 4 5
C
(D)
Fundraising
expenses
2,712
217
5 0 , 8 7 0
5 3 , 7 9 9
26 Joint costs. Complete this line only iftheorganization
reportedin column (B) joint costs froma combined
educational
campaign and fundraising solicitation .
C h e c k
here | | jffollowing S O P98-2( A S C
958-720)
332010 10-29-13
10
Form990
(201
1 6 4 0 1 0 3 1 7 8 3 6 7 3 8 5 2 2 2
2 0 1 3 . 0 4 0 3 0 THEFAMILYYOUNG MEN'SCHRI 8 5 2 2 2
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
13/56
Form
990 (2013)
THE F A M I L Y
YOUNG MEN'S
C H R I S T I A N
A S S O C I A T I O N
OF MARION AND
POLK C O U N T I E S
9 3 - 0 3 8 6 9 8 2
P a a
e1
PartX
Balance
Sheet
CD
m
L x ] -
Par t II | Additiona l (Not Auto matic )
3-MonthExtension
of Ti me . Onlyfilethe original (no
copies
needed).
Type or
Fi le by the
Nameof exempt organization or other fi ler, see instructions.
T H E
F A M I L Y Y OU NG M E N ' S C H R I S T I A N
A S S O C I A T I O N
O F MARION AND P O L K C O U N T I E S
Employer
identification number (EIN) or
93-0386982
due date for
filingyour
re t urn . Se e
Number,street, and room or suite no. If a P.O. box, see ins tructions.
685
C O U R T
S T N E
Social
security number (SSN)
i ns truct i ons .
City,
town or post office, state, and ZIP code. For a foreign address, see instructions.
S A L E M , OR
97301
Enter
the Return code for the return that this application is for (file a separate applica tion for each return) |
0 | 1
Application
Return Applicat ion
Return
Is
For
Code
Is For
Code
Form
990 or Form 990-EZ
01
Form
990-BL
02
Form 1041
-A
08
Form
4720 (individual)
03 Form
4720 (other than individual)
09
Form
990-PF
04 Form 5227
10
Form
990-T (sec.401(a) or 408(a) tru st)
05 Form
6069
11
Form
990-T
(trust
other than above)
06
Form8870
12
S T O P Do not complete Part IIif vou were not alreadv granted an automatic3-monthextension on a previouslvfiledForm 8868.
T H E
O R G A N I Z A T I O N
The books arein the care of
6 8 5
C O U R T
S T N E -
S A L E M ,
OR
97301
TelephoneN o .
503 -399 -2757
Fax
No.
If
the organization doe s not have an office or place of business in the U nited States, check this box .
If
this is for a Group Re turn, enter the orga nization's four digit Group Exemp tion Num ber (GEN)
.
If this is for the whole gro up, check this
box
. If it is for part of the grou p, check this box
n
and attach a list with the names and EINs of all membe rs the extension is for.
4 I request an additional 3-month extension of time until
5 For calendar year 2 0 1 3 , or other tax year beginning
6 If the tax year entered in line 5 is for less than12months, check reason:
Change in account ing per iod
7
State in detail why you need the extension
N O V E M B E R
1 5 , 2014.
Initial return
,
and ending
Final return
A D D T I O N A L T I M E I S
N E E D E D
T O F I L E A
C O M P L E T E
AN D
A C C U R A T E R E T U R N .
8 a
If this applica tion is for Forms 990-BL , 990-PF, 990-T, 472 0, or 606 9, enter the tentative tax, less any
nonrefundablecredits. See instruct ions.
8a
$ 0 .
b If this application is for Forms 990-PF, 990-T, 472 0, or 606 9, enter any refundable credits and e stimated
tax payments made. Include any prior year overpayment allowed as a credit and any amount paid
previously
with Form 8868.
8b
$
0 .
0
Ba lance due.Subtract l ine 8b fromline8a. Include your payment with this form, if required, by using
EFTPS
(Electronic Federal Tax Payment System). See instnjctions.
8c
$ 0 .
Signature
and Verification m ust be com pleted for P art II only.
Under
penalties of
perjury,I
declare that
I
have examined this fo rm, including accompanying schedules
and
statements, and to the best of my knowledge and belief,
it
is true, correct, and complete, and that
I
am authorized to prepare this form .
