2016-06-24T10:07:55-05:00 2015-12-31 010494526 BAKER NEWMAN NOYES PC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2015-01-01 222495808 FANNY ALLEN CORPORATION FANN 9786546363 100 AMES POND DRIVE SUITE 102 TEWKSBURY MA 01876 JOHN AHLE TREASURER 9786546363 2016-06-14 E DREW CHENEY P00182972 8002447444 2016-06-14 2015 2016-09-27 15:27:22Z JOHN AHLE 100 AMES POND DRIVE SUITE 102 TEWKSBURY MA 01876 322741 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 DISENFRANCHISED. 7 7 0 0 0 0 0 200000 0 0 177640 122616 0 125 177640 322741 260243 273150 0 0 0 0 0 0 0 57662 19492 317905 292642 -140265 30099 8054035 7789041 8944 0 8045091 7789041 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND DISENFRANCHISED. 0 0 291292 273150 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND DISENFRANCHISED. 291292 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 0 0 X 7 7 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/CHAIR 3.00 3.00 X 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 1.00 1.00 X 0 1000 0 HEIDE ST PETER DIRECTOR 1.00 1.00 X 0 0 0 ELLEN KANE DIRECTOR/ PRESIDENT THRU 3/2015 4.00 6.00 X X 0 15240 6304 JOHN AHLE TREASURER/ CH 1.00 39.00 X 0 408243 105644 0 424483 111948 0 0 1 0 0 200000 200000 86186 86186 36430 0 36430 36430 36430 OTHER INCOME 900099 125 125 125 322741 0 0 122741 273150 273150 1350 1350 780 780 1266 1266 ADMINISTRATIVE FEES 16096 16096 292642 291292 1350 0 88565 238926 1000 5891416 5582061 2074054 1967054 8054035 7789041 8944 0 8944 0 X 6101075 5845025 1362279 1362279 581737 581737 8045091 7789041 8054035 7789041 30099 -286149 0 X 0 1 X 0 0 X X 1 COVENANT HEALTH INC 222484505 9 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 ORGANIZATION MAKES GRANTS TO CERTAIN UNRELATED CHARITABLE ORGANIZATIONS, CONSISTENT WITH THE MISSION OF COVENANT HEALTH, INC., WHICH IS TO PROVIDE HEALTH AND HUMAN SERVICES ASSISTANCE IN A MANNER CONSISTENT WITH THE HEALING MINISTRY OF JESUS IN THE ROMAN CATHOLIC CHURCH. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1944016 1944016 1944016 1944016 1930974 13042 1944016 1865323 1283586 65651 1283586 1930974 1931536 -66213 1865323 0.29920 0.70080 1 0 0 PROVIDENTIA PRIMA TRUST 5582061 F 5582061 RESTRICTED FUNDS, CVS, SPLIT INTEREST ACCOUNT 1967054 1967054 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, 2015. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2012 THROUGH 2015 ARE OPEN AND SUBJECT TO EXAMINATION. 1 CAMP EXCLAMATION POINT INC PO BOX 91 RICHMOND VT 05477 030329568 501(C)(3) 6000 DAY CAMP FOR LOW INCOME CHILDERN COMMITTEE ON TEMPORARY SHELTER 95 NORTH STREET BURLINGTON VT 05401 030285606 501(C)(3) 10000 HOMELESS PREVENTION FUND AND DAY SHELTER FAITH IN ACTION NORTHERN COMMUNITIES PARTNERSHIP INC PO BOX 157 CABOT VT 05647 208406050 501(C)(3) 10000 PROVIDE BASIC NEEDS TO SENIORS AND THE DISABLED BURLINGTON DISMAS HOUSE 96 BUELL STREET BURLINGTON VT 05401 030369442 501(C)(3) 7000 HOUSING FOR FORMER PRISONERS JOINT URBAN MINISTRY PROJECT 38 SOUTH WINOOSKI AVENUE BURLINGTON VT 05401 202055113 501(C)(3) 10000 EMERGENCY ASSISTANCE DIRECT AID SAMARITAN HOUSE 20 KINGMAN ST SUITE 1 ST ALBANS VT 05478 030330331 501(C)(3) 15000 SHELTER AND