DEREK SHEELY FOUNDATION INC: Form 990EZ, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
DEREK SHEELY FOUNDATION INC (EIN 45-3553641)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-03-30
IRS object ID
201300899349200505
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-03-30T10:22:23-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990EZReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN453553641EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Derek Sheely Foundation IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDERENameControl
Phone2026579371Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line114001 Falconcrest RoadAddressLine1
CityGermantownCity
StateMDState
ZIP Code20874ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKristen SheelyName
TitleExecutive Dir.Title
Date Signed2013-03-29DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashXMethodOfAccountingCash
Web Sitewww.thedereksheelyfoundation.orgWebSite
Organization501c3XOrganization501c3
Gross Receipts60054GrossReceipts
Info In Schedule O Part IXInfoInScheduleOPartI
Contributions Gifts Grants Etc50730ContributionsGiftsGrantsEtc
Investment Income77InvestmentIncome
Cost Other Basis And Sales Expenses0CostOtherBasisAndSalesExpenses
Fundraising Gross Income9247FundraisingGrossIncome
Special Events Direct Expenses6731SpecialEventsDirectExpenses
Special Events Net Income Loss2516SpecialEventsNetIncomeLoss
Cost Of Goods Sold0CostOfGoodsSold
Total Revenue53323TotalRevenue
Grants And Similar Amounts Paid2000GrantsAndSimilarAmountsPaid
Printing Publications Postage1026PrintingPublicationsPostage
Other Expenses Total14280OtherExpensesTotal
Total Expenses17306TotalExpenses
Excess Or Deficit For Year36017ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY17036NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY53053NetAssetsOrFundBalancesEOY

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY17036BOY
EOY53053EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17036BOY
EOY53053EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY17036BOY
EOY53053EOY
FieldValueIRS element (for citing)
Primary Exempt PurposeIncrease awareness and research of traumatic brain injuries, including supporting advancements in education, prevention, and treatment of traumatic brain injuries with a focus on youth sports.PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomConcussion Awareness Kits were provided to athletes and their families to educate them on the signs, symptoms, dangers, and prevention of traumatic brain injuries.Approximately 4,700 kits were distributed in seven states. Funded in part from grants from the Walmart Foundation.DescriptionProgramServiceAccom
Grants And Allocations11828GrantsAndAllocations
FieldValueIRS element (for citing)
Total Program Service Expenses11828TotalProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (4 entries)

TitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensation
Kristen Sheely
Executive Dir.00
Michael Haase
Director00
Keyton Sheely
Chairman00
Stephen P Kadner
Director00
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously RptfalseActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc DocfalseMadeChangesToOrgnzngEtcDoc
Organization Had UBIfalseOrganizationHadUBI
Organization Filed990 TfalseOrganizationFiled990T
Subject To Proxy TaxfalseSubjectToProxyTax
Organization Dissolved EtcfalseOrganizationDissolvedEtc
Did Org File Form1120 POL This YearfalseDidOrgFileForm1120POLThisYear
Made Loans To From OfficersfalseMadeLoansToFromOfficers
Initiation Fees And Capital Contri0InitiationFeesAndCapitalContri
Gross Receipts For Public Use0GrossReceiptsForPublicUse
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTrans
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKristen SheelyNamePerson

Address US AddressUS

FieldValueIRS element (for citing)
Address Line114001 Falconcrest RoadAddressLine1
CityGermantownCity
StateMDState
ZIP Code208742280ZIPCode
FieldValueIRS element (for citing)
Telephone Number2408998579TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccount
Foreign OfficefalseForeignOffice
Maintain Any Donor Advised FundsfalseMaintainAnyDonorAdvisedFunds
Does Org Have HospitalfalseDoesOrgHaveHospital
Tanning Services ProvidedfalseTanningServicesProvided
Form720 FiledfalseForm720Filed
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction With Control EntityfalseTransactionWithControlEntity
Engage Political Cmpgn ActivitiesfalseEngagePoliticalCmpgnActivities
Engage In Lobbying ActivitiesfalseEngageInLobbyingActivities
Operating SchoolfalseOperatingSchool
Trnsfrs Exempt Non Char Related OrgfalseTrnsfrsExemptNonCharRelatedOrg
Related Org Section527 OrgfalseRelatedOrgSection527Org
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule AtrueFiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year18199CurrentTaxYearMinus1Year
Current Tax Year50730CurrentTaxYear
Total68929Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Total0Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year18199CurrentTaxYearMinus1Year
Current Tax Year50730CurrentTaxYear
Total68929Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50968929PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year77CurrentTaxYear
Total77Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year77CurrentTaxYear
Total77Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year18199CurrentTaxYearMinus1Year
Current Tax Year50807CurrentTaxYear
Total69006Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event110K RaceNameOfEvent1
Gross Receipts Event116994GrossReceiptsEvent1
Charitable Contributions Event17747CharitableContributionsEvent1
Gross Revenue Event19247GrossRevenueEvent1
Cash Prizes Event1300CashPrizesEvent1
Non Cash Prizes Event13340NonCashPrizesEvent1
Other Direct Expenses Event13091OtherDirectExpensesEvent1
Gross Receipts Total16994GrossReceiptsTotal
Charitable Contributions Total7747CharitableContributionsTotal
Gross Revenue Total Events9247GrossRevenueTotalEvents
Cash Prizes Total Events300CashPrizesTotalEvents
Non Cash Prizes Total Events3340NonCashPrizesTotalEvents
Other Direct Expenses Total Events3091OtherDirectExpensesTotalEvents
Direct Expense Summary Events6731DirectExpenseSummaryEvents
Net Income Summary2516NetIncomeSummary

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierPart I, Line 2b - Fundraiser Additional InformationIdentifier
Explanation10K RaceExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990-EZ, Part I, Line 16.6Other Expenses.6Computer and software $166
Form 990-EZ, Part I, Line 16.5Other Expenses.5Processing fees $308
Form 990-EZ, Part I, Line 16.4Other Expenses.4IRS filing fee $850
Form 990-EZ, Part I, Line 16.2Other Expenses.2SUPPLIES $1346
Form 990-EZ, Part I, Line 16.1Other Expenses.1Concussion awareness kits $11015
Form 990-EZ, Part I, Line 16.1012Other Expenses.1012Insurance $595

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