2015-07-15T09:56:28-05:00 2014-12-31 010494526 BAKER NEWMAN NOYES PC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2014-01-01 222495808 FANNY ALLEN CORPORATION FANN 9786546363 100 AMES POND DRIVE SUITE 102 TEWKSBURY MA 01876 JOHN AHLE TREASURER 9786546363 2015-07-13 E DREW CHENEY P00182972 8002447444 2015-07-13 2014 2016-03-07 17:11:31Z JOHN AHLE 100 AMES POND DRIVE SUITE 102 TEWSBURY MA 01876 177640 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. 8 7 0 0 0 0 0 0 0 0 179429 177640 0 0 179429 177640 207300 260243 0 0 0 0 0 0 0 113405 57662 320705 317905 -141276 -140265 8157323 8054035 73647 8944 8083676 8045091 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND DISENFRANCHISED. 0 0 316805 260243 THE FANNY ALLEN CORPORATION PROVIDES SUPPORT AND GRANTS TO OTHER NOT FOR PROFIT ORGANIZATIONS IN VERMONT THAT SERVE THE POOR AND DISENFRANCHISED. 316805 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 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 8 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 0 0 HEIDI ST PETER DIRECTOR 1.00 1.00 X 0 0 0 ELLEN KANE DIRECTOR/ PRESIDENT 15.00 25.00 X X 0 70127 28633 JOHN AHLE TREASURER/ CHS 1.00 39.00 X 0 396146 102749 0 466273 131382 0 0 1 0 0 77415 77415 100225 0 100225 100225 100225 177640 0 0 177640 260243 260243 1100 1100 475 475 564 564 2447 2447 996 996 ADMINISTRATIVE FEES 52080 52080 317905 316805 1100 0 192102 88565 5823276 5891416 2141945 2074054 8157323 8054035 73647 8944 73647 8944 X 6139660 6101075 1362279 1362279 581737 581737 8083676 8045091 8157323 8054035 X -140265 111159 -9479 X 0 1 X 0 0 X X 1 COVENANT HEALTH INC 222484505 9 1 0 0 1 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. 1944016 1944016 1930974 13042 1944016 1865323 1283586 65651 1283586 1930974 1931536 -66213 1865323 1901991 29545 1931536 0.29920 0.70080 1 0 0 PROVIDENTIA PRIMA TRUST 5891416 F 5891416 RESTRICTED FUNDS, CVS, SPLIT INTEREST ACCOUNT 2065110 DEFERRED COMPENSATION 8944 2074054 DEFERRED COMPENSATION 8944 8944 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, 2014. UNDER INTERNAL REVENUE SERVICE REGULATIONS, THE SYSTEM'S TAX YEARS FROM 2011 THROUGH 2014 ARE OPEN AND SUBJECT TO EXAMINATION. 1 CAMP EXCLAMATION POINT INC PO BOX 91 RICHMONT VT 05477 030329568 501(C)(3) 6000 DAY CAMP FOR LOW INCOME CHILDERN COMMITTEE ON TEMPORARY SHELTER PO BOX 1616 BURLINGTON VT 05401 030285606 501(C)(3) 10000 HOMELESS PREVENTION FUND AND DAY SHELTER 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 BURLINGTON DISMAS HOUSE 96 BUELL STREET BURLINGTON VT 05401 030369442 501(C)(3) 6850 HOUSING FOR FORMER PRISONERS JOHN GRAHAM EMERGENCY CENTER 69 MAIN STREET VERGENNES VT 05401 030275219 501(C)(3) 15000 HOMELESS SHELTER PROGRAMS JOINT URBAN MINISTRY PROJECT 38 SOUTH WINOOSKI AVENUE BURLINGTON VT 05401 202055113 501(C)(3) 10000 EMERGENCY ASSITANCE DIRECT AID SAMARITAN HOUSE 20 KINGMAN ST SUITE 1 ST ALBANS VT 05478 030330331 501(C)(3) 15250 SHELTER AND TRANSITIONAL HOUSING FOR