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CAC 10 30 1997z Qum& U `y OF TNT CULTURAL COMMISSION AGENDA Special Meeting La Quinta Civic Center Council Chambers 78-495 Calle Tampico - La Quinta, CA 92253 October 30, 1997 6:00 PM I. CALL TO ORDER A. Pledge of Allegiance B. Roll Call 11. PUBLIC COMMENT The Chair reserves the right to limit discussion on any topic to five minutes or less. III. CONFIRMATION OF AGENDA Corrections, deletions or reorganization of the agenda IV. CONSENT CALENDAR V. PUBLIC HEARING VI. BUSINESS ITEMS A. Consideration of Community Services Grant Applications VII. CORRESPONDENCE AND WRITTEN MATERIALS VIII. COMMISSIONER ITEMS IX. ADJOURNMENT T � Oz U � .c• CFM OF CULTURAL COMMISSION MEETING DATE: October 30, 1997 ITEM TITLE: Consideration of Community Services Grant Applications :• �• '�� • ll�d� The City Council has asked that the Commission review and make a funding recommendation on the Community Services Grant Applications for Fiscal Year 1997- 98. Staff mailed copies of the applications to the Commission on September 26th to give the Commissioners time to review the proposals. In addition, a table summarizing the grant applications was mailed to the Commission. Commissioners are being asked to bring those applications to the meeting as they are not attached to this staff report. However, an additional copy of the table showing a summary of the grant applications is attached to this staff report. Also, the City Council approved scoring/evaluation sheet is attached for the Commission's use. The seventeen applications reflect multiple interests and disciplines and may not necessarily directly relate to "culture" or "arts". The grant requests total $74,450. The Special Projects Contingency Account, from which the grants will be funded, contains $25,000. It is not known at this time whether the Council will appropriate the entire $25,000 for grant purposes. All grant applicants have been sent a letter inviting them to attend the Cultural Commission Special Meeting on October 30, 1997. A copy of the letter is attached to this staff report. On September 15, 1997, one of the grant applicants (Media Arts Foundation), delivered a letter (attached) and two video tape samples of their work. Commissioners wishing to view the video tapes may contact the City Manager's Office to arrange to view or borrow the tapes. Review the grant applications and make a funding recommendation to the City Council. Kalf- �) &14"Ll Mark Weiss, Assistant City Manager cultstaff68.wpd COMMUNITY SERVICES GRANT APPLICATIONS NAME OF AMOUNT OF PURPOSE OF REQUEST ORGANIZATION REQUEST Miss La Quinta 500 -$700 Senior Center facility use and Pageant insurance fee Friends of the La SOU $3,700 Install phone line for internet Quinta Library access and pay phone charges for one year; $3,000 for books California Desert b0 o $2,500 Choral music program for the Chorale City of La Quinta Community $8,200 Create a community garden and Gardens of the L/5vo organization to support it Coachella Valley La Quinta $1,000 Payment of travel costs, Monarchs Baseball tournament entry fees, Club `o(0 insurance, etc. Martha's Kitchen $20,000 Administrative costs for OLPH Church �-060 organization and to provide ✓ food baskets to families FISH 00 $3,000 Purchase of food supplies and �� distribution costs Family Service of 00 $5,000 Counseling and crisis Coachella Valley intervention for needy families Family YMCA. of $6,000 Subsidized child care programs the Desert/La 0Q Quinta Preschool -)00 The La Quinta Arts $1,850 Liability insurance and a Association 5� permanent sign for the art �n b gallery at the Von's Shopping Center PGA West C $2,500 Partial funding for an Automatic Volunteer Fire �' 1©� External Defibulator Company COMMUNITY SERVICES GRANT APPLICATIONS NAME OF AMOUNT OF PURPOSE OF REQUEST ORGANIZATION REQUEST Volunteers for $2,000 Special equipment for patrols Increased Public (e.g. pager network, night Safety �� vision goggles, etc.) La Quinta-Indio $3,000 Transportation expenses SHARE of the associated with food pickup Desert L�Q� ' ✓ and delivery for needy families San Gorgonio Girl $3,150 Materials for contemporary Scout Council 0 issues programs for girls Humane Society of 090 $2,150 Offset of costs associated with the Desert/Orphan La Quinta pets using Pet Oasis Pet Oasis services Media Arts $4,700 Video/film production Foundation highlighting the arts/culture e which will benefit the i" community Shelter from the $5,000 Emergency shelter for women Storm, Inc. and children in domestic ��0 violence situations ---Jl C:\MyData\WPDocs\CULTURAL COMMISSIOWgrantablempd Tiht 4 s4� Q" 78-495 CALLE TAMPICO — LA QUINTA, CALIFORNIA 92253 — (760) 777-7000 FAX (760) 777-7101 TDD (760) 777-1227 October 2, 1997 Dear Community Services Grant Applicant: Thank you for submitting a Community Services Grant application to the City of La Quinta. The City Council's policy on this grant program includes the review of the applications by the City's Cultural Commission. To facilitate this review, the Cultural Commission has scheduled a special meeting for October 30, 1997 from 6:00 p.m. to 9:00 p.m. The meeting will be held in the Council Chambers at La Quinta City Hall, located at 78-495 Calle Tampico. Applicants are being invited to attend this meeting at which time a brief, three (3) minute presentation may be made by each applicant. In addition, the Commission may ask questions of the applicants. There has been considerable public interest in this grant program. Grant application requests exceed $85,000 while the account from which the grant funds are distributed contains only $25,000 - not all of which is necessarily earmarked for grants. Following review by the Cultural Commission, the Commission's funding recommendation will be forwarded to the City Council for the final grant award determination. The Council is currently scheduled to consider the grant applications and Cultural Commission recommendation during November 1997. If you have any questions regarding the grant process or your application, please call me at (760) 777-7041. Sincerely, gl� , Britt W. Wilson Management Assistant City Manager's Office C. Mark Weiss, Assistant City Manager ,,* MAILING ADDRESS P.O. BOX 1504 LA QUINTA, CALIFORNIA 92253 Sept. 15, 1997 cultural grts Commission, this Note is is to provide additional information pertinent to our grant application which occurred after the application was submitted. Veart Hawkins has joined the Media Arts foundation as editor. He has a degree in film and is an award -winning filmmaker. He also has $ZOk worth of editing equipment so it is no longer to purchase editing equipment. thus the amount requested could be less than the previous amount requested and any hourly rate would be split between the two of us. 9 have also attached two videos to demonstrate examples of our experience. thank you for this opportunity. Sincerely, ?} -CL., tz1l- Diane {teed Director, Media Arts 3oundation COMMUNITY L 3VICES GRANT FY1997-98 SCO. JG SHEET Screening Committee Screening Statement: The Community Services Grant Program seeks to assist organizations who enhance the quality of life of the residents of La Quinta Name of Applicant: Date: Amount Requested: Purpose: Criteria for Scoring Points Total 1. Is application legible and clearly written? (10 pts) Comments: 2. Is application complete, relative to requested information? (10 pts.) Comments: 3. Based on the overall content of the application, is it apparent that the applicant has the ability to manage and deliver the proposed services? (10 pts.) Comments: 4. Is the need statement clear, and are the needs identified? (10 pts.) Comments: 5. Are the goals expressed measurable and specific? (10 pts.) Comments: 6. Is the program of interest and benefit to the City of La Quinta residents? (15 pts.) Comments: 7. Based on the organization's budget, is there a clear need for the funding? (15 pts.) Comments: 8. Is it evident that either the organization is based in La Quinta and serving La Quinta citizens, or the organization is not based in La Quinta but services provided to La Quinta residents is documented? (20 pts.) Comments: Total Possible Points ]QQ Total Project Points 9. If the organization applied for funding in FY96-97, was a Reconciliation Form submitted as requested, by the date requested? Yes No 10. If granted funding in FY96-97, how much funding did the organization receive? C:WyData\WPDoca\GRANTS\C ITYGRANTSCORE.wpd Fan Coa Farnii the L t uinta sa Qi Soci, I 2 M0R4 ANDUM fission � Cultural commission t, City Manager s office TO: Management Assistan Britt W W i►son, FROM: 1 g97 September 26, DATE: lications Community Services Grant ApP find RE: enclosed please Commission meeting referred to the 1997 Com►� been September 25, lications that have summarizing the at the Sep Services Grant app ma ss at the As discussed Community Also attached is a lications copies of the the City Council. the grant review P and renew 9 the actual grant aPP Commission by Commission will be considering applications. T Commission meeting, 1997 Commission special meeting. October 23, 7p4,1. Thank you Very at the October 30, 1997 If you have any questions, please feel free to call me at 777- much. Manager C. Mark Weiss, Assistant City v1 th, it COMMUNITY SERVICES GRANT APPLICATIONS NAME OF AMOUNT OF PURPOSE OF REQUEST ORGANIZATION REQUEST Miss La Quinta "$700 Senior Center facility use and Pageant insurance fee Friends of the La $3,700 Install phone line for internet Quinta Library access and pay phone charges for one year; $3,000 for books California Desert $2,500 Choral music program for the Chorale City of La Quinta Community $8,200 Create a community garden and Gardens of the organization to support it Coachella Valley La Quinta $1,000 Payment of travel costs, Monarchs Baseball tournament entry fees, Club insurance, etc. Martha's Kitchen $20,000 Administrative costs for OLPH Church organization and to provide food baskets to families FISH $3,000 Purchase of food supplies and distribution costs Family Service of $5,000 Counseling and crisis Coachella Valley intervention for needy families Family YMCA of $6,000 Subsidized child care programs the Desert/La Quinta Preschool The La Quinta Arts $1, 850 Liability insurance and a Association permanent sign for the art gallery at the Von's Shopping Center COMMUN11 Y SERVICES GRANT APPLICH fIONS NAME OF AMOUNT OF PURPOSE OF REQUEST ORGANIZATION REQUEST PGA West $2,500 Partial funding for an Automatic Volunteer Fire External Defibulator Company Volunteers for $2,000 Special equipment for patrols Increased Public (e.g. pager network, night Safety vision goggles, etc.) La Quinta-Indio $3,000 Transportation expenses SHARE of the associated with food pickup Desert and delivery for needy families San Gorgonio Girl $3,150 Materials for contemporary Scout Council issues programs for girls. Humane Society of $21150 Offset of costs associated with the Desert/Orphan La Quinta pets using Pet Oasis Pet Oasis services Media Arts $4,700 Video/film production Foundation highlighting the arts/culture which will benefit the community Shelter from the $5,000 Emergency shelter for women Storm, Inc. and children in domestic violence situations D R�R0wC AUG 2 21997 CIIYttMAN GA EWSI DEPT. CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR q9 Name of Organization: rtil i s S J- +4 (dr1 ii 6 4 Amount Requested: N u Contact Person: u cf a v M an u e-I Mailing Address: 0ie,'A- A op City: n cl �`� State: Zip Code: D 4 y C Ve-A> 6- Phone No.: '7 G o 319 -.2 z 1 o -7t,o 3 Lh- 93 9 5- 501(c)3 Taxpayer I. D. Number: N 1A Date Submitted: ?wtowc 0 10. 4 Please provide information on your Executive Board members or contact person: g Title Home Address Phone SAC( i u, F.9 %CI,,., y 7 ,Or y i�z0 1 What is your annual schedule of events, and during what months does your organization operate? rs Not-ln. l held O .i.02 Ot9- 11. Do you charge admission, membership fee, dues, etc.? Yes —)(_No If yes, please describe: 12. What are .your other sources of revenue for this funding year? Source Amount C h� bfr of Comme�e� �50•�� Total Needed Total Received Balance #ly $ 700, ® a $2,_g o , 0 0 $ LSD, O V 3 CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-1998 Friends of the La Quinta LibrarY Name of Organization: $3,700.00 Amount Requested: Contact Person: Robert Wright, Pres. Mailing Address: City: La Quinta 78-080 Calle Estado #2 State: Ca. 92253 Zip Code: Phone No.: (769) 564-4767 95-386-8737 501(c)3 Taxpayer I. D. Number: Date Submitted: 9/1/97 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone Robert S, Wright (Pres.) 53795 Eisenhower, .la Quinta 564-0393 p,obb Atkins (Tress.) 