KELLERMANN FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
KELLERMANN FOUNDATION (EIN 34-2018044)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-06
IRS object ID
201222199349300607
Schema version
2011v1.2
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)
Timestamp2012-08-06T06:35:16-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CMROSEN LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 797983AddressLine1
CityDALLASCity
StateTXState
ZIP Code753797983ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN342018044EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Kellermann FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKELLNameControl
Phone2145199279Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 832809AddressLine1
CityRichardsonCity
StateTXState
ZIP Code75083ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSally StillingsName
TitleExecutive Dir.Title
Date Signed2012-08-03DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameChad M Rosen CPAName
Phone9728181400Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSally StillingsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 832809AddressLine1
CityRichardsonCity
StateTXState
ZIP Code75083ZIPCode
FieldValueIRS element (for citing)
Gross Receipts689289GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitekellermannfoundation.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTo provide funds necessary to sustain the medical and spiritual works being accomplished in Uganda.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees4TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year539281ContributionsGrantsPriorYear
Contributions Grants Current Year682359ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year3891OtherRevenueCurrentYear
Total Revenue Prior Year539281TotalRevenuePriorYear
Total Revenue Current Year686250TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year432273GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY553789GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15000SalariesEtcPriorYear
Salaries Etc Current Year51134SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY4038TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year26709TotalFundrsngExpCurrentYear
Other Expense Prior Year45892OtherExpensePriorYear
Other Expenses Current Year39803OtherExpensesCurrentYear
Total Expenses Prior Year493165TotalExpensesPriorYear
Total Expenses Current Year648764TotalExpensesCurrentYear
Revenues Less Expenses Prior Year46116RevenuesLessExpensesPriorYear
Revenues Less Expenses CY37486RevenuesLessExpensesCY
Total Assets BOY77973TotalAssetsBOY
Total Assets EOY134938TotalAssetsEOY
Total Liabilities EOY10400TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY77973NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY124538NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide funds necessary to sustain the medical and spiritual works being accomplished in Uganda.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense567786Expense
Grants553789Grants
DescriptionProvided program support that helped:1.Make high-quality, low-cost healthcare available to over 60,000 people in this poor, rural region of Uganda.2.Reduce malaria from 23.2% to 13.5% (across a 5-year span) among children under five seen at Bwindi Community Hospital.3.Improve the neonatal unit at Bwindi Community Hospital, helping reduce the neonatal mortality rate from 14.3% to 8.9% over three years.4.Build a new primary school at the Mukongoro Batwa settlement.5.Support more than 220 Batwa children in education, at every level from nursery to university.6.Develop and begin construction on the Batwa Women's Center to provide adult education, skills development, and income generation opportunities for indigenous Batwa women and girls.7.Expand services at the Waiting Mothers Hostel at Bwindi Community Hospital, allowing mothers from isolated rural communities to stay close to the hospital prior to childbirth.8.In partnership with MedShare, deliver a shipping container of donated medical equipment and supplies valued at $195,580 to Bwindi Community Hospital.9.Provide volunteer linguists to begin documenting the ancient Rutwa language of the Batwa pygmies.10.Build partnerships with Colgate University, the University of Vermont, St. Mary's College of California, Tulane University, and other schools and organizations in support of the programs in Uganda.11.Begin developing plans for a new Nursing School at Bwindi.12.Provide over 100 volunteers the opportunity to assist at Bwindi and experience first-hand the joys and needs of southwest Uganda.Description
Total Program Service Expense567786TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationstrueMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees4NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSally StillingsNamePerson
Telephone Number2145199279TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 Thompson DrAddressLine1
CityRichardsonCity
StateTXState
ZIP Code75080ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Scott Kellermann
Director2.00X000
Carol Kellermann
Director2.00X000
Sarah Woerner
Director2.00X000
Diane Stanton
Director2.00X000
Lynn Schwaab
Director2.00X000
James Phillips
Director2.00X000
Rob Michelin
Director2.00X000
Don Fultz
Director2.00X000
Richard Cunningham
Director2.00X000
Harry Auld
Director2.00X000
Jean Creasey
Secretary/Treas3.00X000X
Bert Barker
Director3.00X000
R Simi Lyss
President4.00X000X
Sally Stillings
Executive Dir.35.004200000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org42000TotalReportableCompFromOrg
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events6614FundraisingEvents
All Other Contributions675745AllOtherContributions
Noncash Contributions4029NoncashContributions
Total Contributions682359TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events5383GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events6614CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses3039FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column2344TotalRevenueColumn
Exclusion$2,344ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOther revenueDescription
Total Revenue Column1547TotalRevenueColumn
Exclusion$1,547ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1547TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column686250TotalRevenueColumn
Exclusion$3,891ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total43415Total
Program Services43415ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total510374Total
Program Services510374ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total41999Total
Program Services5880ProgramServices
Management And General23939ManagementAndGeneral
Fundraising12180Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5499Total
Program Services3678ProgramServices
Management And General1209ManagementAndGeneral
Fundraising612Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3636Total
Program Services731ProgramServices
Management And General1926ManagementAndGeneral
Fundraising979Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3884Total
Management And General3884ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total407Total
Management And General407ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total4038Total
Fundraising4038Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4615Total
Management And General3500ManagementAndGeneral
Fundraising1115Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2481Total
Program Services1125ProgramServices
Management And General786ManagementAndGeneral
Fundraising570Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total5896Total
Program Services1833ProgramServices
Management And General3638ManagementAndGeneral
Fundraising425Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total140Total
Management And General140ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1667Total
Management And General1667ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraisingProgram ServicesProgramServices
Printing and Publications729333933900
Postage and Shipping1365546819
Miscellaneous1158287612071750
Fees328328
Bank charges145145