Sgnature
4AJL,
f.
bfAAfcdVX Title
C P A
Date
Form8868(Rev.1-2014
^ 1
t t
323842
12-31-13
2 0 1 3 . 0 4 0 1 0
T H E F A M I L Y Y OU NG M E N ' S
C H R I 85222
1
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
54/56
Form8868
Application
for
Extension
of Time T o
File
a n
(Rev.
January 2014)
Exempt
Organization Return
OMBN o.1545-1709
Depar tment
of the T r e a s u r y
File
a sep arate application for
each
return.
Internal
R e v e n u e S ervi ce
Informationabout Form
8868
and its instruc tions is at www.irs.gov/form8868.
If you are filing for an
Automatic3-MonthExtension,complete only PartI
and check this box >
LX]
If you are filing for an
Additional (Not Automatic)3-MonthExtension,complete only Part II
(on page 2 of this form).
Donot complete Part II unless you have already been granted an automatic 3-month extension on a previously fi led Form 8868 .
Electronic filing(e-file). You ca n electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 monthsfora corporation
required
to file Form 990-T), or an additional (not automatic) 3-month extension of time. You ca n electronically fi le Form 886 8 to requ est an e xtension
of
time to file any of the forms listed in Part
I
or Part II with the exc eption of Form 8870 , Information Return for Transfers Assoc iated W ith Certain
Personal
Benefit Contra cts, which must be s ent to the IRS in paper format (see instructions). For more details on the electronic fi l ing of this form,
visit
www.irs.aov/efile and click one-file for Charities & Non profits.
Part
II
Automatic
3-Month Extension
of T im e. Only submit original (no
copies
needed).
A
corporation required to file Form 990-T and requesting an automatic 6-month extens ion - check this b ox and c omplete
Part I
only
Allother corporations (including1120-C filers),partnerships, R EMIC s, and trusts must use Form 7004 to requestanextension of time
tofile income tax returns. _ ^ _. , .. .
>
Type or
Nameof exempt o rganization or other fi ler, see instructions.
T H E
F A M I L Y Y OUN G M E N ' S C H R I S T I A N
Employer
identification number (EIN) or
File
by the
due date for
filing
your
return.
See
A S S O C I A T I O N
O F MARION AN D
P O L K C O U N T I E S
93-0386982
File
by the
due date for
filing
your
return.
See
Number,
street, and room or s uite no. If a P.O. box, see instruc tions.
685 C O U R T
S T N E
Socialsecurity num ber (SSN)
instructions.
City,
town or po st office, state, and ZIP code . For a foreign address , see instructions.
S A L E M , OR
97301
Enter
the Return co de for the return that this a pplication is for (fi le a separate application fo r each return)
|Q| 1
Application
Return
Application
Return
Is For
Code
Is
For
Code
Form
990 or Form 990-EZ
01
Form 990-T (corporation)
07
Form
990-BL
02
Form 1041-A
08
Form
472 0 (individual)
03
Form
4720 (other than individual)
09
Form 990-PF
04
Form
5227
10
Form 990-T (sec.401(a) or 408(a) tru st)
05
Form
6069
11
Form
990-T (trust other tha n above)
06
Form
8870
12
T H E
O R G A N I Z A T I O N
The books are in the care of
6 8 5
C O U R T
S T N E
S A L E M ,
OR
97301
TelephoneN o .
5 0 3 - 3 9 9 - 2 7 5 7
FaxNo.
If the organization does not have an office or place of business in the U nited States, chec k this box ^
If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) .
If
this is for the whole gro up, check this
box I IIf it is for part of the g roup, che ck this box
L~~1and attach a list with the names and EINs of all members the e xtension is for.
1
I
request an automatic 3 -month (6 months for a corporation required to file Form 990-T) extension of time until
A U G U S T
1 5 , 2 0 1 4 ,
to file the exempt organization return for the organization named above. Theextensigj
is
for the organization's return for:
Lx] calendar year 2 0 1 3 or
C Z I tax year beginning , and ending .
2 If the tax year entered in line
1
is for less than
12
months, check reason:
C Z
Initial return
LZH
Final return
[Of-
3a
If this application is for Forms 990-BL , 990-PF, 990-T, 472 0, or 6069 , enter the tentative tax, less any
nonrefundablecredits. See instructions.
3a
$
0 .
b If this application is for Forms 990-PF, 990-T, 472 0, or 6069, enter any refundable credits and
estimated
tax paymen ts mad e. Include any prior year overpayment allowed as a credit.