52470 Avenida Madero, La Quinta 564-7400 Lesle Wenzel (Sect') P.O. Box 419,.La Quinta 564-4212 Honey Atkins (V.P.) 52470 Avenida Madero, La Quinta 564-7400 10. What is your annual schedule of events, and during what months does your organization operate? We have fund rasising events which include a golf tournament and periodic book salesR Our organization operates twelve months.of the year. 11. Do you charge admission, membership fee, dues, etc.? x Yes ---No If yes, please describe: SEE ATTA= 12. What are your other sources .of revenue for this funding year? Source Annual Golf Tournament Am amt $8000.00 (estimate) Book Sales 1031.00 (estimate) Memberships 200.00 (estimate) Total Needed $ $3,700.00 Total Received $ Balance $ $3, 700.00 3 QUESTION #11 AITACEATT. I ANNUAL MEMBERSHIP — JANUARY THRU DECEMBER Students 3.00 Family 6.00 Senior Citizens 3.00 Sustaining 20.00 Individual 4.00 Patron 50.00 Org. & Bus. 25.00 Life 100.00 NAME ADDRESS CITY STATE ZIP PHONE NO. Please make your tax deductible checks payable to: Your Local Chapter of FRIENDS OF THE DESERT LIBRARIES Membership card will be mailed upon receipt of dues. I CAN HELP WITH: ❑ Ongoing Booksale (Branch) ❑ Annual Booksale (Friends) ❑ Other Fundraising ❑ Gifts & Endowment Committee ❑ Legislation ❑ Hospitality ❑ Telephoning ❑ Special Events ❑ Volunteer Work at the Library ❑ Moral Support ❑ Publicity & Newsletter Q=IC N # 17 ATrACHMENT Intended expenditures - $700.00 for the installation and one year service change for a telephone line to connect our ocmputer to the internet. $3,000.00 for the purchase of books. CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-98 Name of Organization: California Desert Chorale Amount Requested: $ 2, 500.00 Contact. Person: Mrs. Nancy Williams President Mailing Address: Post office Box 2416 City: Palm Desert State: CA Zip Code: 92261-2416 Phone No.: (760) 346-7292 501 (c)3 Taxpayer 1. D. Number: 33-0620607 Date Submitted: September 1 1. 2. 3. 4. 5 6. 7. APPLICATION What is the overall purpose or goal of your organization? The California Desert Chorale's MissionStatement: "To provide pro- fessional quality choral performances in concert and chamber settings in order to provide musical and artistic enrichment to the cultural life of Coachella Vnlle✓ communities." How long has your organization been in existence? 3 Years 8 Months Describe in general the activities or services of your organization: The California Desert Chorale focuses on chamber and concert per- formances of Baroque, Classical and Early Romantic music, a curr- ent focus on indigenous Southwest American and Mixican sources. Provides music education programs, including a new Children's Choir School and adult study in choral repertoire, music theory, sight singing, and performance. How many people does your organization currently serve? 2,000 to 3,000 No. of Youth 3 0 % No. of Adults 3 5 % No. of Seniors 3 5 % How many people do you intend to serve during this Fiscal Year? No. of Youth 1 , 500 No. of Adults 2.000 No. of Seniors 1. 500 How many people served this Fiscal Year will be La Quinta residents? No. of Youth 4 0 0 No. of Adults 4 0 0 No. of Seniors 4 0 0 How many paid employees/volunteers does your organization employ? No. of full time employees 2 No. of volunteers 14 t o 18 No. of part-time employees 36 Describe how your organization is managed and governed. The Chorale is a 501(c)3 private nonprofit corporation, with a governing board of 13. The Artistic Director and founder is Jackie Doyle (see attached bio.). 2 9. Please provide information on your Executive Board members or contact person: Title Home Address Phone Nancy Williams President Indian Wells 346-7242 Michael McCafferty Brd. Member Rancho Mirage 341-5804 Ann Stephens Secretary La Quinta 771-0194 Jackie Doyle Artistic Dir. La Quinta 345-2961 10. What is your annual schedule of events, and during what months does your organization operate? Major concert performances are limited to three or four per year, with an additional six to eight chamber performances. Chorale training and rehersal programs are varied but run year-round. Our performance season is primarily October through May. 11. Do you charge admission, membership fee, dues, etc.? x Yes No If yes, please describe: Concerts and several of our chamber performances require a modest admission fee, typically $ 10 to $ 12. Many of each year's chamber concerts are free and frequently at public venues. 12. What are your other sources of revenue for this funding year? Source Amount Donations $ 20,000.00 Admission Sales $ 8,000.00 Contract Performances $ 7,000.00 Total Needed Total Received Balance $ 35,000.00 $ 6,000.00 3 13. Amount of money requested from the City of La Quinta? $ 2 , 5 0 0 0 0 14. Has your organization been funded by the City of La Quinta previously? Yes No x If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. The California Desert Chorale proposes to bring three to four free performances of choral chamber musicto the City.of La Quinta, tapping the Chorale's substantial repertoire. Program would run 30 to 40 minutes and shall be a cappalla. Performance venues may include City Hall, St. Francis Church, La Quinta Arts Festival and Senior Center. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. Residents of La Quinta will benefit from quality live chamber choral performances of important and exciting music in a more intimate and less formal environment. Artistic Director Jackie Doyle will intro- duce and discuss the music, and she will direct the chorale. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. See attached. 18. Non-profit organizations must attach a copy of the organizationiscurrent IRS Form 990. Not applicable. Form 990 filings are.required only for nonprofit organizations with annual budgets in excess -of $ 25,000. E,I gqp888 $ p$$p$$p8$$$'88$$g g $g OOO O O $o$O S$§696.8 tOO O Otol!�1f�$Ogt-m O Its M0 '-+ a r j CV M M .-1 -4 -4 r• " CV .--4 M M M m r•1 40} 4& 4l} 4& E9 6F} M tJ3 !e} Ei} 41i d3 d3 le e/-} 4{} 4& 403 V} 61 } ergo$ �°a�o,n"�` g$��pp+r;0MM0aoo��7$ p ,•,pp y � of-. O N .-i -1 .-1" r-1 N Ntz GN Cl J pppp ` o 8cq 8$ c t� o t C r-1 r•d O Gil ri Iff i[� N Q� eN CD M O r•i_ rl ri eH 400 409 ee is 4f} 4fe 0& 4& ko Q CD $ CO M "' '0 GV $ 4g�QV o$$$$$gg`�c'icMc�g$7$ GVC�90J0 n �LO�'� War-l�-1d�MGcc7�r•i0 y} yg �} 4f3 4i} tJ4 4A -es Oil 4f3 4i} �13 {�3 ff} o O Q v m UO U •� •� ii 44 rn czcd Q49 m 04 W 40 es o U m a tw ca 1. U o-d^do O •d�oo��o�da � OO 0 E-E- TS THE CALIFORNIA DESERT CHORALE HAD ICE OF PARTSBEGINNING II CONCERT IN APRIL OF 1994 WITH A PERFORMANCE AND III OF MESSIAH COMPLETE WITHPROFESSIONAL LL BEG TINNING GROUP OF ORCHESTRA AND SOLOISTS. THIS S SINGERS HAS GROWN TO 50 AS WE BEGIN OUR 41", SEASON. PERFORMANCES HAVE TAKEN PLACE IN DIFFERENT VENUES SINCE THE INITIAL CONCERT WHICSENHOWER H WAALS HELD INCTE OF ASSISI CATHOLIC I ANNENBERG CENTERCAHURCH ON WASHINGTON IN LA QUINTA, ST. MARGARET' S EPISCOPAL ON HWY 74 IN PALM SETTINGS DESERT, THE DEL WEBB' S SUN CITY, PALM DESERT ARE I CHORALE HAS USED. THERE WAS ALSO�D O� OF THE RT FOR YOUTH AT THE MC CALLUM THEATRE, CHRISTMAS CONCERTS WAS HELD IN THE PERFORMING ARTS CENTER AT PALM DESERT HIGH SCHOOL. THE pR.IMARY WORKS PERFORMED WITH ORCHESTRA AND SOLOISTS INCLUDE: BRUCKNER'S REQUIEM, PURCELL'S TE DE UM, MOZART,S REQUIEM, SCHUBERT'S MASS IN G, VIVALDI'S GLORIA, MOZART, S REGINA COELI, AND MANIFFICAA BACK SCHUBERT AND PERGO RYFOR HODB BY GABRIELI AND TH�E�MONOF CAROLS BY BRITTEN HAVE ALSO BEEN PERFORMED. AMERICAN FOR CHOIRSHAVE FOLK SONGS AND MANY OTHER SHORTER PIECES APPEARED ON SEVERAL OF THE PROGRAMS. THES FROM EVENING AT THE POPS CONCERTS EACH YEAR FEATURE MUSICAL THEATRE. THE 4THSEASON WILL OPEN WITH OUR FIRST ALL A CAPPELLA CONCERT. THE PROGRAM CONSIS TI OFF SELECTIONS FROM THE RENAIS � O'I' ROMANTIC CONCERTS THIS CONTEMPORARY LITERATURE SEASON CONSIST OF THE CHRISTMAS PORTION OF MESSIAH, MOZART'S VESPERS, VIVALDI'S REDO AND �LISTS. THE FAURE REQUIEM, ALL WITH FULL ORCI' THE CALIFORNIA DESERT CHORALE IS AVAILABLE FOR SMALL GROUP PERFORMANCES. THESE MIGHT BE TIES SMALL CAROLERS AT CIVIC EVENTS OR PRIVATE ENSEMBLES ON THE CONCERT SERIES AT A LIBRARY, OR A SELECTED GROUP ON A CONCERT GIVEN BY ANOTHER PERFORMENG ORGANIZATION. -- FOUNDER/ARTISTIC DIRECTOR IS JACKIE DOYLE, CHOIR TEACHER AT PALM DESERT HIGH SCHOOL FOR 10 YEARS. SHE HOLDS A MASTER'S DEGREE IN CHORAL AND INSTRUMENTAL CONDUCTING FROM CAL STATE UNIVERSITY, NORTHRIDGE WHERE SHE STUDIED PRIVATELY WITH JOHN ALEXANDER, ARTISTIC DIRECTOR OF THE 180 VOICE PACIFIC CHORALE OF ORANGE COUNTY AND DIRECTOR OR CHORAL ACTIVITIES AT CAL STATE UNIVERSITY, FULLERTON FOR OTHE DIRECTOR OF AST 4 YEARS. SHE HAS WORKED WITH PAUL SALE THE LOS ANGELES MASTER CHORALE, ROGER WAGNER AND ROBERT SHAW, AMONG OTHERS. THE CALIFORNIA DESERT CHORALE, RECOGNIZING THE NEED TO FILL THE VOID CREATED BY A LACK OF MUSIC IN THE SCHOOLS, IS IN THE PROCESS OF OPENING THE CALIFORNIA DESERT CHORALE CHOIR SCHOOL. @�FORNIA i)ESER, TeHORALE August 31,199, Artistic Director Jackie Doyle Mr. Britt Wilson Management Assistant Board of Directors City of La Quinta President 78-495 Calle Tampico Nancy Williams La Quinta, CA 92253 Vice -President RE: City of La Quinta Community Services Grant Program Application Publicity Francee Jimenez Dear Mr. Wilson: Secretaru Music ' is the most direct and universal form of communication, yet truly great and Ann Stephens important music gets neglected these days in the heat generated by our plugged in pop culture. Still, there are those who know the value of classical vocal music, and who Treasurer are dedicated to its performance and wider appreciation. In this regard, the Stan Borntrager California Desert Chorale, through its performances at St. Francis of Assisi and other La Quinta and Coachella Valley venues, has established itself as a valuable Honorary Director and important cultural resource in the community. John Alexander Jane Foster The Chorale, now in its 4th season of non-profit status, is under the direction of Jackie Doyle. Our mission includes the programming of works primarily for chorus Members at Large and orchestra. Works from the Renaissance to the 20th Century have been performed, Jack Bourquin including Mozart's Requiem, Purcell s Te Deum, Bruckner's Requiem. Britten's Mark Cohen r pr�monv of Carols, Vivaldi's =Loria, Bernstein's Chichester Psalms, Bach's John Criste 124 and Brahms' ipberslieder Walzes. Also, on some of our programs you Cantata j, HenryHoyle Michael enry Hoyle McCrty will also find spirituals, folk songs and classic show tunes. Michaeline Staley Dawn Tomlinson Today, with between 50 and 60 singers, the California Desert Chorale's semi- with orchestra and soloists, have astounded professional voices, along professional audiences with their great musical integrity. Planning, rehearsing and performing these concerts requires a tremendous amount of hard work and money. Ticket sales cover less than one-third the Chorale's expenses, so we must rely upon the generous of our friends and benefactors, including the communities we serve. The support importance of the City's support far exceeds any dollar value, since it will be leveraged with the hours invested by musicians and volunteers; an excellent return on the City's investment. Post Office Box 2716, Palm Desert, California 92261-2716 (619)773-2216 - California Desert Chorale is a non-profit organization CDC/City of La Quinta Comm. Serv. Grant Program/Page 2 In addition to our three to four concerts each season, we have been growing and expanding our program to perform for children at the McCallum Theater and to send forth our chamber group on a year-round basis for special events, small gatherings, fund raisers and education in the schools. With the funding we are requesting from the City, the Chorale will provide three to four chamber performances during the current fiscal year. Final dates and venues will be developed in coordination with the City Community Services or other appropriate department. We are looking forward to the opportunity to expand our community performance program in the City of La Quinta and to having the City as a member of the California Desert Chorale family. If you have any questions or would like additional information on our grant application, please do not hesitate to contact me. John D. Criste Board Member Director of Grants JDC/sw Enclosure CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-98 Name of Organization: community Gardens Of The Coachella Valley Amount Requested: $ 8 0 0 0 0 Contact Person: Stephen B. Merritt Mailing Address: 78-175 Avenue 42 City: Bermuda Dunes State: CA Zip Code: 92201 Phone No.: �4s_go9n 501(c)3 Taxpayer I.D. Number: 33-0684205 Date Submitted: September 1, 1997 1 APPLICATION 1. What is the overall purpose or goal of your organization? To provide material and organizational resources which will assist and encourage cities, institutions, and neighborhoods to develop and maintain gardens for the purpose of beautification, recreation, therapy and food security. To reduce human hunger and malnutrition while restoring pride and self- respect through teaching food self-sufficiency in the garden. Z. How long has your organization been in eristence? 