Yes No
lla
llb
llc
2 Yes No
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supporting organization was vested in the same persons that controlled or managed the supported organization(s).
Section D. All Type Ill Supporting Organizations
Did the organization provide to each of its suppo1·ted organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents 1n effect on the date of notification, to the extent not previously provided? 2 Were _any of the organization's office1·s, directors, or trustees either (i) appo1n_ted DI" elected by the supported oi·ganization(s) 01· (ii) serving on the governing body of a supported organization? ff 'No,' exp/am in Part VI how the organization maintained a close and continuous workmg relat1onsh1p with the supported organization(s). 3 By reason of the relationship described 1n (2), did the organization's supported organizations have a significant voice 1n the organization's investment policies and in directing the use of the organization's income or assets at all times du1·ing the tax yea1·? If 'Yes,' descnbe in Part VI the role the organization's supported organizations played in this regard
Section E. Type Ill Functionally Integrated Supporting Organizations Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions). a D The mganization satisfied the Activities Test. Complete line 2 below. b D The organization is the parent of each of its supported organizations, Complete line 3 below. c O The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions). 2 Activities Test. Answer (a) and (b) below.
a Did substantially all of the organization's activities during the tax yea1· directly further the exempt purposes of the supported organizat1on(s) to which the organization was rnsponsive? ff 'Yes,' then in Part VI identity those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
b Did the activities described in (a) constitute act1v1ties that, but for the organization's involvement, one or morn of the organization's supported organization(s) would have been engaged in? If 'Yes,' explain in Part VI the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement
3 Parent of Suppo1·ted Organizations, Answer (a) and (b) below. a Did the organization have the power to regularly appoint or elect a majority of the office1·s, directors, or trustees of each of the supported organizations? Provide details in Patt VJ. b Did the organization_ exercise a substant_ial degree of direction over the policies, programs, an_d activities of each of its supported organizations? If 'Yes,' descnbe m Patt VI the role played by the orgamzation in this regard. 2a
2b
3a
3b
BAA TEEA0405L 07 /03/19 Schedule A (Form 990 or 990-EZ) 2019 325
Schedule A (Form 990 or 990-EZ) 2019 ATTERDAG AT HOME, INC tiili!M'mII Type Ill Non-Functionally Integrated 509(a)(3) Supporting Organizations 81-2961607
D Check here if the organization satisfied the Integral Part Test as a qualifyin_g trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type Ill non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (8) Current Year (optional)
1 Net short-term capital gain
2 Recoveries of prior-year distributions
3 Othe1· grnss income (see instructions)
4 Add lines I through 3,
5 Depreciation and depletion
6 Portion of operating expenses paid or incurred for production 01· collection of gross ·1ncome or for management, conse1·vation, or maintenance of property held for prnduction of income (see instructions)
7 Other expenses (see instructions)
8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4) 2 3
4 5
6 7
8 Section B - Minimum Asset Amount (A) Prior Year
a Average monthly value of securities
b Average monthly cash balances
c Fair market value of other non-exempt-use assets
d Total (add lines la, lb, and le)
e rnscount claimed fo1· blockage or other
factors (explain in detail in Part VI):
2 Acquisition indebtedness applicable to non-exempt-use assets 3 Subtract l'lne 2 from line 1 d.
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 6 Multiply line 5 by .035.
7 Recoveries of priN-year distnbutions
8 Minimum Asset Amount (add line 7 to line 6)
Section C -- Distributable Amount
1 Adjusted net income for prior year (from Section A, line 8, Column A) 2 Enter 85% of line 1 .
3 Minimum asset amount for p1·ior year (from Section B, line 8, Column A) 4 Enter greater of line 2 or line 3.
5 Income tax imposed in pr'1or year
6 Distributable Amount. Subtrnct line 5 from line 4, unless subject to emergency temporary reduction (see instructions).
la
lb
le
2 3
4 5
6 7
8 2
3 4
5 6
Current Year
7 D Check here if the current year ·rs the organization's first as a non-functionally integrated Type Ill supporting organization (see 1nstruct1ons).
BAA Schedule A (Form 990 or 990-EZ)2019
TEEA0406L 07 /03/19
326
Schedule A (Form 990 or 990-EZ) 2019 ATTERDAG AT HOME, INC 81-2961607 Page 7 Mi Type Ill Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued) Sectio,n D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 2 Amounts paid to pe1·form activity that directly furthe1·s exempt pu1·poses of supported organizations, 1n excess of income frnm activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval requii-ed) 6 Other dist1·ibutions (describe in Part VI). See inst1·uctions. 7 Total annual distributions. Add lines 1 through 6,
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See 1nst1·uctions.
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by line 9 amount
Section E - Distribution Allocations (see instructions) (i)
Excess
Distributions
(ii)
Underdistributions
Pre-2019 ---------------------------1-- 1 Distributable amount for 2019 from Section C, line 6 2 Underdistribut1ons, If any, for years p1·ior to 2019 (reasonable cause required - explain in Part VI). See inst1·uctions. 3 Excess distributions carryover, if any, to 2019
a From 2014
b Frnm 2015.
c From 2016 ..
dFrom2017
eFrom2018
f Total of lines 3a through e
g Applied to underdist1·ibutions of p1·ior yea1·s
h Applied to 2019 distributable amount
i Ca1Tyover from 2014 not applied (see inst1·uctions)
j Remainder. Subtract lines 3g, 3h, and 31 from 3f.
4 Distributions for 2019 from Section D,
line 7: $
a Applied to underdistributions of prior years
__ bApplied to 2019 distributable amount
c RemaindN. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions fo1· years prio1· to 2019, if any.
Subtract lines 3g and 4a from line 2. For result greate1· than zero, explain in Part VI. See instructions.
6 Remaining underdistribut1ons for 2019. Subtract lines 3h and 4b from line 1. For result greate1· than zero, explain 1n Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c. 8 Breakdown of line 7:
a Excess from 2015
b Excess from 2016.
c Excess from 2017. .
d Excess from 2018 .
e Excess from 2019
i1f Ml��b�ttt:± :�@&\;1�
:}:L/Lf:t\�LL�,-, ...
;n�trt@Gt.. t�mtttn�m�;:�tll;
():J:\D//s\o+
(iii)
Distributable
Amount for 2019
BAA Schedule A (Form 990 or 990-EZ) 2019
TEEA0407L 07/03/19
327
ScheduleA(Form99Dor990-EZ)2019 ATTERDAG AT HOME, INC 81-2961607 Page8 !Rl'J!lliHISupplemental Information. Provide the explanations required by Part II, line 10; ,
Part II, line 17� or 17b;Part IIL line 12;,Part IV,
Section A, Imes 1, 2, 3b, 3c, 4b, 4c, Sa, 6, 9a, 9b, 9c, lla, llb, and llc; Part Iv, Section B, lines 1 and 2; rart IV, c,ect1on C, line l; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines le, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line le; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)
BAA TEEA0408L 07/03/19 Schedule A (Form 990 or 990-EZ)2019 328
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Schedule of Contributors
► Attach to Form 990, Form 990-EZ, or Form 990-PF.
0MB No. 1545-0047
2019
Department of the Treasury
Internal Revem,e Service ► Go to www.irs.gov/Form990 for the latest information.
Name of the organization Employer identification number
ATTERDAG AT HOME, INC
Organization type (check one):
81-2961607
Filers of: Section:
Form 990 or 990-EZ IBl
□
□
501 (c)( 3 ) (ente1· numbe1") organization
4947(a)(l) nonexempt cha1·itable trust not treated as a private foundation Fmm 990-PF 527 political organization
D 501 (c)(3) exempt private foundation
D 4947(a)(l) nonexempt charitable t1·ust treated as a private foundation D 501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General !Rule
[]{] Fo1- an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or prope1-ty) from any one confributor. Complete Pa1·ts I and II. See instructions fo1· determining a contributor's total contributions.
Special Rules
□
□
□
For an 01·ga11ization described in section 501 (c)(3) filing Form 990 01· 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(l)(A)(vi), that checked Schedule A (Fo,·m 990 or 990-EZ), Part 11, line 13, 16a, or 16b, and that received from any one contributor, du1·ing the year, total contributions of the greate1· of (1) $5,000; or (2) 2% of the amount on (i) Fo1m 990, Part VIII, line 1h; or (ii) Form 990-EZ, line I. Complete Parts I and II.
For an organization desc1·ibed in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one confributor, during the year, total cont1·ibutions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, 01· for the prevention of cruelty to children or animals. Complete Parts I, II, and Ill.
For an organization described in section 501 (c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, cl1aritable, etc., purpose. Don't complete any of the pa1-ts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year., ► $ -------- Caution: An 01·ganization that isn't cove1·ed by the Genei-al Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but it must answer 'No' on Part IV, line 2, of its Form 990; or check the box on line Hof its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
BAA For Paperwork Reduction Act Notice, see the instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2019) TEEA070ll 08/09/19
329
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 2 Page 2 Name of organization Employer identification number
ATTERDAG AT HOME, INC 81-2961607
!ftiffifM Contributors (see instructions) Use duplicate copies of Pa,·t I if additional space is needed (a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total
contributions
1 JilOOD-CLAEYSSEN S FOUNDATION _________________ _
(a)
No.
2 (a)
No.
3 (a)
No.
4 (a)
No.
5 (a)
No.
J'O BOX 30586 ____________________________ $ _____ 30,000.
J,ANTA BARBARAL CA 93101 ___________________ _
(b)
Name, address, and ZIP + 4
T-------------------------------------- OWBES FOUNDATION (c)
Total
contributions
-------------------------------------- 21 E. VICTORIA ST SUIT E 200 $ ------ 5 L 000.
J>bl!T_A_BARBARA, CA 93101 ___________________ _
(b)
Name, address, and ZIP + 4
�LATKIN ------------- FOUNDATION ------------------------ (c)
Total
contributions
)Q�l_ bl!_ACN'__BJ)_ A ____ --- -----__ --_ -- ___ --- _ $ -----_ 5,000.
J,ANTA BARBAR A, CA 93101 ___________________ _
(b)
Name, address, and ZIP + 4
�----------------- SLH ENDOWMENT FUND -------------------- (c)
Total
contributions
_6]§__'.['.['.A R_E_Q�G_ Bl)_ __________________________ $ _____ 50,000.
JOLVANG,_ CA 93463 ________________________ _
(b)
Name, address, and ZIP + 4
DR------------ . HILDEGARD H ------------------------ BALIN CHARITABLE TR -- (c)
Total
contributions
_lQQ_]l_�_Hl_S_T_ ----_ --- ---___ -- _ -- _ -- _ ---_ $ __ -- __ 5,000.
LWINSTON- S ALEM, NC 27101 _ --- -- ____ ----- _ ---_
(b)
Name, address, and ZIP + 4
(c)
Total
contributions
6 Ji!ILLIAM CORBETT FOUNDATION _________________ _
J'O BOX 50340 ____________________________ $ ______ 5,000.
J,ANTA BARBARA, _ CA 93150 ___________________ _
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part II for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person
Payroll
Noncash
IBl
□
□
(Complete Part 11 for
noncash contributions.)
BAA TEEA0702L 08109/19 Schedule B (Form 990, 990-EZ, or 990-PF)(2019) 330
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 2 2 Page 2 Name of organiz.itlon Employer identification number
ATTERDAG AT HOME, INC 81-29616 07
ffl:iftmffl Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (a)
No.
--- 7
(a)
No.
--- 8
(a)
No.
9 (a)
No.
---
(a)
No.
---
(a)
No.
---
BAA
(b)
Name, address, and ZIP + 4
JIUTTON FOUNDATION ________________________
J6 WEST ANAPAMU ST ________________________
J,ANTA BARBARA, CA 93101 ____________________
(b)
Name, address, and ZIP + 4
_CHRISTIAN SCIENCE _________________________
_po BOX_834 ______________________________
_SOLVANG, CA 93463 _________________________
(b)
Name, address, and ZIP + 4
-------------------------------------- SYV FOUNDATION
�-------- 458 ALISAL RD -----------------------------
J,OLVANG,_ CA 93463 _________________________
(b)
Name, address, and ZIP+ 4
�-------------------------------------
�-------------------------------------
L-------------------------------------
(b)
Name, address, and ZIP + 4
�-------------------------------------
�--------�----------------------------
L-------------------------------------
(b)
Name, address, and ZIP + 4
L _____________________________________
L-------------------------------------
---------------------------- ---------
TEEA0702L 08/09119
$
$
$
$
$
$
(c) (d)
Total Type of contribution
contributions
Person
Payroll □
_____ 12 L500. Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person IBl
Payroll □
------ 5L000 . Noncash □
(Complete Part II for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person IBl
Payroll □
------ 5, 000 . Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person
Payroll □
----------- Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person
Payroll
----------- Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person □
Payroll □
----------- Noncash □
(Complete Part 11 for
noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF)(2019)
331
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 1 1 Page 3 Name of organization Employer identification number
ATTERDAG AT HOME, INC 81-2961607
f�@jft�UtM Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed. .
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
BAA
(b)
Description of noncash property given
-------- N/A ---------------------------------
� "$
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
�---------------------------------------- -------------------- (b)
Description of noncash property given
-
$
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
---------------------------------------- - -------------------- (b)
Description of noncash property given
------------------------------------ ------
-
"$
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
�---------------------------------------- -------------------- D . . f
(b)
escnption o noncas h property given
(b)
Description of noncash property given
-----------------------------------------
---- -
•"$
(c)
FMV (or estimate)
(See instructions.)
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
(d)
Date received
---------------------------------------- - -------------------- (b)
Description of noncash property given
------------------------------------------
�----------------------------------------
f---- ---- - -
$
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
------------------------------------------ -------------------- Schedule B (Form 990, 990-EZ, or 990-PF)(2019)
TEEA0703L 08/09/19
332
Schedule B (Fo1·m 990, 990-EZ, or 990-PF) (2019) 1 Page 4 Name of organization Employer identification number
�
ATTERDAG AT HOME, INC 81-2961607
lb Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. Far organizations completing Part Ill, ente1· the total of exclusively rnligious, charitable, etc., (a)
No. from
Part I
(a)
No. from
Part I
(a)
No.from
Part I
(a)
l\lo. from
Part I
BAA
contributi
_
ons of $1
_
,000 or less for the year. (Enter this information once. See instructions.). ► $ ________ NLA Use duplicate copies of Part Ill If additional space is needed (b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
�N/A ------------------ -------------------- ----------- ----- �-------------------� --------------------+--------------------- ----------------------------------------- --------------------- Transferee's name, address, and ZIP + 4
(e)
Transfer of gift
Relationship of transferor to transferee
1-----------------------------------r-------------------------- �----------------------------------r--------------------------- (b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
(e)
Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee -----------------------------------
(b)
Purpose of gift
(c)
Use of gift
�----------------------------------------
�------------------ ---------------------
(d)
Description of how gift is held
(e)
Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee �----------------------------------
1-----------------------------------
�----------------------------------
(b)
Purpose of gift
(c)
Use of gift
1-----------------------------------------
I-- - - ----------- - - -- - - -- - -- --- - -- - ----- -- (e)
Transfer of gift
(d)
Description of how gift is held
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee 1-----------------------------------�--------------------------- r----------------------------------r--------------------------- 1-----------------------------------r--------------------------- TEEA0704L 08/09/19
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
333
SCHEDULE 0
(Form 990 or 990-EZ)
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. ► Attach to Form 990 or 990-EZ.
► Go to www.irs.gov/Form990 for the latest information.
OMS No. 1545-0047
2019
N;:;1111e of the organization Employer identification number
ATTERDAG AT HOME INC
FORM 990, PART VI, LINE 11 B - FORM 990 REVIEW PROCESS
REVIEWED BY CFO
81-2961607
FORM 990, PART VI, LINE 12C - EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS
EACH YEAR A NEW CONFLICT LETTER IS SIGNED
FORM 990, PART VI, LINE 19- OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ, TEEA4901 L 08/19/19 Schedule O (Form 990 or 990-EZ) (2019) 334
SCHEDULER
(Form 990)
Department of the TreasL1ry
Internal Revenue Ser.rice
Related Organizations and Unrelated Partnerships
► Complete if the organization answered ·ves' on Form 990, Part IV, line 33, 34, 35b, 36, or '37. ► Attach to Form 990.
► Go to www.irs.gov/Form990 for instructions and the latest information. 0MB No. 1545-0047
2019
Name of the organization ATTERDAG AT HOME r INC Employer identification number 81-2961607
lil1!\f@i!Mj Identification of Disregarded Entities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 33. 0)
(a) I
(b) I
(c) I
(d) I
(e)
Name, address, and EIN (if applicable) of disregarded entity Primary activity Legal domicile (state Total income End-of-year assets or foreign country)
----------------------------
-----------------------------
- -----------------------------
(2)
- ----------------------------
-----------------------------
----- (3) ----------------------------
---------------------------------
-- ----------------------------
(I)
Direct controlling
entity
!®lil!UH@ Identification of Related True-Exempt Organizations. Complete if the organization answered 'Yes' on Form 990, Part IV, line 34, because it had one or more related tax-exempt organizations during the tax year. (a) (b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organization Primary activity Legal domicile (state Exempt Code Public charity status Direct controlling Sec 511(b)(13) or foreign country) section (if section 501(c)(3)) entity controlled entity? (1) ENDOWMENT FUND
Yes No
-636 ATTERDAG RD--
-------- ---
-
-SOLVANG, CA 93463 ELDERLY
.17-0153001 -- --- ---- RESIDENTIAL CARE CA 501C3 N/A X �--------------------------
----------------------------
----------------------------
(�--------------------------
----------------------------
----------------------------
�--------------------------
----------------------------
----------------------------
BAA For Papeiwork Reduction Act Notice, see the Instructions for Form 990. TEEA5001L 06/27/19 Schedule R (Form 990) 2019 335
Schedule R (Form 990) 2019 ATTERDAG AT HOMEL INC 81-2961607 m111tffl/P] Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered 'Yes' on Form 990, Part IV, line 34, , .. •·"······"'····'·•'-s,
.
, because it had one or more related organizations treated as a partnership during the tax year. (a) (b) (c) (d) (e) (f) (g) (h) (i) 0)
Page2
(k) Name, address, and EIN of Primary activity Legal Direct Predominant income Share of total Share of Dispropor- Code V-UBI General or Percentage rnlated organization domicile controlling (related, unrelated, income end-of-year t1onate amount in box managing ownership (state or entity excluded from tax assets allocations? 20 of Schedule partner? foreign under sections K-1 (Form
country) 512-514) Yes No 1065) Yes No
-------------- (1)
--------------
--------------
-------------- (2)
--------------
--------------
------------�
(3)
-
--------------
--------------
�f!liWNWI Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered 'Yes' on Form 990, Part IV, ,
.
. ,· .......... u .. w, line 34, because it had one or more related organizations treated as a corporation or trust during the tax year. (a)
Name, address, and EIN of related organization
------------- (1) ----------- -
------------------------ -
--------------------------
----------------- (2) ------- -
--------------------------
--------------------------
------------------ (3) --------
--------------------------
-------------------------
BAA
(b)
Primary activity
(c)
Legal domicile
(d)
Direct
(state or foreign controlling
country) entity
TEEA5002L 06/27/19
(e) (f) (g) (h) (i)
Type of entity Share of Share of end-of- Percentage Sec 512(b)(13) (C corp, S corp, total income year assets ownership controlled entity? or trust)
Yes No
Schedule R (Form 990) 2019
336
Schedule R (Form 990) 2019 ATTERDAG AT HOMEL INC 81-2961607 Page 3 l!ilffllt,'VJ Transactions With Related Organizations. Complete if the organization answered 'Yes' on Form 990, Part IV, line 34, 35b, or 36.
Note: Complete line 1 if any entity is listed in Parts 11, Ill, or IV of this schedule.
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV? a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity. b Gift, grant, or capital contribution to related organization(s). c Gift, grant, or capital contribution from related organization(s). . d Loans 01· loan guarnntees to or for related organization(s) e Loans or loan guarantees by related organization(s).
Dividends from related organization(s). .
g Sale of assets to related organization(s).
h Purchase of assets from related organization(s)
Exchange of assets with related organization(s)
Lease of facilities, equipment, or other assets to related organization(s). k Lease of facilities, equipment, or other assets from related organizat1on(s).
I Performance of services or membership or fundraising solicitations for related organization(s) m Performance of services or membership or fundraising solicitations by related organization(s). n Sharing of facilities, equipment, mailing lists, or othe1· assets with related organizat1on(s). o Sharing of paid employees with related organization(s). p Reimbursement paid to related organization(s) for expenses q Reimbursement paid by related organization(s) for expenses Yes I No
!ftfi?ffilt#tjt#¾fi
la X
1 b X
1 C X
1 d X
le X
M!Mtfffft.fff.i1ff.fff1
1 f X
1 g X
lh X
1 i X
1 j X
>hYfi1 WnUJ;?ttW
1 k X
1 I X
lm X
ln X
1 0 X
[lMff.t ?f:@ff@Jf!M
1 p X
1 q X
tltl@lttifil: :ittm
r Other transfer of cash or property to related organization(s) . I 1 r I I X
s Other transfer of cash or property from related organization(s). 1 s X 2 If the answer to any of the above is 'Yes,' see the instructions for information on who must complete this line, including covered relationships and transaction thresholds. (a) (b) (c) (d)
Name of related organization Transaction Amount involved Method of determining type (a�s) amount involved
(1)
(2)
(3)
(4)
(5)
(6)
BAA TEEA5003L 06/27/19 Schedule R (Form 990) 2019
337
Schedule R (Fo1w 990) 2019 ATTERDAG AT HOME, INC 81-2961607 11'.lll'U:l@i!;I Unrelated Organizations Taxable as a Partnership. Complete if the organization answered 'Yes' on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships. (a)
Name, address, and EIN of entity
0) _______________
-----------------
-----------------
�---------------
-----------------
-----------------
J�---------------
-----------------
-----------------
----------------- (4)
-----------------
-----------------
(5) -- -------------
-----------------
-----------------
----------- (6) ------
-----------------
-----------------
m _______________
-----------------
-----------------
00 _______________
-----------------
-----------------
BAA
(b)
Primary activity
(c)
Legal domicile
(d)
Predominant
(e)
Are al I partners
(state or foreign mcome section
country) (related, unre- 501(c)(3)
lated, excluded organizations?
from tax under
sections 512"514) Yes No
TEEA5004L 06/27/19
(f) Share of (g) Share of
(h)
Dispropor-
(i)
Code V-UBI fj) General or
(k)
Percentage
total income end"of-year tionate amount in box managing ownership assets allocations? 20 of Schedule partner?
K-1
(Form 1065)
Yes No Yes No
Schedule R (Form 990) 2019
338
Edll!MI
ScheduleR (Form 990) 2019 ATTERDAG AT HOME, INC 81-2961607 Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
BAA TEEA5005L 06/27 /19 Schedule R (Form 990) 2019
339
TAXABLE YEAR
2019 California Exempt Organization
Annual Information Return
Calendar Year 2019 or fiscal yea1· beginning (mm/dd/yyyy) Corporat1on10rganization name
ATTERDAG AT HOME, INC
Additional information. See instructions
Street address (suite or room)
636 ATTERDAG RD
City
SOLVANG
Foreign country name
A First Return ....... B Yes ; No J
B Amended Return. . . . . . • Yes No
IRC Section 4947(a)(l) trust . . . . . . Yes �No
D Final Information Return?
ill FORM
199
, and ending (mm/ddiWYY)
Cali orn1a corporation number
3889864
FEIN
81-2961607
PMB no
State Zip code
CA 93463
Foreign province/state/county Foreign postal code
If exempt u11der R& TC Section 23701d, has the
orga11izatio11 engaged in political activities?
See i11structions. • Oves �No
• 0 Diss olved D Surrendered (Withdrawn) D Merged/Reorganized K Is the organization exempt under R&TC Section 23701g?.. • Oves �No E
F
Enter date: (mm/dd/yyyy) •
Check accounting method:
1 [ill Cash 2 D Accrual 3 D Other
Federal return filed7 1 • D 990T 2 • D 990H
4 D Other 990 series
L
3 • □ Scl1 H (990)
M
If "Yes," enter the gross receipts from
nonmember sources. $
If organization is a public charity exempt under
R&TC Section 23701d and meets the filing fee
exception, check box. No filing fee is required. •□
Is the organization a Limited Liability Company? • Oves �No G Is this a group filing? See instructions . • D Yes �No N Did the organization file Form 100 or Form 109 to report taxable income?. • Dves �No
H Is this Ot'ganization in a group exemption . D Yes �No 0 Is the organization under audit by the IRS or has the IRS If "Yes," what is the parent's name? audited in a prior year?. • OYes �No p Is federal Form 1023/1024 pending? .. OYes □ No
I Did the organization have any changes to its guidelines • D Yes �No Date filed with IRS
not reported to the FTB? See instructions ........
