2017-10-19T08:06:52-05:00 2016-12-31 990 2016-01-01 222495808 FANNY ALLEN CORPORATION FANN 9786546363 100 AMES POND DRIVE SUITE 102 TEWKSBURY MA 01876 JOHN AHLE TREASURER 9786546363 2017-10-19 155.212.6.161 2017-10-19 09:06:44 ED P E1A65C102B06E5C9ADAF8DC78101520DB9B2CC9D E1A65C102B06E5C9ADAF8DC78101520DB9B2CC9D 2016 2021-01-29 14:40:06Z JOHN AHLE 100 AMES POND DRIVE SUITE 102 TEWSBURY MA 01876 313076 0 X N/A X 1983 VT THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND MOST NEEDY. 9 9 0 0 0 0 200000 200000 0 0 122616 113076 125 0 322741 313076 273150 268802 0 0 0 0 0 0 0 19492 1485 292642 270287 30099 42789 7789041 8273051 0 0 7789041 8273051 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND MOST NEEDY. 0 0 269287 268802 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND MOST NEEDY. 269287 1 1 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 X X JOHN AHLE 9786546363 100 AMES POND DRIVE SUITE 102 TEWKSBURY MA 01862 MICHAEL TOMKOWICZ DIRECTOR 1.00 1.00 X 0 0 0 LAURA WARREN DIRECTOR/SECRETARY 1.00 1.00 X X 0 0 0 MICHAEL NEW DIRECTOR 1.00 1.00 X 0 0 0 CHRISTINE WERNEKE DIRECTOR 1.00 1.00 X 0 0 0 NADINE SCIBEK DIRECTOR 1.00 1.00 X 0 0 0 DAVID JILLSON DIRECTOR/ CHAIR 3.00 3.00 X X 0 0 0 HEIDI ST PETER DIRECTOR 1.00 1.00 X 0 0 0 PETER MOINO DIRECTOR FROM 7/16 1.00 1.00 X 0 0 0 MAUREEN O'REILLY DIRECTOR FROM 7/16 1.00 1.00 X 0 0 0 JOHN AHLE TREASURER/ CH 1.00 39.00 X 0 738263 36019 0 738263 36019 0 0 1 0 0 200000 200000 113076 113076 313076 0 0 113076 268802 268802 1000 1000 53 53 432 432 270287 269287 1000 0 238926 237033 1000 5582061 6070941 1967054 1965077 7789041 8273051 0 0 X 5845025 6329035 1362279 1362279 581737 581737 7789041 8273051 7789041 8273051 42789 441221 0 X 0 1 X 0 0 X X 1 COVENANT HEALTH INC 222484505 10 1 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, QUESTION 6 THE ORANIZATION MAKES GRANTS TO CERTAIN UNRELATED ORGANIZATIONS, CONSISTENT WITH THE MISSION OF COVENANT HEALTH, INC., WHICH IS TO PROVIDE HEALTH AND HUMAN SERVICES ASSITANCE IN THE MANNER CONSISTENT WITH THE HEALING MINISTRY OF JESUS CHRIST IN THE ROMAN CATHOLIC CHRUCH. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1944016 1944016 1944016 1944016 1944016 1944016 1930974 13042 1944016 1865323 1283586 65651 1283586 1930974 0.29920 0.70080 1 0 0 PROVIDENTIA PRIMA TRUST 6070941 F 6070941 RESTRICTED FUNDS, SPLIT INTEREST ACCOUNT 1965077 1965077 X PART X, LINE 2: COVENANT AND ITS MEMBER ORGANIZATIONS ARE CONSIDERED NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE, EXCEPT AS NOTED BELOW. TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. UNDER GUIDANCE ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD, ASSETS AND LIABILITIES ARE ESTABLISHED FOR UNCERTAIN TAX POSITIONS TAKEN OR POSITIONS EXPECTED TO BE TAKEN IN INCOME TAX RETURNS WHEN SUCH POSITIONS ARE JUDGED TO NOT MEET THE "MORE-LIKELY-THAN-NOT" THRESHOLD, BASED UPON THE TECHNICAL MERITS OF THE POSITION. ESTIMATED INTEREST AND PENALTIES, IF APPLICABLE, RELATED TO UNCERTAIN TAX POSITIONS ARE INCLUDED AS A COMPONENT OF INCOME TAX EXPENSE. THE SYSTEM HAS EVALUATED THE POSITION TAKEN ON ITS FILED TAX RETURNS. THE SYSTEM HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2016. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2013 THROUGH 2016 ARE OPEN AND SUBJECT TO EXAMINATION. 