1 year, 7 months 3. Describe in general the activities. or servieee of your organization: Gardens of the Coachella Valley provides the following services: LhMM= tnsuucaon Provides classes to the general public on growing vegetables in a desert environment utilizing qualified instructors. Such classes are provided to train teachers and administrators who wish to develop gardens and to develop a cadre of trained volunteers to assist in the development of Community gardens We have graduated over 100 people from our 15-week course to date. Material Resources We provide a central source for accessing critical materials for garden development and maintainaaoe. The matamb are donated specifically by local businesses for this purpose and include soil, soil amendment, mulches, fertilize, seeds, transplants, tools, irrigation, composting equipment, lumber, Planters, etc. Financial Resources We locate, qualify, and prepare grant applications for funding garden development and maintenance Administrative Resources We recruit and organize community gardening citizens groups and provide direction, guidance, and organizational support to ensure a broadly based, successful, and sustainable organization supporting the garden We supply reference material on all garden -related topics and oversee the development of appropriate forms critical for success such as newsletters, meeting notices, phone trees, neighborhood approval forms, task foreeleommittee agendas, garden planning worksheets, activities calendar, garden rules and regulations, gardener recruitment activities, budget preparation, fundraising planning guides, on -site workshop development forms, lease agreements for land, gardener application forms and plot maintain agreements, and gardener injury waiver and release forms. We provide curriculum materials for teachers who wish to incorporate schools gardens in the instruction of traditional subject matte such as math, science, literature, creative writing and history. Nutrition and Food Promms Working with schools and Desert Cities Hunger Action, we help expand utilization of the National School Breakfast Program, the Summer Food Service Program, Start Your Head Program, and Nutrition FAication In The Classroom where gardens enhance the learning process with "hands on" practical knowledge. Anti-Hunw Gardens Worldng with existing "soup 4citchens" and organizations providing temporary housing and meals to transient families, we develop fresh food gardens, cultivated by the clients of these organizations, to supply fresh produce for use in food programs. Clients learn self-sufficiency and experience the pride Of accomplishment. Demonstration Garden We are constructing a demonstration garden in Bermuda Dunes which will utilized as a classroom for teaching desert food gardening to the public, local school children, and institutions serving the disabled This garden is entirely comprised of 400 planters providing 7000 square feet of planting area at waist height for use by those with physical disabilities. 4. now many people does your organization currently serve? 773 No. of Youth: 698 No. of Adults: 50 - No. of Seniors: 25 S. How many people do you intend to serve during this fiscal Year:► 4M No. of Youth: 4263 No. of Adults: 250 No. of Seniors: 325 6. How many people served this Fiscal Year will be La Qainta residents? 1000 No. of Youth: 750 No. of Adults: 50 No. of Seniors: 200 7. How many paid employea/voluuteers does you orgau' Atiou employ? No. of full time employees: .0 No. of part time employees: 9 No. of volunteers: 145 S. Describe how your organization is managed and governed. CGCV is managed and governed by the president and the Executive. Board. 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone Stephen B. Merritt President 78-175 Ave. 42 Bermuda Duna 345-9090 RicbardFarmer, ph.D. Vice-president 44-201 Had Cn.WayjWm Desert 340-6602 Ted Weichwki ,E.A. Treasurer 206 Marisma Way, Cath. City 321-2329 Christie Poor Director 100 Sumise Way, Palm Springs 416-6702 Teri Clump Director 52-420 Ave. Juarez, La Quints 564-4622 Don Ad dey,M.S. Ag.Ed Director 74-165 Chicory, Palm Desert 346-5153 1o. What is your annual schedule of events, and daring what months does your organization operate? CGCV operates during all 12 months of the year. 2 Our preliminary schedule for the following 12 months is: September Class "How To Grow Vegetables In The Desert" begins fall tens. Fall planting begins Quadrille Academy garden opens. Desert Cities Hunger Action co -host state conference for Summer Food sponsors "Grooving Kids and Families" programs starts at Cathedral City Elementary CGCV Demonstration garden opens Garden construction begins at Coachella Valley Housing Coalition (CVHC) site Composting workshops at all gardens October Palm Valley School garden opens American Community Gardening Association Annual Conference "Growing Kids and Families" program starts at Rancho Mirage Elementary Construction of community garden starts in Indio Pumpkin Festival and Halloween Party Fundraisers at all gardens Agua Caliente Elementary School prden opens Garden plan developed for Coachella Valley Rescue Mission (CVRM) CVHC garden opens Water wise gardening workshops at all gardens. November Indio community garden opens Harvest Festival at all operating gardens Squanto and the First Thanlagiving program at all school gardens Construction begins for CVRM garden Native Foods Garden Opens in Palm Springs Garden PbWland acquisition completed for "The Well" Food Preservation workshop at CGCV December Our Lady of Perpetual Help ("OLPH") Garden Opens CVRM garden opens Garden at The Well begins construction Vegetable class graduates Volunteer appreciation party at CGCV Demonstration Garden Fall planting clean up at all gardens Cooadng with Vegetables workshops at all gardens January Summer Food Program training begins for local tribes in partnership with CAUNEVA Tool donation drive begins Spring planting begins at all gardens Class "How to Grow Vegetables in the Desert" begins spring term Pruning workshops at CGCV Garden at The well opens Recruit -A -Gardner campaign begins February Garden Management workshop at CGCV Vermicult+ue workshops at all gardens Slag planting continues Fundraising event New gardener training begs March Companion planting and pest control workshop Garden Tours fundraiser 3. 1 New gardener training continues April Earth Day activities m all gardens Cooldng with Vegetables workshop at CGCV Planting begins for summer harvest May Harvest Festivals Preservation workshops Garden clean up Cover crop planing Spring "Growing Vegetables!' class graduates June/July/August Summer harvest Garden clean up New garden planning plamni n Mudgeting for next cycle Grant writing 11. Do you charge admission, membership fee, dues, etc.' Yes If yea, please describe: CGCV Annual Membership: $25.00 CGCV Monthly Garden Plot Rental each $20.00 (plot rental for CGCV demo garden only) Tuition for "Growing Vegetables" class $40.00 12. What an your other sources of revenue for this funding year? (Excludes in4dad contributions) Source Public Contributions Ruth Mott Fund Kraft RAP Consulting Amour $10,000. $15,000 $25,000 $25,000 $16,000 Total Needed S919000. Total Received $50.000. Balance $419000. 4 13. Amount of money requested from the City of La Quintal $9020.00 14. Has your organization been fimded by the City of La Quinta previously? No 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used if awarded The funds are being requested in order to create a community garden and a permanent community gardening organization to support it in the City of La Quinta. As you will see from the following breakdown of tasks, thousands of hours are required to develop the groundwork and organize a community garden m such a way that the city can be sure of its long-term success and benefit to the community. A community garden would both beautify the area and provide a useful recreational opportunity for citizens of La Quinta and, as cities across the nation have fitund, would act as a deterrent to graffiti, vandalism, and other crime through the active and visible presence of community members growing vegetables, herbs, and flowers in the area By creating a non -threatening, beautiful place for neighbors of all economic and social status to learn and -grow" in, a community is built where people can for each other and their property. Community gardens can also act as an important source of inexpensive and nutritious food for the participants and local food banks while providing therapeutic benefits to seniors and guided activity for youth. In short, community gardens can provide benefits that far exceed the costs of development and on- going administration, benefits which positively effect citizens of all ages and cultures. Specific benefits are outlined below in question 16. Community Gardens of the Coachella Valley (CGCV) a non-profit corporation, was established to provide the service of community garden development and administration for all cities and institutions in the Coachella Valley desiring to prmde the benefits of community gardens to their citizens and members. By funding CGCV's garden development work in La Quimta, the city can develop community gardens in a professional and cost-effective manner, in -effect, sharing administrative costs with other gardens and taking on no new sta$ CGCV acts as a clearing house for current information on community garden development across the state and country through our memberships in The American Community Gardening Association, The American Horticultural Therapy Association, Community Alliance with Family Farmers and the National Gardening Association. Our membership in these associations also provides us with access to an almost unlimited array of community gardening material including models of development and nun nerrous legal and administrative forms. In this way, we benefit from the experience of community gardening leaders acmes the country. We learn and pan -on information about ammsses and failures to further enhance a sucoessfid experience from the very start. Our membership and association with local support orpwations such as California Women In Agriculture, the Coachella Valley Resource Conservation, District, University of California Cooperative Extension Service, and the U.SD.A: provides us access to expert technical advice. Finally, local businesses and service organizations provide us with the donated materials, advice, and volunteer support c r ical to developing a n=ssful community PtdmM ProBM CGCV maintains a library of resource material, conducts classes in mwcesdW growing techniques, and maintains a volunteer list of over 100 local gardeners. We have overscen garden development at Quadrille Academy, Washington Charter School, Palm Valley School, and are under contract to develop gardens for the Coachella Valley Housing Coalition. The following cost breWWown will illustrate a method for La Quinta To develop a successful community prdening organization with CGCV and will lay the basis for additional community gardens in the Future. COST SUMMARY FOR THE DEVELOPMENT OF COMMUNITY GARDENS IN LA QUINTA ONUTau COSTS PHASE ONE COM1vIUNTTy ORGANIMG $1000. PHASE TWO ACTION PLAN AND BUDGET PHASE SEE FUNDING RESOURCE $900. $600. PHASE FOUR CONSTRUCTION SUPERVISION $320. TOTAL OF ONE -TM COSTS M0. ANNUAL COSTS PHASE FIVE ONGOING SUPERVISION $3200. TOTAL ANNUAL COSTS S5200. 6 COST BREAKDOWN FOR THE DEVELOPMENT OF COMMUNITY GARDENS IN LA QUINTA Phase One: Community Organizing: Ascertainment of Needs and Interest Coat: $1000.00 The most important component to the success of any community garden is, of course, the active support and participation of the community followed closely by the commitment of the city cotmcil and staff to a vision and action plan for the support of community gardens. Community support can best be obtained through the active solicitation of existing community groups, neighborhood associations, and informal networks with the ultimate goal of establishing a group of citizen representatives organized with the express purpose of creating an action plan for the development and use Of community gardens in the city. Some cities have skipped this step and taken the "build it and they will come" philosophy. This method has often led to disaster when the one or two passionate founding gardeners become discouraged due to lack of support or move away leaving an empty garden. It is also a tearable waste of human and financial capital. We therefore strongly recommend that the city invest in the community organizing necessary to support a garden on an ongoing basis CGCV will make presentations, organize follow-up meetings and solicit commitments, from key organizations for the development of the "Senior Center Garden" or other sites. The organizations will include groups identified by CGCV and city staff. The results of this phase will be a group of approximately 25 La Quinta residents representing a broad cross-section of the community who are prepared to commit their time to the development and maimaince of one or more community gardens. Among this group will be individuals able to secure support from civic organizations. Phase Two: Development of Action Plan and Costs Cost: $900.00 This phase may commence anytime the city feels this information is required and can run concurrent with phase one if desired The most important requirement for this phase is the identification of the site since all cost estimates are site specific. It is highly recommended that the city approve a site with the following characteristics: A. Will not be utilized for another incompattble purpose for three to five years; B. Is within walking distance of community it intends to serve or has ample parking; C. Receives plenty of sunlight; D. Has access to water (water meter); and, E. Is approved by neighbors. The "Senior Center Carden" site would seem to qualify for all the above criteria. 