TRANSITIONAL HOUSING FOR THE HOMELESS CHAMPLAIN SENIOR CENTER 241 NO WINOOSKI AVENUE BURLINGTON VT 05401 237056383 501(C)(3) 10000 SENIOR LUNCH PROGRAM VERMONT CATHOLIC CHARITIES INC 55 JOY DRIVE BURLINGTON VT 05403 030181216 501(C)(3) 20000 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 EMPLOYMENT CHARTER HOUSE COALITION PO BOX 344 EAST MIDDLEBURY VT 05740 562531802 501(C)(3) 8000 FOOD FOR THE HOMELESS SPECTRUM YOUTH AND FAMILY SERVICES 31 ELMWOOD BURLINGTON VT 05401 030253232 501(C)(3) 7500 HOMELESS YOUTH FOOD PROGRAM VERMONT FOODBANK 33 PARKER ROAD BARRE VT 05641 223021942 501(C)(3) 8000 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) 5000 LOW INCOME EMPLOYEE ASSISTANCE LUND PO BOX 4009 BURLINGTON VT 05406 030179434 501(C)(3) 10000 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) 5000 HEALTH CSA FOR LOW INCOME FAMILIES VISITING NURSE ASSN OF CHITTENDEN & GRAND ISLE COUNTIES 1110 PRIM ROAD COLCHESTER VT 05446 030179603 501(C)(3) 10000 CHILD CARE & FAMILY SERVICES FOR LOW INCOME WINOOSKI FAMILY CENTER 80 NORMAND STREET WINOOSKI VT 05404 030179433 501(C)(3) 5000 MENTAL HEALTH SERVICES AND PROGRAMS FOR CHILDREN 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) 15000 SERVICES FOR ELDERLY DAY CARE INCLUDING TRANSPORTATION, MEALS, ACTIVITIES AND EDUCATION. PATHWAYS VERMONT INC 125 COLLEGE STREET BURLINGTON VT 05401 300604758 501(C)(3) 6000 SUPPORT 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) 10000 PROMOTES AND SUPPORTS HEALTHY RELATIONSHIPS WITHIN FAMILIES, SCHOOLS AND COMMUNITIES TO ELIMINATE CHILD ABUSE. SARA HOLBROOK COMMUNITY CENTER 66 NORTH AVENUE BURLINGTON VT 05401 030179595 501(C)(3) 10000 COMMUNITY CENTER DEVELOPS PRODUCTIVE AND RESPONSIBLE FAMILIES, CHILDREN, AND YOUTH THROUGH SOCIAL DEVELOPMENT, RECREATIONAL, AND EDUCATIONAL OPPORTUNITIES. UNITED WAY OF CHITTENDEN COUNTY 412 FARRELL STREET SUITE 200 BURLINGTON VT 05403 030217229 501(C)(3) 5000 SUPPORT RESIDENTS OF CHITTENDEN COUNTY. VT ASSOCIATION FOR THE BLIND & 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. GREATER BURLINGTON YMCA 266 COLLEGE STREET BURLINGTON VT 05401 030185810 501(C)(3) 10000 SUPPORT CAMP GREYLOCK TRIP FOR BOYS 29 PART I, LINE 2: INTERVIEW GRANTEE ORGANIZATIONS SEEKING DONATIONS AND MONITOR THEIR ACTIVITIES. 0 1 0 0 0 0 0 0 0 JOHN AHLE TREASURER/ CH 0 404450 0 0 0 3793 0 70600 0 35044 0 513887 0 0 PART I, LINE 4B THE RELATED ORGANIZATION, COVENANT HEALTH,INC., MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM FOR CERTAIN EXECUTIVES UNDER WHICH THE ORGANIZATION MAKES A CONTRIBUTION FOR THE BENEFIT OF THE EXECUTIVE THAT IS INTENDED TO PROVIDE A SPECIFIED LEVEL OF RETIREMENT BENEFITS AT RETIREMENT AGE COMMENSURATE WITH RETIREMENT BENEFITS PROVIDED TO EXECUTIVES IN COMPARABLE POSITIONS BY SIMILARLY SITUATED ORGANIZATIONS. AMOUNTS CONTRIBUTED ARE HELD FOR THE BENEFIT OF THE EXECUTIVE UNTIL HE OR SHE REACHES AGE 60, AT WHICH TIME THEY ARE RELEASED TO THE EXECUTIVE. THE FULL AMOUNT IS TAXABLE TO THE EXECUTIVE WHEN SO PAID, AND IS INCLUDED IN THE EXECUTIVE'S REPORTED COMPENSATION. 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 11 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 1 0 0 1 1