BETA

ROLE MODEL PROGRAM: Form 990EZ, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ROLE MODEL PROGRAM (EIN 77-0230503)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201201359349203445
Schema version
2010v3.4
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)
Timestamp2012-05-14T18:08:05-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BERGER LEWIS ACCOUNTANCY CORPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 ALMADEN BLVD STE 600AddressLine1
CitySAN JOSECity
StateCAState
ZIP Code95113ZIPCode
FieldValueIRS element (for citing)
Return Type990EZReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN770230503EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ROLE MODEL PROGRAMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlROLENameControl
Phone4082460433Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12625 ZANKER ROADAddressLine1
CitySAN JOSECity
StateCAState
ZIP Code95110ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARYBETH AFFLECK-NACEYName
TitleEXECUTIVE DIRECTORTitle
Phone4082460433Phone
Date Signed2012-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLAWRENCE S KUECHLERName
Phone4084941200Phone
Date Prepared2012-05-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Method Of Accounting AccrualXMethodOfAccountingAccrual
Web SiteWWW.THEROLEMODELPROGRAM.ORGWebSite
Organization501c3XOrganization501c3
Gross Receipts104856GrossReceipts
Info In Schedule O Part IXInfoInScheduleOPartI
Contributions Gifts Grants Etc80590ContributionsGiftsGrantsEtc
Investment Income109InvestmentIncome
Cost Other Basis And Sales Expenses8149CostOtherBasisAndSalesExpenses
Gain Or Loss From Sale Of Assets-8149GainOrLossFromSaleOfAssets
Fundraising Gross Income24157FundraisingGrossIncome
Special Events Direct Expenses24157SpecialEventsDirectExpenses
Special Events Net Income Loss0SpecialEventsNetIncomeLoss
Total Revenue72550TotalRevenue
Salaries Other Comp Empl Benefits74407SalariesOtherCompEmplBenefits
Fees And Oth Pymt To Ind Contractors2273FeesAndOthPymtToIndContractors
Occupancy Rent Utilities And Maint6725OccupancyRentUtilitiesAndMaint
Printing Publications Postage76PrintingPublicationsPostage
Other Expenses Total85637OtherExpensesTotal
Total Expenses169118TotalExpenses
Excess Or Deficit For Year-96568ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY39302NetAssetsOrFundBalancesBOY
Other Changes In Net Assets0OtherChangesInNetAssets
Net Assets Or Fund Balances EOY-57266NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIXInfoInScheduleOPartII

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY24432BOY
EOY673EOY

Land And Buildings LandAndBuildings

FieldValueIRS element (for citing)
BOY4153BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY37235BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY65820BOY
EOY673EOY