7 phase two activities include site visits for design and owing development of garden plans with the community groups; development of a list of needed materials and labor used on the location and design. - organizing and attending, with community members, meetings with city staff, community groups, local businesses to determine which cost items could be donated and which must be purchased; site visits for design and planning; development of garden plans with the community groups; development of all materials into a plan and budget; and, presentation of result to the com11IrmitY, staff, and if desired, city council. Phase two activities will also include the recommended plan for annual garden administtatim Issues lilac who will garden, hours of operation, deposits to ensure personal responsibility for cleat up at the end of the season, annual fees (if any), liability release forms, shared work requirements for common areas and special provisions for the handicapped Result of this phase is an approved and funded plan for one or more community gardens in La Quiz Phase Three: Identification of Potential Funding Sources Coat: $600.00 Community gardens have many sources of fmndirig based upon what is to be taught and accomplished in the garden. Funding can come from redevelopment funds, water conservation demonstration site funding, rec�,clingicomposting demonstration site funding, anti htutgerlmrirition education funding, job trainingleducation funds, and community revitalization funds. Local sources would be solicited through the participation of service clubJcivic organization members in the pr&n development. State and national foundations supporting community gardens would also be researched Results of this phase would be a list of potential finding sources and estimated amount of funding available from all sources. Phase Four. Supervision of Garden Construction to Meet Approved Specifications Costa: $320.00 Garden construction will require the coordination of truciting, earth -moving egtWpmeat, labor, irrigation, fencing, signage, delivery and mixing of S0WC0mp0st,porta-pmes, beaches, and other one-time activities Results of this phase is a community garden readY to be utilized! Phaaa Fes; Ongoing Supervision of the Garden Time Required: 10 Hours Per Week coat: $5200 per year CGCV will supervise garden activities providing organizational and technical assistance to the community group organized in Phase One. We will also provide access to our donated materials, volunteers, and discounts an our educational programs. We will provide guidance and assistance to the group when it wants 8 to expand the programs offered in the garden such as composting demonstrations, food preparation and canning, or nutritional education. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. An investment by the City of La Quints in the development of comaumity gardens will benefit many citizens as indicated below: Who Benefits? How? Low Income Seniors Low-cost access to good quality, nutritious food Increased socialisation and stimulating contact with youth and adults from a variety of backgrounds and cultures physical fitness and dexterity — promotes long-term healthy habits Greater disposable income through money saved by growing rather than buying vegetables Helps restore self-worth through the experience of nurturing a living plant to maturity Utilizes skills often aim* possessed but not exercised due to limited access to land and ignorance of growing techniques particular to our desert environment Youth A positive outlet for creative energies An intergenerational activity where youth learn skills from seniors and seniors benefit from the ea aW and strength of young people A place where youth can experience the cycle of life, learn patience, develops self-esteem, and learns leadership skills. A place when anger and aggression can dissipate through physical work and the diming nature of plants themselves. Low-income Citizens Can conserve on average $ 1200.00/year by growing their own vegetables. These funds can then be redeployed into other critical areas of need — such as education, child-care, or ttansportation. Overall health will improve due to better eating habits. garden vegetables are the most nutritious available and people who grow vegetables are more likely to eat them. Will develop a greater sense of control over their own lives knowing they have the ability to be less dependent on others in the critical area of food supply ,The Community Community Gardening develops good relationships between participants as they help each other with problems. Studies have shown that real-estate values improve in neighborhoods where community gardens are located Statistics point to a reduction in crime in neighborhoods with community gardens Composting recycling, and water conservation are learned in the garden. Citizens who are often marginalized can learn both leadership skills and the mechanics of the local governmental process by participating in proc cu of starting a community garden Excess food can be made available to the senior a or other institutions that distribute food to the community. this will provide cost -savings and imps w the nutritional contort of food Cities that provide places for their citizens to gather and grow food or flowers benefit from the imago of being a city that is innovative and cares about it's people. A community garden can be a great place to display public art and another source for informal community input into the governing process. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. CGCV Program Operating Budget is attached. Imended Community Services grant expenditures are detailed above, item 15, entitled Cost Breakdown for the Development of Community Gardens in Ira Quima. is. Non -pro t orgaukatiooa must attach a copy of the organizations current IRS Form 990. Our IRS Form 990 for 1996 is attached. 10 PROPOSED BUDGETS FOR COMMUNITY GARDENS OF THE COACHELLA VALLEY REVENUE GRANTS SALE OF GARDEN PLOTS SALE OF SERVICES GENERAL PUBLIC CONTRIBUTIONS TOTAL GROSS REVENUE OPERATING EXPENSES ACCOUNTING FEES ADVERTISING AUTO/TRUCK EXPENSES BROCHURES/LOCO/ART WORK CONSULTING FEES - HORTICULTURAL THERAPIST - GRANTSMAN - MASTER GARDENER EMPLOYEE BENEFIT PROGRAM INSURANCE - GENERAL - W/C LEGAL FEES LICENSES/PERMITS OFFICE EXPENSES PUBLICITY RENT - OFFICE - LAND REPAIRS 6 MAINTENANCE SUPPLIES TAXES - PAYROLL TRAVEL WAGES/SALARIES - EXECUTIVE DIRECTOR - LABORERS UTILITIES/TELEPHONE CONTINGENCIES TOTAL OPERATING EXPENSES CAPITAL REQUIREMENTS COMPUTER/FAX/MODEM/MONITOR/SOFTWARE GARDEN EQUIPMENT GARDEN PLOTS TOTAL CAPITAL REQUIREMENTS TOTAL CASH EXPENDITURES r� 1998 $50,000 13,000 8,000 25,000 $96,000 $ 2,400 600 3,600 600 2,400 1,500 1,200 1,440 900 600 300 100 960 600 3,600 4,800 500 2,400 3,030 1,800 27,600 12,000 2,200 8,270 $83,400 -0- 2,600 10,000 $12,600 $96,000 9�0 Return e-Irganizatlon Exempt From IncAme Taxeam 9��s Under section bt,,(a) of the Intarnal Revenue Code (except bi. _A king benefit trust or private foundation) or section 4Q47(a)(1i nonexempt ohs+rl 0 to Public Dow Wit of fh. lrwwr new ro ass s co of dlJs retu►n ro sath sate uJ►srri rats. 1 n w.n,rw AWW . ttaMo. Nob: The to tees. end ending p For Vitt late t:aNnder ear. OR tax r period 0 EmpWigr klantrncatfon nurntw B Qwok ff: pt.." 0 Name of orpffinU&b^ ❑ own of two" «w COMMUNITX GARDENS 0 THE V ®"turn sea w Nuff0v and atraet (or P.O. box it MW Is not delhered m *Vast addna goort>/aWte E stets reeistrstivn number ❑ 1962308 FOW MWm abO.. 78-175 AVENUE 42 ❑ Amended mtunt speaft riti. town►, or Goat OtfiOe, stw. and ZIPN F Check [3 it exemptlo,+ er,a++cat+or+ (r1QuWW also for tiou. BERMUDA DUNES, CA 92201 is �r0k'0 state repor kv) a Typo of organaselon--r ® Fx�Pt u� �^ 501(cx 3 ) 4 f�eR number) OR ► � section 4947(a)(1) nfxtexemPt chdA • ws Nob: 8eotlon 601(c)f3l oryantrations and �rl f) nonatcempt oharttabN trails MUST attach oorrtpnetd 5clteduJe A (F°^^ ao0)_ t� x in H is orlecked'Yee' enter fW-ftft Mla) k Vile a 9r9W bled for afN1a11? . ❑Yes 1f..f I e either bo return exarnptbn rwmber (OEM No .................... . J Accourift rneV+cd: ❑ Cash Accrue! pW M 'Yee.' enter iM numbr of •flUlatae lot wA�eh fhb return b bled:. grow roil ? Yee No ❑ Other (epecfN! � isJ is v" a separatereasn flied by �+ � +�^ � by a K Crook herso, If the orPrilnt 'I gross r•Dpte We nWnwly riot rocs then W5.01A The OrgarWn need not Vile s return wrHh tf+s IRS: but if it received re a complete r*WM. a rm Fo990 P in the ma . It Vwuid Me a rewtaxr+ Mwut frME �'i 4" sots statesthan Z1001WOi and toWl assetsts less than S250,W0 of and of yeti. Note: rAmi a90-E2r ntsy be used by orperAZEd" **h grossr00plpts is" -- --.A f%ka ..e. in Nat Assets or Fund Balances (See Specific instructions on page 9.) 1 Contributions, gifts, grants, and similar amounts received' is 27,690 j a Direct public support. . . . . . . . . . . 1 b -0— b Indirect public suppOn . . . . . . . • • • • • is _0_ c Government contributions (grants) . . • d Total (add lines to through 1c) (attach schedule of contributors) 1d 27,690 (cash $ 27,690 — noncesh $ ---- feand contracts (from Part VIi, line 93) es S 2 including government program service revenue in 3 3 Membership dues and assessments . . . . . . . . . . . . . . . . . 4 _ - 4 Interest on savings and temporary cash Investments . . . . . . . . . . . 5 5 Dividends and interest from securities ... . • • •6-1 ' ' . ' ' ' 4s Gross rents . . . . . . . . . . . . . . . db b Low: rental expenses . . . . . . . . . . . . . income or (lose) (subtract line 6b from line ea) . . . . . . . • � 7 ^--_-._-- e 7 Net rental Other investment Income (describe ► W Securities (6) Other 8a Gross amount from sale of assets other as than Inventory • ' ' 8b b Lou: cost or other basis and sales axpense$. o Gain or (loss) (attach schedule) . . . . ad d Net gain or pose) (combine line 8c, columns and (B)) . . . . . . . . . . . 9 Special events and activities (attach schedule) a Gross revenue (not including $ of 96 contributions reported on line 1 a) . . - • Yb b Less: direct expenses other than fundralsing expenses from special events (subtract line 9b homfl0i. 9a) 90 o Net income or (loss) sales of Inventory, leas returns and Wkrhances 10a Grose 10b b (_.ass: cost of goods sold . � li -ink from line t oe) 100 c Gross profit or (lo=s) from SHIN of inventory (attach schedule) (subtract ' .2 11 Other revenue (from Part Vll, line 103 . . . . . „_.._. verity add lines 1d, 2, 3, 4, 5,)t3c. 7, ed, 9c, Joe,sand 11 12 Total n_ . 13 Program services (from line 44, column (B)) . . . . • • 14 Management and gQ ( 44 column (C)) -.... neral from line I.-. 15 Fundraising (from line 44, column (0)) j in-' _. _ -__.•.... ._..__._ IS Payments to affiliates (attach schedule) . . . . „ Id lines 16 and 44 column A -- nsee ' 17 Total a ..•, ... -...� ..... _.,...- subtract line 1? corn li-7td 12.) . . . • . . . . . tf! Excess or (deficit) for Vitt year( 'fund balances at beginning of year (frcm itno 7 , CO3vr?"t 6 Net assets or . n;rt•ertar+t4 tN fund belenoes (attach explanation) `21 Net as r r iiled ii_ fi7 ...!•...., ...• .........T �_... • r SOts Of lu,-,d t-A" :t fr e i r l a t� r For Pepstrvork Reduction Act Notice, see Gaffe t vc swa)jy+s+ta :n3;rt+ct:;=:tie. Statement of M Orgaruutiom Mwft Compiew COiu= V* �.aumne (0), kVj, W ti k.I kwtp Funcdonsl Expenses w4 swOm 4p47(e,)(t) nmmmpt dwitwA tnud but opdov for ottwe. (See Swft Instructions on page 13.) Do not include amounts reported on line W Tessl (a) Aram (c) Menagemem (pl Funanueu+q 6b, 8b, eb. 10b, or 16 of Part 1, N servias and gaww 22 Grams and allocations (attach schedule) . (cash = noncash $ 23 Specific assistance to individuals (attach schedule) 24 Benefits paid to or for members (attach schedule). 25 Compensation of officers, directors, etc. . . 20 Other salaries and wages . . . . . . . 27 Pension plan contributions . . . . . . 28 Other employee benefits . . . . . . . 29 Payroll taxes . . . . . . . . . . . 30 Professional fundraising fees . . . . . . 31 Accounting fees . . . . . . . . . . 32 Legal fees . . . . . . . . . . . . 33 Supplies . . . . . . . . . . . . 34 Telephone . . . . . . . . . . . . 35 Postage and shipping . . . . . . . . 38 Occupancy . . . . . . . . . . . 37 Equipment rental and maintenance . . . . 38 Printing and publications . . . . . . . 39 Travel . . . . . . . . . . . . . 40 Conferences, conventions, and meetings . . 41 Interest . . . . . . . . . . . . 42 Depreciation, depletion, etc. (attach schedule) 43 Other expenses (Itemize): a - SCHEDULE b.................................. ATTACHID .................. C.................................................... d.................................................... e....-••............................................. 44 Tote) tuft ftW eperaee pod lines 22 through 4 ---pup— . 131.1 1.059 1 635 1 424 1 N. 14 _ ooelpilMiriy ookerrra arty these tobk <ti Mee 19tS . 1 44 1 29,780 1 25, 600 1 4,180 Reporting of Joint Costa. —Did you report in column (8) (Program services) any Joint costs from a combined educational campaign and fundraising solicitation? . . . . . . . . . . . . . . . . . ► ❑ Yes ® No If 'Yes," enter (q the aggregate amount of these joint costs S ; pq the amount allocated to Program services $�_; II the amount allocated to Management and general i ; and (ir) the amount allocated to Fundraising $ Statement of Proram Service Accomplishments See Sp2cific instructions on page 16. What Is the organization's primary exempt purpose? .................................. Program service All organizations must describe their exempt purpose achievements. State the number of clients served, IRW*w sorts see publications issued, etc. Discuss achlevemertts that are not measurable. (Secrion 501(cx3) and (4) organizations (4 � i and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) sews.l a SEE .PART. VIII,- LINE. , ERPLAINED. Np1!ipER OF. �iT$ ACHIEVEMENIS.T.HAT ARE NOT MEASURABLE: COMMU.N_ITY-�}(•1D O7kt.F,R.XNVJ1tQN��IT� kf:NCIES"gig *MADE AWARE OE' SERVICES PROVIDED $Y THIS�ORGANIZATION. ........................................................... ..................... ..................................... ...... (Grants and allocations S —0— ) 25.600 b.................................................. .......................................................................................................................... ...................................................................................................I.