2013-10-28T10:24:00-05:00 2013-01-31 750807999 SPROLES WOODARD LLP 777 MAIN STREET SUITE 3250 FORT WORTH TX 761025304 990 2012-02-01 752267609 JEWEL CHARITY BALL INCORPORATED JEWE 8178709064 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 LESLIE JOHNSON 8178709064 2013-10-17 1 ROBERT W DUKE P00151313 8173321328 2012 2016-03-07 17:11:31Z LESLIE JOHNSON 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 4377903 0 X WWW.JEWELCHARITY.ORG X 1988 TX RAISE FUNDS TO PROVIDE HEALTH CARE FOR CHILDREN AT COOK CHILDREN'S MEDICAL CENTER. 62 62 0 400 0 0 3490675 3532162 0 0 17161 28170 -290441 -420151 3217395 3140181 3000202 3133500 0 0 0 0 0 0 36051 90503 76782 3090705 3210282 126690 -70101 3333927 3236492 0 0 3333927 3236492 PROVIDE FINANCIAL SUPPORT TO FORT WORTH COOK CHILDREN'S MEDICAL CENTER. 0 0 3133500 3133500 30901 JEWEL CHARITY BALL RAISES FUNDS FOR UNCOMPENSATED HEALTHCARE FOR CHILDREN AT COOK CHILDREN'S MEDICAL CENTER. FUNDRAISING IS ACCOMPLISHED BY SOLICITING DONATIONS FROM LOCAL, NATIONAL, AND INTERNATIONAL INDIVIDUALS, BUSINESSES AND FOUNDATIONS. ALL PROCEEDS ARE DONATED TO COOK CHILDREN'S MEDICAL CENTER FOR THE UNCOMPENSATED CARE FUND AND OTHER SPECIFIC FIELDS OF INTEREST AS DESIGNATED ANNUALLY BY THE JEWEL CHARITY BALL BOARD OF DIRECTORS. JEWEL CHARITY BALL'S 2012 DONATION TO COOK CHILDREN'S MEDICAL CENTER WAS OVER $3 MILLION. 3133500 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 56 26 1 0 0 0 0 0 0 1 1 0 0 0 0 X 62 62 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X JONELLE O'NEILL 8177329333 5020 COLLINWOOD AVENUE SUITE 400 FORT WORTH TX 76107 X MICHELE REYNOLDS 40.00 X X 0 0 0 LESLIE JOHNSON 5.00 X X 0 0 0 MARY ANNE POLSON 5.00 X X 0 0 0 LAURA BIRD 5.00 X X 0 0 0 KIM DARDEN 5.00 X X 0 0 0 KATHRYN LAUGHLIN 5.00 X X 0 0 0 ANN BIGGS 5.00 X X 0 0 0 HARRIETTE GACHMAN 10.00 X 0 0 0 LAURI LAWRENCE 10.00 X 0 0 0 MICHELLE MARLOW 10.00 X 0 0 0 ANGIE DONAHUE 2.00 X 0 0 0 PAM PIGMAN 2.00 X 0 0 0 ALDEN KAROTKIN 2.00 X 0 0 0 SANDRA LUSKEY 2.00 X 0 0 0 WENDY DAVIS 2.00 X 0 0 0 LESLIE MORITZ 2.00 X 0 0 0 LINDA MOTLEY 2.00 X 0 0 0 STEPHANIE BRENTLINGER 2.00 X 0 0 0 MELISSA TAPP 2.00 X 0 0 0 VALERIE MALLICK 10.00 X 0 0 0 JAN SCULLY 10.00 X 0 0 0 MARCEE JAMES 2.00 X 0 0 0 KELLEY ROYER 2.00 X 0 0 0 LYNNY SANKARY 2.00 X 0 0 0 JOY ANN HAVRAN 2.00 X 0 0 0 KAREN SIMON 2.00 X 0 0 0 SELMA SHERMAN 2.00 X 0 0 0 ANN CLINKSCALES 10.00 X 0 0 0 DEE HOLMES 10.00 X 0 0 0 NANCY MITCHELL 10.00 X 0 0 0 MARY KATHERINE TETIRICK 10.00 X 0 0 0 ALICIA LINDSEY 10.00 X 0 0 0 KATHI MAHAFFEY 10.00 X 0 0 0 HEIDI SCHUTTS 10.00 X 0 0 0 MICHELLE HANCOCK 2.00 X 0 0 0 JEAN ROACH 2.00 X 0 0 0 CAROL DUNAWAY 2.00 X 0 0 0 LOUELLA MARTIN 2.00 X 0 0 0 THERESE MONCRIEF 2.00 X 0 0 0 KIM CAREY 2.00 X 0 0 0 CAROL SPURLOCK 2.00 X 0 0 0 BRENDA MAXWELL 2.00 X 0 0 0 BRAD ALFORD 2.00 X 0 0 0 SUSIE FINLEY 2.00 X 0 0 0 JUDY MILLER 2.00 X 0 0 0 BONNIE EPSTEIN 2.00 X 0 0 0 MELANIE TATUM 2.00 X 0 0 0 ERAN WEST 2.00 X 0 0 0 JANIE HARPER 10.00 X 0 0 0 JULIE SAWYER 10.00 X 0 0 0 JEANIE LUSKEY 2.00 X 0 0 0 GEORGE ANN BAHAN 2.00 X 0 0 0 NENETTA TATUM 2.00 X 0 