3b
$
0 .
c
Balancedue.Subtract l ine 3b from line 3a. Include your pay ment w ith this form, if required,
bv
using EFTPS (Electronic Federal Tax Payment Sys tem). See instructions.
3 c
$
0 .
Caution.If you are going to make an electronic fun ds withdra wal (direct debit) with this Form 88 68, see Form
8453-EO
and Form
8879-EO
for paym ent
instructions.
L HA
Fo rPrivacyAct and Paperwork Reduction Act Notice, see instructions.
323841
12-31-13
Form
8868(Rev.1-2014)
2013.03030 T H E F A M I L Y Y OU NG M E N ' S C H R I 85222 1
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
55/56
Form
8868 (Rev.1-2014)
Page
If you are fil ing for an
Additional (Not Au tomatic)3-MonthExtension,complete only Part II
and check this box
Note.Only complete Part II if you have already been granted an automatic 3-month extension on a previously fi led Form 8868.
* If you are fil ing for an Automatic3-MonthExtension,complete only PartI(on page 1).
Lx]
Part
III
Additional (Not Autom atic)
3-MonthExtension
of T ime . Onlyfilethe original (no
copies
needed).
Type
or
Fi l e
by the
Name
of exempt organization or other fi ler, see instructions.
T H E F A M I L Y YO UN G M E N ' S C H R I S T I A N
A S S O C I A T I O N
O F MARION AND
P O L K
C O U N T I E S
Employer
iden tification number (EIN) o
93-0386982
due date for
filing
your
re t urn . See
Number,street, and room or suite no. If a P.O. box, see instructions.
685 C O U R T
S T N E
Social
security n umbe r (SSN)
i ns truct i ons .
City,
town or post o f f ice, state, and ZIP co de. For a foreign address, see instruct ions.
S A L E M ,
OR
97301
Enterthe Return cod e for the return that this applic ation is for (fi le a separate applic ation for each return) ]Q | 1
Applicat ion
Return Applicat ion
Return
Is
For
Co d e
Is
For
Code
Form
990 or Form 990-EZ
01
Form
990-BL
02
Form 1041-A
08
Form 4720 (individual)
03
Form
4720 (other than individual)
09
Form
990-PF
04
Form
5227
10
Form
990-T (sec. 401(a) or 408(a) trust)
05 Form
6069
11
Form
990-T (trust other than above)
06
Form 8870
12
S T O P Do not complete Part II if vou were not alreadv granted an automatic3-monthextension on a previouslvfiledForm8868.
T H E O R G A N I Z A T I O N
The books are in the care of
6 8 5
C O U R T
S T N E
- S A L E M ,
OR
97301
FaxNo. elephoneN o .
503 -399 -2757
If
the organizat ion does not have an off ice or place of business in the U nited States, check this box
If
this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
If
this is for the whole group, check this
box .
If it is for part of the grou p, chec k this box and attach a list with the names and EINs of all memb ers the extension is for.
4
I
request an addit ional 3-month extension of t ime un t i l
5
For calendar year
2 0 1 3
, or other tax year beginn ing
6 Ifthetax year en tered in line 5 is for less than12months, check reason:
Change in account ing per iod
7
State in detai l why you need the extension
N O V E M B E R
1 5 ,
2014.
Initial return
,
and ending
Final return
A D D T I O N A L T I M E I S
N E E D E D
T O
F I L E
A
C O M P L E T E
AND
A C C U R A T E
R E T U R N .
8a If this applica tion is for Forms 990-BL, 990-PF, 990-T, 472 0, or 6069, enter the tentative tax, less any
nonrefundable
credits. See instruct ions.
8a
S 0
b If this applica tion is for Forms 990-PF, 990-T, 47 20 , or 6069, enter any refundable cred its and estima ted
tax
payme nts ma de. Include any pr ior year overpayment al lowed as a credit and any amount paid
previouslywith Form 8868.
8b
$
0
c
Balan ce du e. Subtract l ine 8b from line 8a. Include your payment with this form, if required, by using
EFTPS
(Electronic Federal Tax Payment System). See instructions.
8c
$ 0
Signature
and Verification must be completed for Part II only.
Under
penalties of
perjury,I
declare that
I
have examined this form , including accompanying schedules and statements, and to the best of my knowledge and belief,
it
is true, correct, and complete, and that
I
am authorized to prepare this form .