---.................. (Grants and allc ,abons S ) c...................................................................---._................................................... ................................................................................•--..............---....................... (Grants and all,x;ations S ) d........................................................................................................................... ..................................................... I. Grants and allocations ..S.................................. . s Other program services attach schedule Grants and al(ocatiorts $ ) f Total of Prowern Service Expenses (sWuld equal line 44, column (B), Program services) . . ► 25,600 __ P" 3 F— M (1"M �1 Balance Sheets (See Specific Instructions on page 18.) Mow. wear nvui+ed, ettsched schedulyt &vounts within the description cokwm should ba fm end-of-yrar &mounts OWY 45 Cash —non -interest -bong . . . . . . . . . 48 Savings and temporary cash Investments . . . . . . . ' 44 47a Accounts receivable . . . . . . . 7a 9306 _0_ b Less: allowance for doubtful accounts . 47b 48s pledges receivable . . . . . . . . b Less: allowance for doubtful accounts . . 49 50 Grants receivable . . . . . . . . . . . pecoivables from officers, directors, trustees, and key employees . (attach schedule) . . . . . . . . • ' ' ' ' . . 51a Other notes and loans receivable (attach 618 ._. b schedule). . . . . . . . . ' Less: allowance for doubtful accounts . bib 5 Inventories for sale or use . . 69 prepaid expenses and deferred charges . securities (attach schedule) . . . • . . . . . . . . . 54 6" Investment& Inveatments-4and, buildings, and 66s equipment: basis . . . . . . . . . b Less: accumulated depreciation (attach 5ab schedule). . . . . . . . . . . . 58 Investments --other (attach schedule) . basis . 57s • . . . 578 b Land, buildings, and equipment: . , Loss: accumulated depWAtion (attach IS7b b8 schedule). . . . . . . . asD . IT Other sets (describe ► 1 59 Total assets add Imes 45 through 58 muse a um +mv 00 Accounts payable and accrued expenses. . . • • 61 Grants payable . . . . . . . . . . . . . . . . . 62 Deferred revenue . . . . . . . . • . . • . . . . ' . , 63 Loans from officers, directors, trustees. andkey employees (attach schedule), • • . 8" Tax-exempt bond liabilities (attach schedule) . . • . , • . b Mortgages and other notes payable (attach schedule) ; 65 other liabilities (describe ► 66 Total liabilities add lines 6o tnmu n cal . . • • • organingons that follow SPAS 117, check here ► ® and complete Imes 67 through 69 and lines 73 and 74. 47 Unrestricted . . . . . . . . . . . . . . . ' ' . . G6 Temporariy restricted . . . . . . . . . . . . 69 permanently restricted . . . . . . . . . . . organisstlons that do not follow SFAS 117, check here ► ❑ and complete lines 70 through 74. 70 Capita! stock. trust principal, or current funds . . . . . . . • 71 Paid -in or Capital surplus, or land, building, and equipment fund . 72 Retained earnings, endowment, accumulated income, or other funds ua��dlines 67 u 69 R73 Toal net ases°(A)m equal 19dcomn Bmust 70 through 72, column equal line 21) . . 74 Total Nablllties and net assets / fund bsisnoes (add linos 89 and 7� FIRST FILING Winning of year J + Endo( year 48c E_J 62 4 Financial Statements with Revenue per Return (See Spe, Instructions, page 16 a Total revenue, gains, and other support N A/ per audited financial statements. . ► e b Amounts included on line a but not on line 12, Form 990: o (1) Net unrealized gains on investments . . $ (2) Donated services and use of facilities (3) Recoveries of prior year grants . . . 3 (4) Other (specify): ..-• Add amounts on lines (1) through (4) Do- c Una a minus line b. . . . . . ► d Amounts included on line 12. Form 990 but not on line a: (1) Investment expenses not included on line Bb, Form SW . . . $- (2) Other (specify): Add amounts on Imes (1) and (2) ► d N/A e Total revenue per line 12, Form 990 line o plug line ► e N/A LEM List of Officers, Directors, Trustees, and Key Instructions on page 18.) Financial Statements with Expenses per Rt n a Total expenses and losses per audited financial statements . . ► a b Amounts Included on tine a but not on line 17, Form 990: (1) Donated services and use of facilities 3 (2) Prior year adjustments reported on tine 20, Form 00 . . . . i (3) Losses reported on , line 20, Form 990 S (4) Other (specify): ...................... s Add amounts on lines (1) through (4)10, o Una a minus line b . . . . . ► d Amounts Included on line 17, Form 990 but not on line a: (1) Investment expenses not included on line 6b. Form 990. . . >R (2) Other (specify): ...................... Add amounts on lines (1) and (2) ► d _ • Total expenses per line 17, Form 990 _(line c plus line d) ► • I N/A imployees (Ust each one even N not compensated: see Specific pq Nama and add►. le) This and avanpa how. per weak devoted to pootlon ) cOTpMMtlon r not paid, en -0. a Ctrnlae M to nnter a+bkr� Ow*ft o It d�landCMVWUMM (q Expanw account and odw allowwum . STEPHEN ....MF.R)ixxT-------------------- 78-17.5 Ave,PRESIDENT 30 HRS. —0— — .... NAD ,A,,, WIECHEgn.., 206 MARISMA WA CAT ED CTREASURER — — — .. KAREN MERRITT ..................................... 78-175 AVE.42 BERMUDA DUNE A (AS NEEDED) ...........................•------.....-----....•-----.......... ...........................•---•-------------................... ....-••----••----•-•............................................ ................................................................ ...............................•----••--------------.......----- 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? ► ❑ Yea EM No If •Yes," attach schedulesoSpegf<c Instructions on page 18. ------------------------------------------------------- --------------------------------------------- Form eeo now on 78 Old the= engage b ' not ^ to the RRS? If 'Yas,' attach a detakd description of each activity- 77 Weany changes made in the organizing or governing documents but not reported to the IRS? re If "Yes.' attach a conformed copy of the changes. 78a Did the organization have unrelated buslness gross income of $1,Ooo or more during the year covered by this return?. b If -yes," has it filed a tax return on Form M-T for this year? . . . . . . . . . . . . . • 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement 80m Is the organization related (other than by amoelatlon with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? . . . ••--.................................... b If'Ye$," enter the name of the organization ► ..d........whe __...--_-- ,,,_,,,,,•,,... and check whether It is ❑ exempt OR ❑nonexempt. ... 81a Enter the amount of political expenditures, direct or indirect, as described in the Lis -0- instructions for line 81 . . . . . . . . . . . . . . . . . . ' . b Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . • • 82a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? . . . . . . . . . . . . b if eyes,, you may Indicate the value of these items here. Do not this amount ot Include as revenue in Part I or as an expense in Part II. (See instructions for reporting in 182b I Part ni.). . . . . . . . 83a Did the organization comply with the public Inspection requirements for retums and exemption applications? b Did the orgartizatlon comply with the disclosure requirements relating to quid pro quo contributions? . . 84a Did the organization solicit any contributions or gifts that were not tax deductible? . . . . . . . . b if "Yes,` did the organization Include with every solicitation an express statement that such contributions or gifts were not tax deductible? . . . . . . . . • . . . . . . . . . . . S6 501(c)(4), jV, or (6) WpnIzations.--a Were substantially all dues nondeductible by members? . . . . . . b Did the organization make only In-house lobbying expenditures of .$2,0W or less? . . . . . . . . if "Yea" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. 850 a Dues, assessments, and similar amounts from members . . . . . . . . 85d d Section 182(e) lobbying and political expenditures . . . . . . • • • 85e e Aggregate nondeductible amount of section $=ex1XA) dues notices . . f Taxat�le amount of lobbying and political expenditures (line 85d less 85e) 85f g Does the organization elect to pay the section 6o33(e) tax on the amount in 85f? . . . . . . . . . h If section e=aX1)(A) dues notices were sent, does the organization agree to add the the amount infollowing f to its tax yoarsonable estimate of dues allocable to nondeductible lobbying and political expenditures 86 501(c)(7) &Vsniiations.—Enter: a Initiation fees and capital contributions included on a" line 12 . . . . . . . . . . . . . . . . . . . . • . 88b b Gross receipts, included on line 12, for public use of club facilities. . . 87a 87 501(c)(12) Organizations —Enter. a Gross income from members or shareholders b pros$ income from other sources. (Do not net amounts due or paid to other 87b sources against amounts due or received from them.) . . . . . . . . . 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? if "Yes," complete Part IX . . . . . . . . . . . . . . • • as 501(c)(3) organizations. —Enter: Amount of tax paid during the ear under. 4914 h. section 4912 ► '� ; section 4955 ► X sectwn b moralon and 501(c)(4) organizations. --Did the organization engage In any section 4958 excess benefit 89b �� X" transaction during the year? If "Yea," attach a statement explaining each transaction . . . c Enter: Amount of tax paid by the organization managers or disqualified persons during the year under section 4958 . . . . . . . . . . . . . . . . . . . . r . . . . . ► d Enter: Amount of tax In 89c, above, reimbursed by the organization . . . 90 List the states with which a copy of this return is filed ►............................................................32 -23?9 91 The books are in care of ► . TED, A;,, WECHECKI,,.. E.lj..................... Telephone no. ► p�..?' ? ,WAY,. CATHEDRAL ITY CA ZIP + 4 ► . 92VAr: �10 __,_..._... Located at :_. ► 92 SecU rater trigamountnonexempt tax-excharitable l �terest racerng Form 990 in ved or accrued 'durinf Form tax year �eck 9Z . . artr e Enter gross amounts unless otherwise indicated. 93 Program service revenue: a GENERAL' PUBLIC CONTRIBUTIONS b c d s f p Fee* and contracts from government agencies 94 Membership dues and assessments . . . 93 Interest on savings and temporary cash investments 00 Divicends and interest from securities 97 Net rental income or (loss) from real estate: a debt -financed property . . . . . . . . b not debt -financed property . , . , . . . 98 Net rental income or (loss) from personal property 99 Other investment Income . . . , . . . 100 Gain or (loss) from sales of assets other than inventory 101 Net income or (loss) from special events , 1o2 Gross profit or (toss) from sales of inventory . 103 Other revenue: a CLASSROOM FEES b C d s 104 Subtotal (add columns (B), (D), and (Q) 106 Total (add line 104, columns (8), (D), and (Q) Note: (Une 105 plus line Id, Part 1, should equal Ow amount Unrelated business income Exauded by A 512, 513, or 514 (El Related or exempt function income W Businso Code (a) Amount (C) exclusion code (D) Amount 27,690 16 2 641 —0' —O— 30 on line . 12, Party . . , . . . ► 30, 347 FMITKUM Relationship of Activities to the Accomallel ment of Exemot Purooses See Specific Instructions on page 23. Une No. Explain how each activity for which inowo Is reported In column (e) of Part VII contributed importantly to the s000mplishmsint of the organization's exempt purposes (other than by providing funds for such purpoeea). 105 PROVIDES HOMELE VEGETABLES FOR FROM • Information Regarding Taxable Subsidiaries (Complete this Part H the "Yes" box on line 88 Is checked. Name, address, and employer identification number of corporation or partnership Percentage of ownership interest Nature of businsas activities Total inoome End -of -year assets 96 96 9fi Please Sign Here Under penalties of perjury. I declare that I have examined this reh m, Ineludi V accompanying schodulas and statements, and to the bat of my irrwwlsops and tlegsf, it is true. correct, and complete. oecl.ntlan of oftwer Other than offlosr) is based a1 all information of which wepersr has any wrowledpe. a" Gerwai instructions an papa ea / STEPHEN B. MERRITT, PRESIDENT ' 6lpnatun of officer pate ' Type sir prM1t name and title. Pslf� ��` I _C(, Cat. Cneotc M ,`�,,,�" Prep.nr'e 301 12 337 i 12 :6SSS Preperer'S Only firms name (a 01, yours if self-employed)ZIN end address TED A. WIECHECKI. E.A.U:a 206 WAY CATHEDRAL. CITY CA ZiP+4 ► 92234 8 WAOM Cod) IMpow atlas. GOVIKAMMENT► WINO OFFICE:199e•407.174 COMMUL,ry GARDENS OF THE COACHELLA VAL--Y FORM 990- PART 11 - STATEMENT OF FUNCTIONAL EXPENSES LINE 43(a) - OTHER EXPENSES ADVERTISING $ 79 AUTO 6 TRUCK EXPENSES 1,182 BANK CHARGES 44 CONSULTING FEES 5,616 LICENSES & PERMITS 565 MEALS (882 X 50%) 441 OFFICE EXPENSES 2,415 PUBLICITY 50 REPAIRS 2,356 UTILITIES 115 MISCELLANEOUS 618 EARTHMOVING COSTS 702 DUES & PUBLICATIONS 1,019 YARD CARE - ..