2013-11-14T15:53:06-06:00 2012-12-31 560574444 CHERRY BEKAERT LLP 401 EAST JACKSON STREET SUITE 3400 TAMPA FL 33602 990 2012-01-01 593705979 THE CENTER FOR SPECIAL NEEDS TRUST ADMINISTRATION INC CENT 7278944489 4912 CREEKSIDE DRIVE CLEARWATER FL 337604019 TODD BELISLE 7278944489 2013-11-14 1 JANICE A RATICA P00358837 8132511010 2012 2016-02-24 21:20:13Z TODD BELISLE 4912 CREEKSIDE DRIVE CLEARWATER FL 337604019 5034975 0 X WWW.SNTCENTER.ORG X 2000 FL THE CENTER FOR SPECIAL NEEDS TRUST ADMINISTRATION, INC. (THE CENTER) PROVIDES SPECIALIZED ADMINISTRATIVE SERVICES FOR IMPOVERISHED PEOPLE WITH DISABILITIES WHO HAVE SPECIAL NEEDS TRUSTS FOR THE PURPOSE OF IMPROVING THEIR QUALITY OF LIFE. EVERY TRUST MUST BE APPROVED BY THE GOVERNMENT AGENCY ADMINISTERING THE TRUST BENEFICIARY'S PUBLIC ASSISTANCE PROGRAM. ALTHOUGH THESE AGENCIES OVERSEE SPECIAL NEEDS TRUSTS, THE CENTER RELIEVES THEM OF THE BURDEN OF DAY-TO-DAY ADMINISTRATION OF THE TRUSTS' FUNDING, COMPLIANCE AND OTHER REQUIREMENTS. THIS IS ACCOMPLISHED BYADMINISTERING THE TRUSTS ACCORDING TO THE STRICT GUIDELINES UNDER MEDICAID LAW AND THE INVESTMENT OF TRUST ASSETS IN THE BEST INTEREST OF THE TRUST BENEFICIARIES, WHILE DISBURSING FUNDS IN ACCORDANCE WITH MEDICAID PROGRAMS AND RULES, WHICH CAN VARY CONSIDERABLY FROMPROGRAM-TO-PROGRAM AND STATE-TO-STATE. DURING 2012, THE CENTER ACCEPTED 286 NEW TRUSTS AND HAD APPROXIMATELY 1,887 TRUSTS UNDER ADMINISTRATION AT DECEMBER 31, 2012. 4 1 35 0 0 0 2693464 1012055 3507957 3565563 394389 311721 54449 35433 6650259 4924772 895228 581473 0 0 2129385 2993273 0 0 51564 3391709 1509840 6416322 5084586 233937 -159814 3681642 3586947 38670 142351 3642972 3444596 TO OFFER SPECIALIZED ADMINISTRATIVE SERVICES FOR IMPOVERISHED PEOPLE WITH DISABILITIES WHO HAVE SPECIAL NEEDS TRUSTS FOR THE PURPOSE OF IMPROVING THEIR QUALITY OF LIFE. 0 0 4394569 581473 3600996 PROVIDING SPECIALIZED ADMINISTRATIVE SERVICES FOR IMPOVERISHED PEOPLE WITH DISABILITIES WHO HAVE SPECIAL NEEDS TRUSTS FOR THE PURPOSE OF IMPROVING THEIR QUALITY OF LIFE. FOR 2012, THE CENTER ACCEPTED 286 NEW TRUSTS AND NOW HAS 1,887 TRUSTS UNDER ADMINISTRATION. 4394569 1 1 0 0 0 0 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 677 0 1 35 1 0 0 0 0 0 0 0 0 0 0 X 4 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X TODD BELISLE 7278944489 4912 CREEKSIDE DRIVE CLEARWATER FL 33760 JOSEPH HUENKE 5.00 X 12000 0 0 RICHARD SHONTER 40.00 X 150000 0 0 PATRICIA JULIAN 40.00 X X 16667 0 0 TODD BELISLE 40.00 X X 150000 0 0 CAITLIN GOVONI 40.00 X X 73061 0 0 401728 0 0 2 0 0 0 AUSTIN COLBY COMPANY INC 4912 CREEKSIDE DRIVE CLEARWATER FL 33760 LIFE PLANNING, ADMINISTRATIVE & ADVISORY 802545 STAUNTON & FAGLIE PL 3000 GULF TO BAY BLVD STE 102 CLEARWATER FL 33759 LEGAL COMPLIANCE & CONSULTATION 461729 ALL COVERED PO BOX 39000 SAN FRANCISCO CA 94139 IT & HARDWARE SUPPORT 130109 3 1012055 47169 1012055 TRUST ADMINISTRATION 900099 3565563 3565563 3565563 272970 272970 148954 110203 38751 38751 38751 MISCELLANEOUS REVENUE 900099 35433 35433 35433 4924772 3600996 0 311721 521209 521209 