2013-11-15T11:00:56-06:00 2012-12-31 221478099 COHNREZNICK LLP 1212 6TH AVENUE NEW YORK NY 10036 990 2012-01-01 273530769 AGAHOZO-SHALOM YOUTH VILLAGE INC AGAH 6463817866 498 SEVENTH AVENUE 15TH FLOOR NEW YORK NY 10018 JOHN HOOVER 6463817866 2013-11-13 1 THOMAS LANNING P00851654 2122970400 2012 2016-02-25 16:41:14Z ANNE HEYMAN 498 SEVENTH AVENUE 15TH FLOOR NEW YORK NY 10018 2634670 0 X WWW.ASYV.ORG X 2010 DE ASYV IS A COMPREHENSIVE HOME, COMMUNITY, AND HIGH SCHOOL FOR 500 ORPHANS INRWANDA'S EASTERN PROVINCE. 14 14 7 34 0 0 14531193 2486089 0 0 0 810 18621 58733 14549814 2545632 0 0 0 0 1160963 1477043 0 0 324160 1150414 1699004 2311377 3176047 12238437 -630415 12794756 12180441 556319 572419 12238437 11608022 X TO ENABLE ORPHANED AND VULNERABLE YOUTH TO REALIZE THEIR MAXIMUM POTENTIAL BY PROVIDING THEM WITH A SAFE AND SECURE LIVING ENVIRONMENT, HEALTH CARE, EDUCATION AND NECESSARY LIFE SKILLS. EDUCATION AND SERVICE ARE USED TO MODEL AND CREATE SOCIALLY RESPONSIBLE CITIZENS IN RWANDA AND AROUND THE WORLD. 0 0 2588293 ASYV PROVIDES A HIGH SCHOOL EDUCATION, RESIDENTIAL FACILITIES AND THERAPEUTIC TREATMENT TO ORPHANED AND VULNERABLE TEENS IN RWANDA. 2588293 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 15 0 1 7 1 0 1 RW 0 0 0 1 1 0 0 0 0 X 14 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY DE X LOUIS D'SOUZA 6463817866 498 SEVENTH AVENUE 15TH FLOOR NEW YORK NY 10018 ANNE E HEYMAN 40.00 X X 0 0 0 BETRAND KAYIRANGA 2.00 X 0 0 0 DEBORAH RATNER 2.00 X 0 0 0 JEAN KAGUBARE 2.00 X 0 0 0 JERILYN MEDREA 2.00 X 0 0 0 JOHN HOOVER 5.00 X X 0 0 0 LAURIE TOLL FRANZ 2.00 X X 0 0 0 LISA ISSROFF 5.00 X 0 0 0 LIZ STERN 2.00 X 0 0 0 MARTIN SEGAL 2.00 X 0 0 0 RAN GOSHEN 2.00 X 0 0 0 SAM MERRIN 2.00 X 0 0 0 STEVE MOSS 2.00 X 0 0 0 SUSIE SARLO 2.00 X 0 0 0 TINA WYATT 2.00 X 0 0 0 TAMAR M COPELAND 40.00 X 125077 0 22457 125077 0 22457 1 0 0 0 0 460146 2025943 30251 2486089 810 810 34500 460146 89038 -54538 -54538 FEE INCOME 541900 117486 117486 FARM INCOME 110000 2513 2513 LOSS ON CURRENCY EXCHA 900099 -10230 -10230 3502 3502 113271 2545632 123501 0 -63958 147533 120503 10239 16791 1252946 1076555 65010 111381 5344 3102 892 1350 46917 27232 7834 11851 24303 14106 4058 6139 2056 2056 105220 105220 110395 46327 1184 62884 354983 329353 5673 19957 71918 63959 2933 5026 122168 99978 15650 6540 11317 7736 3075 506 25417 25417 328484 328484 67737 61582 6155 FOOD 154279 147098 2220 4961 EQUIPMENT RENTAL AND MA 98064 97305 280 479 SPECIAL EVENTS 68232 68232 MEDICAL EXPENSES 60694 60694 118040 104279 5698 8063 3176047 2588293 263594 324160 420872 664709 243659 596351 1250140 315815 4926 57133 30669 11110393 551678 10822952 10558715 0 9256 12794756 12180441 36369 72419 19950 500000 500000 556319 572419 X 11018297 11210207 1220140 397815 12238437 11608022 12794756 12180441 -630415 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 219677 219677 10765175 481650 10283525 125541 70028 55513 10558715 X 2587748 6866 6866 2580882 -35250 -35250 2545632 3218163 6866 35250 42116 3176047 0 3176047 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ASYV IS AN EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ASYV HAS NO UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31,2012. ASYV WAS INCORPORATED IN 2010, THEREFORE ITS 2010 AND 2011 FEDERAL AND STATE INCOME TAX RETURNS ARE OPEN AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF NECESSARY, ASYV WOULD RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENT OF FINANCIAL POSITION. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRASING EXPENSES -35,250. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRASING EXPENSES 35,250. 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 EXPLANATION OF NONDISCRIMINATORY POLICY PUBLICATION SCHEDULE E, PART I, LINE 3 THE ORGANIZATION HAS PUBLICIZED OUR POLICY IN THE NEW TIMES NEWSPAPER IN RWANDA. EXPLANATION OF DOCUMENT RETENTION SCHEDULE E, PART I, LINE 4 ALL FULL TIME STAFF AND FACULTY ARE RWANDAN. SUB-SAHARAN AFRICA - RWANDA 1 141 PROGRAM SERVICES PROVIDES A HIGH SCHOOL EDUCATION, RESIDENTIAL FACILITIES AND THERAPEUTIC TREATMENT TO ORPHANED AND VULNERABLE TEENS IN RWANDA. 2588293 1 141 0 0 1 141 2588293 0 2588293 0 0 0 0 0 0 X X X X X X 1 SPECIAL EVENT PARTNERS 208 WEST 80TH STREET SUITE 1E NEW YORK NY 10024 EVENT PLANNING 0 494646 32750 461896 494646 32750 461896 NY STAND UP EVENT 494646 460146 34500 25723 28065 2500 32750 494646 460146 34500 25723 28065 2500 32750 89038 -54538 EXPLANATION OF FUNDRAISING PAYMENTS SCHEDULE G, PART I, LINE 2B, COLUMN (V) FUNDRAISER ORGANIZED AND EXECUTED STAND UP EVENT FOR ORGANIZATION. X 1 30251 BOOK VALUE 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 2 ANNE HEYMAN, BOARD CHAIR, AND SAM MERRIN, BOARD MEMBER, HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT. THEN THE RETURN IS PRESENTED TO THE BOARD FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C AT THE ANNUAL BOARD MEETING WHICH IS USUALLY IN FEBRUARY OF EACH YEAR THE OFFICERS & DIRECTORS, ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD ENGAGES A PRO-BONO HUMAN RESOURCES CONSULTANT, TO DETERMINE THE EXECUTIVE DIRECTOR'S COMPENSATION. THEY ALSO CONSULT WITH LEGAL COUNSEL AND COMPARE COMPENSATION TO OTHER ORGANIZATIONS. ORGANIZATIONAL GOALS ARE SET FOR THE EXECUTIVE DIRECTOR, AND EVALUATIONS OF PERFORMANCE ARE DONE ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. FORM 990, PART V, 2A: EMPLOYEES IN THE UNITED STATES ARE PAID THROUGH A THIRD PARTY AND DID NOT RECEIVE A W-2 FROM ASYV. EMPLOYEES IN RWANDA ARE PAID BY ASYV BUT DO NOT RECEIVE A W-2.