THE HOMELESS CHAMPLAIN SENIOR CENTER 241 NO WINOOSKI AVENUE BURLINGTON VT 05401 237056383 501(C)(3) 7800 SENIOR LUNCH PROGRAM VERMONT CATHOLIC CHARITIES INC 55 JOY DRIVE BURLINGTON VT 05403 030181216 501(C)(3) 10000 EMERGENCY ASSISTANCE FOR ECONOMICALLY DISADVANTAGED CAMP AGAPE VERMONT PO BOX 8283 ESSEX VT 05451 263990854 501(C)(3) 6000 SUMMER CAPE FOR UNDER PRIVILEGED YOUTH CHAMPLAIN HOUSING TRUST 88 KING STREET BURLINGTON VT 05401 222536446 501(C)(3) 24000 HARBOR PLACE SHELTER CHAMPLAIN VALLEY OFFICE OF ECONOMIC OPPORTUNITY PO BOX 1603 BURLINGTON VT 05402 030216837 501(C)(3) 5000 SUPPORT LOW INCOME SEEKING EMPLOYMENT CHARTER HOUSE COALITION PO BOX 344 EAST MIDDLEBURY VT 05740 562531802 501(C)(3) 7000 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) 10000 COMMUNITY KITCHEN BOYS AND GIRLS CLUB OF BURLINGTON 62 OAK STREET BURLINGTON VT 05401 031079307 501(C)(3) 6000 SUMMER PROGRAM FOR LOW INCOME YOUTH BURLINGTON CHILDREN'S SPACE 241 NO WINOOSKI AVENUE BURLINGTON VT 05401 222533646 501(C)(3) 9913 BCS CHILD NUTRITION COLCHESTER FOOD SHELF 416 CHURCH ROAD COLCHESTER VT 05446 030600941 501(C)(3) 5250 FOOD FOR THE POOR CATHEDRAL SQUARE CORPORATION 412 FARRELL STREET SUITE 100 BURLINGTON VT 05403 030264362 501(C)(3) 4600 REDUCE CHRONIC HEART FAILURE AMONG LOW INCOME SENIORS CHAMPLAIN VALLEY AGENCY ON AGING 76 PEARL ST STE 201 ESSEX JCT VT 05452 222474636 501(C)(3) 5000 PROGRAMS FOR THE ELDERLY KIDSAFE COLLABORATIVE 308 PINE STREET BURLINGTON VT 05401 030303867 501(C)(3) 8980 PROMOTE THE RIGHTS OF CHILDREN WITH SAFE AND NURTURING ENVIROMENTS KING STREET YOUTH CENTER PO BOX 1615 BURLINGTON VT 05402 237236312 501(C)(3) 12000 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 OUR COMMUNITY CARES CAMP PO BOX 503 RICHMOND VT 05477 264398448 501(C)(3) 6000 SUMMER CAMP FOR LOW INCOME CHILDREN RESOURCE 266 PINE STREET BURLINGTON VT 05401 030326293 501(C)(3) 5000 JOB TRAINING PROGRAM 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) 9100 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 PROGREAMS FOR CHILDERN AND THEIR FAMILIES 30 0 PART I, LINE 2: INTERVIEW GRANTEE ORGANIZATIONS SEEKING DONATIONS AND MONITOR THEIR ACTIVITIES. 0 1 0 0 0 0 0 1 0 JOHN AHLE TREASURER/ CHS 0 351858 0 0 0 44288 0 70050 0 32699 0 498895 0 0 PART I, LINE 4B THE RELATED ORGANIZATION, COVENANT HEALTH, 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. 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 PAID INCENTIVE COMPENSATION AWARDS TO JOHN AHLE IN 2014 BASED ON PERFORMANCE DURING 2013. DURING 2014, THE ORGANIZATION DID NOT PAY ANY ACCRUED INCENTIVE COMPENSATION TO THE OFFICERS. 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 XI, LINE 9: TRANSFER AMONG AFFILIATES -9,479. 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 CHS 0 COVENANT HEALTH INC 100 AMES POND DRIVE TEWKSBURY MA 01876 222484505 HEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATION MA 501(C) 3 9 CHS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1