2012-11-09T09:59:17-06:00 2012-01-31 750807999 SPROLES WOODARD LLP 777 MAIN STREET SUITE 3250 FORT WORTH TX 761025304 990 2011-02-01 752267609 JEWEL CHARITY BALL INCORPORATED JEWE 8178709064 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 MICHELE REYNOLDS 8178709064 2012-10-19 1 ROBERT W DUKE P00151313 8173321328 2011 2016-02-24 21:20:13Z MICHELE REYNOLDS 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 4349784 0 X WWW.JEWELCHARITY.ORG X 1988 TX RAISE FUNDS TO PROVIDE HEALTH CARE FOR CHILDREN AT COOK CHILDREN'S MEDICAL CENTER 66 66 0 400 0 0 3586757 3490675 0 0 24287 17161 -538067 -290441 3072977 3217395 2839261 3000202 0 0 0 0 0 0 35238 71139 90503 2910400 3090705 162577 126690 3211108 3333927 0 0 3211108 3333927 PROVIDE FINANCIAL SUPPORT TO FORT WORTH COOK CHILDREN'S MEDICAL CENTER 0 0 3000202 3000202 96643 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 2011 DONATION TO COOK CHILDREN'S MEDICAL CENTER WAS OVER $3 MILLION. 3000202 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 0 1 37 15 1 0 0 0 0 0 0 1 1 0 0 0 0 X 66 66 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 OLIVIA KEARNEY 40.00 X X 0 0 0 MICHELE REYNOLDS 5.00 X X 0 0 0 LESLIE JOHNSON 1.00 X X 0 0 0 SHANNON RAY 1.00 X X 0 0 0 KAREN SIMON 1.00 X X 0 0 0 NENETTA TATUM 1.00 X X 0 0 0 KATHRYN LAUGHLIN 2.00 X X 0 0 0 LAURA BIRD 3.00 X 0 0 0 BETH RIVERS 3.00 X 0 0 0 SANDY STEPP 3.00 X 0 0 0 VICKI ANDREWS 3.00 X 0 0 0 KAYDEE BAILEY 5.00 X 0 0 0 ANNE BASS 1.00 X 0 0 0 LINDA BATTON 2.00 X 0 0 0 KIM MARTIN-BERKOWITZ 1.00 X 0 0 0 ANN BIGGS 1.00 X 0 0 0 TERESA BROWNLIE 1.00 X 0 0 0 ANDREA CARRINGTON 2.00 X 0 0 0 JIM CASHION 3.00 X 0 0 0 JOELLEN CASHION 3.00 X 0 0 0 LINDA CHRISTIE 1.00 X 0 0 0 LU JO CHURCHILL 2.00 X 0 0 0 ANN CLINKSCALES 1.00 X 0 0 0 JACKIE DANIEL 2.00 X 0 0 0 KIM DARDEN 1.00 X 0 0 0 WENDY DAVIS 7.00 X 0 0 0 ANGIE DONAHUE 2.00 X 0 0 0 LINDA FIERKE 1.00 X 0 0 0 LISA FLEET 1.00 X 0 0 0 ANN FLORSHEIM 3.00 X 0 0 0 HARRIETTE GACHMAN 1.00 X 0 0 0 MARY LYNN GARRETT 1.00 X 0 0 0 CAMI GOFF 1.00 X 0 0 0 ANNE GREEN 5.00 X 0 0 0 JANIE HARPER 7.00 X 0 0 0 JOY ANN HAVRAN 1.00 X 0 0 0 HILLARY JENNINGS 1.00 X 0 0 0 MELISSA KIRTLEY 1.00 X 0 0 0 JULIE KLEBERG 5.00 X 0 0 0 GINGER LAWHON 2.00 X 0 0 0 BOO LIVELY 1.00 X 0 0 0 BROOKE LIVELY 2.00 X 0 0 0 VALERIE MALLICK 1.00 X 0 0 0 FAITH MALLORY 1.00 X 0 0 0 LOU MARTIN 1.00 X 0 0 0 PRISCILLA MARTIN 1.00 X 0 0 0 ROBIN MILLMAN 1.00 X 0 0 0 IRIS MOORE 1.00 X 0 0 0 LESLIE MORITZ 1.00 X 0 0 0 ANNA MELISSA PHILPOTT 7.00 X 0 0 0 MARY ANNE POLSON 1.00 X 0 0 0 DANA PORTER 1.00 X 0 0 0 SALLY PRATER 7.00 X 0 0 0 MICHELLE PURVIS 7.00 X 0 0 0 GAIL RAWL 1.00 X 0 0 0 DEBBIE REYNOLDS 3.00 X 0 0 0 KELLEY ROYER 1.00 X 0 0 0 ROBIN SANDERS 1.00 X 0 0 0 JOEL SAWYER 1.00 X 0 0 0 JAN SCULLY 1.00 X 0 0 0 TERRI SEXTON 1.00 X 0 0 0 SELMA SHERMAN 1.00 X 0 0 0 PEGGY SIMS 3.00 X 0 0 0 MELISSA TAPP 1.00 X 0 0 0 JERRY TAYLOR 2.00 X 0 0 0 KATHY WOMACK 2.00 X 0 0 0 0 0 0 0 0 0 0 TWENTY MINUTES OF RED VELVET LLC 1444 OAK LAWN AVE STE 206 DALLAS TX 752073600 DESIGN AND BALL PRODUCTION 278500 1 341400 3081936 67339 249420 3490675 12424 12424 4737 0 4737 4737 4737 559770 3081936 947547 -387777 -387777 281485 184842 96643 