Sum Of Total Liabilities SumOfTotalLiabilities

FieldValueIRS element (for citing)
BOY26518BOY
EOY57939EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY39302BOY
EOY-57266EOY
FieldValueIRS element (for citing)
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Primary Exempt PurposeTHE SPECIFIC AND PRIMARY PURPOSES OF THIS CORPORATION ARE TO ENCOURAGE STUDENTS IN SANTA CLARA COUNTY TO STAY IN SCHOOL, TO STAY FREE OF DRUGS AND TO REALIZE MORE OF THEIR POTENTIAL BY ARRANGING SPORTS AND ENTERTAINMENT CELEBRITIES AND COMMUNITY LEADERS TO SPEAK TO THE STUDENTS IN THE CLASSROOMS; TO WORK WITH COUNTY HEALTH AND EDUCATION EXPERTS TO ADDRESS THE PROBLEM OF LOW ACHIEVEMENT IN COUNTY SCHOOLS.PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomTHE ROLE MODEL PROGRAM PROVIDED INSPIRATION, EMPOWERMENT AND POSITIVE ADULT ROLE MODELS TO APPROXIMATELY 5,000 UNDERSERVED YOUTH IN LOCAL ELEMENTARY AND MIDDLE SCHOOL CLASSROOMS. STUDENTS LEARN THE PATHWAY TO SUCCESS THROUGH EDUCATION AND COLLEGE ASPIRATIONS.DescriptionProgramServiceAccom
Grants And Allocations0GrantsAndAllocations
Program Service Expenses93814ProgramServiceExpenses
FieldValueIRS element (for citing)
Total Program Service Expenses93814TotalProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
KEVIN BEBER
2625 ZANKER ROADSAN JOSECA95110CHAIR3.00000
STEVE GUERRERO
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
LOURDES ANDRADE
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
KEVIN BEBER
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
CHRIS JEW
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
ANDREA LICHTER
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
ROBIN LYKINS
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
RON LIND
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
DOLORES SANDOVAL
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
KELLY SNIDER
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
PATRICK SUSEMIHL
2625 ZANKER ROADSAN JOSECA95110BOARD MEMBER2.00000
MARYBETH AFFLECK-NACEY
2625 ZANKER ROADSAN JOSECA95110EXECUTIVE DIRECTOR40.003400000
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously Rpt0ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc0MadeChangesToOrgnzngEtcDoc
Organization Had UBI0OrganizationHadUBI
Organization Dissolved Etc0OrganizationDissolvedEtc
Direct Indirect Political Expend0DirectIndirectPoliticalExpend
Made Loans To From Officers0MadeLoansToFromOfficers
Tax Imposed Under IRC49110TaxImposedUnderIRC4911
Tax Imposed Under IRC49120TaxImposedUnderIRC4912
Tax Imposed Under IRC49550TaxImposedUnderIRC4955
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTrans
Amount Of Tax Imposed On Org Mgr0AmountOfTaxImposedOnOrgMgr
Amount Of Tax Reimbursed By Org0AmountOfTaxReimbursedByOrg
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARYBETH AFFLECK-NACEYBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12625 ZANKER ROADAddressLine1
CitySAN JOSECity
StateCAState
ZIP Code95110ZIPCode
FieldValueIRS element (for citing)
Telephone Number4082460433TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccount
Foreign Office0ForeignOffice
Maintain Any Donor Advised Funds0MaintainAnyDonorAdvisedFunds
Does Org Have Hospital0DoesOrgHaveHospital
Tanning Services Provided0TanningServicesProvided
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction With Control Entity0TransactionWithControlEntity
Engage Political Cmpgn Activities0EngagePoliticalCmpgnActivities
Engage In Lobbying Activities0EngageInLobbyingActivities
Operating School0OperatingSchool
Trnsfrs Exempt Non Char Related Org0TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule A1FiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years280933CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years357789CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years283960CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year278569CurrentTaxYearMinus1Year
Current Tax Year80590CurrentTaxYear
Total1281841Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years280933CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years357789CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years283960CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year278569CurrentTaxYearMinus1Year
Current Tax Year80590CurrentTaxYear
Total1281841Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total44704AmountsSubstContributorsTotal
Public Support Total1701237137PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years864CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years787CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years217CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year72CurrentTaxYearMinus1Year
Current Tax Year109CurrentTaxYear
Total2049Total
FieldValueIRS element (for citing)
Total Support1283890TotalSupport
Gross Receipts From Admissions Etc194476GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.96360PublicSupportPertcentage170
Public Support Pertcent Prior Year0.94550PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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 Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event121952GrossReceiptsEvent1
Charitable Contributions Event16216CharitableContributionsEvent1
Gross Revenue Event115736GrossRevenueEvent1
Other Direct Expenses Event115736OtherDirectExpensesEvent1
Name Of Event2POKER TOURNAMENTNameOfEvent2
Gross Receipts Event213657GrossReceiptsEvent2
Charitable Contributions Event210721CharitableContributionsEvent2
Gross Revenue Event22936GrossRevenueEvent2
Other Direct Expenses Event22936OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events15531GrossReceiptsOtherEvents
Charitable Contrib Other Events10046CharitableContribOtherEvents
Gross Revenue Other Events5485GrossRevenueOtherEvents
Other Direct Expenses Other Events5485OtherDirectExpensesOtherEvents
Gross Receipts Total51140GrossReceiptsTotal
Charitable Contributions Total26983CharitableContributionsTotal
Gross Revenue Total Events24157GrossRevenueTotalEvents
Other Direct Expenses Total Events24157OtherDirectExpensesTotalEvents
Direct Expense Summary Events24157DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER INVESTMENT INCOMEFORM 990-EZ, PART I, LINE 4INTEREST 109..
OCCUPANCY, RENT, UTILITIES AND MAINTENENCEFORM 990-EZ, PART I, LINE 14DESCRIPTION: DEPRECIATION. AMOUNT: 3,338. DESCRIPTION: OTHER EXPENSES. AMOUNT: 3,387. TOTAL TO FORM 990-EZ, LINE 14: 6,725.
OTHER EXPENSESFORM 990-EZ, PART I, LINE 16DESCRIPTION: TRAINING. AMOUNT: 4,957. DESCRIPTION: MISCELLANEOUS. AMOUNT: 120. DESCRIPTION: PROGRAM SPECIFIC EXPENSES. AMOUNT: 21,923. DESCRIPTION: BAD DEBT EXPENSE. AMOUNT: 23,465. DESCRIPTION: IT EXPENSES. AMOUNT: 998. DESCRIPTION: INSURANCE. AMOUNT: 3,327. DESCRIPTION: FUNDRAISING EXPENSES. AMOUNT: 22,484. DESCRIPTION: DUES AND SUBSCRIPTIONS. AMOUNT: 947. DESCRIPTION: BANK FEES. AMOUNT: 1,816. DESCRIPTION: TELEPHONE. AMOUNT: 2,002. DESCRIPTION: OFFICE SUPPLIES. AMOUNT: 351. DESCRIPTION: EQUIPMENT LEASE. AMOUNT: 3,247. TOTAL TO FORM 990-EZ, LINE 16: 85,637.
OTHER ASSETSFORM 990-EZ, PART II, LINE 24DESCRIPTION: PLEDGES RECEIVABLE. BEG. OF YEAR AMOUNT: 21,605. END OF YEAR AMOUNT: 0. DESCRIPTION: PREPAID EVENT EXPENSE. BEG. OF YEAR AMOUNT: 6,435. END OF YEAR AMOUNT: 0. DESCRIPTION: ACCOUNT RECEIVABLE. BEG. OF YEAR AMOUNT: 1,861. END OF YEAR AMOUNT: 0. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 7,334. END OF YEAR AMOUNT: 0.
OTHER LIABILITIESFORM 990-EZ, PART II, LINE 26DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 10,018. END OF YEAR AMOUNT: 42,939. DESCRIPTION: LOAN PAYABLE. BEG. OF YEAR AMOUNT: 15,000. END OF YEAR AMOUNT: 15,000. DESCRIPTION: DEFERRED REVENUE. BEG. OF YEAR AMOUNT: 1,500. END OF YEAR AMOUNT: 0.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.Declaration

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