0 0 MARYANNE MITCHELL 5.00 X 0 0 0 JULIE MURPHY 5.00 X 0 0 0 DEBBIE REYNOLDS 2.00 X 0 0 0 SHARON CORCORAN 2.00 X 0 0 0 MICHELLE PURVIS 2.00 X 0 0 0 LADYE ANNE MILLER 2.00 X 0 0 0 TERRI SEXTON 2.00 X 0 0 0 LESLIE JOHNSON 2.00 X 0 0 0 PEGGY SIMS 5.00 X 0 0 0 0 0 0 0 0 0 0 EVENTS BY BILL 3246 S RAVINIA ST DALLAS TX 75233 DESIGN AND BALL PRODUCTION 398423 TRINITY F&B SERVICES 1201 HOUSTON ST FORT WORTH TX 76102 CATERING FOR BALL 267295 2 337000 3139276 55886 229269 3532162 18396 18396 9774 0 9774 9774 9774 570314 3139276 1022003 -451689 -451689 246620 215719 30901 30901 CALENDAR & CARD SALES 453000 637 637 637 3140181 30901 0 -422882 3133500 3133500 565 565 62547 26496 36051 11167 11167 191 191 OTHER ADMINISTRATIVE EX 2312 2312 3210282 3133500 40731 36051 3157274 3038732 1000 1000 0 0 91256 83139 85397 114621 3333927 3236492 0 0 X 3145274 3000752 85668 132755 102985 102985 3333927 3236492 3333927 3236492 X -70101 4842 -32176 X X 0 1 X 1 0 X 3270018 3535105 3586757 3490676 3532162 17414718 3270018 3535105 3586757 3490676 3532162 17414718 17414718 21467 12015 18088 12424 18396 82390 765050 614782 779568 841948 817571 3818919 21316027 0.81700 0.82760 X 176653 5020 16087 0 197760 189025 50 3344 15766 176653 166778 800 22017 570 189025 141509 200 31891 6747 166853 200333 245 -48471 10598 141509 0.52070 0.47930 1 0 1000 1000 0 0 5362784 4842 650551 427000 1082393 4280391 -1140210 -1140210 3140181 5291176 650551 4563843 5214394 76782 3133500 3133500 3210282 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE JEWEL CHARITY BALL (THE BALL) ENDOWMENT WAS FORMED TO PROVIDE ADDITIONAL OPERATING FUNDS FOR THE BALL SHOULD MEMBERSHIP DUES FAIL TO COVER THE COSTS OF ADMINISTRATION AND CONDUCTING THE BALL. THIS IS DONE SO THAT MORE (OFTEN ALL) OF THE FUNDS RAISED BY MEMBERS OF THE BALL AND THE BALL'S SPECIAL EVENTS CAN BE USED TO SUPPORT COOK CHILDREN'S MEDICAL CENTER. PART XI, LINE 2D - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/13 427,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/12 COLLECTED IN FYE 2013 82,847. FUNDRAISING EXPENSES -1,022,003. GAMING EXPENSES -215,719. BOOK-TAX TIMING DIFFERENCE 14,665. PART XII, LINE 2D - OTHER ADJUSTMENTS: OTHER ACCRUED EXPENSES AT 1/31/13 3,340,786. FUNDRAISING EXPENSES 1,022,003. GAMING EXPENSES 215,719. BOOK-TAX TIMING DIFFERENCE -14,665. PART XII, LINE 4B - OTHER ADJUSTMENTS: ACCRUED EXPENSES AT 1/31/12 PAID IN FYE 2013 3,133,500. JEWEL CHARITY BALL 2511303 2312972 198331 23030 267295 23000 414202 AUCTION 277030 26233 250797 26233 10484 5 921257 800071 121186 257759 3709590 3139276 570314 26233 23030 267295 23000 682445 1022003 -451689 246620 203036 12683 1 1.00000 246620 203036 12683 215719 30901 TX 0 THE STATE OF TEXAS DOES NOT REQUIRE AN EXEMPT ORGANIZATION TO HAVE A GAMING LICENSE FOR THE PURPOSES OF HOLDING A RAFFLE. 