Part I
Recetts
an
RevenLtles
Expenses
Filing
Fee
Sign
Here
Paid
Preparer's
Use Only
Complete Part I unless not required to file this form. See General Information Band C. 1 2
3 4
5 6
7 8
9 10
11 12
13 14
15 16
Gross sales or receipts from other sources. From Side 2, Pa1·t II, line 8.
Grnss dues and assessments from membe1·s and affiliates.
Gross contributions, gifts, grants, and similar amounts rnceived . . . S.E:E .. S.CH,.
Total gross receipts tor filing requirnment test. Add line I through line 3.
This line must be completed. If the result is less than $50,000, see General Information B.
Cost of goods sold.
Cost or other basis, and sales expenses of assets sold .
Total costs. Add line 5 and line 6.
Total moss income. Subtract line 7 from line 4.
.. " ' . ;
. :
5 I
6 I
Total expenses and disbu1·sements, From Side 2, Part II, line 18.
Excess of rnceipts over expenses and disbursements. Subtract line 9 from line 8 Total payments.
Use tax. See Genernl lnfo1·mation K.
Payments balance. If line 11 is more than line 12, subtract line 12 from line II.
Use tax balance. If line 12 is more than line 11, subtrnct line 11 from line 12.
Filing fee $10 01· $25. See General Information F
Penalties and lnternst. See General Information J
• 1 113.
•
.\l . • 3 203,312.
flli1�t;�?�tti�ibi'fr+❖\B1fitdlr
·- 203, 425 .
,;t;�:- :,�-: ��,�itt�i��,��-;
7 • 8 203,42 5.
• 9 147,491.
• 10 55,934.
•
11 • 12
• 13
• 14
15 10.
16 17 Balance due. Add line 12, line 15, and line 16. Then subtract line 11 from the result. .... ® 17 10.
Under penalti� of perjuty, I declare that I have examined this retum, inclu_ding accompany_ng schedules and _statements, and to the best of my knowledge and belief, it is true, coccect, sod complete. Declscat100 of pcepacec (otl,e1 tl,ai, taepaye,) r based oo all 11,fo1matio1a of wh,ch p1epace1 has aoy koowledge.
Signah.ue ►
Title Date
of officer PRESIDENT
Check if
P_reparer's ► self-
• Telephone
(805) 688-3263
• PTIN
s1gnatl1re KENNETH D. SORENSON, CPA I
Date
employed ► � P00083774
SORENSON & ASSOCIATES Firm'5 name
(or yours, ii ► 2027 VILLAGE LANE. STE 203 !��•:rfr�i:d ) SOLVANG, CA 93463
May the FTB discuss this rntum with the preparer shown above? See instructions. .
CACA1112L 12/13/19 059 3651194
" . " .
• Firm's FEIN
46-4246494
• Telephone
( 8 05) 688-1122
• lxl Yes 17 No
Form 199 2019 Page 1
340
ATTERDAG AT HOME, INC 81-2961607
Part fl Organizations with gross receipts of more than $50,000 and private foundations regardless of amount of gross receipts - complete Part II or furnish substitute information. 1 Gross sales or rece·1pts from all business activities. See instructions. 2 Interest.
3 Dividends.
Receipts 4 Gross rents. from
Other 5 Gross royalties
Sources 6 Grnss amount received from sale of assets (See Instructions). 7 Other income, Attach schedule.
8 Total gross sales or receipts from other sources. Add line 1 through line 7. Enter here and on Page 1, Part I, line 1. 9 Contributions, gifts, grants, and similar amounts paid. Attach schedule ... 10 0·1sbursements to or for members.
11 Compensation of officers, directors, and trustees, Attach schedule. SEE ST.MT 12 Other salar'Ies and wages
Expenses 13 Interest. and
Disburse� 14 Taxes ..
rnents 15 Rents
16 Depreciation and depletion (See instructions).
17 Other Expenses and Disbursements. Attach schedule. . . $E;E. S.TAT!sME.N'.I'. 18 Total expenses and disbursements. Add line 9 through line 17. Enter here and on Page 1, Part I, line 9 ..
Schedule L Balance Sheet
Assets
1 Cash ..
2 Net accounts receivable.
3 Net notes receivable .
4 Inventories
5 Federal and state government obligations
6 Investments in other bonds .
7 Investments in stock.
8 Mortgage loans.
9 Other investments. Attacl1 schedule.
10 a Depreciable assets
b Less accumulated depreciation.
11 l,nd.
12 Other assets. Attach schedule.
13 Total assets.
Liabilities and net worth
14 Accounts payable
15 Contributions, gifts, or grants payable ..
76 Bonds and notes payable.
·17 Mortgages payable.
18 Other liabilities. Attach schedule.
Beginning of taxable year
.\::::_::_•}�i;Jfi.(�gJ.h{fi;)�. 5 9 , 3 4 2 .
:'}'.}JXFJ.£3:Z;:t.tE>MtSntrztd;J
• 1
• 2 113,
•
• 4
•
• 6
• 7
8 113,
• 9
• 10
1 • 11 o •
• 12
• 13
• 14
• 15
• 16
. 2 .• 17 147,491.
18 147.491.
End of taxable year
(d)
115,276.
115,276.
·19 Cap'1tal stock or principal fund. . . £1f7/J{{'(:;tf.'.ft\%:;53/?W: 5 9, 342 . 115,276. 20 Paid-in or capital surplus, Attach reconciliation, w:=:'ftf:tft:P:(rt\(f--:'ifa:AeW 21 Retained earnings or income fund. �hl;f;�",\;;V,;;i;)_�z;;w.;;.:r;}.:\i 22 Total liabilities and net worth . J)t%¥W}f:%45WtfffffJ!· 115, 2 7 6.
Schedule M� 1 Reconciliation of income per books with income per return Do not complete this schedule if the amount on Schedule L, line 13, column (d) , is less than $50,000
1 Net income per books. • 5 5, 9 3 4 . 7 Income recorded on books this year not included ;)}i�l��fr\i�i:f}�:��i:�¼i�:�§:fo;fa 2 Federal income tax • in this return. Attach schedule . 3 Excess of capital losses over capital gains.
4 Income not recorded on books this year.
Attach schedule
5 Expenses 1ecorded on books this year not deducted
in this return. Attach schedule.
6 Total. Add line 1 through line 5
II Page2 Form 199 2019
• 8 Deductions in this return not charged
{/;i��·�/2:�Li.tfki,Xfr-JtkVii%4i against book income this year. • Attach schedule. .
,�(f::t'.J�.;\:5,,n}.S:.;..AK\ki:A%-�:. 9 Total. Add line 7 and line 8 • 10 Net income per return.
55,934. Subti-act line 9 from line 6.
059 3652194 CACA1112L 12/13/19
55,934.
341
Schedule B
(Form 990, 990-EZ,
or 990-PF)
CALIFORNIA COPY
Schedule of Contributors
► Attach to Form 990, Form 990-EZ, or Form 990-PF.
0MB No. 1545-0047
2019
Department of the Treasury
Internal Revenue Service ► Go to www.irs.gov/Form990 for the latest information.
Name of the organization Employer identification number
ATTERDAG AT HOME, INC
Organization type (check one):
81-2961607
Filers of: Section:
Form 990 or 990-EZ IBJ so1ccJc 3 ) (enter numbel") organization Form 990-PF
D 4947(a)(1) nonexempt charitable trust not treated as a private foundation D 527 political organization
D 501 (c)(3) exempt private foundation
D 4947(a)(l) nonexempt charitable trust treated as a private foundation D 501 (c)(3) taxable private foundation
Check if your organization is covered by the General Rule Na Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
Genera! !Rule
IBl For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for dete1·mining a contributor's total contributions.
Special Rules
□
□
□
For an organization described in section 501 (c)(3) filing Form 990 or 990-EZ that met the 33-1/3% support test of the regulations under sections 509(a)(1) and 170(b)(l)(A)(vi), that checked Schedule A (Form 990 01· 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the grnater of (1) $5,000; or (2) 2% of the amount on (i) Form 990, Part VIII, line lh; or (ii) Form 990-EZ, line 1. Complete Parts I and II, Fo1· an organization described in section 501 (c)(7), (8), 01· (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to childrnn 01· animals. Complete Parts I, 11, and Ill.
For an organization described in section 501 (c)(7), (8), N (10) filing Form 990 or 990-EZ that received from any one contributor, du1·ing the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1, 000. If this box is checked, ente1· here the total cont1·ibutions that were received during the year for an exclusively religious, charitable, etc,, purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively rnligious, cha1-itable, etc., contributions totaling $5,000 or more du1·ing the year.. ► $ --------- Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF), but 1t must answer 'No' on Part IV, line 2, of its Form 990; or check the box on line Hof its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule 8 (Form 990, 990"EZ, 01· 990-PF), BAA For Paperwork Reduction Act Notice, see the instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2019) TEEAD701 L 08/09/19
342
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 1 2 Page 2 Name of organiz.ition Employer identification number
ATTERDAG AT HOME, INC 81-2961607
lliHJ!@ Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed. (a) (b) (c)
No. Name, address, and ZIP + 4 Total
contributions
1 rWOOD-CLAEYS --------------------- SENS FOUNDATION ---------------- r-- PO BOX ---------- 30586 -------------------------$ ----- 30, 000 .
J3ANTA BARBARA.L CA 93101 ____________________
��- (b)
Name, address, and ZIP + 4
(c)
Total
contributions
2 ------- TOWBES FOUNDATION ---------------------------- --- ----------------------- 21 E. VICTORIA ST SUITE 200 ---------------$ ------ 5,000.
J3ANTA BARBARA.L CA_93101 ____________________
(a) (b) (c)
No. Name, address, and ZIP + 4 Total
contributions
3 �------------- LATKIN FOUNDATION ------------------------ ------------ 1021 ANACAPA RD --------------------------$ ------ 5, 000 . -------- SANTA BARBARA, --------- CA 931 0--1 ------------------- (a) (b) (c)
No. Name, address, and ZIP + 4 Total
contributions
---
4 �--------------------------- SLH ENDOWMENT FUND ---------- -------------------------------- 636 ATTERDAG RD ------$ ----- 50,000 . ----------------- SOLVANG, CA 93463 --------------------- (a) (b) (c)
No. Name, address, and ZIP + 4 Total
contributions
5 ---------- DR. HILDEGARD ---------- H BALIN CHARITABLE ------------------ TR --------------- 100 N MAIN ST -----------------------$ ______ 5,000 . ---------- WINSTON-SALEM, ----- NC 271----------------- 01 ------ (a) (b) (c)
No. Name, address, and ZIP + 4 Total
contributions
6 ----------------- WILLIAM CORBETT FOUNDATION --------------------- ---- PO BOX ------- 50340 ------------------- --------$ ------ 5, 000 . ------------- SANTA BARBARA, CA ------------------------- 93150 (d)
Type of contribution
Person �
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person �
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person �
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person �
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
(d)
Type of contribution
Person �
Payroll D
Noncash D
(Complete Part 11 for
noncash contributions.)
BAA TEEA0702l 08/09/19 Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 343
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Name of organization
ATTERDAG AT HOME, INC
2 Page 2
Employer identification number
81-2961607
m@1li!UW! Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (a)
No.
---
7 (a)
No.
8 (a)
No.
9 (a)
No.
---
(a)
ifo,
--· - -
(a)
No.
---
BAA
(b)
Name, address, and ZIP + 4
�----------------------- HUTTON FOUNDATION -------------- �------------ 26 WEST ANAPAMU ST ------------------------- LSANTA BARBARAL CA 93101 ____________________
(b)
Name, address, and ZIP + 4
_CHRISTIAN SCIENCE _________________________
J'O BOX 834 ______________________________
_80LVANG,_ CA 93463 _________________________
(b)
Name, address, and ZIP + 4
§fV FOUNDATION ___________________________
J58 ALIS_AL RD ___________________________
J,OLVANG,_ CA 93463 _________________________
(b)
Name, address, and ZIP + 4
�-------------------------------------
--------------------------------------
--------------------------------------
(b)
Name, address, and ZIP + 4
--------------------------------------
--------------------------------------
�-------------------------------------
(b)
Name, address, and ZIP + 4
�-------------------------------------
�-------------------------------------
L _____________________________________
TEEA0702L 0S./09/19
$
$
$
$
$
$
(c) (d)
Total Type of contribution
contributions
Person
Payroll
----- 12, 500 . Noncash □
(Complete Part 11 for
noncash contributions.)
(c)
Total
contributions
(d)
Type of contribution
Person IBl
Payroll □
------ 5, 000. Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person IBl
Payroll □
------ 5, 000 . Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person
Payroll □
----------- Noncash □
(Complete Part 11 for
noncash cont1·ibutions.)
(c) (d)
Total Type of contribution
contributions
Person
Payroll
----------- Noncash □
(Complete Part 11 for
noncash contributions.)
(c) (d)
Total Type of contribution
contributions
Person □
Payroll □
----------- Noncash □
(Complete Part 11 for
noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF)(2019)
344
Schedule B (Form 990, 990-EZ, or- 990-PF) (2019) 1 1 Page 3 Name of organizaition Employer identification m1mber
ATTERDAG AT HOME, INC 81-2961607
lcRifflLMd Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed. (a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
(a) No.
from
Part I
BAA
(b)
Description of noncash property given
�----------- N/A -----------------------------
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
�------------------------
�---------------------------------------- ----------------- $ -------------------- (b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
�----------------------------------------
�---------------------------------------- $ -------------------- (b)
Description of noncash property given
�------------------------�---------------
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
�-------------------------------
�---------------------------------------- --------- $ -------------------- (b)
Description of noncash property given
�----------------------------------------
�-----------------------------------------
$
(b)
Description of noncash property given
(b)
Description of noncash property given
---------------------------------------- -
(c)
FMV (or estimate)
(See instructions.)
(c)
FMV (or estimate)
(See instructions.)
(c)
FMV (or estimate)
(See instructions.)
(d)
Date received
(d)
Date received
(d)
Date received
�
�--------------------------------------- --$
- --------------------
Schedule B (Form 990, 990-EZ, or 990-PF)(2019)
TEEA0703L 08/09/19
345
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) 1 1 Page 4 Name of organization Employer identification number
ATTERDAG AT HOME, INC 81-2961607
;B: · 1.If Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and (a)
No. from
Part I
(a)
No. from
Part I
(a)
No. from
Part I
(a)
No. from
Part I
BAA
the following line enfry. FoI· organizations completing Part Ill, enter the total of exclusively religious, charitable, etc., confributions of $1
_
,000 or less for the year. (Enter this information once. See instructions.). . ► $ ________ __N.LA Use duplicate copies of Part Ill if additional space 1s needed.
N
/A
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
------------------- - ------------------- " --------------------- ----------------------------------------- --------------------. (e)
Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
1--------------------- - --------------------1- - - - - --- -------- ------ (e)
Transfer of gift
Transferee's name, address, and ZIP+ 4 Relationship of transferor to transferee --------------------------------------------------------------· ----------------------------------- --------------------------- --------------------------------------------------------------- (b)
Purpose of gift
(c)
Use of gift
------------------------------------------
-----------------------------------------
�----------------------------------------
(d)
Description of how gift is held
(e)
Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee 1-----------------------------------�--------------------------- �----------------------------------r--------------------------- r----------------------------------
(b)
Purpose of gift
(c)
Use of gift
------------------- -------------------- -
------------------- -------------------- -
-----------------------------------------
(e)
Transfer of gift
(d)
Description of how gift is held
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee -----------------------------------
--------------------------------------------------------------· -----------------------------------�--------------------------· Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
TEEA0704L 08/09/19
346
2019 CALIFORNIA STATEMENTS PAGEl
ATTERDAG AT HOME, INC 81-2961607
STATEMENT 1
FORM 199, PART II, LINE 11
COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES CURRENT OFFICERS:
TITLE AND TOTAL CONTRI- EXPENSE
AVERAGE HOURS COMPEN- BUTION TO ACCOUNT/
NAME AND ADDRESS PER WEEK DEVOTED SATION EBP & DC OTHER CHRIS BROWN TREASURER $ 0. $ 0. $ 0.
636 ATTERDAG RD 5.00
SOLVANG, CA 93463
BARBARA CIRONE PRESIDENT 0. 0. 0.
636 ATTERDAG RD 5.00
SOLVANG, CA 93463
BARBARA MARSH KLEIN SECRETARY 0. 0. 0.
636 ATTERDAG RD 5.00
SOLVANG, CA 93463
SUZI MATTHIES DIRECTOR 0. 0. 0.
636 ATTERDAG RD 5.00
SOLVANG, CA 93463
ERNEST ZOMALT DIRECTOR 0. 0. 0.
636 ATTERDAG RD 5.00
SOLVANG, CA 93463
TOTAL$ 0. $ 0. $ 0.
-
STATEMENT 2
FORM 199, PART II, LINE 17
OTHER EXPENSES
ADVERTISING AND PROMOTION .. $ 271.
DUES & MEMBERSHIP .. 509.
FOOD, MEAL EXPENSE. 75,348.
INSURANCE. 6,891.
MANAGEMENT FEES. 60,800.
OFFICE EXPENSES .. 3,672.
TOTAL $ 147,491.
347
CITY OF SOLVANG
HUMAN SERVICES GRANT FUNDING
POLICIES and PROCEDURES
The Solvang City Council recognizes the importance of the human services and programs and organizations that serve community residents. As part of the annual budget process and financial plan development, the City Council may consider appropriation of such funds as it deems prudent and reasonable to award grants to non-profit community service organizations.
Policy
A. Non-Profit / Not for Profit. Tax-exemption is the result of a nonprofit organization being recognized by the IRS as being organized for any purpose allowable under 501(c)(3) – 501(c)(27).
B. Grants Shall Not be available to organizations who intend to directly or indirectly act as a conduit to provide grant funding to other organizations.
C. The City will prioritize funding for Solvang citizen services, senior citizen services, Veterans, youth and minors with disabilities.
D. City grant funds Shall Not be used by the agency for administrative/overhead types of costs.
E. Applicants must be in good standing with the IRS, FTB and current with their registration with the Attorney General / Department of Justice.
F. Applicants agree to sign the City’s Standard Grant Agreement, abide by all conditions and requirements, and shall present a report of a detailed accounting of how the funds were spent.
G. Applicants will provide three years of financial statements, if available.
Procedures
A. The application period for Organizations wishing to apply for grant funds will be opened on February 1, 2023 and deadline to apply will be March 31, 2023. In addition to the completed Application, Applicants are to provide the last three most recent 990’s filed with the IRS.
Completed applications may be subsidized with additional information regarding the Organization and their programs. Email applications to [email protected] or deliver to City Hall (1644 Oak Street, Solvang, CA 93463)
B. Staff will review applications for completeness and qualifications based upon grant program parameters and will provide the Council with analysis whether the grant applications qualify under this program.
C. Copies of all funding applications received will be provided to all City Council members and will be considered by Council as part of the budget adoption hearing and will be a public record.
D. A representative from the requesting organization must be available for questions from City staff and/or City Council related to their grant funding application and must attend and present at the annual City budget hearing. Following adoption of the annual City budget and execution of City standard Grant Funding Contract with the City, the City will disburse approved funds within 30 days.
Grant Funding Policy CC 2022-08-08
348
CITY OF SOLVANG
HUMAN SERVICES GRANT FUNDING
APPLICATION
1. Legal Organization/Agency Name and dba if applicable:
SYV Fruit and Vegetable Rescue
2. Total funding request: $15,000
3. Contact Person Name, Title within the Organization, Email and phone number:
Christine Franke
Director of Development and Communications
[email protected]
310 502-0746
4. Mailing Address:
PO Box 1651, Santa Ynez, CA 93460
5. Physical Address:
3558 Sagunto St., Santa Ynez, CA 93460
6. Organization’s purpose? Goals and objectives?
The mission of Veggie Rescue is to improve the nutrition of and quality of life for community members struggling with food insecurity by providing them with local produce and high-quality prepared food while having a positive environmental impact through the reduction of food waste. Through our unique, flexible food access model, we strategically bridge the gap between farmers and people who are unable to access or afford healthy food. Veggie Rescue works closely with local farmers, farmer markets, and businesses, rescuing nutritionally dense produce and prepared foods that would otherwise go to waste. Our operations team delivers these perishable items where they are needed most within 24 hours - at no cost - to nonprofit organizations serving our most vulnerable populations.
Having recently approved a Strategic Plan, our goals for 2023 include:
• Double the amount of food rescued over the next 3 years, utilizing our current operating structure to its fullest capacity
• Grow the Community Cooking Project, where, in partnership with the SYV Community Kitchen at St. Marks, volunteers prepare soups and side dishes using rescued produce, to be delivered to nonprofit organizations serving housing and food insecure community members
• Continue seeking new recipient partners, extending our reach into the community to uncover and respond to unmet needs
7. Program of the funding request? Provide a detailed accounting of what specific program the granted funds will be used for.
Veggie Rescue is the only nonprofit in the county’s food network focused on rescuing locally grown fresh produce. The support received from generous funders enables Veggie Rescue to provide fresh, nutritious fruits and vegetables to many Santa Ynez nonprofit organizations throughout each week. For example, we deliver healthy, perishable food to People Helping People for their outdoor food pantry and their weekly Santa Inez Mission food distribution program. We also deliver locally grown produce to the senior center in Buellton, specifically for their outdoor free farmer’s table and self-serve refrigerator. Members of the community, whether they are senior citizens, veterans, or low-income families, can access and select from the donated food, based on their personal needs, honoring the humanity and dignity of each recipient. 349
Rescued produce is also delivered weekly to Bethania Lutheran Church, for their food distribution program; Solvang Senior Center, for use in prepared meals as well as where seniors are able choose nutrient dense fruits and vegetables to take home; and Atterdag at Home, where the fruit we provide is used to supplement their weekend brown bag program. In addition, we deliver healthy food to Solvang School, Santa Ynez Charter school, and the United Way Fun in the Sun summer program.
Our delivery team is made up of three part-time drivers and a fleet of three refrigerated vehicles.
Since 2019, while our total servings of food rescued has grown over 300%, our Direct Program costs increased 170%. The current operational structure can handle two times the produce we currently rescue. There are plenty of fruits and vegetables to rescue, the only thing holding us back is the need for funding.
Grant funds received by the City of Solvang will help cover costs associated with fleet and delivery costs for deliveries to nonprofits serving the residents of Solvang and nearby communities in the Santa Ynez Valley. The one-year budget for these local deliveries is as follows:
Driver Payroll related costs 30,200
Fuel 10,350
Auto Insurance 1,290
Fleet maintenance and registration 1,750
Supplies and uniforms 680
Vehicle depreciation 7,855
Total Direct Program Budget 52,125
8. How many Solvang residents will be impacted by the proposed use of the grant funds? Veggie Rescue delivers directly to the nonprofits feeding those in our community who are living with food insecurity. In 2022, we delivered over 310,000 servings of nutritious food to benefit residents of Solvang and the surrounding communities, for a total value of $183,000. With a focus on fresh, locally grown produce, we are providing access to nutritious, perishable items that these individuals and families may otherwise not be able to afford. These collaborative efforts improve the mental and physical health of residents, as well as contributing to a closed loop economy where waste and negative environmental impacts are minimized.
9. What is the organization’s total budget? $411,705
10. What are the sources of revenue for your organization? How are you funded? Veggie Rescue provides free services to farmers and businesses to pick up food that would otherwise go to waste. We then deliver that food to nonprofits feeding those living with food insecurity, also at no cost. Our program is funded through grants and individual donations. In order to achieve our 2023 goals, we will need to increase our overall income by nearly 40%.
INCOME 2022(Act) 2023(Bud)
Grants 195,028 225,000
Donations 70,515 137,000
Events 8,016 18,000
Total 273,559 380,000
Grant Funding Policy CC 2022-08-08
350
Is this a group return for subordinates?
OMB No. 1545-0047
Form
Return of Organization Exempt From Income Tax
2021 990
Part I Summary
Part II Signature Block
Sign
Here
Paid
Preparer
Use Only
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Do not enter social security numbers on this form as it may be made public. Open to Public Inspection
A For the 2021 calendar year, or tax year beginning , 2021, and ending , 20 B
1 2
3 3
4 4
5 5
6 6
Activities & Governance
7a 7a
b 7b
8 9
10 Revenue
11 12
13 14
15 16a
b
Expenses
17 18
19 20
21 22
Yes No
For Paperwork Reduction Act Notice, see the separate instructions.
Go to www.irs.gov/Form990 for instructions and the latest information.
Briefly describe the organization's mission or most significant activities:
Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets.