1 ADDISON COUNTY COMMUNITY ACTION GROUP 282 BOARDMAN STREET MIDDLEBURY VT 05753 237393720 501(C)(3) 5000 EMERGENCY SUPPORT FOR HOMELESS AND SICK OF ADDISON COUNTY, VT BOYS AND GIRLS CLUB OF BURLINGTON 62 OAK STREET BURLINGTON VT 05401 030179307 501(C)(3) 6000 AFTER SCHOOL PROGRAM FOR CHILDREN BURLINGTON SUPPORTIVE HOUSING INTIATIVES INC 65 MAIN STREET BURLINGTON VT 05401 201308308 501(C)(3) 5000 NURTRITION AND DROP IN PROGRAM CAMP EXCLAMATION POINT INC PO BOX 91 RICHMONT VT 05477 030329568 501(C)(3) 6000 DAY CAMP FOR LOW INCOME CHILDERN CAMP TA KUM TA PO BOX 459 SOUTH HERO VT 05486 030362578 501(C)(3) 7500 SUMMER CAMP FOR CHILDREN COMMITTEE ON TEMPORARY SHELTER 95 NORTH STREET BURLINGTON VT 05401 030285606 501(C)(3) 10000 HOMELESS PREVENTION FUND AND DAY SHELTER COMMUNITY HEALTH CENTERS OF BURLINGTON 617 RIVERSIDE AVE BURLINGTON VT 05401 237182584 501(C)(3) 15000 COMMUNITY HOUSING FAITH IN ACTION NORTHERN COMMUNITIES PTRSHP INC 2 COMMON WAY PO BOX 157 CABOT VT 05647 208406050 501(C)(3) 10000 PROVIDE BASIC NEEDS TO SENIORS AND THE DISABLED GREEN MOUNTIAN HABITAT FOR HUMANITY 300 CORNERSTONE DR STE 335 WILLISTON VT 05495 222558923 501(C)(3) 5000 AFFORABLE HOMES JOHN GRAHAM SHELTER 69 MAIN ST VERGENNES VT 05491 030275219 501(C)(3) 10000 HOMELESS SHELTER JOINT URBAN MINISTRY PROJECT 38 SOUTH WINOOSKI AVENUE BURLINGTON VT 05401 202055113 501(C)(3) 10000 EMERGENCY ASSITANCE DIRECT AID MARTHA'S KITCHEN 86 NORTH MAIN STREET ST ALBANS VT 05478 030290790 501(C)(3) 5000 COMMUNITY SOUP KITCHEN OUR COMMUNITY CARES CAMP PO BOX 503 RICHMOND VT 05477 264398448 501(C)(3) 5000 SUMMER FOOD AND ACTIVITIES SAMARITAN HOUSE 20 KINGMAN ST SUITE 1 ST ALBANS VT 05478 030330331 501(C)(3) 10000 SHELTER AND TRANSITIONAL HOUSING FOR THE HOMELESS VERMONT CATHOLIC CHARITIES INC 55 JOY DRIVE BURLINGTON VT 05403 030181216 501(C)(3) 10000 EMERGENCY ASSISTANCE FOR ECONOMICALLY DISADVANTAGED CAMP AGAPE VERMONT 36 RANDALL STREET 1 ESSEX VT 05451 263990854 501(C)(3) 7500 SUMMER CAPE FOR UNDER PRIVILEGED YOUTH CHAMPLAIN VALLEY OFFICE OF ECONOMIC OPPORTUNITY 255 SOUTH CHAMPLAIN STREET BURLINGTON VT 05402 030216837 501(C)(3) 10000 SUPPORT LOW INCOME SEEKING FOOD AND EMPLOYMENT SPECTRUM YOUTH AND FAMILY SERVICES 31 ELMWOOD BURLINGTON VT 05401 030253232 501(C)(3) 8000 HOMELESS YOUTH FOOD PROGRAM VERMONT FOODBANK 33 PARKER ROAD BARRE VT 05641 223021942 501(C)(3) 10000 COMMUNITY KITCHEN KING STREET YOUTH CENTER PO BOX 1615 BURLINGTON VT 05402 237236312 501(C)(3) 10000 PROGRAMS FOR CHILDREN LEROYER EMPLOYEE ASSISTANCE FUND 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 501(C)(3) 6500 LOW INCOME EMPLOYEE ASSISTANCE LUND PO BOX 4009 BURLINGTON VT 05406 030179434 501(C)(3) 12000 EARLY CHILDHOOD EDUCATION VERMONT WORKS FOR WOMEN 32A MALLETS BAY AVENUE WINOOSKI VT 05404 222894557 501(C)(3) 8000 TRAINING PROGRAMS VERMONT YOUTH CONSERVATION CORP 1949 EAST MAIN STREET RICHMOND VT 05477 030328834 501(C)(3) 7500 HEALTH CSA FOR LOW INCOME FAMILIES VISITING NURSE ASSN OF CHITTENDEN & GRAND ISLE COUNTIES 1110 PRIM ROAD COLCHESTER VT 05446 030179603 501(C)(3) 9450 CHILD CARE & FAMILY SERVICES FOR LOW INCOME WINOOSKI FAMILY CENTER 80 NORMAND STREET WINOOSKI VT 05404 030179433 501(C)(3) 10000 MENTAL HEALTH SERVICES AND PROGREAMS FOR CHILDERN AND THEIR FAMILIES ANEW PLACE 89 NORTH STREET BURLINGTON VT 05401 030827599 501(C)(3) 10000 SUPPORT FOR HOMELESS ADULTS. CANCER PATIENT SUPPORT FOUNDATION PO BOX 1804 WILLISTON VT 05495 030365270 501(C)(3) 8000 TO MEET THE IMMEDIATE NEED OF CANCER PATIENTS IN FINANCIAL CRISIS DUE TO THEIR ILLNESS. ELDERY SERVICES INC 112 EXCHANGE STREET MIDDLEBURY VT 05753 030280968 501(C)(3) 10000 SERVICES FOR ELDER DAY