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total648764Total
Program Services567786ProgramServices
Management And General54269ManagementAndGeneral
Fundraising26709Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY77973BOY
EOY125896EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY8483EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis699LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec140LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY559EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY77973BOY
EOY134938EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY10400EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY10400EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-361BOY
EOY-663EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY78334BOY
EOY125201EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY77973BOY
EOY124538EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY77973BOY
EOY134938EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses37486ReconcilationRevenueExpenses
Reconcilation Other Changes9079ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteefalseAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years504128CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years637282CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years501428CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year519334CurrentTaxYearMinus1Year
Current Tax Year682359CurrentTaxYear
Total2844531Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years504128CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years637282CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years501428CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year519334CurrentTaxYearMinus1Year
Current Tax Year682359CurrentTaxYear
Total2844531Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total309385AmountsSubstContributorsTotal
Public Support Total1702535146PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year6930CurrentTaxYear
Total6930Total
FieldValueIRS element (for citing)
Total Support2851461TotalSupport
Public Support Pertcentage1700.88910PublicSupportPertcentage170
Public Support Pertcent Prior Year0.85600PublicSupportPertcentPriorYear
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 D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis699OtherCostOrOtherBasis
Depreciation140Depreciation
Book Value559BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings559TotalOfBookValueLandBuildings
Total Revenue686250TotalRevenue
Total Expenses648764TotalExpenses
Excess Or Deficit For Year37486ExcessOrDeficitForYear
Excess Or Deficit Per FS37486ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt688401TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities2151DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F9902151RevenueNotRptdF990
Revenue Subtotal686250RevenueSubtotal
Total Revenue Per Form990686250TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt650915TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities2151DonatedServicesUseOfFacilities
Expenses Not Rptd F9902151ExpensesNotRptdF990
Expenses Subtotal648764ExpensesSubtotal
Total Expenses Per Form990648764TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationPrior period adjustment to change from cash to accrual methd $9079Explanation

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionSub-Saharan AfricaRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedGrants to receipientsTypeOfActivitiesConducted
Specific Services ProvidedHealth & developmentSpecificServicesProvided
Total Expenditures510374TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Amount Spent510374SubtotalAmountSpent
Total Amount Spent510374TotalAmountSpent

Grants To Orgs Outside US GrantsToOrgsOutsideUS (2 entries)

RegionRegionPurpose Of GrantPurposeOfGrantAmount Of Cash GrantAmountOfCashGrantManner Of Cash DisbursementMannerOfCashDisbursementAmount Of Non Cash AssistanceAmountOfNonCashAssistanceDescription Of Non Cash AssistanceDescriptionOfNonCashAssistanceMethod Of ValuationMethodOfValuation
Sub-Saharan AfrMedical386229Wire Trnfrs6000ComputersCost
Sub-Saharan AfrDevelopment117020Wire Trnsfrs1125SuppliesEst value
FieldValueIRS element (for citing)
Total Number Of Other Orgs2TotalNumberOfOtherOrgs
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierAdditional Supplemental InformationIdentifier
ExplanationThough the Organization did maintain records to substantiate the amount of grants or other assistance, it did not maintain records of eligibility or selection criteria. This was because the Organization's founder also helped build the grantees and their programs. While the Organization is aware of the need to avoid discrimination against applicants based upon various factors including organizational insiders, the Organization understands that the grantees supported are the only of their kind in the local area. Nevertheless, the Organization had learned of this additional requirement during 2011 and plans to do so during 2012.Explanation

Schedule I IRS990ScheduleI

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Virunga Artisans
PO Box 38OrindaCA94563205762680152150Craft development for Batwa Pygmies
Medshare International Inc
3240 Clifton Springs RdDecaturGA30034582433968282000Medical supplies for Uganda
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierAdditional Supplemental InformationIdentifier
ExplanationThough the Organization did maintain records to substantiate the amount of grants or other assistance, it did not maintain records of eligibility or selection criteria. It had learned of this additional requirement during 2011 and plans to do so during 2012.Furthermore, the Organization has thus far informally monitored progress on the grants and eligibility. However, beginning in 2012, it will begin a more formal monitoring procedure consistent with its growth.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSally StillingsNamePerson
FieldValueIRS element (for citing)
RelationshipOfficerRelationship
Amount Of Transaction2151AmountOfTransaction
Description Of TransactionRentDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThese documents are available upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAnnual conflict of interest questionnaires are required to be completed by each board member, officer, senior management, and any related entities. Potential and ongoing conflicts are reviewed by the board to determine whether they are in the best interest of the Organization and do not violate any laws. Those with any approved conflicts are excused from board deliberations and voting.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessAll board members were provided with this Form 990 for review and comment within a time-frame that allowed the organization to meet the filing deadline.
Form 990, Part VI, Line 4Form 990, Part VI, Line 4: Description of Significant Changes to Organizational DocumentsRevisions to the bylaws were made upon recommendation by the Organization's attorney. Because activity is conducted outside the United States, certain extra precautions and procedures were recommended, and the bylaws were revised to reflect these.

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