Number of voting members of the governing body (Part VI, line 1a) Number of independent voting members of the governing body (Part VI, line 1b) Total number of individuals employed in calendar year 2021 (Part V, line 2a) Total number of volunteers (estimate if necessary)
Total unrelated business revenue from Part VIII, column (C), line 12 Net unrelated business taxable income from Form 990-T, Part I, line 11 Contributions and grants (Part VIII, line 1h)
Program service revenue (Part VIII, line 2g)
Investment income (Part VIII, column (A), lines 3, 4, and 7d) Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) Grants and similar amounts paid (Part IX, column (A), lines 1-3) Benefits paid to or for members (Part IX, column (A), line 4) Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) Professional fundraising fees (Part IX, column (A), line 11e) Total fundraising expenses (Part IX, column (D), line 25) Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) Revenue less expenses. Subtract line 18 from line 12
Total assets (Part X, line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20 May the IRS discuss this return with the preparer shown above? See instructions Form 990 (2021)
C D Employer identification number
E
G
F H(a) Yes No
H(b) Yes No
I
J Website: H(c)
K L M
Prior Year Current Year
Beginning of Current Year End of Year
Net Assets or
Fund Balances
Department of the Treasury
Internal Revenue Service
Check if applicable: Name of organization
Address change Doing business as
Name change Number and street (or P.O. box if mail is not delivered to street address) Room/suite Telephone number Initial return
Final return/terminated City or town, state or province, country, and ZIP or foreign postal code Gross receipts Amended return $
Application pending Name and address of principal officer:
Are all subordinates included?
Tax-exempt status: 501(c)(3) 501(c) ( ) (insert no.) 4947(a)(1) or 527 If "No," attach a list. See instructions Group exemption number
Form of organization: Corporation Trust Association Other Year of formation: State of legal domicile:
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Signature of officer Date
Type or print name and title
Print/Type preparer's name Preparer's signature Date PTIN Check if self-employed
Firm's name Firm's EIN
Firm's address Phone no.
EEA
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SYV FRUIT & VEGETABLE RESCUE
VEGGIE RESCUE 45-1797788
P O BOX 1651 (805)350-9154
SANTA YNEZ, CA 93460 432,812
TERRY DELANEY X
1859 REFUGIO RD SANTA YNEZ CA 93460
X
WWW.VEGGIERESCUE.ORG
X 2011 CA
THE MISSION OF VEGGIE RESCUE IS TO IMPROVE THE
NUTRITION AND QUALITY OF LIFE FOR COMMUNITY MEMBERS WHO ARE STRUGGLING WITH FOOD INSECURITY BY
PROVIDING THEM WITH HEALTHY, LOCAL PRODUCE AND HIGH-QUALITY PREPARED FOOD & TO WORK WITH
FARMERS AND LOCAL BUSINESSES TO REDUCE FOOD WASTE
7 7
7 25
0 0
336,029 416,209
0 969 952
767 15,651
337,765 432,812
0 0
143,960 189,669
0 15,903
107,187 116,181
251,147 305,850
86,618 126,962
366,532 472,846
33,126 12,373
333,406 460,473
TERRY DELANEY, PRESIDENT
X
HILDA ZACARIAS CPA 03-07-2022 P01328979
Hilda Zacarias CPA MPA
801 South Broadway Suite 17
Santa Maria CA 93454 805-922-9800
X
351
Part III Statement of Program Service Accomplishments
1 2
Yes No
3 Yes No
4 4a
4b
4c
4d
4e
Form 990 (2021) Page 2
Check if Schedule O contains a response or note to any line in this Part III Briefly describe the organization's mission:
Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?
If "Yes," describe these new services on Schedule O.
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
If "Yes," describe these changes on Schedule O.
Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) Other program services (Describe on Schedule O.)
(Expenses $ including grants of $ ) (Revenue $ )
Total program service expenses
EEA Form 990 (2021)
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
THE MISSION OF VEGGIE RESCUE IS TO IMPROVE THE NUTRITION AND QUALITY OF LIFE FOR COMMUNITY
MEMBERS WHO ARE STRUGGLING WITH FOOD INSECURITY BY PROVIDING THEM WITH HEALTHY, LOCAL PRODUCE AND
HIGH-QUALITY PREPARED FOOD & TO WORK WITH FARMERS AND LOCAL BUSINESSES TO REDUCE FOOD WASTE X
X
266,819
IN 2021, WE RECOVERED 550,000 POUNDS OF FRESH, LOCALLY GROWN PRODUCE AND HIGH-QUALITY PREPARED
FOOD THAT WOULD OTHERWISE HAVE GONE TO WASTE, AND DELIVERED IT TO COMMUNITY KITCHENS, SHELTERS,
FOOD PANTRIES, SENIOR CENTERS AND YOUTH PROGRAMS THROUGHOUT SANTA BARBARA COUNTY WHO ARE FEEDING PEOPLE LIVING WITH FOOD INSECURITY. THIS IS THE EQUIVALENT OF $962,500 WORTH OF FOOD, OR 458,343 MEALS. THE REDUCTION IN FOOD WASTE ALSO ACCOUNTS FOR AVOIDANCE OF 114.37 PARTS PER MILLION OF CO2, WHICH EQUATES TO THE ANNUAL EMISSIONS OF 25 CARS.
266,819
352
Part IV Checklist of Required Schedules
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 a
11a
b
11b
c
11c
d
11d
e 11e
f
11f
12a
12a
b
12b
13 13
14a 14a
b
14b
15 15
16 16
17 17
18 18
19 19
20 a 20a
b 20b
21 21
Form 990 (2021) Page 3
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV Did the organization, directly or through a related organization, hold assets in donor-restricted endowments or in quasi endowments? If "Yes," complete Schedule D, Part V If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete Schedule D, Part VI
Did the organization report an amount for investments - other securities in Part X, line 12, that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII Did the organization report an amount for investments - program related in Part X, line 13, that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII Did the organization report an amount for other assets in Part X, line 15, that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete Schedule D, Parts XI and XII
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E Did the organization maintain an office, employees, or agents outside of the United States? Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If "Yes," complete Schedule F, Parts II and IV Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If "Yes," complete Schedule F, Parts III and IV Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I See instructions Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I and II Form 990 (2021)
Yes No
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
X
X
X
X
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353
Part IV Checklist of Required Schedules (continued)
Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V 22 22
23 23
24a
24a
b 24b
c
24c
d 24d
25a
25a
b
25b
26 26
27 27
28 a
28a
b 28b
c
28c
29 29
30 30
31 31
32 32
33 33
34 34
35a 35a
b
35b
36 36
37 37
38 38
Yes No
1a 1a
b 1b
c
1c
Form 990 (2021) Page 4
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and III Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b through 24d and complete Schedule K. If "No," go to line 25a Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I
Did the organization report any amount on Part X, line 5 or 22, for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member or any of these persons? If "Yes," complete Schedule L, Part II Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons? If “Yes,” complete Schedule L, Part III
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions, for applicable filing thresholds, conditions, and exceptions):
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If “Yes,” complete Schedule L, Part IV
A family member of any individual described in line 28a? If “Yes,” complete Schedule L, Part IV A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If “Yes,” complete Schedule L, Part IV
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1
Did the organization have a controlled entity within the meaning of section 512(b)(13)? If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization?If "Yes," complete Schedule R, Part V, line 2 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note: All Form 990 filers are required to complete Schedule O.
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable Enter the number of Form W-2G included in line 1a. Enter -0- if not applicable Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? Form 990 (2021)
Yes No
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
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2 0
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354
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? Part V Statements Regarding Other IRS Filings and Tax Compliance Yes No 2a
2a
b 2b
3a 3a
b 3b
4a
4a
b
5a 5a
b 5b
c 5c
6a
6a
b
6b
7 Organizations that may receive deductible contributions under section 170(c). a
7a
b 7b
c
7c
d 7d
e 7e
f 7f
g 7g
h 7h
8 8
9 Sponsoring organizations maintaining donor advised funds. a 9a
b 9b
10 a 10a
b 10b
11 a 11a
b
11b
12a 12a
b 12b
13 Section 501(c)(29) qualified nonprofit health insurance issuers. a 13a
b
13b
c 13c
14a 14a
b 14b
15 15
16 16
17 17
Form 990 (2021) Page 5
(continued)
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return If at least one is reported on line 2a, did the organization file all required federal employment tax returns? Note: If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
Did the organization have unrelated business gross income of $1,000 or more during the year? If "Yes," has it filed a Form 990-T for this year? If "No" to line 3b, provide an explanation on Schedule O At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? If "Yes," enter the name of the foreign country
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? If "Yes" to line 5a or 5b, did the organization file Form 8886-T? Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?
If "Yes," did the organization notify the donor of the value of the goods or services provided? Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?
If "Yes," indicate the number of Forms 8282 filed during the year Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? Did the sponsoring organization make any taxable distributions under section 4966? Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? Section 501(c)(7) organizations. Enter:
Initiation fees and capital contributions included on Part VIII, line 12 Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities Section 501(c)(12) organizations. Enter:
Gross income from members or shareholders
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.)
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? If "Yes," enter the amount of tax-exempt interest received or accrued during the year Is the organization licensed to issue qualified health plans in more than one state? Note: See the instructions for additional information the organization must report on Schedule O.
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans Enter the amount of reserves on hand
Did the organization receive any payments for indoor tanning services during the tax year? If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation on Schedule O Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year?
If "Yes," see instructions and file Form 4720, Schedule N.
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? If "Yes," complete Form 4720, Schedule O.
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952 or 4953? If "Yes," complete Form 6069.
EEA Form 990 (2021)
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
7 X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
355
Part VI Governance, Management, and Disclosure
Section A. Governing Body and Management
Section B. Policies
Section C. Disclosure
1a 1a
b 1b
2 2
3 3
4 4
5 5
6 6
7a
7a
b
7b
8 a 8a
b 8b
9 9
10a 10a
b
10b
11a 11a
b
12a 12a
b 12b
c
12c
13 13
14 14
15 a 15a
b 15b
16a
16a
b
16b
17 18
19 20
Form 990 (2021) Page 6
For each "Yes" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI Enter the number of voting members of the governing body at the end of the tax year If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain on Schedule O.
Enter the number of voting members included in line 1a, above, who are independent Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee?
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? Did the organization become aware during the year of a significant diversion of the organization's assets? Did the organization have members or stockholders?
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body?
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
The governing body?
Each committee with authority to act on behalf of the governing body? Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes," provide the names and addresses on Schedule O (This Section B requests information about policies not required by the Internal Revenue Code.) Did the organization have local chapters, branches, or affiliates? If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Did the organization have a written conflict of interest policy? If "No," go to line 13 Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done
Did the organization have a written whistleblower policy? Did the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? The organization's CEO, Executive Director, or top management official Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements? List the states with which a copy of this Form 990 is required to be filed Section 6104 requires an organization to make its Forms 1023 (1024 or 1024-A if applicable), 990, and 990-T (Section 501(c) (3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
Own website Another's website Upon request Other (explain on Schedule O) Describe on Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
State the name, address, and telephone number of the person who possesses the organization's books and records Form 990 (2021)
Yes No
Yes No
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
X
7 7
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
California
X
DIANA O'CONNELL (805)350-9154, P O BOX 1651, SANTA YNEZ, CA 93460 356
Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
Form 990 (2021) Page 7
Check if Schedule O contains a response or note to any line in this Part VII 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
List all of the organization's current key employees, if any. See instructions for definition of "key employee." List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.
List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations.
List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations.
See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
Form 990 (2021)
(C)
(A) (B) (D) (E) (F) Position
(do not check more than one
Name and title Average box, unless person is both an Reportable Reportable Estimated amount hours officer and a director/trustee) compensation compensation of other per week from the from related compensation or director Individual trustee Institutional trustee Officer Key employee employee Highest compensated Former organization (W-2/ organizations W-2/ from the (list any 1099-MISC/ 1099-MISC/ organization and hours for
1099-NEC) 1099-NEC related organizations
related
organizations
below
dotted line)
EEA
............................
SYV FRUIT & VEGETABLE RESCUE 45-1797788
X
DIANA O'CONNELL 30.00
EXECUTIVE DIRECTOR X 63,479 0 0
HAROLD LITWILER 0.50
DIRECTOR X 0 0 0
ELLEN ALBERTONI 0.50
DIRECTOR X 0 0 0
MARK OVERDUIN 0.50
DIRECTOR X 0 0 0
JANESSA VAN VECHTEN 0.50
SECRETARY X X 0 0 0
ASHLEY COSTA 0.50
TREASURER X X 0 0 0
TERRY DELANEY 2.00
PRESIDENT X 0 0 0
357
Part VII
Section B. Independent Contractors
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
1b Subtotal
c Total from continuation sheets to Part VII, Section A d Total (add lines 1b and 1c)
2 Yes No
3 3
4 4
5 5
1 2
Form 990 (2021) Page 8
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization
Did the organization list any former officer, director, trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization Form 990 (2021)
(C)
(A) (B) (D) (E) (F)
(A) (B) (C)
Position
(do not check more than one
Name and title Average box, unless person is both an Reportable Reportable Estimated amount hours officer and a director/trustee) compensation compensation of other per week from the from related compensation or director Individual trustee Institutional trustee Officer Key employee employee Highest compensated Former organization (W-2/ organizations (W-2/ from the (list any 1099-MISC/ 1099-MISC/ organization and hours for
1099-NEC) 1099-NEC) related organizations
related
organizations
below
dotted line)
Name and business address Description of services Compensation EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
63,479 0 0
0 X
X
X
358
Contributions, Gifts, Grants
and Other Similar Amounts
Business Code
Part VIII Statement of Revenue
1a 1a
b 1b
c 1c
d 1d
e 1e
f
1f
g
1g
h
2a
b
c
d
Revenue
e
Program Service
f
g
3 4
5 6a 6a
b 6b
c 6c
d
7a
7a
b
7b
c 7c
d
8a
Other Revenue
8a
b 8b
c
9a
9a
b 9b
c
10a
10a
b 10b
c
11a
b
c
Revenue
d
Miscellanous
e
12 Form 990 (2021) Page 9
Check if Schedule O contains a response or note to any line in this Part VIII Federated campaigns
Membership dues
Fundraising events
Related organizations
Government grants (contributions)
All other contributions, gifts, grants,
and similar amounts not included above
Noncash contributions included in
lines 1a-1f $
Total. Add lines 1a-1f
All other program service revenue
Total. Add lines 2a-2f
Investment income (including dividends, interest, and
other similar amounts)
Income from investment of tax-exempt bond proceeds
Royalties
Gross rents
Less: rental expenses
Rental income or (loss)
Net rental income or (loss)
Gross amount from
sales of assets
other than inventory
Less: cost or other basis
and sales expenses
Gain or (loss)
Net gain or (loss)
Gross income from fundraising
events (not including $
of contributions reported on line
1c). See Part IV, line 18
Less: direct expenses
Net income or (loss) from fundraising events
Gross income from gaming
activities, See Part IV, line 19
Less: direct expenses
Net income or (loss) from gaming activities
Gross sales of inventory, less
returns and allowances
Less: cost of goods sold
Net income or (loss) from sales of inventory
Business Code
All other revenue
Total. Add lines 11a-11d
Total revenue. See instructions
Form 990 (2021)
(A) (B) (C) (D)
Total revenue Related or exempt Unrelated Revenue excluded function revenue business revenue from tax under
sections 512–514
(i) Real (ii) Personal
(i) Securities (ii) Other
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
18,602
397,607
5,488
416,209
952 952
FISCAL SPONSOR INCOME 561000 15,651 15,651
15,651
432,812 16,603 0 0
359
Part IX Statement of Functional Expenses
1 2
3 4
5 6
7 8
9 10
11 a
b
c
d
e
f
g
12 13
14 15
16 17
18 19
20 21
22 23
24 a
b
c
d
e
25 26
Form 990 (2021) Page 10
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX Do not include amounts reported on lines 6b, 7b,
8b, 9b, and 10b of Part VIII.
Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
Grants and other assistance to domestic
individuals. See Part IV, line 22
Grants and other assistance to foreign
organizations, foreign governments, and
foreign individuals. See Part IV, lines 15 and 16
Benefits paid to or for members
Compensation of current officers, directors,
trustees, and key employees
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Other salaries and wages
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Other employee benefits
Payroll taxes
Fees for services (nonemployees):
Management
Legal
Accounting
Lobbying
Professional fundraising services. See Part IV, line 17 Investment management fees
Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O.)
Advertising and promotion
Office expenses
Information technology
Royalties
Occupancy
Travel
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings
Interest
Payments to affiliates
Depreciation, depletion, and amortization
Insurance
Other expenses. Itemize expenses not covered
above (List miscellaneous expenses on line 24e. If
line 24e amount exceeds 10% of line 25, column
(A) amount, list line 24e expenses on Schedule O.)
All other expenses
Total functional expenses. Add lines 1 through 24e
Joint costs. Complete this line only if the
organization reported in column (B) joint costs
from a combined educational campaign and
fundraising solicitation. Check here if
following SOP 98-2 (ASC 958-720)
Form 990 (2021)
(A) (B) (C) (D)
Total expenses Program service Management and Fundraising expenses general expenses expenses
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
62,322 43,384 6,714 12,224
110,621 103,496 7,125
16,726 13,582 2,126 1,018
1,586 793 793
1,658 829 829
2,079 1,639 198 242
3,781 1,895 1,886
290 145 145
12,535 10,614 1,471 450
200 162 38
1,536 937 586 13
24,740 24,740
17,099 15,951 1,063 85
PROGRAM SUPPLIES 41,099 41,099
FUNDRAISING SUPPLIES 2,084 1,042 1,042
DUES AND SUBSCRIPTIONS 894 447 447
OTHER MISCELLANEOUS 1,112 576 536
5,488 5,488
305,850 266,819 23,128 15,903
360
Part X Balance Sheet
(A) (B)
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
Assets
9 9
10a
10a
b 10b 10c
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
Liabilities
23 23
24 24
25 25
26 26
Organizations that follow FASB ASC 958, check here
and complete lines 27, 28, 32, and 33.
27 27
28 28
Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29 29
30 30
31 31
32 32
Net Assets or Fund Balances
33 33
Form 990 (2021) Page 11
Check if Schedule O contains a response or note to any line in this Part X Beginning of year End of year
Cash - non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
Accounts receivable, net
Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) Notes and loans receivable, net
Inventories for sale or use
Prepaid expenses and deferred charges
Land, buildings, and equipment: cost or other
basis. Complete Part VI of Schedule D
Less: accumulated depreciation
Investments - publicly traded securities
Investments - other securities. See Part IV, line 11
Investments - program-related. See Part IV, line 11
Intangible assets
Other assets. See Part IV, line 11
Total assets. Add lines 1 through 15 (must equal line 33) Accounts payable and accrued expenses
Grants payable
Deferred revenue
Tax-exempt bond liabilities
Escrow or custodial account liability. Complete Part IV of Schedule D Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D
Total liabilities. Add lines 17 through 25
Net assets without donor restrictions
Net assets with donor restrictions
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances
Total liabilities and net assets/fund balances
EEA Form 990 (2021)
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
302,151 261,537
34,903
22,400
3,401 5,107
284,168
112,869 38,580 171,299
366,532 472,846
5,178 12,373
27,948
33,126 12,373
X
273,597 426,537
59,809 33,936
333,406 460,473
366,532 472,846
361
Part XI Reconciliation of Net Assets
Part XII Financial Statements and Reporting
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
Yes No
1 2a 2a
b 2b
c
2c
3a
3a
b
3b
Form 990 (2021) Page 12
Check if Schedule O contains a response or note to any line in this Part XI Total revenue (must equal Part VIII, column (A), line 12) Total expenses (must equal Part IX, column (A), line 25) Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
Other changes in net assets or fund balances (explain on Schedule O) Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
Check if Schedule O contains a response or note to any line in this Part XII Accounting method used to prepare the Form 990: Cash Accrual Other If the organization changed its method of accounting from a prior year or checked "Other," explain on Schedule O.
Were the organization's financial statements compiled or reviewed by an independent accountant? If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis Were the organization's financial statements audited by an independent accountant? If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain on Schedule O.
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why on Schedule O and describe any steps taken to undergo such audits EEA Form 990 (2021)
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
X
432,812
305,850
126,962
333,406
105
460,473
X
X
X
X
362
Name of the organization Employer identification number Schedule A (Form 990) 2021
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
(Form 990)
Public Charity Status and Public Support 2021
SCHEDULE A
Open to Public
Inspection
Part I Reason for Public Charity Status. (All organizations must complete this part.) See instructions.
Attach to Form 990 or Form 990-EZ.
1 2
3 4
5 6
7 8
9 10
11 12
a
b
c
d
e
f
g
Yes No
(A)
(B)
(C)
(D)
(E)
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.) A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).) A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.) A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or university:
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions, subject to certain exceptions; and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.) An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.
Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.
Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.
Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.
Enter the number of supported organizations
Provide the following information about the supported organization(s).
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. (i) Name of supported organization (ii) EIN (iii) Type of organization (iv) Is the organization (v) Amount of monetary (vi) Amount of (described on lines 1-10 listed in your governing support (see other support (see above (see instructions)) document? instructions) instructions) EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
X
363
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Calendar year (or fiscal year beginning in)
1 2
3 4
5 6
Calendar year (or fiscal year beginning in)
7 8
9 10
11 12 12
13 14 14
15 15
16a
b
17a
b
18 (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.")
Tax revenues levied for the
organization's benefit and either paid to
or expended on its behalf
The value of services or facilities
furnished by a governmental unit to the
organization without charge
Total. Add lines 1 through 3
The portion of total contributions by
each person (other than a
governmental unit or publicly
supported organization) included on
line 1 that exceeds 2% of the amount
shown on line 11, column (f)
(a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
Amounts from line 4
Gross income from interest, dividends,
payments received on securities loans,
rents, royalties, and income from
similar sources
Net income from unrelated business
activities, whether or not the business
is regularly carried on
Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part VI.)
Total support. Add lines 7 through 10
Gross receipts from related activities, etc. (see instructions) First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here
Public support percentage for 2021 (line 6, column (f), divided by line 11, column (f)) % Public support percentage from 2020 Schedule A, Part II, line 14 % 33 1/3% support test - 2021. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization 33 1/3% support test - 2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization 10%-facts-and-circumstances test - 2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain in Part VI how the organization meets the facts-and-circumstances test. The organization qualifies as a publicly supported organization
10%-facts-and-circumstances test - 2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain in Part VI how the organization meets the facts-and-circumstances test. The organization qualifies as a publicly supported organization
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Public support. Subtract line 5 from line 4
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
364
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Gifts, grants, contributions, and membership fees
received. (Do not include any "unusual grants.")
Calendar year (or fiscal year beginning in)
1 2
3 4
5 6
7a
b
c
8 Calendar year (or fiscal year beginning in)
9 10a
b
c
11 12
13 14
15 15
16 16
17 17
18 18
19a
b
20 (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total Tax revenues levied for the
organization's benefit and either paid to
or expended on its behalf
The value of services or facilities
furnished by a governmental unit to the
organization without charge
Total. Add lines 1 through 5
Amounts included on lines 1, 2, and 3
received from disqualified persons
Add lines 7a and 7b
Public support. (Subtract line 7c from
line 6.)
(a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (f) Total
Amounts from line 6
Unrelated business taxable income (less
section 511 taxes) from businesses
acquired after June 30, 1975
Add lines 10a and 10b
Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part VI.)
Total support. (Add lines 9, 10c, 11,
and 12.)
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here
Public support percentage for 2021 (line 8, column (f), divided by line 13, column (f)) % Public support percentage from 2020 Schedule A, Part III, line 15 % Investment income percentage for 2021 (line 10c, column (f), divided by line 13, column (f)) % Investment income percentage from 2020 Schedule A, Part III, line 17 % 33 1/3% support tests - 2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions Part III Support Schedule for Organizations Described in Section 509(a)(2) Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
Section D. Computation of Investment Income Percentage
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II.
If the organization fails to qualify under the tests listed below, please complete Part II.)
Gross receipts from admissions, merchandise
sold or services performed, or facilities
furnished in any activity that is related to the
organization's tax-exempt purpose
Gross receipts from activities that are not an
unrelated trade or business under section 513
Amounts included on lines 2 and 3
received from other than disqualified
persons that exceed the greater of $5,000
or 1% of the amount on line 13 for the year
Gross income from interest, dividends,
payments received on securities loans, rents,
royalties, and income from similar sources
Net income from unrelated business
activities not included on line 10b, whether
or not the business is regularly carried on
33 1/3% support tests - 2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
107,413 239,522 251,149 336,029 431,209 1,365,322
107,413 239,522 251,149 336,029 431,209 1,365,322
1,365,322
107,413 239,522 251,149 336,029 431,209 1,365,322
1 1 970 952 1,924
1 1 970 952 1,924
107,413 239,523 251,150 336,999 432,161 1,367,246
99.86 99.91
0.00 0.00
X
365
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Yes No
1 1
2 2
3a
3a
b
3b
c
3c
4a
4a
b
4b
c
4c
5a
5a
b
5b
c 5c
6 6
7 7
8 8
9a
9a
b
9b
c
9c
10a
10a
b
10b
Are all of the organization's supported organizations listed by name in the organization's governing documents? If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain.