CARE INCLUDING TRANSPORTATION, MEALS, ACTIVITES AND EDUCATION. PATHWAYS VERMONT INC 125 COLLEGE STREET BURLINGTON VT 05401 300604758 501(C)(3) 8000 SUPORT THOSE STRUGGLING WITH MENTAL HEALTH AND OTHER LIFE CHALLENGES, INCLUDING HOMELESSNESS, ADDICTION AND POVERTY. PREVENT CHILD ABUSE VERMONT 94 MAIN STREET MONTPELIER VT 05601 030267183 501(C)(3) 7500 PROMOTES AND SUPPORTS HEALTHY RELATIONSHIPS WITHIN FAMILIES, SCHOOLS AND COMMUNITIES TO ELIMINATE CHILD ABUSE. VT ASSOCIATION FOR THE BLIND AND VISUALLY IMPAIRED 60 KIMBALL AVENUE BURLINGTON VT 05403 036000834 501(C)(3) 5000 ENABLE VERMONTERS WITH VISION PROBLEMS, WHETHER BLINDNESS OR IMPAIRMENT, TO ACHIEVE AND MAINTAIN INDEPENDENCE. 32 0 PART I, LINE 2: INTERVIEW GRANTEE ORGANIZATIONS SEEKING DONATIONS AND MONITOR THEIR ACTIVITIES INCLUDING RECEIVING AND REVIEWING OUTCOME REPORTS FROM EACH GRANTEE. 0 0 0 0 0 0 0 1 0 JOHN AHLE TREASURER/ CH 0 738263 0 0 0 0 0 10600 0 25419 0 774282 0 0 PART I, LINE 7 THE RELATED ORGANIZATION, COVENANT HEALTH, MAINTAINS AN INCENTIVE COMPENSATION PLAN FOR EXECUTIVES THAT IS ADMINISTERED BY THAT ORGANIZATION'S COMPENSATION COMMITTEE. THE PLAN PROVIDES EXECUTIVES WITH THE OPPORTUNITY TO EARN REASONABLE INCENTIVE COMPENSATION BASED ON THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE INDIVIDUAL EXECUTIVE, AS MEASURED AGAINST GOALS THAT ARE SET AT THE BEGINNING OF THE YEAR. THE ENTITLEMENT TO AWARDS FOR A PARTICULAR YEAR IS NOT DETERMINED UNTIL EARLY THE FOLLOWING YEAR. THE ORGANIZATION PAYS INCENTIVE COMPENSATION AWARDS TO OFFICERS INCLUDING THE TREASURER IN THE CURRENT YEAR BASED ON PERFORMANCE DURING THE PRECEDING YEAR. DURING 2016, THE ORGANIZATION DID NOT PAY ANY ACCRUED INCENTIVE COMPENSATION TO THE OFFICERS. ADDITIONALLY, THE RELATED ORGANIZATION, COVENANT HEALTH, PAID THE TREASURER AN INCENTIVE RETENTION BONUS DURING 2016 FOR CONTINUOUS SERVICE OVER THE PRECEDING 5 YEARS. FORM 990, PART VI, SECTION A, LINE 6 COVENANT HEALTH, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A COVENANT HEALTH, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION AND AS SUCH HAS CERTAIN RESERVED RIGHTS. FORM 990, PART VI, SECTION A, LINE 7B COVENANT HEALTH, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION AND AS SUCH HAS CERTAIN RESERVED RIGHTS TO APPROVE CERTAIN DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL BY THE GOVERNING BODY PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS AN OPERATIONAL INTEGRITY OFFICER THAT MONITORS ALL AREAS FOR POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 FOR THE RELATED PARTY, COVENANT HEALTH, INC. - EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH'S BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THIS ANALYSIS ARE TO: - ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM. - DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS. - ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 ALL POLICIES AND FORM 990'S ARE MAINTAINED WITH THE BOOKS AND RECORDS AND ARE AVAILABLE TO THE PUBLIC FOR INSPECTION UPON REQUEST. FORM 990 PART VII & SCHEDULE J THE REPORTABLE AND OTHER COMPENSATION PAID BY A RELATED ORGANIZATION TO JOHN AHLE WAS PAID BY COVENANT HEALTH, INC. FANNY ALLEN HOLDINGS 101 COLLEGE PARKWAY COLCHESTER VT 05446 030181052 REAL ESTATE HOLDING VT 501(C) 3 11 CH 0 COVENANT HEALTH INC 100 AMES POND DRIVE TEWKSBURY MA 01876 222484505 HEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATION MA 501(C) 3 9 CH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1