60264 60264 401728 158460 194003 49265 2417784 2417784 47432 41503 5929 126329 110538 13492 2299 16120 16120 145541 105051 40490 4250 4250 54088 54088 42297 41174 1123 59576 59576 110843 108183 2660 450943 214314 236629 274280 274280 12738 12738 478 478 85160 85160 39190 39190 SPONSORSHIPS 83399 83399 CONSULTING 61192 36715 24477 DUES & SUBSCRIPTIONS 28566 28566 CONTINUING EDUCATION 1029 1029 40150 9655 30495 5084586 4394569 638453 51564 81098 153770 41741 49519 666109 482653 1099893 243304 846473 856589 1579850 1528110 444325 494163 22046 22143 3681642 3586947 38670 142351 38670 142351 X 0 0 0 0 3642972 3444596 3642972 3444596 3681642 3586947 -159814 -38562 0 X X 0 0 0 X 2590320 1761517 1681037 2693464 1012055 9738393 2848189 3110839 3253022 3507957 3565563 16285570 5438509 4872356 4934059 6201421 4577618 26023963 0 4611 36227 40838 4611 36227 40838 25983125 175346 240117 218306 272133 272970 1178872 175346 240117 218306 272133 272970 1178872 769 54449 35433 90651 5613855 5112473 5153134 6528003 4886021 27293486 0.95200 0.96200 0.04320 0.03380 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 98480652 27176249 28770615 96886286 0 709054 709054 25269 15730 9539 365570 227574 137996 856589 STOCK - SNAP FOR SENIORS 1028100 C STOCK - BEACON MTD 500010 C 1528110 LOANS 134532 C VIALEGAL 2 55693 C ANNUITIES 303938 C 494163 PART IV, LINE 2B: THE ORGANIZATION PROVIDES SPECIAL ADMINISTRATIVE SERVICES FOR IMPOVERISHED PEOPLE WITH DISABILITIES WHO HAVE SPECIAL NEEDS TRUSTS FOR THE PURPOSE OF IMPROVING THEIR QUALITY OF LIFE. THESE TRUSTS ARE ADMINISTERED ACCORDING TO STRICT GUIDELINES UNDER MEDICAID LAW. THE ORGANIZATION ALSO ADMINISTERS THE INVESTMENT OF THE TRUSTS IN THE BEST INTERESTS OF THE TRUST BENEFICIARIES. 1 BEYOND THE BOROUGHS INC PO BOX 107 KATONAH NY 10536 611542985 501(C)(3) 5000 GENERAL SUPPORT HANNAH & FRIENDS INC 51250 HOLLYHOCK ROAD SOUTH BEND IN 46637 300171137 501(C)(3) 60000 GENERAL SUPPORT HILLSBOROUGH COUNTY BAR FOUNDATION INC 1610 N TAMPA STREET TAMPA FL 33602 593443939 501(C)(3) 130000 GENERAL SUPPORT MIKE PETERSON FOUNDATION INC 1320 FORESTEDGE BLVD OLDSMAR FL 34677 201663818 501(C)(3) 5500 GENERAL SUPPORT ST PETERSBURG BAR FOUNDATION INC 4701 CENTRAL AVENUE SUITE B ST PETERSBURG FL 33713 223858256 501(C)(3) 10000 GENERAL SUPPORT THE CHAMPIONS FUND INC 1320 FORESTEDGE BLVD OLDSMAR FL 34677 593685490 501(C)(3) 118700 GENERAL SUPPORT THERESA ALESSANDRA RUSSO FOUNDATION INC 250 LIDO BOULEVARD LIDO BEACH NY 11561 113126316 501(C)(3) 30759 GENERAL SUPPORT JEFFREY MODELL FOUNDATION 780 THIRD AVENUE NEW YORK NY 10017 133380237 501(C)(3) 11050 GENERAL SUPPORT WESTERN KENTUCKY FOUNDATION 1906 COLLEGE HEIGHTS BLVD NO 8094 BOWLING GREEN KY 42101 611251555 501(C)(3) 50000 GENERAL SUPPORT OHIO CHARITY FOUNDATION 300 WEST WILSON BRIDGE RD WORTHINGTON OH 43085 593705979 501(C)(3) 30000 GENERAL SUPPORT THE MARCUS STROUD CHARITABLE FOUNDATION 13820 OLD ST AUGUSTINE RD JACKSONVILLE FL 32258 261700710 501(C)(3) 13000 GENERAL SUPPORT BEST BUDDIES OF TAMPA BAY 4302 HENDERSON BLVD STE 104 TAMPA FL 33629 