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
Was any supported organization not organized in the United States ("foreign supported organization")? If "Yes," and if you checked 12a or 12b in Part I, answer lines 4b and 4c below.
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If "Yes," describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If "Yes," explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
Did the organization add, substitute, or remove any supported organizations during the tax year? If "Yes," answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
Substitutions only. Was the substitution the result of an event beyond the organization's control? Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If "Yes," provide detail in Part VI.
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (as defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If "Yes," complete Part I of Schedule L (Form 990).
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If "Yes," complete Part I of Schedule L (Form 990).
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If "Yes," provide detail in Part VI.
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If "Yes," provide detail in Part VI.
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If "Yes," provide detail in Part VI.
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If "Yes," answer 10b below.
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) Part IV Supporting Organizations
Section A. All Supporting Organizations
(Complete only if you checked a box in line 12 on Part I. If you checked box 12a, Part I, complete Sections A and B. If you checked box 12b, Part I, complete Sections A and C. If you checked box 12c, Part I, complete Sections A, D, and E. If you checked box 12d, Part I, complete Sections A and D, and complete Part V.)
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
366
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Yes No
11 a
11a
11b
11c
Yes No
1 1
2 2
Yes No
1 1
Yes No
1 1
2 2
3 3
1 a
b
c
2 Yes No
a
2a
b
2b
3 a
3a
b
3b
Has the organization accepted a gift or contribution from any of the following persons? A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization? A family member of a person described in line 11a above? A 35% controlled entity of a person described in 11a or 11b above? If "Yes" to line 11a, 11b, or 11c, provide detail in Part VI.
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If "Yes," explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization.
Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organization(s)? If "No," describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
By reason of the relationship described in line 2, above, did the organization's supported organizations have a significant voice in the organization's investment policies and in directing the use of the organization's income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization's supported organizations played in this regard.
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions).
The organization satisfied the Activities Test. Complete line 2 below.
The organization is the parent of each of its supported organizations. Complete line 3 below.
Activities Test. Answer lines 2a and 2b below.
Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
Did the activities described on line 2a, above, constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement.
Parent of Supported Organizations. Answer lines 3a and 3b below.
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? If "Yes" or "No," provide details in Part VI.
Part IV
Section B. Type I Supporting Organizations
Section C. Type II Supporting Organizations
Section D. All Type III Supporting Organizations
Section E. Type III Functionally Integrated Supporting Organizations Supporting Organizations (continued)
b
c
Did the governing body, members of the governing body, officers acting in their official capacity, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's officers, directors, or trustees at all times during the tax year? If "No," describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization's activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove officers, directors, or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).
Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
367
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
1 Section A - Adjusted Net Income
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
Section B - Minimum Asset Amount
1 a 1a
b 1b
c 1c
d 1d
e
2 2
3 3
4 4
5 5
6 6
7 7
8 8
Section C - Distributable Amount
1 1
2 2
3 3
4 4
5 5
6 6
7 Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E. (B) Current Year (A) Prior Year (optional)
Net short-term capital gain
Recoveries of prior-year distributions
Other gross income (see instructions)
Add lines 1 through 3.
Depreciation and depletion
Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) Other expenses (see instructions)
Adjusted Net Income (subtract lines 5, 6, and 7 from line 4) (B) Current Year (A) Prior Year (optional)
Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):
Average monthly value of securities
Average monthly cash balances
Fair market value of other non-exempt-use assets
Total (add lines 1a, 1b, and 1c)
Discount claimed for blockage or other factors
(explain in detail in Part VI):
Acquisition indebtedness applicable to non-exempt-use assets Subtract line 2 from line 1d.
Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).
Net value of non-exempt-use assets (subtract line 4 from line 3) Multiply line 5 by 0.035.
Recoveries of prior-year distributions
Minimum Asset Amount (add line 7 to line 6)
Current Year
Adjusted net income for prior year (from Section A, line 8, column A) Enter 0.85 of line 1.
Minimum asset amount for prior year (from Section B, line 8, column A) Enter greater of line 2 or line 3.
Income tax imposed in prior year
Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions).
Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see instructions).
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
368
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Section D - Distributions Current Year
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
(ii) (iii) (i) Underdistributions Distributable Excess Distributions Pre-2021 Amount for 2021 1 2
3 a
b
c
d
e
f
g
h
i
j
4 a
b
c
5 6
7 8
a
b
c
d
e
Amounts paid to supported organizations to accomplish exempt purposes Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
Administrative expenses paid to accomplish exempt purposes of supported organizations Amounts paid to acquire exempt-use assets
Qualified set-aside amounts (prior IRS approval required) - provide details in Part VI) Other distributions (describe in Part VI). See instructions.
Total annual distributions. Add lines 1 through 6.
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions.
Distributable amount for 2021 from Section C, line 6
Line 8 amount divided by line 9 amount
Section E - Distribution Allocations (see instructions) Distributable amount for 2021 from Section C, line 6
Underdistributions, if any, for years prior to 2021
(reasonable cause required - explain in Part VI). See
instructions.
Excess distributions carryover, if any, to 2021
From 2016
From 2017
From 2018
From 2019
From 2020
Total of lines 3a through 3e
Applied to underdistributions of prior years
Applied to 2021 distributable amount
Carryover from 2016 not applied (see instructions)
Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
Distributions for 2021 from
Section D, line 7: $
Applied to underdistributions of prior years
Applied to 2021 distributable amount
Remainder. Subtract lines 4a and 4b from line 4.
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. For result
greater than zero, explain in Part VI. See instructions.
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. For result greater than zero, explain in Part VI. See instructions.
Excess distributions carryover to 2022. Add lines 3j
and 4c.
Breakdown of line 7:
Excess from 2017
Excess from 2018
Excess from 2019
Excess from 2020
Excess from 2021
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
369
Schedule A (Form 990) 2021
Schedule A (Form 990) 2021
Part VI Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)
EEA 370
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990) (2021) OMB No. 1545-0047
(Form 990)
Schedule of Contributors
2021
Schedule B
Attach to Form 990 or Form 990-PF.
Employer identification number
Filers of: Section:
General Rule
Special Rules
Go to www.irs.gov/Form990 for the latest information.
Name of the organization
Organization type (check one):
Form 990 or 990-EZ 501(c)( ) (enter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000; or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I (entering "N/A" in column (b) instead of the contributor name and address), II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year $
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990), but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990).
Department of the Treasury
Internal Revenue Service
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
X 3
X
371
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021) Page
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
Noncash
2 Part I
$
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
Name of organization Employer identification number
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
1 COMMUNITY ENVIRONMENTAL COUNCIL
120,431
X
1219 STATE STREET
SANTA BARBARA CA 93101
2 CITY OF BUELLTON
5,550
X
P O BOX 1819
BUELLTON CA 93427
3 CITY OF SOLVANG
10,000
X
1644 OAK STREET
SOLVANG CA 93463
4 HUTTON PARKER FOUNDATION
10,000
X
15 EAST CARRILLO STREET
SANTA BARBARA CA 93101
5 KEVIN AND JANESSA VAN VECHTEN
5,000
X
690 CHELHAM WAY
SANTA BARBARA CA 93108
6 LINDA VISTA FOUNDATION
5,000
X
P O BOX 923
BUELLTON CA 93427
372
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021) Page
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
Noncash
2 Part I
$
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
Name of organization Employer identification number
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
7 MORGAN STANLEY
10,000
X
2005 S BROADWAY
SANTA MARIA CA 93454
8 SANTA BARBARA FOUNDATION
55,000
X
111 CHAPALA SUITE 200
SANTA BARBARA CA 93101
9 SANTA YNEZ VALLEY FOUNDATION
12,500
X
485 ALISAL ROAD SUITE 272
SOLVANG CA 93463
10 SCHLINGER FAMILY FOUNDATION
10,000
X
501 SILVERSIDE ROAD SUITE 123
WILMINGTON DE 19809
11 SG FOUNDATION
10,000
X
P O BOX 444
BUELLTON CA 93427
12 THE DELASKI FAMILY FOUNDATION
53,200
X
1201 CONNECTICUT AVE NW SUITE 300
WASHINGTON DC 20036
373
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021) Page
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
$ Noncash
(a) (b) (c) (d)
No. Name, address, and ZIP + 4 Total contributions Type of contribution Person
Payroll
Noncash
2 Part I
$
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
Name of organization Employer identification number
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
(Complete Part II for
noncash contributions.)
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
13 HERBERT & GERTRUDE LATKIN CHARITABL
7,500
X
UNION BANK P O BOX 2340
SANTA BARBARA CA 93106
14 TOWBES FOUNDATION
12,000
X
33 EAST CARRILLO STREET SUITE 201
SANTA BARBARA CA 93101
374
Name of the organization Employer identification number Held at the End of the Tax Year
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
Open to Public
Inspection
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
Supplemental Financial Statements
2021
SCHEDULE D
(Form 990)
Part I
Part II Conservation Easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
Attach to Form 990.
1 2
3 4
5 Yes No
6 Yes No
1 2
a 2a
b 2b
c 2c
d
2d
3 4
5 Yes No
6 7
8 Yes No
9 1a
b
(i)
(ii)
2 a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.
Total number at end of year
Aggregate value of contributions to (during year)
Aggregate value of grants from (during year)
Aggregate value at end of year
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control? Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit?
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (for example, recreation or education) Preservation of a historically important land area Protection of natural habitat Preservation of a certified historic structure Preservation of open space
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Total number of conservation easements
Total acreage restricted by conservation easements
Number of conservation easements on a certified historic structure included in (a) Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year
Number of states where property subject to conservation easement is located Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year $
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements.
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide in Part XIII the text of the footnote to its financial statements that describes these items.
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
Revenue included on Form 990, Part VIII, line 1 $
Assets included in Form 990, Part X $
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under FASB ASC 958 relating to these items:
Revenue included on Form 990, Part VIII, line 1 $
Assets included in Form 990, Part X $
(a) (b)
Schedule D (Form 990) 2021
Donor advised funds Funds and other accounts
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
375
Part III
Part IV Escrow and Custodial Arrangements.
Part V Endowment Funds.
Part VI Land, Buildings, and Equipment.
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10. 3 a d
b e
c
4 5
Yes No
1a
Yes No
b
c 1c
d 1d
e 1e
f 1f
2a Yes No
b
1a
b
c
d
e
f
g
2 a
b
c
3a
Yes No
(i) 3a(i)
(ii) 3a(ii)
b 3b
4 1a
b
c
d
e
Using the organization's acquisition, accession, and other records, check any of the following that make significant use of its collection items (check all that apply):
Public exhibition Loan or exchange programs
Scholarly research Other
Preservation for future generations
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection? Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X?
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
Beginning balance
Additions during the year
Distributions during the year
Ending balance
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII Beginning of year balance
Contributions
Net investment earnings, gains, and
losses
Grants or scholarships
Other expenditures for facilities and
programs
Administrative expenses
End of year balance
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment %
Permanent endowment %
Term endowment %
The percentages on lines 2a, 2b, and 2c should equal 100%.
Are there endowment funds not in the possession of the organization that are held and administered for the organization by:
Unrelated organizations
Related organizations
If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? Describe in Part XIII the intended uses of the organization's endowment funds.
Land
Buildings
Leasehold improvements
Equipment
Other
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10c.) (a) (b) (c) (d) (e)
(a) (b) (c) (d)
Schedule D (Form 990) 2021
Schedule D (Form 990) 2021
Current year Prior year Two years back Three years back Four years back Description of property Cost or other basis Cost or other basis Accumulated Book value (investment) (other) depreciation
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
284,168 112,869 171,299
171,299
376
Total. (Column (b) must equal Form 990, Part X, col. (B) line 25.) Part VII Investments - Other Securities.
Part VIII Investments - Program Related.
Part IX Other Assets.
Part X Other Liabilities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
(1)
(2)
(3)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
1. 2.
Financial derivatives
Closely-held equity interests
Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.) Total. (Column (b) must equal Form 990, Part X, col. (B) line 13.) Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.) (1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FASB ASC 740. Check here if the text of the footnote has been provided in Part XIII (a) (b) (c)
(a) (b) (c)
(a) (b)
(a) (b)
Schedule D (Form 990) 2021
Schedule D (Form 990) 2021
Description of security or category Book value Method of valuation:
(including name of security) Cost or end-of-year market value Description of investment Book value Method of valuation:
Cost or end-of-year market value
Description Book value
Description of liability Book value
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
377
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Part XIII Supplemental Information.
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a. 1 1
2 a 2a
b 2b
c 2c
d 2d
e 2e
3 3
4 a 4a
b 4b
c 4c
5 5
1 1
2a 2a
b 2b
c 2c
d 2d
e 2e
3 3
4a 4a
b 4b
c 4c
5 5
Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, Part VIII, line 12:
Net unrealized gains (losses) on investments
Donated services and use of facilities
Recoveries of prior year grants
Other (Describe in Part XIII.)
Add lines 2a through 2d
Subtract line 2e from line 1
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIII.)
Add lines 4a and 4b
Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) Total expenses and losses per audited financial statements Amounts included on line 1 but not on Form 990, Part IX, line 25:
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIII.)
Add lines 2a through 2d
Subtract line 2e from line 1
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIII.)
Add lines 4a and 4b
Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Schedule D (Form 990) 2021
Schedule D (Form 990) 2021
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
378
Employer identification number
Schedule O (Form 990) 2021
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
Name of the organization
SCHEDULE O
(Form 990) 2021
Supplemental Information to Form 990 or 990-EZ
Open to Public
Inspection
Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or Form 990-EZ.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
EEA
SYV FRUIT & VEGETABLE RESCUE 45-1797788
01. Form 990 governing body review (Part VI, line 11)
THE BOARD OF DIRECTORS REVIEWS THE FORM 990 PRIOR TO FILING AS AN AGENDIZED ITEM WITH
APPROVAL DOCUMENTED IN THE MINUTES OF MEETING
02. Conflict of interest policy compliance (Part VI, line 12c) THE BOARD OF DIRECTORS MAINTAINS A CONFLICT OF INTEREST POLICY. A DISCLOSURE IS COMPLETED
BY EACH NEW BOARD MEMBER WHICH IS UPDATED EVERY THREE YEARS TO ENSURE COMPLIANCE WITH THIS POLICY.
03. CEO, executive director, top management comp (Part VI, line 15a)
THE BOARD OF DIRECTORS ENSURES THAT COMPENSATION IS FAIR AND STANDARDIZED FOR ALL TOP LEVEL MANAGERS.
04. Other officer or key employee compensation (Part VI, line 15b
THE BOARD OF DIRECTORS PERIODICALLY REVIEWS COMPENSATION STANDARDS ACROSS SIMILAR ORGANIZATIONS.
05. Governing documents, etc, available to public (Part VI, line 19) ANY MEMBER OF THE PUBLIC MAY REQUEST A COPY OF THE FORM 990 BY CONTACTING THE EXECUTIVE DIRECTOR BY PHONE, EMAIL, OR LETTER. THE EXECUTIVE DIRECTOR WILL PROVIDE THE COPY WITHIN 5 BUSINESS DAYS.
06. Explanation of other changes in net assets or fund balances (Part XI, line 9) $99 DIFFERENCE IN PRIOR YEAR FUND BALANCE PLUS $6 ROUNDING FOR 2021 - IMMATERIAL 379
Identifying number
OMB No. 1545-0172
Form
Attachment
Sequence No.
Name(s) shown on return Business or activity to which this form relates (a) Description of property (b) Cost (business use only) (c) Elected cost (b) Month and year (c) Basis for depreciation (d) Recovery (a) Classification of property placed in (business/investment use (e) Convention (f) Method (g) Depreciation deduction period service only-see instructions) Form (2021)
EEA
(Including Information on Listed Property)
1 1
2 2
3 3
4 4
5 5
6 7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
Section A
17 17
18 Section B - Assets Placed in Service During 2021 Tax Year Using the General Depreciation System 19a
b
c
d
e
f
g
h
i
Section C - Assets Placed in Service During 2021 Tax Year Using the Alternative Depreciation System 20a
b
c
d
21 21
22 22
23 23
Note: If you have any listed property, complete Part V before you complete Part I.
Maximum amount (see instructions)
Total cost of section 179 property placed in service (see instructions) Threshold cost of section 179 property before reduction in limitation (see instructions) Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing separately, see instructions
Listed property. Enter the amount from line 29
Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 Tentative deduction. Enter the smaller of line 5 or line 8 Carryover of disallowed deduction from line 13 of your 2020 Form 4562 Section 179 expense deduction. Add lines 9 and 10, but don't enter more than line 11 Carryover of disallowed deduction to 2022. Add lines 9 and 10, less line 12 Note: Don't use Part II or Part III below for listed property. Instead, use Part V. (Don't include listed property. See instructions.)
Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year. See instructions
Property subject to section 168(f)(1) election
Other depreciation (including ACRS)
(Don't include listed property. See instructions.)
MACRS deductions for assets placed in service in tax years beginning before 2021 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here
3-year property
5-year property
7-year property
10-year property
15-year property
20-year property
25-year property 25 yrs. S/L
Residential rental 27.5 yrs. MM S/L
property 27.5 yrs. MM S/L
Nonresidential real 39 yrs. MM S/L
property MM S/L
Class life S/L
12-year 12 yrs. S/L
30-year 30 yrs. MM S/L
40-year 40 yrs. MM S/L
Summary (See instructions.)
Listed property. Enter amount from line 28
Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter here and on the appropriate lines of your return. Partnerships and S corporations - see instructions For assets shown above and placed in service during the current year, enter the portion of the basis attributable to section 263A costs Depreciation and Amortization
2021 4562
179
Part I Election To Expense Certain Property Under Section 179 Part II Special Depreciation Allowance and Other Depreciation Part III MACRS Depreciation
Part IV
4562
Attach to your tax return.
For Paperwork Reduction Act Notice, see separate instructions.
Go to www.irs.gov/Form4562 for instructions and the latest information.
Business income limitation. Enter the smaller of business income (not less than zero) or line 5. See instructions Department of the Treasury
Internal Revenue Service (99)
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SYV FRUIT & VEGETABLE RESCUE FORM 990 - 1 45-1797788
14,362
10,378
24,740
380
(c) (e) (i) (a) (b) (d) (f) (g) (h)
(a) (b) (c) (d) (e) (f)
(e) (b) (a) (c) (d) (f)
Form 4562 (2021) Page
Do you have evidence to support the business/investment use claimed? Basis for depreciation Type of property (list Date placed Cost or other basis Recovery Method/ Depreciation Elected section 179 (business/investment vehicles first) in service period Convention deduction cost use only) Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6 Date amortization Amortization
Description of costs Amortizable amount Code section period or Amortization for this year begins percentage Form (2021)
24a
25 25
26 27
28 28
29 29
Section B - Information on Use of Vehicles
30 31
32 33
34 Yes No Yes No Yes No Yes No Yes No Yes No
35 36
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees 37 Yes No
38 39
40 41
42 43 43
44 44
(Include automobiles, certain other vehicles, certain aircraft, and property used for entertainment, recreation, or amusement.)
Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a, 24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.
Section A - Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.) Special depreciation allowance for qualified listed property placed in service during the tax year and used more than 50% in a qualified business use. See instructions Property used more than 50% in a qualified business use:
Property used 50% or less in a qualified business use:
Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 Add amounts in column (i), line 26. Enter here and on line 7, page 1 Total other personal (noncommuting)
miles driven
Total miles driven during the year. Add
lines 30 through 32
Was the vehicle available for personal
use during off-duty hours?
Was the vehicle used primarily by a more
than 5% owner or related person?
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who aren't more than 5% owners or related persons. See instructions.
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees?
Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners Do you treat all use of vehicles by employees as personal use? Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the vehicles, and retain the information received? Do you meet the requirements concerning qualified automobile demonstration use? See instructions Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," don't complete Section B for the covered vehicles.
Amortization of costs that begins during your 2021 tax year (see instructions):
Amortization of costs that began before your 2021 tax year Total. Add amounts in column (f). See the instructions for where to report 2 Part V Listed Property
Part VI Amortization
4562
Yes No 24b If "Yes," is the evidence written? Yes No
%
%
%
% S/L-
% S/L-
% S/LComplete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
Total business/investment miles driven during
the year (don't include commuting miles)
Total commuting miles driven during the year
Is another vehicle available for personal use?
Business/
investment use
percentage
EEA
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SYV FRUIT & VEGETABLE RESCUE 45-1797788
2020 CHEVY 650 08-02-2021 100.0 124,530 124,530 5 S/L-HY 10,378 10,378
381
Overflow Statement 990 2021
(This page is not filed with the return. It is for your records only.) Name(s) as shown on return FEIN
OVERFLOW.LD
SYV FRUIT & VEGETABLE RESCUE 45-1797788
IN KIND SERVICES
_________________________________________________________ ______________ Description Amount _________________________________________________________ IN KIND GOODS ______________ $ 100 _________________________________________________________ IN KIND SERVICES ______________ 5,388 Total: $______________ ______________ 5,488
PREPAID EXPENSES AND DEPOSITS
_________________________________________________________ ______________ Description Amount _________________________________________________________ DEPOSITS ______________ $ 750 _________________________________________________________ PREPAID INSURANCE ______________ 4,357 Total: $______________ ______________ 5,107
ACCOUNTS PAYABLE AND ACCURED EXPENSES
_________________________________________________________ ______________ Description Amount _________________________________________________________ ACCOUNTS PAYABLE $______________ 4,574 _________________________________________________________ WORKERS COMPENSATION INSURANCE PAYABLE ______________ 2,006 _________________________________________________________ PAYROLL LIABILITIES ______________ 5,793 Total: $ 12,373 ______________ ______________
382
* Item is included in UBIA Depreciation Detail Listing 2021 for Section 199A calculations.
See "UBIA" in lower right corner. (This page is not filed with the return. It is for your records only.) Name(s) as shown on return Social security number/EIN
Basis Business Section Bonus Depreciable Prior Current Accumulated AMT No. Description Date Cost Life Method Rate
Adjustment percentage 179 depreciation Basis Depreciation Depreciation Depreciation Current Program Services
SYV FRUIT & VEGETABLE RESCUE 45-1797788
PAGE 1
1 NISSAN DELIVERY TRUCK 07062012 49,479 100.00 49,479 5 0 49,479 49,479 2 2016 CHEVY CP32003 04092018 59,882 100.00 59,882 5 SL HY 20 32,934 11,976 44,910 11,976 3 2003 HONDA ELEMENT 06302019 1,000 100.00 1,000 5 SL HY 20 300 200 500 200 4 DISPLAY TABLES 05222012 1,044 100.00 1,044 7 0 1,044 1,044 5 SOLAR COOLER 12312018 5,957 100.00 5,957 7 SL HY 14.286 1,702 851 2,553 851 6 SOLAR COOLER 01142019 9,348 100.00 9,348 7 SL HY 14.286 2,670 1,335 4,005 1,335 7 2020 CHEVY 6500XD 18" 08022021 124,530 100.00 124,530 5 SL HY 10 10,378 10,378 10,378 Totals 251,240 251,240 88,129 24,740 112,869 24,740
Land Amount ST ADJ:
Net Depreciable Cost 251,240
CY 179 and CY Bonus
TOTAL CY Depr including 179/bonus 24,740
383
Next Year's Depreciation Worksheet
(This page is not filed with the return. It is for your records only.) 2021 Form Multi-Form Description Date Basis Method Life Deduction Name(s) as shown on return Tax ID Number
SYV FRUIT & VEGETABLE RESCUE 45-1797788
PRG 1 NISSAN DELIVERY TRUCK 07-06-2012 49,479 SL 5
PRG 1 2016 CHEVY CP32003 04-09-2018 59,882 SL 5 11,976
PRG 1 2003 HONDA ELEMENT 06-30-2019 1,000 SL 5 200
PRG 1 DISPLAY TABLES 05-22-2012 1,044 SL 7
PRG 1 SOLAR COOLER 12-31-2018 5,957 SL 7 851
PRG 1 SOLAR COOLER 01-14-2019 9,348 SL 7 1,335
PRG 1 2020 CHEVY 6500XD 18" 08-02-2021 124,530 SL 5 24,906 TOTAL 39,268
384
385
386
387
2021 CA199 Filing Instructions
SYV FRUIT & VEGETABLE RESCUE
Form filed:
CA199 and supplemental forms and schedules
Filing method:
Your return will be e-filed, do not mail your return
Due date:
05-16-2022
Other instructions:
The return reflects neither a refund nor a balance due
388
California Exempt Organization
2021 Annual Information Return 199
043 3651214
Part I
TAXABLE YEAR FORM
Calendar Year 2021 or fiscal year beginning (mm/dd/yyyy) , and ending (mm/dd/yyyy) . . 00 00
00 00
00 00
00 00
00 00
00 00
00 00
00 00
Form 199 2021 Side 1
A I
B
C J
D
K
E L
F M
G N
H
O
Complete Part I unless not required to file this form. See General Information B and C. 1 1
2 2
Receipts 3 3
and
Revenues 4
4 5 5
6 6
7 7
8 8
9 9
Expenses
10 10
11 11
12 12
Filing
Fee 13 13
14 14
15 15
16 16
Sign
Here
Paid
Preparer's
Use Only
Corporation/Organization name California corporation number Additional information. See instructions. FEIN
Street address (suite or room) PMB no.