0 1 0 1.00000 KAY REEVES 5020 COLLINWOOD AVENUE SUITE 400 FORT WORTH TX 76107 0 DEE WEBB AND KAY REEVES MARCEE JAMES, KELLEY ROYER AND LYNNY SANKARY ARE THE CHANCE TICKET ACCOUNTABILITY CO-CHAIRS. THEY FOLLOW ALL ACCOUNTABILITY PROCEDUES SET FORTH IN JEWEL CHARITY BALL'S POLICY AND PROCEDURES HANDBOOK TO ENSURE AN ACCURATE ACCOUNTING OF CHANCE TICKETS AND CHANCE TICKET REVENUE FOR THE ANNUAL AUDIT. THEY ALSO INSTRUCT ALL TICKET SELLERS IN THEIR RESPONSIBILITIES AND ACCOUNTABILITY PROCEDURES. X 1 246620 1 COOK CHILDREN'S MEDICAL - FORT WORTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752051646 501(C)(3) 3133500 UNCOMPENSATED CARE AND GENERAL SUPPORT 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS ARE GIVEN TO COOK CHILDREN'S MEDICAL - FORT WORTH FOR UNCOMPENSATED CARE AND GENERAL SUPPORT. COOK CHILDREN'S MEDICAL PROVIDES JEWEL CHARITY BALL WITH PERIODIC REPORTS REGARDING THE USE OF THE FUNDS. X 20255 RETAIL COST X 2 67630 RETAIL COST X 13 14662 RETAIL COST X TRAVEL & ENTERTAINMENT PACKAGES 5 24600 RETAIL COST X GIFT CERTIFICATES 32 69372 RETAIL COST X JEWELRY 7 32750 RETAIL COST 0 0 0 SCHEDULE B, LIST OF CONTRIBUTORS: FORM 990, PART IV, LINE 2 JEWEL CHARITY BALL IS A 501(C)(3) ORGANIZATION THAT MET THE 33 1/3% SUPPORT TEST UNDER SECTIONS 509(A)(1)/170(B)(1)(A)(VI). IT DID NOT RECEIVE ANY CONTRIBUTIONS OVER 2% OF THE AMOUNT ON FORM 990 PART VIII, LINE 1H ($70,643). THEREFORE, JEWEL CHARITY BALL IS NOT REQUIRED TO FILE SCHEDULE B. FORM 990, PART VI, SECTION A, LINE 2 CURRENT BOARD MEMBERS: MICHELE REYNOLDS AND ANN BIGGS - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 THERE ARE FOUR CLASSIFICATIONS OF MEMBERS: ACTIVE, NON-RESIDENT, LIFE, AND HONORARY. ACTIVE MEMBERS MAINTAIN THEIR PHYSICAL RESIDENCE WITHIN FIFTY MILES OF COOK CHILDREN'S MEDICAL CENTER SO AS TO ALLOW FOR ACTIVE PARTICIPATION IN JEWEL CHARITY BALL ACTIVITIES THROUGHOUT THE YEAR. NON-RESIDENT MEMBERS ARE THOSE ACTIVE MEMBERS WHOSE PHYSICAL RESIDENCE IS BEYOND A FIFTY MILE RADIUS OF COOK CHILDREN'S MEDICAL CENTER. LIFE MEMBERS ARE PREVIOUS ACTIVE MEMBERS IN GOOD STANDING WHO NO LONGER WISH TO ACCEPT THE OBLIGATIONS OF ACTIVE MEMBERSHIP, BUT WISH TO REMAIN INVOLVED WITH THE JEWEL CHARITY BALL. HONORARY MEMBERS ARE THOSE MEMBERS WHO HAVE BEEN PRESIDENT OF THE JEWEL CHARITY BALL. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE BOARD OF DIRECTORS AND COMMITTEE CHAIRS. FORM 990, PART VI, SECTION B, LINE 11 THE PRESIDENT REVIEWS FORM 990 BEFORE IT IS SIGNED AND FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE SIGNED ANNUALLY BY THE BOARD OF DIRECTORS AND FILED IN THE JEWEL CHARITY OFFICES. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY CONTACTING THE JEWEL CHARITY OFFICES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: ACCRUED PAYABLE AT 1/31/12 PAID IN FYE 2013 -32,176. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C JEWEL CHARITY BALL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. ENDOWMENT FUNDS ADMINISTERED BY AN UNRELATED PARTY FORM 990, SCHEDULE D, PART V, LINE 3A(I) JEWEL CHARITY BALL HAS PLACED ITS ENDOWMENT FUNDS WITH COOK CHILDREN'S MEDICAL CENTER TO BE ADMINISTERED AS A PART OF THE MEDICAL CENTER'S ENDOWMENT FUNDS. THIS KEEPS ADMINISTRATIVE AND INVESTMENT COSTS TO A MINIMUM. JEWEL CHARITY BALL CAN WITHDRAW FUNDS AT WILL SHOULD IT NEED TO.