96643 CALENDAR & CARD SALES 453000 693 693 693 3217395 96643 0 -369923 3000202 3000202 912 912 61925 26687 35238 10276 10276 OTHER ADMINISTRATIVE EX 17390 17390 3090705 3000202 55265 35238 3022083 3157274 1000 1000 0 0 153809 91256 35216 85397 3211108 3333927 0 0 X 2951008 3145274 157165 85668 102935 102985 3211108 3333927 3211108 3333927 X 126690 -3871 X X 0 1 1 X 0 X 3499365 3270018 3535105 3586757 3490676 17381921 3499365 3270018 3535105 3586757 3490676 17381921 17381921 58451 21467 12015 18088 12424 122445 497044 765050 614782 779568 841948 3498392 21002758 0.82760 0.83270 X 189025 50 3344 15766 176653 166778 800 22017 570 189025 141509 200 31891 6747 166853 200333 245 -48471 10598 141509 0.58300 0.41700 1 0 1000 1000 0 0 3217395 3090705 126690 -2667 -1200 -4 -3871 122819 4890157 -2667 577909 88176 663418 4226739 -681 -1008663 -1009344 3217395 4960694 577909 4291601 4869510 91184 -681 3000202 2999521 3090705 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 8 - OTHER ADJUSTMENTS: ROUNDING -4. PART XII, LINE 2D - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/12 88,176. PART XII, LINE 4B - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/11 COLLECTED IN FYE 2012 123,726. FUNDRAISING EXPENSES PER AUDITED FINANCIAL STATEMENTS -947,547. GAMING EXPENSES PER AUDITED FINANCIAL STATEMENTS -184,842. PART XIII, LINE 2D - OTHER ADJUSTMENTS: OTHER ACCRUED EXPENSES AT 1/31/12 3,159,212. FUNDRAISING EXPENSES PER AUDITED FINANCIAL STATEMENTS 947,547. GAMING EXPENSES PER AUDITED FINANCIAL STATEMENTS 184,842. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ACCRUED EXPENSES AT 1/31/11 PAID IN FYE 2012 3,000,202. JEWEL CHARITY BALL 2605714 2411668 194046 15000 215231 36650 425007 AUCTION 266584 12710 253874 12710 1939 7 769408 657558 111850 20165 220845 3641706 3081936 559770 32875 15000 215231 36650 647791 947547 -387777 281485 166250 18592 1 1.00000 281485 166250 18592 184842 96643 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 0.00000 1.00000 KAY REEVES 5020 COLLINWOOD AVENUE SUITE 400 FORT WORTH TX 76107 0 DEE WEBB AND KAY REEVES BOO LIVELY, HILLARY JENNINGS AND VALERIE MALLICK 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 281485 1 COOK CHILDREN'S MEDICAL - FORT WORTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752051646 501(C)(3) 3000202 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 22378 RETAIL COST X 2 80500 RETAIL COST X 1 522 RETAIL COST X TRAVEL & ENTERTAINMENT PACKAGES 18 53825 RETAIL COST X GIFT CERTIFICATES 19 41700 RETAIL COST X PRINTED MATERIALS 2 30100 RETAIL COST X JEWELRY 5 20395 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 ($69,814). THEREFORE, JEWEL CHARITY BALL IS NOT REQUIRED TO FILE SCHEDULE B. FORM 990, PART VI, SECTION A, LINE 2 CURRENT BOARD MEMBERS: JIM CASHION AND JOELLEN CASHION - FAMILY RELATIONSHIP BROOKE LIVELY AND BOO LIVELY - FAMILY RELATIONSHIP LOUELA MARTIN AND PRISCILLA MARTIN - 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 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,667. PRIOR PERIOD ADJUSTMENTS: -1,200. ROUNDING -4. TOTAL TO FORM 990, PART XI, LINE 5: -3,871. 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.