City State Zip code
Foreign country name Foreign province/state/county Foreign postal code First return Yes No Did the organization have any changes to its guidelines Amended return Yes No not reported to the FTB? See instructions Yes No IRC Section 4947(a)(1) trust Yes No If exempt under R&TC Section 23701d, has the organization Final information return? engaged in political activities? See instructions Yes No Dissolved Surrendered (Withdrawn) Merged/Reorganized Is the organization exempt under R&TC Section 23701g? Yes No Enter date: (mm/dd/yyyy) If "Yes," enter the gross receipts from nonmember sources $ Check accounting method: (1) Cash (2) Accrual (3) Other Is the organization a limited liability company? Yes No Federal return filed? (1) 990T (2) 990PF (3) Sch H (990) Did the organization file Form 100 or Form 109 to report (4) Other 990 series taxable income? Yes No
Is this a group filing? See instructions Yes No Is the organization under audit by the IRS or has the IRS Is this organization in a group exemption Yes No audited in a prior year? Yes No If "Yes," what is the parent's name? Is federal Form 1023/1024 pending? Yes No Date filed with IRS
Gross sales or receipts from other sources. From Side 2, Part II, line 8 Gross dues and assessments from members and affiliates
Gross contributions, gifts, grants, and similar amounts received Total gross receipts for filing requirement test. Add line 1 through line 3.
This line must be completed. If the result is less than $50,000, see General Information B Cost of goods sold
Cost or other basis, and sales expenses of assets sold
Total costs. Add line 5 and line 6
Total gross income. Subtract line 7 from line 4
Total expenses and disbursements. From Side 2, Part II, line 18 Excess of receipts over expenses and disbursements. Subtract line 9 from line 8 Total payments
Use tax. See General Information K
Payments balance. If line 11 is more than line 12, subtract line 12 from line 11 Use tax balance. If line 12 is more than line 11, subtract line 11 from line 12 Penalties and interest. See General Information J
Balance due. Add line 12 and line 15. Then subtract line 11 from the result Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Title Date Telephone
Signature
of officer
Date Check if self- PTIN
Preparer's
signature employed
Firm's FEIN
Firm's name (or yours,
if self-employed)
and address
Telephone
May the FTB discuss this return with the preparer shown above? See instructions Yes No ......................
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CLIENT COPY DO NOT FILE
SYV FRUIT & VEGETABLE RESCUE 3367228
45-1797788
P O BOX 1651
SANTA YNEZ CA 93460
X
X X
X
X
X
X X
X X
X
X X
X
952
431,860
432,812
432,812
305,850
126,962
TERRY DELANEY PRESIDENT 805-350-9154
03/07/2022 X P01328979
HILDA ZACARIAS CPA MPA 77-0394608
801 SOUTH BROADWAY SUITE 17
SANTA MARIA, CA 93454 805-922-9800
X
389
Total gross sales or receipts from other sources. Add line 1 through line 7. Enter here and on Side 1, Part I, line 1 043 3652214
Part II Organizations with gross receipts of more than $50,000 and private foundations regardless of amount of gross receipts - complete Part II or furnish substitute information. 1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
Schedule L Balance Sheet Beginning of taxable year End of taxable year Assets (a) (b) (c) (d)
1 2
3 4
5 6
7 8
9 10 a
b
11 12
13 Total assets
Liabilities and net worth
14 15
16 17
18 19
20 21
22 Total liabilities and net worth
Schedule M-1 Reconciliation of income per books with income per return 1 7
2 3 8
4 5 9
10 6
Gross sales or receipts from all business activities. See instructions 00 Interest 00
Dividends 00
Gross rents 00
Gross royalties 00
Gross amount received from sale of assets (See instructions) 00 Other income. Attach schedule 00
00 Contributions, gifts, grants, and similar amounts paid. Attach schedule 00 Disbursements to or for members 00
Compensation of officers, directors, and trustees. Attach schedule 00 Other salaries and wages 00
Interest 00
Taxes 00
Rents 00
Depreciation and depletion (See instructions) 00
Other expenses and disbursements. Attach schedule 00
Total expenses and disbursements. Add line 9 through line 17. Enter here and on Side 1, Part I, line 9 00 Cash
Net accounts receivable
Net notes receivable
Inventories
Federal and state government obligations
Investments in other bonds
Investments in stock
Mortgage loans
Other investments. Attach schedule
Depreciable assets
Less accumulated depreciation
Land
Other assets. Attach schedule
Accounts payable
Contributions, gifts, or grants payable
Bonds and notes payable
Mortgages payable
Other liabilities. Attach schedule
Capital stock or principal fund
Paid-in or capital surplus. Attach reconciliation
Retained earnings or income fund
Do not complete this schedule if the amount on Schedule L, line 13, column (d), is less than $50,000.
Net income per books Income recorded on books this year Federal income tax not included in this return. Attach schedule Excess of capital losses over capital gains Deductions in this return not charged Income not recorded on books this year. against book income this year.
Attach schedule Attach schedule
Expenses recorded on books this year not Total. Add line 7 and line 8 deducted in this return. Attach schedule Net income per return.
Total. Add line 1 through line 5 Subtract line 9 from line 6 Side 2 Form 199 2021
Receipts
from
Other
Sources
Expenses
and
Disbursements
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45-1797788
128
824
952
62,322
110,621
12,535
120,372
305,850
302,151 261,537
22,400 34,903
126,709 284,168
88,129 38,580 112,689 171,479
3,401 5,107
366,532 473,026
5,178 12,373
27,948
333,406 460,473
366,532 472,846
126,962
126,962 126,962
390
California Form 199 Supporting Statements 2021
California Form 199
Part I - Line 3 --
Name(s) shown on return Identifying Number
(a) (b) (c) (d)
Gross contributions, gifts, grants, and similar amounts received, Part I, Line 3 Contributor's Contributor's Date Amount
Name Address Received Received
CA199ATT.LD
PG01
SYV FRUIT & VEGETABLE RESCUE 45-1797788
COMM ENVIRON COUNCIL1219 STATE STREET VARIOUS 120,431
SANTA BARBARA, CA 93101
CITY OF BUELLTON P O BOX 1819 09-28-2021 5,550
BUELLTON, CA 93427
CITY OF SOLVANG 1644 OAK STREET 08-30-2021 10,000
SOLVANG, CA 93463
HUTTON PARKER FOUND 15 EAST CARRILLO STREET 06-04-2021 10,000 SANTA BARBARA, CA 93101
MM VAN VECHTEN 690 CHELHAM WAY 02-03-2021 5,000
SANTA BARBARA, CA 93108
LINDA VISTA FOUNDATIP O BOX 923 11-10-2021 5,000
BUELLTON, CA 93427
SMITH MORGAN STANLEY2005 S BROADWAY 12-13-2021 10,000
SANTA MARIA, CA 93454
SANTA BARBARA FOUNDA111 CHAPALA SUITE 200 VARIOUS 55,000 SANTA BARBARA, CA 93101
SANTA YNEZ VALLEY FO485 ALISAL ROAD SUITE 272 VARIOUS 12,500 SOLVANG, CA 93463
SCHLINGER FAMILY FOU501 SILVERSIDE ROAD SUITE 123 10-26-2021 10,000 WILMINGTON, DE 19809
SG FOUNDATION P O BOX 444 12-20-2021 10,000
BUELLTON, CA 93427
DELASKI FAMILY FOUND1201 CONNECTICUT AVE NW SUITE 300 04-20-2021 53,200 WASHINGTON, DC 20036
H G LATKIN CHARITABLUNION BANK P O BOX 2340 01-22-2021 7,500 SANTA BARBARA, CA 93106
TOWBES FOUNDATION 33 EAST CARRILLO ST SUITE 201 03-08-2021 12,000 SANTA BARBARA, CA 93101
PAGE TOTAL: 326,181
391
All questions must be answered. If you answer "yes" to any of the questions below, you must attach a separate page providing an explanation and details for each "yes" response. Please review RRF-1 instructions for information required.
Failure to submit this report annually no later than four months and fifteen days after the end of the organization's accounting period may result in the loss of tax exemption and the assessment of a minimum tax of $800, plus interest, and/or fines or filing penalties. Revenue & Taxation Code section 23703; Government Code section 12586.1. IRS extensions will be honored. (For Registry Use Only) ANNUAL REGISTRATION RENEWAL FEE REPORT
TO ATTORNEY GENERAL OF CALIFORNIA
Sections 12586 and 12587, California Government Code
11 Cal. Code Regs. sections 301-306, 309, 311, and 312
ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311, and 312) Make Check Payable to Department of Justice
Less than $50,000 $25 Between $250,001 and $1 milion $100 Between $20,000,001 and $100 million $800 Between $50,000 and $100,000 $50 Between $1,000,001 and $5 million $200 Between $100,000,001 and $500 million $1,000 Between $100,001 and $250,000 $75 Between $5,000,001 and $20 million $400 Greater than $500 million $1,200
PART A - ACTIVITIES
For your most recent full accounting period (beginning ending ) list:
Total Revenue $
Noncash Contributions $ Total Assets $
Program Expenses $ Total Expenses $
PART B - STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT Note:
Yes No
I declare under penalty of perjury that I have examined this report, including accompanying documents, and to the best of my knowledge and belief, the content is true, correct and complete, and I am authorized to sign.
Check if:
Name of Organization Change of address
Amended report List all DBAs and names the organization uses or has used A State Charity Registration Number ddress (Number and Street) City or Town Corporation or Organization No. , State, and ZIP Code Telephone Number E-mail Address Federal Employer ID No.
Total Revenue Fee Total Revenue Fee Total Revenue Fee
(including noncash contributions)
1. During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization and any officer, director or trustee thereof, either directly or with an entity in which any such officer, director or trustee had any financial interest?
2. During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable property or funds?
3. During this reporting period, were any organization funds used to pay any penalty, fine or judgment?
4. During this reporting period, were the services of a commercial fundraiser, fundraising counsel for charitable purposes, or commercial coventurer used?
5. During this reporting period, did the organization receive any governmental funding?
6. During this reporting period, did the organization hold a raffle for charitable purposes?
7. Does the organization conduct a vehicle donation program?
8. Did the organization conduct an independent audit and prepare audited financial statements in accordance with generally accepted accounting principles for this reporting period?
9. At the end of this reporting period, did the organization hold restricted net assets, while reporting negative unrestricted net assets? Signature of Authorized Agent Printed Name Title Date
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
RRF-1
(Rev. 02/2021)
MAIL TO:
Registry of Charitable Trusts
P.O. Box 903447
Sacramento, CA 94203-4470
STREET ADDRESS:
1300 I Street
Sacramento, CA 95814
(916) 210-6400
WEBSITE ADDRESS:
w w w .oag.ca.gov/charities
SYV FRUIT & VEGETABLE RESCUE
P O BOX 1651
CT-0177246
SANTA YNEZ, CA 93460
C336722
805-350-9154 [email protected]
45-1797788
01-01-21 12-31-21
432,812 5,488 472,846
266,819 305,850
X
X
X
X
X
X
X
X
X
TERRY DELANEY PRESIDENT
392
ANNUAL
REGISTRATION RENEWAL FEE REPORT
TO ATTORNEY GENERAL OF CALIFORNIA
STATEMENT INFORMATION
Sections 12586 and 12587, California Government Code
11 Cal. Code Regs. sections 301-306, 309, 311 and 312
CARRFR.LD2
Name as shown on return: FEIN
SYV FRUIT & VEGETABLE RESCUE 45-1797788
THE ORGANIZATION RECEIVED FUNDS FROM THE CITY OF BUELLTON, CA OF $5, 550; THE CITY OF SOLVANG, CA OF $10,000 THROUGH A COMPETITIVE GRANT MAKING PROCESS.
393
Corporation Depreciation
2021 and Amortization 3885
043 7621214
Part I
Part II
Part III
Part IV
Election To Expense Certain Property Under IRC Section 179 1 1
2 2
3 3
4 4
5 5
(a) (b) (c)
6 7 7
8 8
9 9
10 10
11 11
12 12
13 13
Depreciation and Election of Additional First Year Depreciation Deduction Under R&TC Section 24356 (a) (b) (c) (d) (e) (f) (g) (h)
14 15
15 Summary
16 16
17 17
18 18
Amortization
(a) (b) (c) (d) (e) (f) (g)
19 20 20
21 21
22 22
TAXABLE YEAR CALIFORNIA FORM
Attach to Form 100 or Form 100W.
Maximum deduction under IRC Section 179 for California $25,000 Total cost of IRC Section 179 property placed in service Threshold cost of IRC Section 179 property before reduction in limitation $200,000 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- Dollar limitation for taxable year. Subtract line 4 from line 1. If zero or less, enter -0- Description of property Cost (business use only) Elected cost Listed property (elected IRC Section 179 cost)
Total elected cost of IRC Section 179 property. Add amounts in column (c), line 6 and line 7 Tentative deduction. Enter the smaller of line 5 or line 8 Carryover of disallowed deduction from prior taxable years Business income limitation. Enter the smaller of business income (not less than zero) or line 5 IRC Section 179 expense deduction. Add line 9 and line 10, but do not enter more than line 11 Carryover of disallowed deduction to 2022. Add line 9 and line 10, less line 12 Add the amounts in column (g) and column (h). The total of column (h) may not exceed $2,000.
See instructions for line 14, column (h)
Total: If the corporation is electing:
IRC Section 179 expense, add the amount on line 12 and line 15, column (g) or Additional first year depreciation under R&TC Section 24356, add the amounts on line 15, columns (g) and (h) or Depreciation (if no election is made), enter the amount from line 15, column (g) Total depreciation claimed for federal purposes from federal Form 4562, line 22 Depreciation adjustment. If line 17 is greater than line 16, enter the difference here and on Form 100 or Form 100W, Side 1, line 6.
If line 17 is less than line 16, enter the difference here and on Form 100 or Form 100W, Side 2, line 12. (If California depreciation amounts are used to determine net income before state adjustments on Form 100 or Form 100W, no adjustment is necessary) Total. Add the amounts in column (g)
Total amortization claimed for federal purposes from federal Form 4562, line 44 Amortization adjustment. If line 21 is greater than line 20, enter the difference here and on Form 100 or Form 100W, Side 1, line 6. If line 21 is less than line 20, enter the difference here and on Form 100 or Form 100W, Side 2, line 12 FTB 3885 2021
Corporation name California corporation number
Depreciation Depre- Description of property Date acquired Cost or other basis allowed or Life or Depreciation for Additional first ciation allowable rate this year year depreciation (mm/dd/yyyy) in earlier years method Description of property Date acquired Cost or other basis Amortization allowed or R&TC Section Period or Amortization allowable in earlier years (see instr.) percentage for this year (mm/dd/yyyy) ...............................
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PROGRAM SERVICES - 1
SYV FRUIT & VEGETABLE RESCUE C3367228
124,530
25,000
2016 CHEVY CP32 04/09/2018 59,882 32,934 SL 5 11,976
2003 HONDA ELEM 06/30/2019 1,000 300 SL 5 200
SOLAR COOLER 12/31/2018 5,957 1,702 SL 7 851
SOLAR COOLER 01/14/2019 9,348 2,670 SL 7 1,335
2020 CHEVY 6500 08/02/2021 124,530 SL 5 10,378
24,740
24,740
24,740
394
processing of the exempt organization's return or refund is delayed, I authorize the FTB to disclose to the ERO or intermediate service provider the reason(s) for the delay.
I authorize the exempt organization's account to be settled as designated in Part II. If I check Part II, box 4, I authorize an electronic funds withdrawal for the amount listed on line 4a.
Under penalties of perjury, I declare that I am an officer of the above exempt organization and that the information I provided to my electronic return originator (ERO), transmitter, or intermediate service provider and the amounts in Part I above agree with the amounts on the corresponding lines of the exempt organization's 2021 California electronic return. To the best of my knowledge and belief, the exempt organization's return is true, correct, and complete. If the exempt organization is filing a balance due return, I understand that if the Franchise Tax Board (FTB) does not receive full and timely payment of the exempt organization's fee liability, the exempt organization will remain liable for the fee liability and all applicable interest and penalties. I authorize the exempt organization return and accompanying schedules and statements be transmitted to the FTB by the ERO, transmitter, or intermediate service provider. If the I declare that I have reviewed the above exempt organization's return and that the entries on form FTB 8453-EO are complete and correct to the best of my knowledge. (If I am only an intermediate service provider, I understand that I am not responsible for reviewing the exempt organization's return. I declare, however, that form FTB 8453-EO accurately reflects the data on the return.) I have obtained the organization officer's signature on form FTB 8453-EO before transmitting this return to the FTB; I have provided the organization officer with a copy of all forms and information that I will file with the FTB, and I have followed all other requirements described in FTB Pub. 1345, 2021 Handbook for Authorized e-file Providers. I will keep form FTB 8453-EO on file for four years from the due date of the return or four years from the date the exempt organization return is filed, whichever is later, and I will make a copy available to the FTB upon request. If I am also the paid preparer, under penalties of perjury, I declare that I have examined the above exempt organization's return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on all information of which I have knowledge.
Under penalties of perjury, I declare that I have examined the above organization's return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I make this declaration based on all information of which I have knowledge.
California e-file Return Authorization for
Exempt Organizations 2021 8453-EO
043
DO NOT MAIL THIS FORM TO THE FTB
Part I
Part II
Part III
Part IV
Sign
Here
Part V
ERO
Must
Sign
Paid
Preparer
Must
Sign
1 1
2 2
3 3
Settle Your Account Electronically for Taxable Year 2021 4 5
6 7
Declaration of Officer
Date Accepted
TAXABLE YEAR FORM
Electronic Return Information (whole dollars only)
Total gross receipts (Form 199, line 4)
Total gross income (Form 199, line 8)
Total expenses and disbursements (Form 199, line 9)
Electronic funds withdrawal 4a Amount 4b Withdrawal date (mm/dd/yyyy) Banking Information (Have you verified the exempt organization's banking information?) Routing number
Account number Type of account: Checking Savings
Declaration of Electronic Return Originator (ERO) and Paid Preparer. See instructions.
FTB 8453-EO 2021
Exempt Organization name Identifying number
Signature of officer Date Title
Date Check if Check ERO's PTIN
ERO's also paid if selfsignature preparer employed
Firm's FEIN
Firm's name (or yours
if self-employed)
and address ZIP code
Paid Date Check Paid preparer's PTIN
preparer's if selfsignature employed
Firm's FEIN
Firm's name (or yours
if self-employed)
ZIP code and address
........................................
.........................................
................................
SYV FRUIT & VEGETABLE RESCUE 45-1797788
432,812
432,812
305,850
PRESIDENT
HILDA ZACARIAS CPA X X P01328979
HILDA ZACARIAS CPA MPA 77-0394608
801 SOUTH BROADWAY SUITE 17
SANTA MARIA , CA 93454
395
CAOVFLOW State Supporting Statements 2021
CAOVFLOW.LD
Name(s) as shown on return SSN/FEIN
SYV FRUIT & VEGETABLE RESCUE 45-1797788
OTHER INCOME
_________________________________________________________ ______________ Description Amount _________________________________________________________ OTHER INCOME $______________ 824 Total: $______________ ______________ 824
OTHER EXPENSES
_________________________________________________________ ______________ Description Amount _________________________________________________________ PAYROLL TAXES $______________ 16,726 _________________________________________________________ ACCOUNTING ______________ 1,586 _________________________________________________________ ADVERTISING ______________ 2,079 _________________________________________________________ OTHER MISCELLANEOUS ______________ 2,770 _________________________________________________________ OFFICE EXPENSES ______________ 3,781 _________________________________________________________ INFORMATION TECHNOLOGY ______________ 290 TRAVEL_________________________________________________________ ______________ 200 _________________________________________________________ CONFERENCES MEETINGS ETC ______________ 1,536 _________________________________________________________ DEPRECIATION ______________ 24,740 _________________________________________________________ INSURANCE ______________ 17,099 _________________________________________________________ PROGRAM SUPPLIES ______________ 41,099 _________________________________________________________ FUNDRAISING SUPPLIES ______________ 2,084 _________________________________________________________ DUES AND SUBSCRIPTIONS ______________ 894 _________________________________________________________ IN KIND EXPENSES ______________ 5,488 Total: $ 120,372 ______________ ______________
396
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411
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STATE OF CALIFORNIA
RRF-1 DEPARTMENT OF JUSTICE
(Rev 09/2017) ' 1 PAGE l of 5
IN
MAIL TO
Registry of Charitable Trusts
P O Box 903447
Sacramento, CA 94203-4470
(916) 210-6400
STREET ADDRESS
1300 I Street
Sacramento, CA 95814
(916) 210-6400
WEBSITE ADDRESS
m,w.agicaigoilcharitiest
For Registry Use Only)
ANNUAL REGISTRATION RENEWAL FEE REPORT
TO ATTORNEY GENERAL OF CALIFORNIA RECEIVED
Sections 12586 and 12587, California Government Code Attcmev General's Office 11 Cal. Code Regs. sections 301-306, 309, 311, and 312
Failure to submit this report annually no later than four months and fifteen after the end of the organization's accounting period may result in the loss of tax exemption and the assessment of a NOV 2 3 2070 minimum tax of $800, plus interest, and/or fines or filing penalties. Revenue & Taxation Code section 23703; Government Code section 12586.1. IRS extensions will be honored.
Check if: Regiwli y uf Chaillable Tiusts
SYV FRUIT & VEGETABLE RESCUE
Name of Organization
_] Change of address
J Amended report
List all DBAs and names the organization uses or has used P.O. BOX 1651
Address (Number and Street)
State Charity Registration Number CT0177246
SANTA YNEZ, CA 93460
City or Town, State and ZIP Code
(805) 350-9154
Telephone Number
[email protected]
E-mail Address
Corporation or Organization No. 3367228
Federal Employer ID No. 45-1797788
ANNUAL REGISTRATION RENEWAL FEE SCHEDULE (11 Cal. Code Regs. sections 301-307, 311, and 312) Make Check Payable to Department of Justice
GrgsiAnnuaLENPA//Ue Fee Gross Annual Revenue Eec Gross Annual Revenue fee Less than $25,000 0 Between $100,001 and $250,000 $50 Between $1,000,001 and $10 million $150 Between $25,000 and $100,000 $25 Between $250,001 and $1 million $75 Between $10,000,001 and $50 million $225 Greater than $50 million $300
PART A - ACTIVITIES
For your most recent full accounting period (beginning 1/01/19 ending 12/31/19 ) list:
Gross Annual Revenue $ 255,106. Noncash Contributions $ 0. Total Assets $ 265,157.
Program Expenses $ 0. Total Expenses $ 189,865.
PART B - STATEMENTS REGARDING ORGANIZATION DURING THE PERIOD OF THIS REPORT Note: All questions must be answered. If you answer "yes" to any of the questions below, you must attach a separate page providing an explanation and details for each "yes- response. Please review RRF-1 instructions for information required. Yes NO 1 During this reporting period, were there any contracts, loans, leases or other financial transactions between the organization and any officer, director or trustee thereof, either directly or with an entity in which any such officer, director or trustee had any financial interest? 0® 2 During this reporting period, was there any theft, embezzlement, diversion or misuse of the organization's charitable property or funds? Il ® 3 During this reporting period, were any organization funds used to pay any penalty, fine or judgment? 0® 4 During this reporting period, were the services of a commercial fundraiser, fundraising counsel for charitable purposes, or commercial coventurer used?
5 During this reporting period, did the organization receive any governmental funding? 0® 6 During this reporting period, did the organization hold a raffle for charitable purposes? 0® 7 Does the organization conduct a vehicle donation program? 0® 8 Did the organization conduct an independent audit and prepare audited financial statements ill accordance with generally accepted accounting principles for this reporting period? 0® 9 At the end of this reporting period, did the organization hold restricted net assets, while reporting negative unrestricted net assets? Il " '---that I have examined this report, including accompanying documents, and to the best of my knowledge ·ect and complete, and I am authorized to sign.
ae,iare unaer penally 01 perjury i
indlbelief, th
TERRY DELANEY PRESIDENT
Printed Name Title Date
CAEA9801 L 03/19/20 936995
$95
448
Form 990 OMB No 1545-0047
Return of Organization Exempt From Income Tax 2019
(Rev January 2020)
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury • Do not enter social security numbers on this form as it may be made public. Open to Public Internal Revenue Service - Go to www.irs.gov/Form990 for instructions and the latest information. Inspection A For the 2019 calendar year, or tax year beginning , 2019, and ending , Check if applicable· C
Address change SYV FRUIT & VEGETABLE RESCUE
Name change P.O. BOX 1651
- SANTA YNEZ, CA 93460
Initial return
Final return/terminated
Amended return
Application pending F Name and address of principal officer D Employer identification number
45-1797788
E Telephone number
(805) 350-9154
G Gioss receipts $ 257,404.