-..623 COMPUTER EXPENSES 344 TOTAL LINE 43(a) OTHER EXPENSES $16,.369 1b Form 4562 epreciation and Amortizatior I (including Information on Usted Property) ove No 1545.0172 146 nttacnment pOWWOnt of Me Treasury gN N fete instructions. 10, Attach this torm to your return. Seouence No. 67 imermi nowus Swvice Pa Name(&) shown on return Business or activity to which 1Ms form relates idenufyinp number COMKUNITY GARDENS OF THE COACHELLA ALLEY 33-0684205 • Election To Expense Certain Tangible Property (Section 179) (Note: If you have any "listed property," complete Part V before you complete Part !. 1 Maximum dollar limitation. If an enterprise zone business, see page 2 of the instructions ' ' - ` , "' 2 Total cost of section 179 property placed in service. See page 2 of the instructions. . 2 3 Threshold cost of section 179 property before reduction in limitation . . . . . . . . --A— 4 ? 0 0 , 0 0 0 4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- 4 S Dollar limitation for tax year. Subtract line 4 from line 1. If Zero or less, enter -0-. If married 5 Jilin separately, see page 2 of the Instructions . . . . . tai Description of property(b) cost (business use only) Ic) Ebcteo cost \ 6 \�\ 7 Usted property. Enter amount from line 27. 7 8 8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 9 Tentative deduction. Enter the smaller of line 5 or line 8 . . . . • • • • . . . . 9 9 10 Carryover of disallowed deduction from 1995. Sae page 2 of the instructions . . . . . . 10 11 11 Business income IimRation. Enter the smaller of business Income (not less than zero) or line 5 (see instructions) 12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12 13 Carryover of disallowed deduction to 1997, Add lines 9 and 10, less line 12 ► 13 Note: Do not use )'art tl or Part Ill below for listed property automobiles, certain other vehicles, cellular telephones, # r�^ -gi-wri or amusement). Instead, use Part V for listed pro� certain computers, or Dperty us0c tor e re,loton For tAssets Placed in Service,. ONLY During Your IM Tax Year (Do Not Include • MAG P Listed Prope .) Section A—Qeneral Asset Account Election 14 if you are making the election under section 168(1)(4) to group any assets placed in service during the tax year into one O or more general asset accounts, check this box. See pa s 2 of the Instructions . Section B--General De reciation System (GDS) See Rage 3 of the instructions. rtit ►Annfh and tct Basis br depreGi;;V1 1, M..N ._, P.,....,unn to Method to) Depreciation deductron (e) Classification of property Residential rental Nonresidential real GDS and ADS deductions for assets ptacea wi s101•rwu I-- - - Property subject to section 168(f)(1) election , ACRS and other depreciation ^c t 10 Usted property. Enter amount from fine r6o• 11 Total. Add deductions on line 12, lines 18 and 16 in column (g); and lines 17 through 20. Enter here and on the appropriate lines of your return. Partnerships and S corporations —see instructions . 22 For assets shown above And placed to service during the current year, enter 22 the portion of the basis attributable to section 263A costs • . . ' Cat. No tzeOeN For Paperwork Reduction Act Notice, eee Page 1 of the separate i�tm�one• Form 4562 o9ee) Fepe 2 form 4562 (19%) • Listed Property—Automo. ` ss, Certain Other Vehicles, CellUlar Teit ones, Certain Computers, 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 23a, 23b, columns (a) throw h c of Section A, all of Section B, and Section C it ap hcable. __. _._�_..__ rn_..•t..... eoa .. .0 of thw incrnit. nns for limitations for automobiles.) 23e Do la) Type Of prop"nY Dist vehicles fret► 24 Property use ice to su ort _business IC) (b) twist W Data pWb in use service more than tment use claimed? ❑ Yes ❑ No 23b If "Yes," is the evidence written? U Yes U No Al (i) Idl Basis for depreciation m lg) re6cwtion Ekctetl Cost or other Recovery Method! Deq section 179 u basis (buSinsinwtitmMl period Convention deduction cost usee only) ri h„sinews use (Sete 0209 5 of the instructions.): 25 Property used 50% or less in a qualified business use See a e 5 of the instructions. % - 12, of J ; S/L - 26 Add amounts in column (h). Enter the total here and on line 20, page 1. . . . . . I zo) 27 Add amounts in column (Q Enter the total here and on line 7, page 1 27 Section B--Information on Use of Vehicles Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. tf you crowded vehicles to your employees, first answer the questions in Section C to see if you meet an exception to complating this section for those vehicles. 28 Total businessAnvestment miles driven during the year (DO NOT include commuting miles) 29 Total commuting miles driven during the year 30 Total other personal (noncommuting) miles driven . . . . . . . . . 31 Total miles driven during the year. Add lines 28 through 30. 32 Was the vehicle available for personal use during off -duty hours? . . . . 33 Was the vehicle used primarily by a more than 5% owner or related person? 34 is another vehicle available for personal (a) (b) (c) MI (U M Vehicle 1 vertlGs 2 Vehicle 3 Vehicle 4 1 vehicle 5 Vehicle G Yes No I Yes J No I Yes I No Yes-1 No I Yes I No Yes I No use . . . . , . . . Section C— Questions for Employers Who Provide Vehicles for Use by Their Employees Answer these questions to determine if you meet an exception to completing Section S for vehicles used by employees who er@ not. more than 5% owners or related persons. Yes No 35 Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees? . . • • • . • ' ' ' ' ' ' ' 36 Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees? See page 5 of the instructions for vehicles used by corporate officers, directors. or 1 `yo or more owners 37 Do you treat all use of vehicles by employees as personal use? . . . - 38 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? . . . . . . . . . . . 39 Do you meet the requirements concerning qualified automobile demonstration use? See page 6 Of the instructions , Note: if your answer to 35, 36, 37, 38, or 39 is 'Yes," need not complete Section B for the covered vehicles. Amonizauon (a) lb) Date amortization (c) Amortizable Idl cow (e) Amortization �r'� Or M Amortization for Description of costs begins amount section percentage this year 40 Amortization of costs that be ins during your 1996 tax year: 41 Amortization of costs that be an before 1996 . . . 41 ri,ictions" or "Other Exline of your return .. -, o_.. 3._.r .. A nn "ruhwr nepenses" 42 1L rv•w„ w - � � �• - - CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT Name of Organization: Amount Requested: Contact Person: FISCAL YEAR 997- �8 r-a V v e,ha!/ Cl Mailing Address: 2.6 dsh �� U Z ' City:-Cl L y; & ger-z State: _ zip Code: 922—/1 Phone No.: 241,5 -91 6 U 501(c)3 Taxpayer I.D. Number: Date Submitted: 1 1 APPLICATION What is the overall purpose or goal of your organization? 1,5 2. How long has your organization been in estence? 1 Years Months xi �miz h- q 7 ti/4 J Jur /xt Yam'- 3. Describe in general the activities or services of your organization: 4. How many people does your organization currently serve? 50 No. of Youth No. of Adults & No. of Seniors 5. How many people do you intend to serve during this Fiscal Year? No. of Youth No. of Adults G No. of Seniors 6. How many people served this Fiscal Year will be La Quinta residents? No. of Youth No. of Adults No. of Seniors 7. How many paid employees/volunteers does your organization employ? No. of full time employees No. of part time employees No. of volunteers 60 8. Describe how your organization is managed and governed. 9GT�l/d �/� 5,44M 2 9. Please provide information on your Executive Board members or contact person: 10 11. 12. Name Home Address Phone M ,;-,-3673 What is your annual schedule of events, and during what months does your organization operate? / AM,2 q�- /e-- 27# ✓ Do you charge admission, membership fee, dues, etc.? 'I" Yes No If yes, please describe: A. E�Ck �R�/F.•� /1 4.�eaiz�5 -/P ,per/SE c.P2do. OG fv Jl a �✓ gy,/ ,�f w��,cv-f o o�F JFT 1'fir- S^4w What are your other sources of revenue for this funding year? /,A/-4-D Total Needed Total Received Balance 3 13. Amount of money requested from the City of La Quinta? $ > O DD 14. Has your organization been funded by the City of La Quinta previously? Yes_ No If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. 15�WAOS fie►-- lewd 4W X/ Xer ?ji ere arm 16. Goal Statement. 'Indicate who will benefit from the use of these funds, and how they will benefit. R� lsCCB �G C� e •t 5 � �� 41`,e l �o'S /,w�0/1sr�v s Rr A �!y' ,✓;�� as�i�'r- iN �'�.t�'�ccea's. Q�vr' ` ,��t�'�( - s�r.'.X� p�wy�s �,✓D ri&r .J� Asroe1A-PPJs *Vi-� �oeei�G e�enrrs �c�r � Al S. ,pLcwse- scr rW R��—r�� AgO�- �4rt-- - y'E 94'k 0 t fv Oho 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. TOTAL COST AND BUDGET League (18 games) Umpires $80.00 x 9 home games = 720.00 Baseballs $4.00 each x 36 (4 balls per game) = 144.00 Uniforms $50.00 x 25 members = 1,200.00 Ice Chest and Coolers DONATED = 00.00 Field supplies and maintenance Provided by team = 00.00 Team insurance and league fee 285.00 Tournament 1 - Palm Springs (May 30 to June 1) Tournament Fee DONATED (300.00) = 0 Tournament 2 - S:n Diego (July 4th, 5th and 6th) Tournament Fee = 300.00 Lodging - (6 rooms per night for 6 @ $75.00/room = 450.00 per night 3 nights) 3 nights x 450.00 = 1,350.00 Meals (15.00/day each member 15.00 x 25members = 375.00 per day for 3 days) $375 x 3 days = 1,125.00 Transportation DONATED = . 0 Misc. = 250.00 Tournament3 - San Diego (July 24 to August 2) Tournament Fee = (Note: if parents will work snack bar at Palm Springs tour, this entry fee will be paid) Lodging - (6 rooms per night for 6 @ $75.00/room = 450.00 per night 9 nights) 9 nights x 450.00 = Meals (15.00/day each member 15.00 x 25members = 375.00 per day for 9 days) $375 x 9 days I_ Transportation Misc. DONATED Total Cost & Budget Note: Each team member is expected to raise 200.00 each* 21 members @ 200.00 each GRAND TOTAL 1,000.00 4,050.00 3,375.00 0 500.00 $14,299.00 _ (4,200,00) $10,099.00 * For every two hours that parents work the snack bar at the Palm Springs Tournament, $25.00 will be deducted off the $200.00 total which your son needs to raise. Parents may work up to 8 hours, for a total of $100.00 to be credited towards the player fee. Please see snack bar sign up sheet for further details. It is recommended that players seek additional support from relatives, friends and businesses. This money will be used to purchase uniforms and pay umpires. All donations are tax deductible. Please turn in all checks to Steve Burt, made payable to Platinum Play, Ltd. '000:000- U0010 VT ENTR Y FOkll-f TEAM NAME: MANAGERS NAME. - MANAGERS ADDRESS / PHONE NUMBER: ALTERNATE NAME: ALTERNATEADDRESS /PHONE NUMBER: TOURNAMENT IN WHICH YOU WISH TO REGISTER FOR: CHRISTMAS / NEW YEAR REFUNDABLE; DEPOSIT $150.00 DUE NLT $300.00 ENTRY NON NOV PAID IN FULL NLT 1 DEC. 4TH OF DULY $300.00 ENTRY NON REFUNDABLE; DEPOSIT $150.00 DUE NLT 1 MAY PAID IN FULL NLT 1 JUN. 16 & UNDER WORLD SERIES REFUNDABLE; DEPOSIT $500.00 18 & UNDER WORLD SERIES REFUNDABLE; DEPOSIT $500.00 _$1000.00 ENTRY NON PAID IN FULL NLT 1 APR. _$1000.00 ENTRY NON PAID IN FULL NLT 1 APR. PLEASE MAKE ALL CHECKS PAYABLE TO (UNITED STATES AMATEUR BASEBALL FEDERATION) FORWARDING ADDRESS: UNITED STATES AMATEUR BASEBALL FEDEPI clvr C/O TIMOTHY R. HALBIG M �,& ft7, 7355 PETER PAN AVE.. AY 1T SAN DIEGO CA. 92114 ••...,,� I HAVE ENCLOSED I HAVE ENCLOSED AS A DEPOSIT . PAYMENT IN FULL. o� o also V j_ :_ Irrco pay G'� OF CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 97 - 98 Name of Organization: Martha's Kitchen -oLPx Church Amount Requested: $90 - 000 00 - Contact Person: Gloria Gomez or Claudia Castorena Mailing Address: 45-299 Dealet Noor st. City: Tndi o State: ca Zip Code: 90021 Phone No.: (760) 347-4741 Fax (760) 347-9551 501(c)3 Taxpayer I.D. Number: #95-3293901 Date Submitted: a„gyiGr 99, 1997 APPLICATION 1. What is the overall purpose or goal of your organization? The p=ose of Madjj-�s Kitchen is to assist the people of the Eastem and Central Coachella Valley who 2. How long has your organization been in existence? Years 5 Months 3. Describe in general the activities or services of your organization: 4. How many people does your organization currently serve? An average of 300 daily No. of Youth 85 No. of Adults 175 No. of Seniors 4 5. How many people do you intend to serve during this Fiscal Year? Abort 75.000 No. of Youth 19.750 No. of Adults 45.475 No. of Seniors 9.775 6. How many people served this Fiscal Year will be La Quinta residents? 1.525 No. of Youth 389 No. of Adults 625 No. of Seniors 511 7. How many paid employees/volunteers does your organization employ? No. of full time employees_ No. of volunteers About 275 No. of part time employees 2 8. Describe how your organization is managed and governed. 9. Please provide information on your Executive Board members or contact person: Name Lik Home Address Phone 10. What is your annual schedule of events, and during what months does your organization operate? Ma_rs'_nas Kitchen operates Monday through Friday year round including holidays 11. Do you charge admission, membership fee, dies, etc.? Yes —.X_No if yes, please describe: 12. What are your other sources of revenue for this funding year? I. u•►I -I: _ Ito [sit _ • ,11 11 ��_� n 11 11 Total Needed $ 75-400.00 Total Received $ 25-000.00 Balance $ 50,400.00 13. Amount of money requeste, .rom the City of La Quinta? $ _J00.00 14. Has your organization been funded by the City of La Quinta previously? Yes No X If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. In its 7-year history. Martha!s Kitchen has gromm from a humble beginning when its co-fo-unders !!'