Sgnature
/
JjOfMiZ, f.(LaSs3cSY\ Title
C P A
Date
(J Form 886 8 (Rev.
1
-201
323842
12-31-13
783673 85222 20 13 .04 01 0 T H E
F A M T L Y
YnTTOn MRN' .q P H R T n^ooi
1
8/10/2019 YMCA of Marion and Polk Counties 2013 Charity Report
56/56
Form8868
(Rev.
January 2014)
Department of the T r e a s u r y
Internal
R e v e n u e S e r v i c e
Application
for
Extension
of Tim e To
File
an
Exem pt Organization Return
Filea separate application for eachreturn.
Informationabout Form
8868
an d its instructions is at www.irs.gov/form8868.
OMBNo. 1545-1709
I f you are f i ling for an Autom atic 3 -Month Ex tens ion, complete onlyPar tIand check this box
fx l
If you are fil ing for an Ad diti on al
(Not
A u tom a t i c )
3
- M on th Ex tens ion , com p le te
only
P a r t
II
(on page 2 o f this form).
Donot complete Part II unless
you have already been granted an autom atic 3-month extension on a previously filed Form 8868 .
Electronic f i l ing(e-file). You can electronically fi le Form 8868 if you need a 3-month au tomatic extension of time to file (6 mon ths for a corpo ration
requiredto file Form 990-T), or an additional (not automa tic) 3-month extension of tim e. You can electronically fi le Form 8868 to reque st an extens ion
of
time to file any of the fo rms listed in Part
I
or Part II with the exce ption of Form 887 0, Information R eturn for Transfers Assoc iated W ith Certain
Personal
Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic fi l ing of this form,
visitwww.irs.gov/efile and click one-file for Charities & Nonprofits.
PartI
| Automatic
3-MonthExtension
of Time. Only submit original (no
copies
needed).
A
corporation required to file Form 990-T and requesting an automa tic 6-month extension - chec k this box and com plete
Part Ionly
All other corporations (including 1120-C filers),partnerships, REM ICs, and trusts must use Form 7004 to request an extension of time
tofile income tax returns. _ ^
Typeor
Nameof exempt organ ization or other fi ler, see instruction s.
T H E
F A M I L Y Y OU NG M E N ' S C H R I S T I A N
Employeridentification numbe r (EIN) o
Fi le by t he
due date for
filing your
re t urn . Se e
A S S O C I A T I O N
O F MARION AND
P O L K C O U N T I E S
93-0386982
Fi le by t he
due date for
filing your
re t urn . Se e
Number,
street, and room or suite no. If a P.O. box, see instructions .
685 C O U R T
S T N E
Socialsecurity num ber (SSN)
i ns truct i ons .
City,
town or post office, state, and ZIP code. For a foreign address, see instructions.
S A L E M ,
OR
97301
Enter the Return code for the return that this application isfor (fi le a separate app lication for ea ch return)
1
0I1
Application
Return
Application
Return
Is
For
Code Is
For
Code
Form
990 or Form
990-EZ
01
Form 990-T (corporation)
07
Form 990-BL
02
Form 1041-A
08
Form
4720 (individual)
03
Form
4720 (other than individual)
09
Form
990-PF
04
Form
5227
10
Form
990-T (sec.401(a) or 408(a) trust)
05
Form6069
11
Form
990-T (trust other tha n above)
06
Form
8870
12
T H E
O R G A N I Z A T I O N
The books are in the care of
6 8 5
C O U R T
S T N E -
S A L E M ,
OR
97301
TelephoneN o .
5 0 3 - 3 9 9 - 2 7 5 7
FaxNo.
If the organization does not have an office or place of business in the U nited States, check this box 1
If this is for a Group Return, enter the organization's four digit Group Exemption Numb er (GEN) .
If
this is for the whole group, check this
box EZ3 If it is for part of the group , check this box
I
and attach a list with the names and EINs of all members the extension is for.
1 I
request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until
A U G U S T
1 5 , 2 0 1 4
,
to file the exempt organization return for the organization named above. The extension
isfor the orga nization's return for:
Lx] calendar year2 0 1 3 or
taxyear beginning
,
and ending
2
If the tax year entered in line
1
is for less than12months, check reason:
I
Initial return
I
Final return
3a
If this application is for Forms 990-BL, 990-PF, 990-T, 472 0, or 6069 , enter the tentative tax, less any
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