H(a) Is this a group return for subotdinates 7 Yes No
HO» Are all subordinates included? SAME AS C ABOVE Yes No If "No," attach a list (see instructions)
1 Tax-exempt status: X 501(c)(3) 501(c) ( ) 1 (insert no.) 4947(a)(1) or 527 J Website: WWW. VEGGIERESCUE.ORG H(c) Group exemption number K Form of organization X Corporation Trust Association Other * L Year of formation. 2011 M State of legal domiclie CA Part I Summary
1 Briefly describe the organization's mission or most significant activities: SEE SCHEDIIT,E O -- ------------ ---------- - ---- -ill-- -
RECENED_ ________________
2 62& Thi; B61 -2-CI-Iflt@-oriS-IlizSFIJAdisd61ILued-Its operations or dis**MLBAera196 @maet assets. 3 Number of voting members of the governing body (Part VI, line la) . .. ....... I 3 7 4 Number of independent voting members of the governing body (Part VI, line 1 b) 4 8 5 Total number of individuals employed in calendar year 2019 (Part V, line 28) . 6 Total number of volunteers (estimate if necessary)......... ..... 6 49 NOV 2 3 711?n 5 6 7a Total unrelated business revenue from Part Vill, column (C), line 12 Registry ui·unatilaule } rus» 0 0 b Net unrelated business taxable income from Form 990-T, line 39 ..... . 7b 0.
Prior Year Current Year
8 Contributions and grants (Part Vlll, line lh) 232,504. 251,149. 9 Program service revenue (Part Vlll, line 29)
10 Investment income (Part Vlll, column (A), lines 3,4, and 7* .. . ......... .. 1. 1. 11 Other revenue (Part Vlll, column (A), lines 5, 6d, &, 9(, 10(, and 1 le) 7,017. 3,956. 12 Total revenue - add lines 8 through 11 (must equal Part Vlll, column (A), line 12) 239,522. 255,106. 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 14 Benefits paid to or for members (Part IX, column (A), line 4) 15 Salanes, other compensation, employee benefits (Part IX, column (A), lines 5-10) 73,053. 97,819. 16a Professional fundraising fees (Part IX, column (A), line 11 e). & b Total fundraising expenses (Part IX, column (D), line 25) • 26,826. 17 Other expenses (Part IX, column (A), lines 1la-lld, 1lf-24e) 44,697. 89,748. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25). 117,750. 187,567. 19 Revenue less expenses. Subtract line 18 from line 12. . .. .... . 121,772. 67,539. 8 1 Beginning of Current Year End of Year
20 Total assets (Part X, line 16)..... . 187,416. 265,157. 0 21 Total liabilities (Part X, line 26) .... ... 712. 11,747. 22 Net assets or fund balances. Subtract line 21 from line 20 186,704. 253,410.
Part 11 Signature Block
Under penalties of perjury, 1 declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge Signature of officer Date
HAe * TERRY DELANEY PRESIDENT
Type or print name and title
Print Type preparer's name Preparers signature Date Check | | if PTI N Paid SHERRY THORE, CPA
Preparer Firm's name OWENS & THORE TAX PROFESSIONALS, INC.
USe Only Firm's address * 3568 SAGUNTO- P.O. BOX 397
SANTA YNEZ, CA 93460
May the IRS discuss this return with the preparer shown above? (see instructions) BAA For Paperwork Reduction Act Notice, see the separate instructions. self-employed P00366171
Firm's EIN *- 77-0535701
Phone no (805) 688-6317
X Yes No
TEEA0101L 01/21/20 Form 990 (2019)
449
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE
Part 111 Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part 111 1 Briefly describe the organization's mission:
SEE SCHEDULE 0
45-1797788 Page 2
2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?. . .. . . .. Yes ® No
If "Yes," describe these new services on Schedule O.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?. .El Yes ® No If "Yes," describe these changes on Schedule O.
4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.
Section 501(c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. 4 a (Code: ) (Expenses $ 117,546 . including grants of $ ) (Revenue $ ) -PROy-IDED- FR-E-SH y'BUIT_ AND_ VIETAB-LES_ -TO gliaI-TA-8-L-E_QRPAN-I.ZAT-I-ONS--THAL SE-R-YE -MEA-L-S-QR.
DISTRIBUTE FOOD BY SECURING DONATIONS FROM LOCAL AREA FARMS SO THAT THE CORPORATION'S ye**BS -COUL-P_ G-LE-AN JBE j©NAT-ED »Q®PE ff« f»pa,_ T*80*YL -STO« _ANDZ« -__2 PIATBIBU-TE- -I-T_If)_0-THER _CHNLI-TAW,E_QRPAN-I-ZAT-IPNE_-----_-__-_--__-------_-____ 4 b (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4 c (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4 d Other program services (Describe on Schedule O.)
(Expenses $ including grants of $
4 e Total program service expenses • 117,546.
BAA TEEA0102L 07/31/19
) (Revenue $
Form 990 (2019)
450
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 3 Part IV Checklist of Required Schedules
Yes No
1 Is the organization described in section 501(c)(3) or 4947(a)(1) Cother than a private foundation)? /f 'Yes, ' complete Schedule A. 1 X
2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? /f 'Yes, ' complete Schedule C, Part I 4 Section 501(cX3) organizations. Did the organization engaae in lobbying activities, or have a section 501(h) election in effect during the tax year? /f 'Yes,' complete Schedule C, Part Il . 2 X
3 X
4 X
5 Is the organization a section 501(c)(4), 501(c)(5), or 501 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? /f 'Yes/ complete Schedule C, Part 111 5 X 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? /f 'yes, ' Parti 6 X
complete Schedule D,
7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? /f 'yes, ' complete Schedule D, Part 11 7 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? /f 'Yes, ' complete Schedule D, Part Ill ...,...- 8 X
9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation service€? If 'Yes; complete Schedule D, Part IV. . .. . 10 Did the organization, directly or through a related organization, hold assets in donor-restricted endowments or in quasi endowments? /f 'yes,' complete Schedule D, Part V 9 X
10 X
11 If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, Vill, IX, or X as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? /f 'yes, ' complete Schedule D, Part VI 11 a X
b Did the organization report an amount for investments - other securities in Part X, line 12, that is 5% or more of its total assets reported in Part X, line 16? /f 'yes, ' complete Schedule D, Part VII . . 11 b X c Did the organization report an amount for investments - program related in Part X, line 13, that is 5% or more of its total assets reported in Part X, line 16? /f 'Yes, ' complete Schedule D, Part VI11 . . 11 c X d Did the organization report an amount for other assets in Part X, line 15, that is 5% or more of its total assets reported in Part X, line 16? /f 'Yes, 'complete Schedule D, Part /X. 11 d X e Did the organization report an amount for other habihties In Part X, line 25? /f 'yes, ' complete Schedule D, Part X 11 e X f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's habiltty for uncertain tax positions under FIN 48 (ASC 740)? /f 'Yes,' complete Schedule D, Part X 1lf X 12 a Did the organization obtain separate, Independent audited financial statements for the tax year? /f 'Yes,' complete Schedule D, Parts XI and XII . ......... .. . 12a X
b Was the organization included in consolidated, independent audited financial statements for the tax year? /f 'yes,' and if the organization answered 'No' to line 12a, then completing Schedule D, Parts XI and XII is optional l2b X 13 Is the organization a school described in section 170(b)(1)(A)00? /f 'yes, ' complete Schedule E .. ....... . 13 14a Did the organization maintain an office, employees, or agents outside of the United States?. 14a X b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? /f 'yes,' complete Schedule F, Parts I and IV 14b X 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? /f 'Yes, ' complete Schedule F, Parts //and /V. . . ..... 15 X 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? /f Yes, ' complete Schedule F, Parts ///and /V 16 X 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and Tle? /f 'Yes, ' complete Schedule G, Part I (see instructions> , . 17 X 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIll, lines lc and 8a? /f 'Yes,'complete Schedu/e G, Part // 18 X 19 Did the organization report more than $15,000 of gross income from gaming activities on Part Vlll, line 9a? /f 'Yes, ' complete Schedule G, Part Ill .... . . ..... 19 X
20a Did the organization operate one or more hospital facilities? /f 'yes,' complete Schedule H.. . 20a X b If 'Yes' to line 208, did the organization attach a copy of its audited financial statements to this return? 20b 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? /f 'yes, ' complete Schedule L Parts I and ll BAA TEEA0103L 07/31/19
21 X
Form 990 (2019)
451
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 4 Part IV Checklist of Required Schedules (continued)
Yes No
22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? f 'Yes/ complete Schedule L Parts 1 and 8 22 X 23 Did the organization answer 'Yes' to Part VII, Section A, line 3,4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? /f 'Yes,0 complete Schedule J
24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? /f 'Yes,' answer lines 24b through 24d and complete Schedule K. If 'No, 'go to line 25a
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?.....
d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year? 25 a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? /f 'Yes,' complete Schedule L, Part I.,. b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? /f 'Yes,' complete Schedule L, Part I
23 X
24a X
24b
24c
24d
25a X
25b X
26 Did the organization report any amount on Part X, line 5 or 22, for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or famtly member of any of these persons? /f 'yes,' complete Schedule L, Part ll. 27 Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons? If 'Yes,' complete Schedule L, Part Ill ...
28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions, for applicable filing thresholds, conditions, and exceptions):
a A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? /f 'Yes,' complete Schedule L, Part IV .
b A family member of any individual described in line 28a? /f 'Yes, ' complete Schedule L, Part IV c A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? /f Yes,' complete Schedule L, Part IV. ,...
29 Did the organization receive more than $25,000 in non-cash contributions? /f 'Yes,' complete Schedule M 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? /f 'Yes, ' complete Schedule M
31 Did the organization liquidate, terminate, or dissolve and cease operations? /f 'yes,' complete Schedule N, Part I 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? /f 'Yes, ' complete Schedule N, Part ll
26 X
27 X
28a X
28b X
28c X
29 X
30 X
31 X
32 X
33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If 'Yes, ' complete Schedule R, Part / 34 Was the organization related to any tax-exempt or taxable entity? /f 'yes, ' complete Schedule R, Part Il, Ill, or IV, and Part V, line 1.
358 Did the organization have a controlled entity within the meaning of section 512(b)(13)? b If 'Yes' to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? /f 'yes,' complete Schedule R, Part V, line 2 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If 'Yes:' complete Schedule R, Part V, line 2 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? /f 'yes,' complete Schedule R, Part VI 38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 1lb and 19? Note: All Form 990 filers are required to complete Schedule O .. ....
Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V 33 X
34 X
35a X
35b
36 X
37 X
38 X
Yes No
la Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. | 1 a| 1 b Enter the number of Forms W-2G included in line la. Enter -0- if not applicable | 1 bl o c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? . ,, 1 c X
BAA TEEA0104L 07/31/19 Form 990 (2019)
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Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliance (continued) Yes No
2 a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return 2 al 6 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? 2b X Note: If the sum of lines la and 28 is greater than 250, you may be required to e-file (see instructions) 3 a Did the organization have unrelated business gross income of $1,000 or more during the year? 3a X blf 'Yes,' has it filed a Form 990-T for this year? /f Wo' to hne 34 provide an explanation on Schedule O .. .. .. . Sb 4 a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? 4a X b If 'Yes,' enter the name of the foreign country •
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? 5a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? 5b X c If 'Yes,' to line 5a or 5b, did the organization file Form 8886-T?.. .. . 5c 6 a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? . . 6a X b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? . . . . 6 b
7 Organizations that may receive deductible contributions under section 170(c). a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? .. .. . . 7 a X
b If 'Yes,' did the organization notify the donor of the value of the goods or services provided? 7b c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? 7c X
d If 'Yes,' indicate the number of Forms 8282 filed during the year . | 7 d| e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?.. ........ 7 f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?.. . . , 79
h If the oraanization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a ...... .. 7h
8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?. 8 9 Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 4966? .. . 9 a b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? . . 9b 10 Section 501(cX7) organizations. Enter:
a Initiation fees and capital contributions included on Part Vill, line 12 10a b Gross receipts, included on Form 990, Part Vlll, line 12, for public use of club facilities | 10 b| 11 Section 501(cX12) organizations. Enter:
a Gross income from members or shareholders................ |lla| b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.> ......... . .. .......... . 11 b 12 a Section 4947(aX1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041 ? . 12a b If 'Yes,' enter the amount of tax-exempt interest received or accrued during the year . | 12 b| 13 Section 501(c)(29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? . . . 13a Note: See the instructions for additional information the organization must report on Schedule O. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans | 13 b| c Enter the amount of reserves on hand. | 13 c|
14a Did the organization receive any payments for indoor tanning services during the tax year?, b If 'Yes,' has it filed a Form 720 to report these payments? /f 'No,' provide an explanation on Schedule O . 15 Is the organization subject to the section 4960 tax on payment(s) of more than $1 ,000,000 in remuneration or excess parachute payment(s) during the year?
If 'Yes,' see instructions and file Form 4720, Schedule N. 14a X
14b
15 X
16 Is the organization an educational institution subJect to the section 4968 excise tax on net investment income? 16 X If 'Yes,' complete Form 4720, Schedule O.
BAA TEEA0105L 07/31/19 Form 990 (2019)
453
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 6 Part VI Governance, Management, and Disclosure For each 'Yes' response to lines 2 through 7b below, and for a 'No' response to line 8a, 8b, or 1 Ob below, describe the circumstances, processes, or changes on Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI 134 Section A. Governing Body and Management
Yes No
1 a Enter the number of voting members of the governing body at the end of the tax year If there are material differences in voting rights among members la 7
of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain on Schedule 0. b Enter the number of voting members included on line la, above, who are Independent . 1 b 8 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .. . 2 X
3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, trustees, or key employees to a management company or other person? 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? , . .. 4 X
5 Did the organization become aware during the year of a significant diversion of the organization's assets? 5 X 6 Did the organization have members or stockholders? ... 6 X 7 a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .. .. , 7 a X
b Are any governance decisions of the organization reserved to (or subJect to approval by) members, stockholders, or persons other than the governing body?..... . . 7b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a The governing body? . . Sa X
b Each committee with authority to act on behalf of the governing body? .......... 8b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mamng address? /f 'yes,' provide the names and addresses on Schedule 0 9 X Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) Yes No
10 a Did the organization have local chapters, branches, or affiliates? . .... . 10 a X b If 'Yes; did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? 10b 11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11 a X b Describe in Schedule O the process, if any, used by the organization to review this Form 990. SEE SCHEDULE O 12 a Did the organization have a written conflict of interest policy? /f 'No, ' go to hne 13 12a X b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? 12 b
c Did the organization regularly and consistently monitor and enforce compliance with the policy? /f 'yes, ' describe in Schedule O how this was done ... ...... 12c
13 Did the organization have a written whistleblower policy? ... 13 X 14 Did the organization have a written document retention and destruction policy?. . .. 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official . ..,.. 15a X b Other officers or key employees of the organization ..... . 15 b X If 'Yes' to line 158 or 15b, describe the process in Schedule O (see instructions). 16 a Did the organization Invest In, contribute assets to, or participate In a Joint venture or similar arrangement with a taxable entity during the year? ... . .. . 16a X
b If 'Yes,' did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements?.. ....... . .. .. .. 16 b Section C. Disclosure
17 List the states with which a copy of this Form 990 is required to be filed • NONE -----------------------
18 Section 6104 requires an organization to make its Forms 1023 (1024 or 1024-A, if applicable), 990, and 990-T (Section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
El Own website El Another's website ID Upon request El Other (explain on Schedule 0) 19 Describe on Schedule 0 whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. SEE SCHEDULE 0
20 State the name, address, and telephone number of the person who possesses the organization's books and records • *000=1119=1-u - --··--- 'BIC-Ct 33400 (005; 32I:EWIA.
BAA TEEA0106L 07/31/19 Form 990 (2019)
454
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII .. . El Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
• List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of 'key employee.' • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.
• List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations.
See instructions for the order in which to list the persons above. ] Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C)
(A)
Name and title
Position (do not check more
(B) than one box, unless person
Average is both an officer and a
hours director/trustee)
weerk q (list any g. ' '
organiza- , P 8 3 tions 2 - <D
below w. 5 a N
dotted g $0.
line) g i
(D)
Reportable
compensation from
the organization
(W-2/1099-MISC)
(E)
Reportable
compensation from
related oraanizations
(W-2/1099-MISC)
(F)
Estimated amount
of other
compensation from
the organization
and related
organizations
(1) AMY DERRYBERRY 4 0
-----------
EXECUTIVE DIR. 0 X 47,295. 0. 0.
€)_ MARR_Q-XEBI-UJU _--_-___--_-_ -12 25-
DIRECTOR 0 X 0. 0. 0.
Ce)_ EL-L®N _1*BE-RTQUI_ ___________-1-.
DIRECTOR 0 X 0. 0. 0.
(3)_ HARPLIZ ..LIT-WILE-R- ----------- -0-.3-
DIRECTOR 0 X 0. 0. 0.
0)- IE-RRY -DyLANFJY---------------5--
PRESIDENT 0 X 0. 0. 0.
(5)_ JANE@S-A- YAN_ YE-ClITWL _____-__-1-
SECRETARY 0 X 0. 0. 0.
€)_8811·EY. -COS-TA- _____--_______1_
TREASURER 0 X 0. 0. 0.
®_
(10)
-
91)-
(12)
---
(13)
(14)
BAA TEEA0107L 07/31/19 Form 990 (2019)
455
Form 990 (2019) SU FRUIT & VEGETABLE RESCUE 45-1797788 Page 8 Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (B) (C)
(A)
Name and title
Position
Aveiage (do not check more than one
hours box, unless person is both an
per officer and a director/trustee)
week
<'gey 5/ 1 0 W € i g
related Regq /4-q
* e i
below B O 0
dotted g $4 3
line) -2 g
(D)
Reportable
compensation from
the organization
(W-2/1099-MISC)
(E)
Reportable
compensation from
related oraanizations
(W-2/1099-MISC)
(F)
Estimated amount
of other
compensation from
the organization
and related
organizations
/16)-
93)-
-(18)-
312)-
329)-
/21)-
93)-
-(23)-
92)-
1 b Subtotal. ... .. .... 47,295. 0 . 0.
c Total from continuation sheets to Part VII, Section A. .. 0. 0. 0. d Total (add lineslbandle) ... 47,295. 0. 0.
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 0
Yes No
3 Did the organization list any former officer, director, trustee, key employee, or highest compensated employee on\,ne lac If 'Yes,' complete Schedule J for such individual. 3 X 4 For any individual listed on line la, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? /f 'Yes, ' complete Schedule J for such individual ... ... . . . 4 X
5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? /f 'yes, ' complete Schedule J for such person ...... 5 X Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.
Name and business address
(A) (B) (C)
Description of services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization - 0
BAA TEEA0108L 07/31/19 Form 990 (2019)
456
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 9 Part Vlll 1 Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part Vill (A) (B) (C) (D)
Total revenue Related or Unrelated Revenue
exempt business excluded from tax
function revenue under sections
revenue 512-514
la Federated campaigns . la
b Membership dues. . 1b
c Fundraising events 1c
d Related organizations ld
e Government grants (contributions) le 4,600.
f All other contributions, gifts, grants, and
similar amounts not included above
g Noncash contributions included in
lines la-lf.
h Total. Add lines la-1 f
lf 246,549.
1 g 1,000.
251,149.
Business Code
2a
b
C
d
e
f All other program service revenue
g Total. Add lines 2a-2f
3 Investment income (including dividends, interest, and other similar amounts).
4 Income from investment of tax-exempt bond proceeds. • 5 Royalties.
1. 1.
(i) Real (11) Personal
6 a Gross rents .... 6a
b Less: rental expenses 6b
c Rental income or (loss) 6c
d Net rental income or (loss)
(i) Securities (ii) Other
7 a Gross amount from
sales of assets
other than inventory 7 a
b Less: cost or other basis
and sales expenses 7b
c Gain or (loss) 7c
d Net gain or (loss) .
8 a Gross income from fundraising events
(not including $
of contributions reported on line 1 c)
See Part IV, line 18 8a 6,254.
b Less: direct expenses 8b 2,298.
c Net income or(loss) from fundraising events • 3,956. 3,956. 9 a Gross income from gaming activities.
See Part IV, line 19 .. . 9a
b Less: direct expenses. 9b
c Net income or (loss) from gaming activities -
10 a Gross sales of inventory, less
returns and allowances 10a
b Less: cost of goods sold 10b
c Net income or (loss) from sales of inventory •
Business Code
b
c d All other revenue .
e Total. Add lines 118-1ld
12 Total revenue. See instructions .. 255,106. 0. 0. 3,957.
TEEA0109L 07/31/19 Form 990 (2019)
457
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 10 Part IX Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX (A) (B) (C) (D)
Do not include amounts reported on lines Total expenses Program service Management and Fundraising Bb, 7b, Bb, 9b, and 10b of Part Vill.
expenses general expenses expenses
1 Grants and other assistance to domestic
organizations and domestic governments.
See Part IV, line 21 .
2 Grants and other assistance to domestic
individuals. See Part IV, line 22
3 Grants and other assistance to foreign
organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 4 Benefits paid to or for members
5 Compensation of current officers, directors,
trustees, and key employees . 47,295. 20,457. 12,223. 14,615. 6 Compensation not included above to
disqualified persons (as defined under
section 49580(1)) and persons described
in section 4958(c)(3)(B). . .. 0. 0. 0. 0.
7 Other salaries and wages. . .. . . 44,291 . 35,063. 9,228. 8 Pension plan accruals and contributions
(include section 401(k) and 403(b)
employer contributions)
9 Other employee benefits
10 Payroll taxes. 6,233. 3,778. 1,460. 995.
11 Fees for services (nonemployees):
a Management
b Legal . ,
c Accounting ... 2,429. 1,215. 1,214.
d Lobbying.
e Professional fundraising services. See Part IV, line 17 f Investment management fees .
g Other. (lf line 119 amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O.)
12 Advertising and promotion
13 Office expenses .,,
14 Information technology.. .,.. . ..
15 Royalties . ..
16 Occupancy . ...
17 Travel .
18 Payments of travel or entertainment
expenses for any federal, state, or local
public officials.
3,059. 1,333. 1,124. 602.
4,270. 4,181. 89.
1,750. 1,500. 250.
10,579. 10,579.
19 Conferences, conventions, and meetings
20 Interest ... .
21 Payments to affiliates .
22 Depreciation, depiction, and amortization 12,531. 12,468. 23 Insurance . 14,033. 10,731. 1
63. 669. 1,633.
24 Other expenses. Itemize expenses not
covered above (List miscellaneous expenses
on line 24e. If line 24e amount exceeds 10%
of line 25, column (A) amount, list line 24e
expenses on Schedule O.)
a .GLEANING_ & -D-ELIy.ERY- -__--- 20,756. 20,756.
b gRANT_WRITERS_ __---_-_-_ 7,593. 7,593.
c -SUEP.LIE_S_ ---___---_---_ 4,100. 4,100.
d -TE-LE-PHONE-------------- 1,790. 895. 895.
e Allother expenses . . 6,858. 1,069. 4,714. 1,075.
25 Total functional expenses. Add lines 1 through 24€ . 187,567. 117,546. 43,195. 26,826. 26 Joint costs. Complete this line only if
the organization reported in column (B)
Joint costs from a combined educational
campaign and fundraising solicitation.
Check here • m If following
SOP 98-2 (ASC 958-720)
BAA TEEA0110L 07/31/19 Form 990 (2019)
458
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE
Part X Balance Sheet
Check if Schedule O contains a response or note to any line in this Part X 45-1797788 Page 11
(A) (B)
Beginning of year End of year
1 Cash - non-interest-bearing . 130,497 . 1 211,464.
2 Savings and temporary cash investments 2
3 Pledges and grants receivable, net . 3
4 Accounts receivable, net . . 4
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons . . 5 6 Loans and other receivables from other disqualified persons (as defined under section 4958(0(1)), and persons described in section 4958(c)(3)(B) 6 7 Notes and loans receivable, net .. . ,.,.. . . 7
8 Inventories for sale or use . ....... 8
9 Prepaid expenses and deferred charges . . 9 750.
10a Land, buildings, and equipment: cost or other basis.