521614576 501(C)(3) 10000 GENERAL SUPPORT PLANNING FOR QUALITY CARE INC 1411 WEST AVENUE SUITE 100 AUSTIN TX 78701 454372477 501(C)(3) 30000 GENERAL SUPPORT RON CLARK ACADEMY 228 MARGARET STREET ATLANTA GA 30315 203028755 501(C)(3) 7200 GENERAL SUPPORT KIDZF1STFUND INC 1400 VILLAGE SQUARE BLVD SUITE 3-229 TALLAHASSEE FL 32312 454355903 501(C)(3) 10000 GENERAL SUPPORT 16 0 DISABLED INDIGENT PERSON 2 60264 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF THE FUNDS IT DONATES TO OTHERS ON AN INFORMAL BASIS. THE LARGER THE DONATION, THE MORE ATTENTION IS GIVEN TO THAT RECIPIENT. THE REVIEWS PERFORMED IN THE PAST HAVE PROVIDED THE ORGANIZATION WITH VALUABLE INFORMATION REGARDING THE NEEDS OF THE RECIPIENTS AND HAD AN IMPACT ON FUTURE PLANNED GIFTS. STAUNTON & FAGLIE PL JOHN STAUNTON, PRESIDENT THRU 12.1.09, IS 100% OWNER AND PRESIDENT 461729 JOHN STAUNTON, P.A. PROVIDED LEGAL COMPLIANCE AND CONSULTATION TO THE ORGANIZATION AS AN INDEPENDENT CONTRACTOR. ALL TRANSACTIONS WERE CONDUCTED AT ARM'S LENGTH AND VALUED AT FAIR MARKET VALUE. 0 AUSTIN COLBY COMPANY INC GOVONI, VP THRU 5.20.09, & WALRATH, DIRECTOR THRU 5.20.09, ARE PART OWNERS 802545 MR. GOVONI, VICE PRESIDENT OF THE ORGANIZATION THROUGH MAY 2009, IS VICE PRESIDENT AND 50% OWNER OF AUSTIN COLBY COMPANY. MR. WALRATH, DIRECTOR OF THE ORGANIZATION THROUGH MAY 2009, IS PRESIDENT AND 50% OWNER OF AUSTIN COLBY COMPANY, INC. AUSTIN COLBY COMPANY PROVIDED LIFE PLANNING, ADMINISTRATIVE AND ADVISORY SERVICES TO THE ORGANIZATION AS AN INDEPENDENT CONTRACTOR. ALL TRANSACTIONS WERE CONDUCTED AT ARM'S LENGTH AND VALUED AT FAIR MARKET VALUE. 0 X 3 47169 FAIR MARKET VALUE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF GOVERNING BODY; THUS NO MEETINGS WERE HELD FOR CONTEMPORANEOUS DOCUMENTATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CENTER FOR SPECIAL NEEDS TRUST ADMINISTRATION INC. ("THE CENTER") TAKES ITS RESPONSIBILITY IN THE AREA OF CONFLICT OF INTEREST SERIOUSLY AND HAS ALWAYS HAD A CONFLICT OF INTEREST POLICY. THE CORE OF THIS LONG STANDING POLICY, AS WELL AS THE WRITTEN CONFLICT OF INTEREST POLICY DOCUMENT ("POLICY"), PROVIDES THAT TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF FULLY DISCLOSED, ARE IN THE BEST INTERESTS OF THE CENTER, AND DONE AT FAIR MARKET VALUE. IN THE EVENT OF A POTENTIAL CONFLICT, THAT PERSON SHALL RECUSE THEMSELVES FROM THE DISCUSSION AND VOTE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPANY HAS ESTABLISHED A POLICY OF REVIEW OF EXECUTIVE AND KEY EMPLOYEE COMPENSATION WHICH INCLUDES APPROVAL BY INDEPENDENT PERSONS AND USE OF DATA FROM PEER INSTITUTIONS. THE COMPANY'S BOARD OF DIRECTORS WILL ESTABLISH A "STANDING COMMITTEE" WHICH WILL BE RESPONSIBLE FOR PROVIDING RECOMMENDATIONS REGARDING COMPENSATION FOR ALL COMPANY EXECUTIVE AND KEY EMPLOYEES. THE STANDING COMMITTEE WILL KEEP A DETAILED RECORD OF THE MEETINGS AND DISCUSSIONS RELATIVE TO EXECUTIVE AND KEY EMPLOYEE COMPENSATIONS. THIS POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. OTHER ACCOUNTING METHOD: FORM 990, PART XII MODIFIED CASH BASIS