Complete Part VI of Schedule D 10a 126,709.
b Less: accumulated depreciation 10b 73,767. 56,919. 10c 52,942. 11 Investments - publicly traded securities . ....,, , 11 12 Investments - other securities. See Part IV, line 11 , 12 13 Investments - program-related. See Part IV, line 11 . 13 14 Intangible assets ... ., ,.. 14
15 Other assets. See Part IV, line 11 . .. 15 1.
16 Total assets. Add lines l through 15 (must equal line 33). . 187,416. 16 265,157. 17 Accounts payable and accrued expenses . . .. . . . 17 9,250 . 18 Grants payable ... .. 18
19 Deferred revenue 19
20 Tax-exempt bond liabilities 20
21 Escrow or custodial account liability. Complete Part IV of Schedule D ... 21 22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons 22 23 Secured mortgages and notes payable to unrelated third parties .. 23 24 Unsecured notes and loans payable to unrelated third parties.. . 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 712. 25 2,497. 26 Total liabilities. Add lines 17 through 25 .. .......... 712. 26 11,747.
Organizations that follow FASB ASC 958, check here • ®
and complete lines 27,28,32, and 33.
27 Net assets without donor restrictions . . . . . . . . . . . 117,082. 27 199,210. 28 Net assets with donor restrictions .. .. ........ 69,622. 28 54,200.
Organizations that do not follow FASB ASC 958, check here - and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds ..... .... 29 30 Paid-in or capital surplus, or land, building, or equipment fund . .. 30 31 Retained earnings, endowment, accumulated income, or other funds ..... 31 32 Total net assets or fund balances ...... ... ....... 186,704. 32 253,410. 33 Total liabilities and net assets/fund balances 187,416. 33 265,157.
BAA TEEA0111L 07/31/19 Form 990 (2019)
459
Form 990 (2019) SYV FRUIT & VEGETABLE RESCUE 45-1797788 Page 12 Part XI Reconciliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI 134 1 Total revenue (must equal Part Vill, column (A), line 12) 1 255,106. 2 Total expenses (must equal Part IX, column (A), line 25) . . 2 187,567. 3 Revenue less expenses. Subtract line 2 from line 1 ... 3 67,539. 4 Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) 4 186,704. 5 Net unrealized gains (losses) on investments 5
6 Donated services and use of facilities . . . 6
7 Investment expenses... . 7
8 Prior period adjustments... .... . . 8
9 Other changes in net assets or fund balances (explain on Schedule O) SEE SCHEDULE 0 9 -833. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))... .. .... 10 253,410.
Part XII Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII Yes No
1 Accounting method used to prepare the Form 990: Cash ®Accrual El Other If the organization changed its method of accounting from a prior year or checked 'Other,' explain in Schedule O.
2a Were the organization's financial statements compiled or reviewed by an independent accountant? If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
El Separate basis El Consolidated basis Both consolidated and separate basis b Were the organization's financial statements audited by an independent accountant? If 'Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
El Separate basis El Consolidated basis El Both consolidated and separate basis c If 'Yes' to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? . .
If the organization changed either its oversight process or selection process during the tax year, explain on Schedule O.
3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
b If 'Yes,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why on Schedule O and describe any steps taken to undergo such audits....
BAA TEEA0112L 01/21/20
2a X
2b X
2c
3a X
3b
Form 990 (2019)
460
Schedule O (Form 990 or 990-EZ) (2019)
Name of the otganization
Employer identification number
SYV FRUIT & VEGETABLE RESCUE 45-1797788
FORM 990, PART I, LINE 1 - ORGANIZATION MISSION OR SIGNIFICANT ACTIVITIES
TO PROVIDE FRESH FRUIT AND VEGETABLES TO CHARITABLE ORGANIZATIONS THAT SERVE MEALS OR
DISTRIBUTE FOOD BY SECURING DONATIONS FROM LOCAL AREA FARMS SO THAT THE CORPORATION'S
VOLUNTEERS CAN GLEAN THE DONATED PRODUCE FROM FIELDS, TRANSPORT, STORE, AND/OR DISTRIBUTE IT TO OTHER CHARITABLE ORGANIZATIONS.
BAA Schedule O (Form 990 or 990-EZ) (2019)
TEEA4902L 08/19/19
461
Schedule O (Form 990 or 990-EZ) (2019)
Name of the organization
Employer identification number
SYV FRUIT & VEGETABLE RESCUE 45-1797788
FORM 990, PART Ill, LINE 1 - ORGANIZATION MISSION
TO PROVIDE FRESH FRUIT AND VEGETABLES TO CHARITABLE ORGANIZATIONS THAT SERVE MEALS
OR DISTRIBUTE FOOD BY SECURING DONATIONS FROM LOCAL AREA FARMS SO THAT THE
CORPORATION'S VOLUNTEERS CAN GLEAN THE DONATED PRODUCE FROM FIELDS, TRANSPORT, STORE, AND/OR DISTRIBUTE IT TO OTHER CHARITABLE ORGANIZATIONS.
BAA Schedule O (Form 990 or 990-EZ) (2019)
TEEA4902L 08/19/19
462
Schedule O (Form 990 or 990-EZ) (2019)
Name of the organization
SYV FRUIT & VEGETABLE RESCUE
FORM 990, PART VI, LINE 11 B - FORM 990 REVIEW PROCESS
NO REVIEW WAS OR WILL BE CONDUCTED.
Employer identification number
45-1797788
BAA Schedule O (Form 990 or 990-EZ) (2019)
TEEA4902L 08/19/19
463
Schedule O (Form 990 or 990-EZ) (2019)
Name of the organization Employer identification number SYV FRUIT & VEGETABLE RESCUE 45-1797788
FORM 990, PART VI, LINE 19 - OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC.
BAA Schedule O (Form 990 or 990-EZ) (2019)
TEEA4902L 08/19/19
464
Schedule O (Form 990 or 990-EZ) (2019)
Name of the organization
SYV FRUIT & VEGETABLE RESCUE
Employer identification number
45-1797788
FORM 990, PART XI, LINE 9
OTHER CHANGES IN NET ASSETS OR FUND BALANCES
PRIOR PERIOD ADJUSTMENT $ -833.
TOTAL $ -833.
BAA Schedule O (Form 990 or 990-EZ) (2019)
TEEA4902L 08/19/19
465
2019 FEDERAL WORKSHEETS PAGE 6
CLIENT 1437 SYV FRUIT & VEGETABLE RESCUE 45-1797788
10/28/20 10:46AM
FORM 990, PART 111, LINE 4E
PROGRAM SERVICES TOTALS
PROGRAM
SERVICES
TOTAL FORM 990 SOURCE
TOTAL EXPENSES 117,546. 117,546. PART IX, LINE 25, COL. B GRANTS 0. 0. PART IX, LINES 1-3, COL. B
REVENUE 0. 0. PART VIII, LINE 2, COL. A
FORM 990, PART IX, LINE 24E
OTHER EXPENSES
(A) (B) (C) (D)
PROGRAM MANAGEMENT
TOTAL SERVICES & GENERAL FUNDRAISING
BOARD MEETING 1,456. 1,456.
BOOTHS 92. 92.
DISPLAY STANDS/BOXES 16. 16.
EDUCATION 1,299. 1,299.
FUEL 1,039. 1,039.
FUEL-FUNDRAISING 343. 343.
GIFTS 103. 103.
HR ADMINISTRATION 586. 586.
POSTAGE AND SHIPPING 699. 75. 624.
REPAIRS & MAINTENANCE 210. 210.
TAXES & LICENSES 60. 60.
WEBSITE 955. 859. 96.
TOTAL $ 6,858. $ 1,069. $ 4,714. $ 1,075.
466
Grant Funding Policy CC 2022-08-08
CITY OF SOLVANG
HUMAN SERVICES GRANT FUNDING
APPLICATION
1. Legal Organization/Agency Name and dba if applicable: Santa Ynez Valley Senior Advisory Council DBA Solvang Senior Center
2. Total funding request: $70,000
3. Contact Person Name, Title within the Organization, Email and phone number:
Ellen Albertoni, Executive Director, [email protected], (805) 688-3793
4. Mailing Address: 1745 Mission Drive, Solvang, CA 93463
5. Physical Address: 1745 Mission Drive, Solvang, CA 93463
6. Organization’s purpose? Goals and objectives?
The purpose of the Solvang Senior Center is to help people age vibrantly. Since 1975, the Solvang Senior Center has offered seniors fellowship and activities that keep their minds sharp, bodies healthy, and spirits soaring. The Center has a history of fiscal responsibility and steady growth in membership levels, programs, and attendance.
The goal of the Solvang Senior Center is to increase the overall health and well-being of Santa Ynez Valley seniors through the provision of nutritional meals, physical, social, and preventive activities at the Solvang Senior Center. To meet this goal, the Senior Center will continue to serve a minimum of 8,000 nutritionally balance meals and provide 2,750 educational opportunities in health, safety, finance, and technology to approximately 1,000 unduplicated Valley aging adults and low-income individuals this fiscal year. 420 of our clients live in Solvang.
We strive to increase services by about 5% each year as our budget allows.
In 2022, the Center provided over 8,000 drive-up meals, 2,750 activities, and 150 bus passes to over 1,000 Santa Ynez Valley seniors.
Here’s what our members say about the Solvang Senior Center:
“The Solvang Senior Center has saved my life three times. It is a wonderful resource for the community.” Jeri Dominguez, member.
“We are so appreciative of all you and your staff and volunteers do to make us seniors welcome, well-nourished with amazing affordable meals, and now sharing all your upcoming local events. We have sent the Fiore’s and the Dullea’s to you and as the Welcome Wagon Chair… I will personally be getting the word out!
We can’t tell you how much we appreciate you and having such wonderful meals that gracious Ann serves up for us; it has taken the time shopping, preparing, cleanup weekly out of our lives and frees us up to do all kinds of needed and fun other activities – we are ever so grateful 467
Grant Funding Policy CC 2022-08-08
for this blessing!!! We can’t wait to be more a part of your newly planned Center!” Tom & Sher Kiley, new members
“It’s a hub to which people to come, not just for food and for exercise, but they pick up produce delivered from the local farmers, they come here to have their taxes done... I look at it as a Community Center rather than just a Senior Center,” shares new member and volunteer. “The to-go lunches have been a godsend to us with our medical challenges and restrictions.
Being able to pick up a balanced meal is a real blessing. Not only are the meals tasty, but the volunteers who man the telephone and the pickup/signup table are very cheerful, helpful, and personable.” Tom and Carolynn Petersen, members.
The Center is open Mon. and Fri. 9:00 AM to 2:00 PM and Tues. through Thurs. 9:00 AM to 4:00 PM. The Center provides:
❖ Daily Lunches
❖ Monthly Drive-Up Dinners
❖ Free AARP Tax Preparation (Over 400 low-income community members) ❖ Outdoor Tai Chi classes in our Tai Chi Garden
❖ Yoga, Pilates, Chair Cycling, and Arthritis Exercise classes ❖ Walking Group
❖ Bridge, Mah Jongg, and other Card Games
❖ Arts & Watercolor Classes
❖ Ukulele Class
❖ Knitting/Fiber Arts Class
❖ Floral Arranging
❖ Book Club
❖ Conversation Circles with Ian Jacobsen
❖ Reduced Cost Dial-A-Ride Passes
❖ Free Yarn, Books, and Puzzles for members
❖ Daily Free Produce and Baked Goods Table for anyone
❖ Care 4 Paws semi-monthly pet clinics
❖ Monthly Newsletter and Birthday Cards Mailed
❖ Seniors Helping Seniors
❖ Vaccine & Wellness Clinics
❖ Knitting for our Troops Group and Mask Sewing Group
❖ Fall Prevention Classes & Educational Speakers
❖ HICAP/Medicare Quarterly Workshops
❖ Monthly Field Trips & Special Guests
❖ Smart Phone Classes - Beginner & Advanced
Most of our members are widows and live alone. Because of their connection with the Solvang Senior Center, they have a network of people to look after their well-being.
7. Program of the funding request? Provide a detailed accounting of what specific program the granted funds will be used for?
We are seeking program funding of $70,000 to provide 3,250 meals ($60,000), 700 hours of educational and exercise classes ($3,500), and senior outreach ($6,500). It is imperative for us to have your support. We operate a modest budget and feel that our partnership with the City of Solvang is mutually beneficial.
468
Grant Funding Policy CC 2022-08-08
The Center serves seniors 55 and greater from throughout the Valley. Approximately 70% of the seniors that come to the Center are moderate to low income. We also have members from two nearby affordable senior housing projects, the Golden Inn & Village, and the Solvang Apartments by the Corporation for Better Housing.
As you know, we have nearly completed our Capital Campaign and will begin construction in 2023. Thank you for allowing us to use the Legion Wing of the Veteran’s Hall during construction.
We are thrilled to offer the residents of Solvang and surrounding communities a beautiful, large space to call their own. We will be able to accommodate the increasing number of seniors in the Santa Ynez Valley. The new space will allow us to:
Almost double our current space for programs and services Allow us to double the number of seniors we serve
Allow us to add programs and classes
Increase health and wellness outcomes for our members
Allow us to hold concurrent activities to increase our offerings Allow us to increase our nutrition and health programs
Provide much-need community group space
Thank you so much for your longstanding commitment to Solvang seniors. The partnership between the Solvang Senior Center and the City of Solvang is mutually beneficial. Solvang seniors can access a senior center with robust programs, which helps them age in place safely at home, and keeps them out of the hospital emergency room, for less than the cost of 1 FTE to the City of Solvang. Thank you for your unwavering support.
8. How many Solvang residents will be impacted by the proposed use of the grant funds? 420
9. What is the organization’s total budget? $229,500
10. What are the sources of revenue for your organization? How are you funded? We are funded through grants, donations, and fundraising efforts.
Source FYE 6/2023 Percentage
Budget ($)
Center Generated $ 41,000 18%
Senior Participation $ 29,000 13%
Board Donations $ 10,000 4%
Fundraisers & Valley Support $ 9,500 4%
Foundation Grants $ 55,000 24%
City of Solvang Grant $ 70,000 31%
County of Santa Barbara Grant $ 15,000 7%
TOTAL INCOME $ 229,500 100%
469
Form 990 OMB No. 1545-0047
Return of Organization Exempt From Income Tax 2020
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury • Do not enter social security numbers on this form as it may be made public. Open*00*m:*I Internal Revenue Service •
Go to www.irs.gov/Form990 for instructions and the latest information. : inspectioh;: i Nvt*#w A For the 2020 calendar year, or tax year beginning 7/01 ,2020, and ending 6/30 ,202021 B Check if applicable: C D Employer identification number Address change SANTA YNEZ VALLEY SENIOR
Name change ADVISORY COUNCIL
- 1745 MISSION DRIVE Initial return
- SOLVANG, CA 93463
Final return/terminated
Amended return
Application pending F Name and address of principal officer: ALICE OLLA
SAME AS C ABOVE
Tax-exempt status: X 501(c)(3) 501(c) ( ) 4 (insert no.) 4947(a)(1) or Website: - N/A
77-0236226
E Telephone number
(805) 688-3793
G Gross receipts $ 364,152.
11(a) Is this a group return for subordinates? Yes No
11(b) Are all subordinates included? L-1 Yes LINO
If "No," attach a list. See instructions
527
H(c) Group exemption number 4
K Form of organization: X Corporation Trust Association Other L Year of formation: M State of legal domicile: CA Pa)'tlf { Summary
1 Briefly describe the organization's mission or most significant activities: TO PROVIDE MEALS, SOCIAL ACTIVITIES, 0 -AND- ASSIST-AN-CE TO-SENI-62 -2- ELLAS P®VIDING A GATHERING PLACE FOR SENIORS AND_ % 56*-UNCry)*90*32®_ P*83*8* 3320(TERG-EN}**TU)*4 -AN-Di DO@*83_*Tik[Yi@=___ 2 Check this box •
[]-lf the organilon discontirILAI its operations gr disposed 67 more tfian- 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line la).................................... 3 11 4 Number of independent voting members of the governing body (Part VI, line lb) ....................... 4 11 5 Total number of individuals employed in calendar year 2020 (Part V, line 2al .......................... 5 4 6 Totalnumber of volunteers (estimate if necessary)................................................... 6 20 7a Total unrelated business revenue from Part Vill, column (C), line 12................................... 7a 0 b Net unrelated business taxable income from Form 990-T, Part IRiE!€12IVED 7b 0.
Attorney General's Office
8 Contributions and grants (Part Vlll, line lh).......,.................................. 9 Program service revenue (Part Vill, line 29) 10 Investment income (Part Vlll, column (A), lines 3,4, and 74#'AR 0 7.20222 11 Other revenue (Part Vill, column (A), lines 5, 64 8c, 9(, 10(, and 1 le). 12 Total revenue - add lines 8 through 11 (must equaR,21•tl¥(01[.Chd,Ntdbtel¥,ifts Prior Year Current Year
256,863. 176,364.
23,676. 29,717.
3,289. 143.
44,548. 147,933.
328,376. 354,157.
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)...................... 14 Benefits paid to or for members (Part IX, column (A), line 4).......................... 23,403. 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10). 75,669. 16 a Professional fundraising fees (Part IX, column (A), line 11 e) . . b Total fundraising expenses earl IX, column (D), line 25) • 4 Ii 2'Al >i 0.-3 I 17 Other expenses (Part IX, column (A), lines 1la-lld, 1lf-24-e). 79,082. 18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25). 178,154. 19 Revenue less expenses. Subtract line 18 from line 12................................ 150,222. 31,434.
72,849.
67,824.
172,107.
182,050.
8 5 Beginning of Current Year End of Year
0 51 20 Total assets (Part X, line 16). 644,294. 817,359. 21 Total liabilities (Part X, line 26)..................................................... 65,293. 59,754.
U 22 Net assets or fund balances. Subtract line 21 from line 20 ..,,........................ 579,001. 757,605.
R•41_[f 1 Signature Block
Under penalties of perjury, 1 declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Signature of officer Date
AFre THOM GARRETT TREASURER
Type or print name and title
PrinUType preparer's name Preparer's signature Date Check if PTIN Paid SHERRY THORE, CPA self-employed P00366171
Preparer Firm' s narne OWENS & THORE TAX PROFESSIONALS, INC.
Use Only Firm's address 3568 SAGUNTO- P.O. BOX 397 Firm's EIN 77-0535701 SANTA YNEZ, CA 93460 Phone no. (805) 688-6317
May the IRS discuss this return with the preparer shown above? See instructions........................................ X Yes No BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA0101L 01/19/21 Form 990 (2020) 470
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 2 Pa¢t 111 bl Statement of Program Service Accomplishments ' Chedk if Schedule Ocontainsaresponse ornote toanyline inthis Partlll..................................................El 1 Briefly describe the organization's mission:
FQ -P-RQUPE _M@AIA -SP-CIAJJ- 4(T-IMIT-IES-, AND_ASS-ISTANCE- -TO ..REN][PRS. =8§ --WF+L ..A-S-ERPYIP-ING- A_ PATH-ERIN-G-P-IJQI--FOR--SERI-PRS--AND- -CO-UNITY_MKMWQR-S-TP__ TA-K-E -P-ART _IN-INTER-G-ENE?3TIRNAL-_ _ -AND- -CO-UNITY_ACJIUJUg_Sz ______________________________________________ 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?........................................................................................ Yes ® No If "Yes," describe these new services on Schedule O.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?.....El Yes ® No If "Yes," describe these changes on Schedule O.
4 Describe the or anization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501 (c)(1) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. 4 a (Code: ) (Expenses $ 90,270. including grants of $ )(Revenue $ ) -PROy-IDE- -EN-T-E-RTAI-NM-EN-T-ANP-SP-CIAR-ACT-IMIT-IER FOR„ -SEN-I-OR-S------------------------ 4 b (Code: ) (Expenses $ 53,727. including grants of $ ) (Revenue $ ) -PRQy.IDE- -BOT- MEAL-S-E-9-R_S-E-NIQ-RE --__ _ ___ _- - - - -- -- - -- - - - -- -- -_ - _ _ -- - - - - _ _ _ - 4 c (Code: ) (Expenses $ 2,055. including grants of $ )(Revenue $ ) -PROy-IDE- -ASS-I-STANCE- -AND -E-DUQA-TION_ E-Q-R_ SE-N-IQRS__-_-_----_--___________________ 4 d Other program services (Describe on Schedule O.)
(Expenses $ including grants of $
4 e Total program service expenses • 146,052.
BAA TEEA0102L 10/07/20
) (Revenue $
Form 990 (2020)
471
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 3 MartiV 4 Checklist of Required Schedules
Yes No
1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? if 'Yes,' complete Schedule A...................................................................................................... 1 X 2 Is the organization required to complete Schedule B, Schedule of Contributors See instructions?....................... 2 X 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for pub\\c offic€? If 'Yes,' complete Schedule C, Part I............................................................... 3 X 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election ineffect duringthe tax year? /f 'Yes,'comp/ete Schedu/e C, Part /1................................................... 4 X 5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? /f 'Yes,' complete Schedule C, Part Ill ....... 5 X 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? /f 'Yes,' complete Schedule D, Part/...........................................................................,................................ 6 X 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? /f 'Yes, ' complete Schedu/e D, Part //.......................... 7 X 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? /f 'Yes,' complete Schedule D, Part 111...................................................,.................................. 8 X 9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X, or provide credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes,' complete Schedule D, Part IV.................................................................... 9 X 10 Did the organization, directly or through a related organization, hold assets in donor-restricted endowments orinquasi endowments? /f 'Yes,'complete Schedu/e D, Part V......................................................, 10 X 11 If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI, VII, Vlll, IX, 7 1 9 r or X as applicable.
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? /f 'Yes,' complete Schedule D, Part VI. 11 a X
b Did the organization report an amount for investments - other securities in Part X, line 12, that is 5% or more of its total assets reported in Part X, line 16? /f 'Yes, ' complete Schedule D, Part W/............................................ 11 b X c Did the organization report an amount for investments - program related in Part X, line 13, that is 5% or more of its total assets reported in Part X, line 16? /f 'Yes, ' complete Schedule D, Part VUL . .. .. .. . .. .. . .. . .. .. .. .. . .. .. .. .. . . . .. .. . . . 11 c X d Did the organization report an amount for other assets in Part X, line 15, that is 5% or more of its total assets reported in Part X, \\ne 167 If 'Yes,' complete Schedule D, Part IX. 11 d X e Did the organization report an amount for other liabilities in Part X, line 25? /f 'Yes/ complete Schedule D, Part X. ...... 11 e X f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? M 'Yes/ complete Schedule D, Part X.... 1lf X 12a Did the organization obtain separate, independent audited financial statements for the tax year? /f 'Yes,' complete Schedule D, Parts XI and XII . . . 12a X
b Was the organization included in consolidated, independent audited financial statements for the tax year? /f 'Yes,' and if the organization answered 'No' to line 123, then completing Schedule D, Parts XI and XII is optional. ................. 12b X 13 Is the organization a school described in section 170(b)(1)(A)(ii)? /f 'Yes, ' complete Schedule E........................ 13 X 14a Did the organization maintain an office, employees, or agents outside of the United States?............................ 14a X b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at$100,000 ormore? /f 'Yes,'comp/ete Schedu/e F, Parts land /V .................................................. 14b X 15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization?/f 'Yes, 'complete Schedu/e F, Parts //and /V.................................................. 15 X 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? /f 'Yes, ' complete Schedule F, Parts W and /V ............................................. 16 X 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and lle? /f 'Yes, ' complete Schedu/e G, Part / See instructions................................... 17 X 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part Vlll, lineslcand 8a? /f 'Yes, 'complete Schedu/e G, Part /1.............................................................. 18 X 19 Did the organization report more than $15,000 of gross income from gaming activities on Part Vlll, line 98? /f 'Yes,' complete Schedule G, Part Ill..................................................................................... 19 X 20a Did the organization operate one or more hospital facilities? if 'Yes, ' complete Schedu/e H...................,........ 20a X b If 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return?..... 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? /f 'Yes,' complete Schedule 1, Parts I and Il BAA TEEA0103L 10/07/20
20b
21 X
Form 990 (2020)
472
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 4 PartfIV« Chepklist of Required Schedules (continued)
Yes No
22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If 'Yes,' complete Schedule /, Parts / and Ni..................................................... 22 X 23 Did the organization answer 'Yes' to Part VII, Section A, line 3,4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? /f 'Yes,' complete Schedule J....................................................................................................... 23 X 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? /f 'Yes,' answer lines 24b through 24d and complete Schedule K. If 'No, 'go to line 25a .
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?................... c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?.
d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?.................. 24a X
24b
24c
24d
25 a Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? if 'Yes, ' complete Schedule L, Part 1............................ 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? /f 'Yes,' complete Schedule L Part /. 25b X
26 Did the organization report any amount on Part X, line 5 or 22, for receivables from or payables to any current or former officer, director, trustee, key emplovee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? /f 'Yes, ' complete Schedu/e L, Part //...................................... 26 X 27 Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons'? If 'Yes,' complete Schedule L, Partlll..................................................................... 77 X 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions, for applicable filing thresholds, conditions, and exceptions):
a A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? /f 'Yes,' complete Schedule L, Part IV. 28a X
b A family member of any individual described in line 288? /f 'Yes, ' complete Schedu/e L, Part /V..,.,.,.......,......... 28b X c A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? /f Yes; complete Schedule L, Part IM.. . .... . . ... . . .. . . . ,, .. .. ,. .. . .. . .. . .. . .. . . . .. . .. .. . .. . .. .. .. .. .. . .. . .. . .. , ,. , . . 28c X 29 Did the organization receive more than $25,000 in non-cash contributions? /f 'Yes,' complete Schedule M............... 29 X 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? /f 'Yes,'comp/ete Schedu/e M ....................................................................... 30 X 31 Did the organization liquidate, terminate, or dissolve and cease operations? /f 'Yes,' complete Schedule N, Part I........ 31 X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? /f 'Yes,' complete Schedu/e N, Part n............................................................................................... 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? /f 'Yes,'comp/ete Schedu/e R, Part /.................................................... 33 X 34 Was the organization related to any tax-exempt or taxable entity? /f 'Yes,' complete Schedule R, Part ll, Ill, or IV, and Part V, line L ................................................................................................ 34 X 35 a Did the organization have a controlled entity within the meaning of section 512(b)(13)?................................ 35a X b If 'Yes' to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? /f 'Yes, 'complete Schedu/e R, Part V, /ine 2.......................... 35b 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If 'Yes,' complete Schedule R, Part V, line 2............................................,.,,.,,,...... 36 X 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? /f 'Yes,' complete Schedule R, Part VI....................... 57 X 38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 1lb and 19? Note: All Form 990 filers are required tocomplete Schedule O..................................................
Art V> Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V. .................................. 38X
Yes No
1 a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable.............. la 3 =*Il *1;} ( 1{ I b Enter the number of Forms W-2G included in line la. Enter -0- if not applicable............ I lbI 0 {99 '*IN,F * c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming /0© 23% 4 (gambling) winnings to prize winners?. 1 c X
BAA TEEA0104L 10/07/20 Form 990 (2020)
473
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226
Paa V Statements Regarding Other IRS Filings and Tax Compliance (continued)
Yes No
2 a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State- ments, filed for the calendar year ending with or within the year covered by this return...... 2 a 4:wBi' . blfat least one is reported on line 2a, did the organization file all required federal employment tax returns?.............. 2b X Note: If the sum of lines la and 2a is greater than 250, you may be required to e-file (see instructions) + 43% 3 a Did the organization have unrelated business gross income of $1,000 or more during the year?......................... 3a X blf 'Yes,' has it filed a Form 990-T for this year? /f 'No' to hne 34 provide an exp/anation on Schedu/e 0...................................... 3b 4 a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?.......... 4a X b If 'Yes,' enter the name of the foreign country•
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?.................... 5a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?............. 5 b X c If 'Yes,' to line 5aor 5b, did the organization file Form 8886-T?...................................................... 5c 6 a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?. 6a X b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?................................................................................................ 6b *?' }4{} % M & 7 Organizations that may receive deductible contributions under section 170(c). a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided tothe payor?. 7a X
blf 'Yes,' did the organization notify the donor of the value of the goods or services provided? 7b c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?.
d If 'Yes,' indicate the number of Forms 8282 filed during the year .......................... 7 d| e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?. 7e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?.............. 7f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?. .
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?.
8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?............................................. 8 9 Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 4966?. 9a b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...................... 9b 10 Section 501(cX7) organizations. Enter: A X
a Initiation fees and capital contributions included on Part Vlll, line 12...................... 10a| b Gross receipts, included on Form 990, Part Vlll, line 12, for public use of club facilities. ....| 10 b| 11 Section 501(cX12) organizations. Enter: w#lk I
a Gross income from members orshareholders............................................ |lla| b Gross income from other sources (Do not net amounts due or paid to other sources against amounts due orreceived from them.)........................i................... 11 b 12a Section 4947(aX1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041 ?.. b If 'Yes,' enter the amount of tax-exempt interest received or accrued during the yea[.......| 12 b| 13 Section 501(c)(29) qualified nonprofit health insurance issuers. als the organization licensed to issue qualified health plans in more than one state?........................
Note: See the instructions for additional information the organization must report on Schedule O. 2 * S -37
12a
13a
4= 4 k EES
b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans..........................|13 b| c Enter the amount of reserves on hand.................................................. | 13c| -. k% b. * 14a Did the organization receive any payments for indoor tanning services during the tax year?............................ 14a X b If 'Yes,' has it filed a Form 720 to report these payments? /f 7Vo,' provide an explanation on Schedule 0................ 14b 15 Is the organization subject to the section 4960 tax on payment(s) of more than $1 ,000,000 in remuneration or excess parachute payment(s) during the year?,.,.....................,.,,,,,,,.,..............................,.... 15 X If 'Yes,' see instructions and file Form 4720. Schedule N. 16 Is the organization an educational institution subject to the section 4968 excise tax on net investment income?. .
If 'Yes,' complete Form 4720, Schedule O.
BAA TEEA0105L 1 0/07/20
16 X
Form 990 (2020)
474
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 6 Paft *13 Gogernance, Management, and Disclosure For each 'Yes' response to lines 2 through 7b be/ow, and for a 'No' response to line 8a, 8b, or 1 Ob below, describe the circumstances, processes, or changes on Schedule O. See instructions.
Check if Schedule Ocontainsaresponse ornote toanyline in this Part VI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . ® Section A. Governing Body and Management
Yes No
la Enter the number of voting members of the governing body at the end of the tax yea[...... la 11 r'"' If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain on Schedule O. 4:ill...1 b Enter the number of voting members included on line la, above, who are independent..... 1b 11 J *ji t% ' * "I' 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other 1 4 -4. 1 3 officer, director, trustee, orkey employee?.....SEE..S.CH.EDULE..O .................................,....,........ 2 X 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, trustees, or key employees to a management company or other person?.......................... 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?................................................................................ 4 X 5 Did the organization become aware during the year of a significant diversion of the organization's assets?.............. 5 X 6 Did the organization have members orstockholders?................................................................ 6 X 7 a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governingbody?.......................................,........................................... 7 a X b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, orpersons other than the governing body?............................................................. 7b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by *43%2%49ft f =W the following: E,%9 .13 & £€Le q
a The governing body?. 8a X
b Each committee with authority to act on behalf ofthe governing body?. ............................................... 8b X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? /f 'Yes, ' provide the names and addresses on Schedule O............................. 9 X Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) Yes No
10 a Did the organization have local chapters, branches, or affiliates?..................................................... 10 a X b If 'Yes,' did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?................................................................ 10b 11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filingtheform?...................... 11 a X b Describe in Schedule O the process, if any, used by the organization to review this Form 990. SEE SCHEDULE O « 44 4 12a Did the organization have a written conflict of interest policy? /f 'No, 'gotoline 13..................................... 12a X b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?.........................................,............................................................ 12b c Did the organization regularly and consistently monitor and enforce compliance with the policy? /f 'Yes,' describe in Schedu/e Ohow this was done .................................................................................... 12 c 13 Did the organization havea written whistleblower policy?............................................................ 13 X 14 Did the organization have a written document retention and destruction policy?,....................................... 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent 4% * 2 h 1 persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official.............................................. 15a X b Other officers orkey employees ofthe organization................................................................. 15 b X If 'Yes' to line 15a or 15b, describe the process in Schedule O (see instructions). 16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?..................................................................................... 16a X b If 'Yes,' did the organization follow a written policy or procedure requiring the organization to evaluate its 0, k *Wil .. participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect tosuch arrangements?.................................................... 16 b Section C. Disclosure
17 List the states with which a copy of this Form 990 is required to be filed • NONE -----------------------------
18 Section 6104 requires an organization to make its Forms 1 023 (1024 or 1 024-A, if applicable), 990, and 990-T (Section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
El Own website El Another's website ® Upon request El Other (explain on Schedule O) 19 Describe on Schedule 0 whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. SEE SCHEDULE 0
20 State the name, address, and telephone number of the person who possesses the organization's books and records • SYV SENIOR ADVISORY COUNCIL 1745 MISSION DRIVE SOLVANG CA 93463 (805) 688-3793 BAA TEEA0106L 10/07/20 Form 990 (2020)
475
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 7 Partvll Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Inddpendent Contractors
Check if Schedule Ocontainsaresponse ornote toanyline in this Part Vil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
• List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of 'key employee.' • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1 099-MISC) of more than $100,000 from the organization and any related organizations.
• List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations.
See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (C)
(A)
Name and title
(1) ELLEN ALBERTONI
------------------
EXECUTIVE DIR.
€)_ JANIEr .AI,IYE-#8 ______
SECRETARY
g)- BAIWAR-A- BEE.ZA ------
DIRECTOR
(9)_ 8L-ICE 33&4 --------
PRESIDENT
0)_ JAN- CkEYWi.GyR ______
VICE PRESIDENT
®- TH-0-M-G-AREE-T.y_ ______
TREASURER
€)- DI-ANE 3*MS-Ty*Il _____
DIRECTOR
0)_ JIM- RIC-HAR-D-SQN---___
DIRECTOR
04 JQE_ SANPUL]@T______
DIRECTOR
(10) DENISE EL AMIN
-------------------
DIRECTOR
(12)
------------------
(13)
-------------------
(14)
-------------------
BAA
Position (do not check more
(B) than one box, unless person
Average is both an officer and a
hours director/trustee)
per
week M==3 0 xex -17
(list any g * MI: 03 42 3 9- 9
hours for 3 a S q a
related 51 g g
organiza- ,-4
-2 i E- m
tions 5 3
line) 0
Z
62 -----------
0 X
4 ----------I
0XX
2 0 X
4 0XX
4 0XX
4 0XX
2 0 X
2 ----------I
0 X
2 0 X
2 -----------I
0 X
-----------I
TEEA0107L 10/07/20
(D)
Reportable
compensation from
the organization
(W-2/1099-MISC)
44,188.
0. 0.
0. 0.
0. 0.
0. 0.
0. (E)
Reportable
compensation from
related oraanizations
(W-2/10§9-MISC)
0. 0.
0. 0.
0. 0.
0. 0.
0. 0.
(F)
Estimated amount
of other
compensation from
the organization
and related
organizations
0. 0.
0. 0.
0. 0.
0. 0.
0. 0.
Form 990 (2020)
476
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 8 Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (B) (C)
(A)
Name and title
Position
Average (do not check more than one
hours box, unless person is both an
per officer and a director/trustee)
week
%2:y 3. *a- s: ir s ggi
relld R 3- 8* 1 * 2
organiza € 9, * 58
- tions
below
dotted i 2 1 1
line) e F £
(D)
Reportable
compensation from
the organization
(W-2/1099-MISC)
(E)
Reportable
compensation from
related oraanizations
(W-2/10§9-MISC)
(F)
Estimated amount
of other
compensation from
the organization
and related
organizations
315)-
93-
-08)-
319)-
329)-
91)_
93)-
-(29-
-(25)-
1 b Subtotal.............,..........,...................,.,.....,..,.,..... * 44,188. 0. 0. c Total from continuation sheets to Part VII, Section A.... . ........ . ...... 0 0, 0 d Total (add lineslband Ic)....... ................... ..,. ,,............... 44,188. 0. 0. 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 0
Yes No
3 Did the organization list any former officer, director, trustee, key employee, or highest compensated employee on Une lal If 'Yes; complete Schedule J for such individual.......................................................... 3 4 For any individual listed on line 1 a, is the sum of reportable compensation and other compensation from 44129 the organization and related organizations greater than $150,000? /f 'Kes,' comp/ete Schedule J for such indiWdual.................................................................................................... 4 X 5 Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individual . I - *si, 14 for services rendered to the organization? /f 'Yes, 0 complete Schedu/e J for such person................................ 5 X Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.
Name and business address
(A) (B) (C)
Description of services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who received more than 7 91.- " 7 i $100,000 of compensation from the organization 4 0
BAA TEEA0108L 10/07/20 Form 990 (2020)
477
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 9 Part Vill Stat,ment of Revenue
Check if Schedule Ocontainsaresponse ornote toanyline in this Part VUL. .. .. . . . . . . . . .. . .. .. . . . . . .. .. . .. .. . .. .. . .. . .. .. . ID (A) (B) (C) CD)
Total revenue Related or Unrelated Revenue
exempt business excluded from tax
function revenue under sections
revenue 512-514
=
t la Federated campaigns la 3, 4 . . 4.61
b Membership dues 1b * ' I ,3 @S
' 1 9# IN S
c Fundraising events 1c 2 M + *i
1/ 1 .
i d Related organizations ld -·
9 W,4 j, . 1 £ t€ d 2
, £ i % Ek
e Government grants (contributions) le 64,892. 2 - E'.7: ' * " x* k 4* ®3 *' 14 = f
5 f All other contributions, gifts, grants, and . 34 ? 4 4 -P 0. 1 1% 2- -2 -A , S '.'421,24. 0 Kil - : - similar amounts not included above 1 f 111,472." =t
g Noncash contributions included in * 9 4 1'
i lines la-lf 19 + , * 3 1 1 . 2
p. 1 1%7 1 ./
h Total. Add lines la-lf 176,364. . .00 3 , + 4 -t.= c .1 , = 1 ' Business Code € 1 0, * 3 /&
2 a -NUTIUTION_ERPGRAM_____ 29,717. 29,717.
b
C
d
e
------------------
f All other program service revenue....
© e®:i;i% 1 € 1
g Total. Add lines 2a-2f............................... 29,717.*4144*: 2: ::3 iii:iia** 3 Investment income (including dividends, interest, and other similar amounts).............................. • 143. 4 Income from investment of tax-exempt bond proceeds •
5 Royalties....,...,...............,.....,............ - 143.
(i) Real (ii) Personal *9 %6 +
6 a Gross rents 6a 32 = 3 33 41 *
b Less rental expenses 6b
c Rental income or (loss) 6c
.'W &
1 45 £ 1§.
d Net rental income or (loss) •
4 3
4 1,6
44' 1
. 3
194 =« A
11 .,4, .
.
k € 2 k %4
(1) Securities (11) Other /1 ./ :I :k% .*
7 a Gross amount from . = 9
3.17 .4,4 1- 12 F AV.1 0 1, - 4 -:= e. 49 7 112 IS kk j y t21 03 mventory la L k€ 3 k -£ I b Less cost or other basis
i 1 1 -43 3k w f j S ka S. =*
F. t
and sales expenses 7b .
4|
c Gain or (loss) 7c i *k' .1, I ; ' 141 _ ''61 , # 3
d Net gain or (loss)
, " * I '
8 a Gross income from fundraising events = - r . k *
(not including $
of contributions reported on Ime 1 0
1 A k#=: a k I ** €4 SE ie ' 32 31.01 kk 6
See Part IV, line 18 8a 157,928. 3 kk 5 f *k# 1
h KNig
b Less direct expenses 8b 9.995. 1 B.,s 0,9 + . 11 -2 ' 1 . - 2':ikli L. r c Net income or (loss) from fundraising events 147,933. 111.f .C -,9 1 ./
9 a Gross income from gaming activities . e t
z
See Part IV, line 19 9a . El ' It'Y
i' T .ji-k'ww'lik2ds 2 - - . . * 'I, 1 E E
b Less. direct expenses 9b 5 k v 8 1,1 .1 414 5 7 4
c Net income or (loss) from gaming activities -
10 a Gross sales of inventory, less......
returns and allowances.......... 10a t.
b Less: cost of goods sold..... 10b
c Net income or (loss) from sales of inven -ory.......... • 0 416 11 - 0
k j a 9 225 §t pt E= S m 1
1 kE . 4
1% 'tk **S'jkk:k=
y :tk tt 1% SS k k %
1la
b
C
Business Code
6--12 -- . i t
D d All other revenue...................
e Total. Add lineslla-lld........................,,,. mVW" " .
12 Total revenue. See instructions. 354,157. 29,717. 0.
A TEEA0109L 10/07/20
143.
Form 990 (2020)
478
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 10 Par' 1¥ g Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX. (A) (B) (C) (D)
Do not include amounts reported on lines Total expenses Program service Management and Fundraising 6b, 7b, 8b, 9b, and 10b of Part VIII. expenses general expenses expenses
1 Grants and other assistance to domestic
organizations and domestic governments.
See Part IV, line 21........................
2 Grants and other assistance to domestic
individuals. See Part IV, line 22. .6*...0./Ill -
. t........ 3 Grants and other assistance to foreign
organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. T §74 /54,4 ) ' (4 3 4 Benefits paid to or for members............ 31,434. 31,434.:t: t: *i : WI/11 00 lf5 Compensation of current officers, directors, trustees, and key employees............... 44,188. 39,769. 4,419. 0. 6 Compensation not included above to
disqualified persons (as defined under
section 49580(1)) and persons described
insection 49580)(3)(B).................... 0. 0. 0. 0.
7 Other salaries and wages . 22,997. 22,997.
8 Pension plan accruals and contributions
(include section 40100 and 403(b)
employer contributions)....................
9 Other employee benefits...................
10 Payroll taxes. 5,664. 5,268.
11 Fees for services (nonemployees):
a Management..............................
b Legal. ....................................
c Accounting. ............................... 10,795.
d Lobbying. ....................,............
e Professional fundraising services. See Part IV, line 17... 1 I *> ' w . . :
f Investment management fees..............
396.
10,795.
4%41/0
g Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O.). .... 12 Advertising and promotion.................
13 Office expenses...........................
14 Information technology.....................
15 Royalties.............,.,.,................
16 Occupancy................................
17 Travel.
18 Payments of travel or entertainment
expenses for any federal, state, or local
public officials............................
5,338. 457. 4,881.
5,803. 5,803.
21,558. 19,403. 2,155.
19 Conferences, conventions, and meetings....
20 Interest............................
21 Payments toaffiliates......................
22 Depreciation, depletion, and amortization. . . . 8,918. 8,918. 23 Insurance. 4,406. 3,172. 1,234.
24 Other expenses Itemize expenses not *
covered above (List miscellaneous expenses ' 2 -
on line 24e If line 24e amount exceeds 10% 0 0 0- 4 : . - 9 * of line 25, column (A) amount, list line 24e , 4 .. , 1¥111 expenses on Schedule 0) i - = * #
I)'{t ; 2 22'I
F i -= 1 3 SS tk *$ B.
4k 4 @} 3 3
'46 s " i
13 14 -=- 11* M
i'*':' % ' ' * , 1 .3 1
§ I. ) . 4 ' I ' /
a VEHICLE_ EXPENSE- --------- 4,665. 3,312. 1,353.
b MEMBERS-H-IP JWEE -------- 2,028. 2,028.
c .PRUITING-AND- PUB-LICATION-S_ - 1,188. 1,188.
d EQARD_EXPENSE_---------- 822. 822.
e All other expenses.....................,.,. 2,303. 2,303. 25 Total functional expenses. Add lines 1 through 24e.... 172,107. 146,052. 26,055. 0. 26 Joint costs. Complete this line only if
the organization reported in column (B)
joint costs from a combined educational
campaign and fundraising solicitation.
Check here • if following
SOP 98-2 (ASC 958-720)................
BAA TEEA0110L 1 0/07/20 Form 990 (2020)
479
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 11 Part Xt Balance Sheet
4 Check if Schedule Ocontainsaresponse ornote toanyline in this Part X . .. .. . .. .. . . .. . .. .. . . .. .. .. . .. .. . .. . .. .. . .. .. . . .. . El (A) (B)
Beginning of year End of year
1 Cash -non-interest-bearing................................................., 291,985. 1 401,253. 2 Savings and temporary cash investments...................................... 125,947. 2 175,947. 3 Pledges and grants receivable, net...............,...............,,........... 3 4 Accounts receivable, net..................................................... 85,156. 4 94,563. 5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons ,.............,.,.... 5 6 Loans and other receivables from other disqualified persons (as defined under :10/.LPLid =1 44 „:4 4 3% %%1:thl %7 section 49580(1)), and persons described in section 4958(c)(3)(ED............. 6 7 Notes and loans receivable, net............................................... 7 8 Inventories for sale oruse...,.,,.....................,.................,..... 8 9 Prepaid expenses and deferred charges....................................... 9 10a Land, buildings, and equipment: cost or other basis.
Complete Part VI of Schedule D 10a 252,046.6*4
b Less: accumulated depreciation.................... 10b 160,891. 96,578. 10c 91,155. 11 Investments - publicly traded securities....................................... 11 12 Investments - other securities. See Part IV, line 11............................ 12 13 Investments - program-related. See Part IV, line 11............................ 13 14 Intangible assets .........................................,..,.,............. 14 15 Other assets. See Part IV, line 11. 44,628. 15 54,441. 16 Total assets. Add lines 1 through 15 (must equal line 33)....................... 644,294. 16 817,359. 17 Accounts payable and accrued expenses...................................... 6,461. 17 3,318. 18 Grants payable.............................................................. 18 19 Deferred revenue...................,........................................ 19 20 Tax-exempt bondliabilities................................................... 20 21 Escrow or custodial account liability. Complete Part IV of Schedule D........... 21 22 Loans and other payables to any current or former officer, director, trustee, W - 1,2 12 key employee, creator or founder, substantial contributor, or 35% Flf =2t*<tsfl JllIH*ij:::h:1 27£1 61.jA. controlled entity or family member of any of these persons..................... 22 23 Secured mortgages and notes payable to unrelated third parties................. 23 24 Unsecured notes and loans payable to unrelated third parties................... 24 25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D. 58,832. 25 56,436. 26 Totalliabilities. Add lines 17 through 25............... . .. ...... ... ....... 65,293. 26 59,754.
Organizations that follow FASB ASC 958, check here • ®
''I ' * -1. /:-M. W Z 1
and complete lines 27,28,32, and 33. , a 4- 4
27 Net assets without donor restrictions. ......................................... 377,820. 27 419,145. 28 Net assets with donor restrictions.....................................0....... 201,181. 28 338,460.
Organizations that do not follow FASB ASC 958, check here • *jjtjj}jjjj}Sil @1%@l }{ >i tt * t * :i {j; ', :s ?k? }}*l: 17 7 J & 1, 196 16 i.24'..£*MX.ail«,4; i z ,
and complete lines 29 through 33. .0 .kiglia"b.......11%. f 29 Capital stock or trust principal, or current funds.............,.................. 29 30 Paid-in or capital surplus, or land, building, or equipment fund.................. 30 31 Retained earnings, endowment, accumulated income, or other funds............ 31 32 Total net assets or fund balances. 579,001. 32 757,605. 33 Total liabilities and net assets/fund balances................................... 644,294. 33 817,359.
TEEA0111 L 10/07/20 Form 990 (2020)
480
Form 990 (2020) SANTA YNEZ VALLEY SENIOR 77-0236226 Page 12 Patt XIi Reconciliation of Net Assets
' Check if Schedule Ocontainsaresponse ornote toanyline in this Part XI. .. . .. .. .. .. .. . . . .. .. . . . . . .. .. . .. .. . .. . . ... . .. .. .. . ® 1 Total revenue (must equal Part Vlll, column (A), line 12)........................................,........ 1 354,157. 2 Total expenses (must equal Part IX, column (A), line 25)................................................. 2 172,107. 3 Revenue less expenses. Subtract line 2 from line 1.......................................,............... 3 182,050. 4 Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)).................. 4 579, 001. 5 Net unrealized gains (losses) on investments,........................................................... 5 6 Donated services and use of facilities................................................................... 6 7 Investment expenses.................................................................................. 7 8 Prior period adjustments............................................................................... 8 9 Other changes in net assets or fund balances (explain on Schedule o) ..SEE..SCHEDULE.O............. 9 -3,446. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))........................................................................................... 10 757,605.
Pait*11 Financial Statements and Reporting
Check if Schedule Ocontainsaresponse ornote toany line in this Part XIL. .....................................,........... n Yes No
1 Accounting method used to prepare the Form 990: Cash ® Accrual El Other If the organization changed its method of accounting from a prior year or checked 'Other,' explain W '. t *w in Schedule O. taa= t I
2a Were the organization's financial statements compiled or reviewed by an independent accountant?..................... 2a X If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a %49% 4> ' separate basis, consolidated basis, or both:
ID Separate basis Consolidated basis El Both consolidated and separate basis b Were the organization's financial statements audited by an independent accountant?. 2b X If 'Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
. 3, ' { kA ·t m
El Separate basis IlConsolidated basis O Both consolidated and separate basis c If 'Yes' to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?. 2c If the organization changed either its oversight process or selection process during the tax year, explain . t . F f on Schedule O.
3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?. 3a X
b If 'Yes,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why on Schedule O and describe any steps taken to undergo such audits. 3b BAA TEEA0112L 10/19/20 Form 990 (2020)
481
Schedule O (Form 990 or 990-EZ) (2020)
Name of the organization SANTA YNEZ VALLEY SENIOR Employer identification number ADVISORY COUNCIL 77-0236226
FORM 990, PART VI, LINE 2 - BUSINESS OR FAMILY RELATIONSHIP OF OFFICERS, DIRECTORS, ETC.
ONE DIRECTOR AND THE EXECUTIVE DIRECTOR ARE SISTERS.