.. 1 ..! 1,. 11.• -_ 11 1- 1! each .. (93,500 1- _ -l.g !•_ .. =,I O - ! ' ! 1 ' -! • ! • • __ OF ! - i. ! - ' 4 1 I 11 •170 �_1 1 1 Wit%-1.. 1 - - 1 1 • 1 1! 1! - 1 _ 1 1 _. 1 1 ! 1 1 !1 •.11-11 _1. t _ -.n - JC_1 : �_!! 1 1t% • 1 1 1 1Y_ !. �_�• • ! ._.�' _1. _! 1 �.• 1 1 1 1 �_. !1 11 1 1 1 1. 11� 1!. ••.1i 1!' !• : ! 1 • _ • •_ 11 •.-1 !! •11 ! - 11. !_' 1 ! ! ' . • 1 1 . ... , l 1 ... 1 . �! . • __!!_ ..11 •I 11O all 111 III 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. 1 .- 1 . ! �i� !�r•�• ialIU MOM /" � �-!1 1 P_! -1 MITI 11 ! 11-IF 1 •.1M .1- _ • _ -!"•! ' 1 ' 1 . U' 1 1 1 - • 11 1 !! 1 • l ' • . 1 • 1 • ►/�► 1 • ! 1 • 1 1 MICs xzw & `rr to eep abreast is in need and what their needs are, Seve= percent of O'jr� * •e.1 !!• !. 1' ._ !• •.. ! • ' ._ 1 !!• 1 - 1' . . 11-1 M • --1 •1. 1 1' i . - 1M%.1 - - 1.. : •�• 1 ' i 13 3 K44 P M 1 1 !. 11 1 - 1 1 ._! . 1 1 .! - _ ! ! • .-! . 1 _ 1 1 • 'S dsubsidi7M-a-paftmcnL%aa&mLnilar basis, About 35N are homeless and find shelter in catL_caXU • 1 ' 1 1 i_ ! ' 1 • ! 1 • 1_ • 'J! 1 _!1 I • •_ _ !1 -! 1 ! • • 7. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. 4 APPENDIX A Martha's Kitchen is operated, as it has been from its inception, at Our Lady of Perpetual Help Church, by parishioners and volunteers from throughout the Eastern Coachella Valley. The administration of Martha's Kitchen is carried on by Parish Staff, National Indian Council on Aging volunteers, and other local community leaders. Gloria Gomez and Claudia Castorena under the supervision of Fr. Rafael Partida, Pastor of OLPH Church, are the Parish Staff coordinators. Claudia Castorena with Sandy DeTamble, Parish business manager, are responsible for the day to day business management. Gloria Gomez is the volunteer supervisor and coordinates the daily activities of the program in carrying out its delivery of services. Assisting both, the staff and volunteers, is the Board of Directors under the leadership of Ray Faccenda, the Board Chairperson. This Board meets monthly and sets policy and provides guidance to the overall direction of Martha's Kitchen. The Board also sets up the budget for the operating year which runs from July 1 through June 30. During the monthly meetings operating results are reviewed and budget performance is monitored. The majority of funds for the program come from local churches, service organizations and from government grants. Many businesses donate food and supplies. At Thanksgiving and Christmas the whole valley turns out to provide food, clothing and toys. The volunteers (approximately 300) come from all walks of life. They are trained in performing various tasks relating to the functions of Martha's Kitchen by the coordinators, senior volunteers and board members. Lead volunteers are assigned each day who is responsible for the operation of the Kitchen and the Closet. Martha's Kitchen operates with the permission of the Diocese of San Bernardino Catholic Church Our Lady of Perpetual Help Church serves as Martha's Kitchen fiscal agent and its budget and its budget is audit as part of the churches periodic audit cycle. There is a system of checks and balances between Martha's Kitchen and the Parish. A separate bank account is held for Martha's Kitchen and is managed in accordance Diocesan financial procedures. Monies received are posted before the Business manager makes the deposit. Donations for Martha's Kitchen are made directly to the church and are deposited in the Martha's Kitchen account. Monies for purchases and Kitchen expenses are disbursed through a requisition procedure prepared by the Staff coordinators and approved by a member of the Board of Directors. All purchases. require receipts which are turned into the Parish Business Manager for filing and audit. Audits of all parish transactions are conduct every three years or sooner as directed by the Diocese. Results of these audits are available from the parish business office. Martha's Kitchen Board of Directors 45-118 Park St. Indio, CA 92201 Meetings: Every 2nd. Friday of the Month at 8:30 A.M. Position Chairperson Ray Faccenda 367 Cypress Dr. Palm Desert, CA 92260 (760) 340-4229 Vice Chairperson Alfred W. Meyer 349 Villena Way Palm Desert, CA 92260 (760) 773-0889 Or 779-0844 Treasurer Tom Quinn Finance 48-101 Desert Grove Dr. #131 Indio, CA 92201 (760) 347-1797 Secretary Bud Beck 79-421 Port Royal Bermuda Dunes, CA 92201 (760) 345-4061 Coordinator Supervisor Fund Raising Volunteer Development Fr. Rafael Partida Our Lady of Perpetual Help 82-450 Bliss Ave Indio, CA 92201 (760) 347-3507 James & Joyce Vilmann 2033 Ramon Rd. 3-C Pahn Springs, CA 92264 (760) 327-0069 241 a Huntington Dr. Lakewood, NJ 08701 1-800-247-2544 Nancy Meyer 349 Villena Way Palm Desert, CA 92260 773-0889 Fax:862-1842 Dean and Dorothy Grannan 44-335 Foxtail Circle La Quinta, CA 92253 (760) 345-0171(hm) Retired Business President Lawyer Retired Business Mgr. for Especial. Projects Retired Teacher O.L.P.H. Pastor Retired Teachers/Business Owners Retired Retired Businessman Claudia Castorena On -Site Coordinator 45-299 Deglet Noor St. Program Coordinator Indio, CA 92201 (760) 347-4741(wk) 342-4823(hm) Page 1 Martha's Kitchen Board of Directors Cont. Fr. Rot,.A Crafts S.J.E. Churn„ Pastor St. John's Episcopal Church 45-319 Deglet Noor St Indio, CA 92201 (760) 347-3265 or 342-5091 Jim Foster Lawyer 79-024 Bayside Ct. Bermuda Dunes, CA. 92201 (760) 772-3534 (wk) 360-0635(hm) Gloria Gomez 45-299 Deglet Noor St. Indio, CA 92201 (760) 347-4741(wk) 342-4823(hm) Ginger Kobrin 78-332 Silver Sage Dr. Palm Desert, CA 92211 (760) 772-0097 Mike. Martinez 82-388 Oleander Ave Indio, CA 92201 (760) 347-5476 Barbara Paumier P. O. Box La Quinta, CA 92253 (760)564-4558 Patricia Reese 78-617 Bougainvillea Dr. Palm Desert, CA 92211 (760) 360-7011 Ediberto Romero 43-589 Comanche Indio, CA 92201 (760) 347-0823 John Williams 44-644 Sherwood Dr. Indio,CA 92201 (760) 347-3797 Tom and Rita Martin 2 Churchill Lane Rancho Mirage CA 92270 324-8554 Fax:328-3431 On -site Coordinator Program Coordinator Retired Business Owner Retired Truck Driver Retired Business Owner Volunteer Retired from Water District Retired Deputy Sheriff Retired Business Owner Page 2 �COG'F=LZ12 g!a.,jota (7Z niE 'L 1�. icc= of curs 1�ssrsa:dF,zo TO WHOM IT MAY CONCERN: PLEASE BE ADVISED THAT: OUR LADY OF PERPETUAL HELP P.O. Box BB _ Indio, Ca 92201-2527 IS A UNIT of THE EXEMPT CORPORATION, THE ROMAN CATHOLIC BISHOP OF SAN BERNARDINO, A CORPORATION SOLE, FEDERAL I.D. #95-32939011 STATE I.D. i910-1176-7. THIS INSTITUTION IS LISTED IN THE OFFICIAL CATHOLIC DIRECTORY AND IS EXEXL°T UNDER SECTION 501 (C) OF THE INTERNAL REVENUE CODE AS A MEMBER OF GROUP EMMPTION NUMBER 928. PLEASE SEE COPY OF I.R.S. LETTER AND STATE OF CALIFORNIA EXEMPT STATUS SHEET ATTACHED. r YRO E GREER-WALLACE D CT R OF ACCOUNTING SERVICE DIOCESE OF SAN BERNARDINO THE ROMAN CATHOLIC BISHOP OF SAN BERNARDINO A CORPORATION SOLE 1430 ::�/o-.j4 ' 1�" �Lszt, cars �rsr-cz�lrso, f; fo lsic 92¢03 (909) 55¢-82a0 Martha's Kitchen 997-98 Operations Budget 06/18/97 July 1997 through June 1998 Jul '97 -Jun '98 Income DonatAdminst 8,000.00 DonatGrant 90,000.00 Donations 82,900.00 Donatshelt 2,400.00 DonLBus passes 240.00 GoifReceipts 20,250.00 In -Kind Hours 86,725.00 in -Kind Mat 128.150.00 Interest Income 3,000.00 Misclncome 1,200.00 Yardsale donaL 12,000.00 Total Income 434,865.00 Expense 3,000.00 •Buiidexp 600.00 BusPassExp. 00.00 Cleansupp 9,000.00 Consumables , 3 Dental Exp ,500.00 6,000.00 EquipPurch 2,400.00 EquipRep 12.000.00 FoodCS FoodMK 62.200.00 GolfExp 8,100.00 Mat Don. Adjust 128,150.00 Medicalexp 2,485.00 Miscexpse 5,175.00 OfficeSupply 4,000.00 Postage 300.00 Prescription 1,200.00 PrintExpae 600.00 Rental Assist 9,000.00 Salaries 56,400.00 SalesTax 900.00 SheltVour 6,000.00 Training 2,250.00 Transprtn. Exp 1,650.00 Utilities Bills 7,525.00 Garbage Pick-up 3,000.00 Monthly Service 0.00 Telephone 1,440.00 Total Utilities 11,965.00 VehExpense 6,000.00 Vol Hours Adjus 86,725.00 Volunteer Development 1,250.00 Total Expense 434,450.00 Net income 415.00 Page 1 Adopted 06113/97 CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-1998 Nam-- of Organization: Family YMCA of the Desert/La Quinta Preschool Amount Requested: . $6, 000.00 Contact Person: Gerald A. Hundt Mailing Address: 43-930 San Pablo Avenue City: Palm Desert Phone No.: (760) 341-9622 501(c)3 Taxpayer I.D. Number.: State: CA Zip Code: 92260 95-3673295 Date Submitted: September 1 1997 1 APPLICATION 1. What is the overall purpose or goal of your organization? The purpose of the Family YMCA programs is to provide safe, affordable community based programs in recreation. sports, camps. child care and ether activities. 2 A 4. The programs are tools to work with youth and families with an emphasis on character development. The YMCA programs challenge participants and families to demonstrate positive values like CARING, HONESTY, RESPECT AND RESPONSIBILITY. How long has your organization been in existence? 15 Years 2 Months Describe in general the activities or services of your organization: YMCA programs include child care for preschool and school age, summer day camps and resident camps, youth sports (roller hockey, gymnastics, basketball, martial arts, swimming, skateboarding), teen programs and other programs as needed. How many people does your organization currently serve? 5,000 annually No. of Youth 4,500 No. of Adults 500 No. of Seniors 100 5. How many people do you intend to serve during this Fiscal Year? No. of Youth 5 .000 No. of Adults 500 No. of Seniors 100 6. How many people served this Fiscal Year will be La Quinta residents? No. of Youth 800 No. of Adults 20 No. of Seniors 0 7. How many paid employees/volunteers does your organization employ? No. of full time employees 20 No. of part time employees 60 No. of volunteers 250 8. Describe how your organization is managed and governed. The YMCA is governed by a volunteer Board of Directors. The Board has committees that help set policy, monitor programs, and assist with fundraising. The Board employs the CEO, who administers the YMCA programs. Seasonally the YMCA employs 75 to 100 full and part time staff and works with hundreds of volunteers to provide the programs. 2 9. Please provide information on your Executive Board members or contact person: Name rule Hom AddressPhone See attached Board of Directors List 10. What is your annual schedule of events, and during what months does your organization operate? The YMCA operates programs that are primarily directed at the youth. Seasonal programs are planned to be available when school vacations, etc. indicate the times and dates of availability. Generally, summers include all camps (day & resident), some year round child care, aquatics and some youth sports programs. School year (September -June) includes more school age care, youth sports, and fully enrolled preschools. Teen youth and government program is provided from September to February. 11. Do you charge admission, membership fee, dues, etc.? X Yes No If yes, please describe: Membership and program fees are charged. All fees are based on costs of program All programs include funding for low income families who cannot afford full fees. Sliding fee scales are provide for those who qualify. 12. What are your other sources of revenue for this funding year? Contributions United Way Grants Membership Fees and Dues Total Needed Total Received Balance $ 2,104,838.00 $ 2,085,653.0 $_-19,185.0 3 $131,347.00 $ 52,000.00 $451,995.00 $1,379,043.00 13 14. 15. 16. 17. m Amount of money requested from the City of La Quinta? $ 6, 000.00 La Quinta Preschool $3,000.00 Adams/Truman $3,000.00 Has your organization been-fanded by the City of La Quinta previously? Yes x No_ If yes, when 1995-96 Amount received $2, 000.00 Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. The YMCA provided $43,997.00 to La Quinta Child Care Programs in 1996. $8,664.00 for the School Age Programs at Adams/Truman Schools and $35,333.00 at La Quinta YMCA Preschool Child Care Center. These funds are used to provide slidine scale fees for low income families who need lower fees to continue to provide care for their children. The programs are growing with the addition of an on -campus program at the Adams School, and cost increase for transporting Kindergarten children from Adams School to the Preschool on Park Avenue. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. Low income families who in many cases are single parent homes will benefit the most from these funds. There are many families who are productive. good citizens who need the assistance provided so they can keep working and know that their children will be in a safe place when not in school. The children will benefit by receiving quality supervision by a licensed provider. All staff are trained to nurture the children and work with the family.to help develop children with an emphasis on values like CARING, HONESTY, RESPECT AND RESPONSIBILITY. The City of La Quinta will benefit as the children will'be supervised in a safe place, helping to reduce juvenile delinquency and keeping parents employable. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. Non-profit organizations must attach a copy of the organization's current IRS Form 990. 4 gamily Y.NTCA of the Desert - ,196 annual Budget Summary Operating'/ Checking Fund 1996 1997 ACTUAL BUDGET REVENUE: $117,197.00 $171,500.00 Contributions 536,242.00 $50,000.00 Special Events $518,348.00 S501,995.00 Grants S29,224.00 $36,482.00 Membership 54,922.00 54,000.00 Health Enhancement H S22,472.00 $22,600.00 Aquatics $11,093.00 $10,400.00 Youth Sports S62,488.00 $133,278.00 Gymnastics $142,400.00 $175,500.00 Day Camp Leadership/Parent Child LeadershipSchool $17,815.00 S19,100.00 $367,588.00 PreChild $260,974.00 $357,758.00 $497,428.00 Care $58,208.00 $45,100.00 Resident Camps IS39,198.00 $46,554.00 Holiday Camps $12,208.00 $20,330.00 Sales Miscellaneous Income 515,138.00 $7,750.00 TOTAL INCOME $1,705,686.00 $2,109,605.00 EXPENSE: Salaries Adm/Prog/Off $289,522.00 $167,692.00 $359,664.00 $182,595.00 La Quinta Pre School Salaries Jean M. Benson Child Care Center Salaries $0.00 $64,102.00 WBCC Salaries $85,098.00 $63,546.00 $94,136.00 $71,721.00 WBPS Salaries Salaries - Prog/Instructor $80,689.00 $98,366.00 $430.00 Salaries - Resident Camp $91.00 $81,806.00 $99,000.00 Salaries- Day Camp Salaries - Child Care $116,941.00 $166,163.00 Salaries - Holiday Camp $5,999.00 $163,331.00 $7,350.00 $211,595.00 Employee Benefits/PR Tax $78,083.00 $50,549.00 Contractual Fees Supplies - Administration $24,711.00 $27,447.00 Supplies - Program $75,508.00 $6,139.00 $103,790.00 $6,350.00 Postage Utilities/Rent/Lease $221,966.00 $204,493.00 Equip. New/Repair/Lease $33,937.00 $5,525.00 $60,461.00 $10,175.00 Resale Supplies $5,976.00 $6,100.00 Entry Fees Printing/Publicity $32,371.00 $31,600.00 Nat'l Dues/Y&G/Meet/Train Cost $57,041.00 $52,975.00 $56,265.00 $46,606.00 Insurance Transportation $18,338.00 $17,300.00 Special Events $27,516.00 $16,801.00 $27,500.00 $15,347.00 MisclRefunds/Bad Debts 00 $,.00 Board Appropriations TOTAL EXPENSE $11711,601.00 $2,109,605.00 ARROYO, SARA Psychological Services P.O. Box 1226 Indio, CA 92201 (760) 7714919 (760) 771-5545 (residence) ART WR, LAYNE; V.P. Property Desert Sands Unified Schools 47-950 Dune Palms Road La Quinta, CA 92253 (760) 777-4200 (760) 000-0000 (residence) (760) 771-8522 (fax) BALLESTEROS, DOLORES 47875 Via Firenze La Quinta, CA 92253 (760) 771-1082 BAXLEY, DICK Baxley Properties P.O. Box 13183 Palm Desert, CA 92255 (760) 773-3310 (760) 360-6018 (residence) (760) 773-3013 (fax) BLANKE, RICK Dean Witter 72996 El Paseo Dr. Palm Desert, CA 92260 (760) 776-6200 (760) 5684030 (residence) (760) 776-6250 (fax) CALLANDER, CHARLIE; V.P. Program Vintage Club Sales 75005 Vintage Drive West Indian Wells, CA 92210 (760) 346-5566 (760) 568-5177 (residence) (760) 568-3531 (fax) Spouse: Assistant: Spouse: Assistant: Cindy Spouse: David Spouse: Paula Assistant: Sandy Spouse: Janet Assistant: Anna Spouse: Melanie Assistant: Carmen CECIL, SHELLEY 69337 Woodside Avenue Cathedral City, CA 92234 (760) 328-8725 (residence) (760) 328-7385 (fax) CHRIST L4N, STEVE Palm Desert Nat'l Bank 73745 El Paseo Palm Desert, CA 92260 (760) 340-1145 (760) 568-5422 (residence) (760) 341-8050 (fax) DUNPHY, JIM; President J.T. Dunphy 424 N. Hermosa Palm Springs, CA 92262 (760) 323-1948 (760) 325-9620 (residence) (760) 320-4423 (fax) GIBBS, JOE Law Offices of Joseph Gibbs 74900 Hwy I I I Indian Wells, CA 92210 (760) 779-1790 (760) 346-7322 (residence) (760) 779-1780 (fax) GORDON, STEVE Cove & Sea Realty 73415 Pinyon Street Palm Desert, CA 92260 (760)773-0677 (760) 568-6708 (residence) (760) 341-2661 (ofc. fax) (760) 568-6784 (home fax) GREEN, CHRISTINE; V.P. Financial Dev. Downey Savings 198 Desert Falls East Palm Desert, CA 92211 (760)773-1031 (760) 341-5125 (residence) (760) 340-4571 (fax) HORDADD8/% Spouse: Assistant: Spouse: Assistant: Spouse: Assistant: Spouse: Assistant: Spouse: Assistant Spouse: Assistant: Chipper -0- Doreen Michelle JoAnne Carol Julie -0- 0 HAYES, JOE Del Webb Sun City 39755 Berkey Drive Palm Desert, CA 92211 (760) 772-5307 (760) 360-0034 (residence) (760) 772-5372 (fax) JOHNSON, MATT Orr Company; Industrial West 77570 Springfield Lane, Ste. C Palm Desert, CA 92211 (760) 360-2033 (760) 568-5809 (residence) (760) 360-2634 (fax) L111 , JEFF State Farm Insurance 43875 Washington Street, Ste. A Palm Desert, CA 92211 (760)345-2424 (760) 346-3173 (residence) (760) 345-5126 (fax) LONG, MIICE Plaza Dental Group 167 Luring Drive Palm Springs, CA 92262 (760) 327-3863 (760) 564-5455 (L.Q. ofc.) (760) 778-7774 (fax) LOZANO, ISABEL Power Marketing 78401 Hwy 111, Ste. F-2 La Quinta, CA 92253 (760) 564-5272 (760) 564-5076 (residence) (760) 564-8535 (fax) MCQU LLEN, JAY; V.P. Sec/Treas Granite Construction 38000 Monroe Indio, CA 92203 (760) 775-7500 (760) 345-6978 (residence). (760) 775-8229 (fax) BORDADD8/M Spouse: Assistant Spouse: Assistant: Spouse: Assistant: Spouse: Assistant Spouse: Assistant: Spouse: Assistant: -0- Nancy Linda Elissa Pat Jan Christine Doreen Vicki Cindy MELGOSA, MELISSA 73-720 Shadow Mountain #14 Palm Desert, CA 92260 (760) 776-0922 NEATHERTON, MWE Betty Ford Center 44060 Dalea Circle La Quinta, CA 92253 (760) 773-4118 (760) 345-3625 (residence) (760) 7734141 (fax) NETHERY, MARTY; Past President Best, Best & Krieger 39-700 Bob Hope Drive Suite 312 Rancho Mirage, CA 92270 (760) 340-2445 (760) 340-2381 (residence) (760) 341-7039; 340-6698 (fax) NOBLE, FRM U.S. Filter 76896 Oklahoma Palm Desert, CA 92211 (760) 341-8177 (760) 346-4024 (fax) (760) 345-0437 (residence) RUTHERFORD, TED; V.P. Public Policy Rutherford Investments 45275 Prickly Pear Ln., #1 Palm Desert, CA 92260 (760) 779-1771 (760) 568-2839 (residence) (760) 779-0673 (fax) SPARKS, NOLAN Sparks Construction 77W Calle Las Brisas North Palm Desert, CA 92260 (760) 771-1941 (760) 360-0045 (residence) (760) 771-1841 (fax) BORDADDM use: Spouse: Assistant Spouse: Assistant: Spouse: Assistant: Spouse: Assistant: Spouse: Assistant Maria Laurie Carrie Holly Cecile -0- Dina Kim TANNER, VAN; V.P. Board Dev. Hilb, Rogal & Hamilton 39918 Cricket Cove Palm Desert, CA 92260 (760) 360-4700 (760) 360-6337 (residence) (760) 360-4799 (fax) THOMAS, GAYLE 48676 Desert Flower Drive Palm Desert, CA 92260 (760) 340-9875 (residence) (760) 347-5453 (fax) UNDERWOOD, BRUCE Healthy Futures 75895 Altamira Drive Indian Wells, CA 92210 (760)773-9706 (760) 773-9525 (residence) (760) 773-9706 (fax) WELTON, SUE 77590 California Palm Desert, CA 92260 (760) 345-5436 (residence) (760) 251-2581 (fax) update &97 noanADosM Spouse: Assistant: Spouse: Spouse: Assistant Judy Diane Joe Janet -0- Spouse: Jeff Assistant: -0- VIN.7 vc:, Form 990 Retum of "Nanization Exempt from Income -Tax Under section Sol (c) of the internal Revenue Code (except black lung bensit trust trust or private foundation) or section 4947(aX1) Pth re uil Li"e„ Re^„te�� s rv�s ry Note: The organization may have t0 use a Copy of this retuRl t0 Sat/Sfy state reporting Q ,1996, A For the 1996 calendar ear, Or tax ear n be fnnin B Check if: C Name of organmtion Please use Change of address IRslab.l FAMILY YMCA OF THE DESERT or Print Number 6 street (or P.O. box if mail is not delivered to street addr) Initial return ortrPe• Final return pr a 43-930 SA PA ILO AVE state City. torn, or Post office Amended return tioes. CA (required also for P A L M DESERT state reporting) 3 • (insert number) or ..... GType of organization ....... X Exempt under section 501(c Note: Section 501 c exem t o anizations and 4947 a 1 nonexempt Yes charitableX No st mud box^ H'st� four -digit group H(a) Is this a group return filed for affiliates? 9 exemption number (GEN) (b) If 'Yes,' enter the number of affiliates for which this return is filed ......... ► J Accounting method: Cash X Accrual c Is this a separate return filed by an organization covered by a p ruli ? ...... Yes X No Others ci . . KCheck here .. ► if the organization's gross receipts are normally not more than $25,000. The organization need not file a return with the IRS; but if it received a Form 990 package in the mail, it should file a return without financial data. some states re Wine a complete return. late: Form 990-EZ ma be used by organizations with gross receipts less that $10a0,000a and total assetslessice, $250,000 at end of year, 1996 ts. IThis This Form is Open to Public lnspectior .19 D Emwlover tdenti8cab- Number 95-3673295 Roomisuite Estate roois0atiom rmnnbe► 48935 ZIP.4 FChec k . - Lj if exemption 9221 application is pending section 4947(aXl) nonexempt charitable trust a l) <>> Revenue Ex nses and cnan es in rret t+S�� • • �••-- __.__.___ ___ 1 Contributions, gifts, grants, and similar amounts received: 1 e 204L943. a Direct public support ......... • .......................... • • • • 1 b b Indirect public support .............................................. 1 c 856. 468 c Government contributions (grants) ................................... d Total (add lines 1 a through 1 c) (attach schedule of contributors) $ 1,869.) .. • • • • L.- Id. .Sta t...... id 673,799. (cash $ 671, 930 . noncash fees and contracts (from Part VII, line 93) ......... 2 977 328. 2 Program service revenue including government 3 31,481. 3 Membership dues and assessments ........................................ 4 14,611. 4 Interest on savings and temporary cash investments ....................................... ...... 5 5 Dividends and interest from securities ................................ . .. a ................. 6a Gross rents......................................................... 6 b b Less: rental expenses ............................................... or (loss) (subtract line 6b from line 6a) .......................... c Net rental income 7 7 Other investment income (describe . ► (A) Securities (B) Other 8a Gross amount from sale of assets other 8 a 584 712. R than inventory ..................... • • • • • .. " " 8 b 500,000. v b Less: cost or othtr basis and sales expenses ........... 8 c 84 , 712 . ue Gain or (loss) (attach schedule) .:.................... 84,712. d Net gain or Qoss) (combine line 8c, columns (A) and (B)) .. • • • • • • • • • • • ""' E 9 Special events and activities (attach schedule) a Gross revenue (not including ... $ 36,242. 9a 12 208. of contributions reported on line la) ................ • • • • • • .•.•,,.... 9b 12,208.9 b Less: direct expenses other than fundraising expenses ........,...... events (subtract line 9b from line 9a) c 0 c Net income or (loss) from special 10 a 10a Gross sales of inventory, less returns and allowances ............... b Less: cost of goods sold ........................................ inventory (attach schedule) (subtract line 10b from line 10a) .. c Gross profit or (loss) from sales of 11 11 Other revenue (from Part VII, line 103) .................... 12 1.781.931. 12 Total revenue add lines 1d, 2, 3, 4, 5, 6c, 7, 8d, 9c, IOc, and 11 ............................... . 1 353 984. 13 355 13 Program services (from line 44, column (B)) ...•••••••••••••••••••••••."""'•"."......'•'".. 14 122. E . ........................... x 14 Management and general (from line 44, column ( ... • • • • • • • • • • • • • • 15 111 403. 15 Fundraising (from line 44, column (D)) ............... • • 16 N . • .... • • .. • ..... • ....... .... E16 Payments to affiliates (attach schedule) ................ 17 1 733, 509 . s........................................ 17 Total expenses add lines 16 and 44, column A) ........ 18 48 422. n 18 Excess or (deficit) for the year (subtract line 17 from line 12) .. 19 959 410, N s 19 Net assets or fund balances at beginning of year (from line 73, column (A)) .. T T 20 Other changes in net assets or fund balances (attach explanation) ......................... 21 1, 007,832. s 21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) ........ . ....... Form 990 (1996) BAA For Paperwork Reduction Act Notice, see instructions. r==_n0101 12116.P96 Form990(1996) FAMILY YMCA OF THE DESERT 95-3673295 Pa Statement of Functional nseS All organizations must complete colun ). Columns (B), (C), and (D) are required for section 501(c)(3) aha-(4) organizations and section 4947(a)(1) nonexemp, charitable trusts but optional for others. Page2. Do not include amounts reported on line 6b, Bb, 9b, 10b, or 16 of Part 1. (A) Total (B) Program services (C) Management and general D Fundraisin () g 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Grants and allocations attach schedule) ) cash non cash ific assistan a to individuals attach sch ... S c ( ) Benefits id to r for members attach sch .... Be o Pa Compensation of officers, directors, etc ........ Other salaries and wages ............. Pension plan contributions ............ Other employee benefits .............. Payroll taxes ......................... Professional fundraising fees .......... Accounting fees ....................... Legalfees ............................ Supplies .............................. Telephone ............................ Postage and shipping ................. Occupancy ........................... Equipment rental and maintenance .... Printing and publications .............. Travel ................................ Conferences, conventions, and meetings ........ Interest ............................... Depreciation, depletion, etc (attach schedule) .... Other expenses (itemize): a _ _ _ _ _ _ _ _ b_A_mo_r_tiz_a_tio_n c_INT_E_RES_T d FOOD ---------------- 22 .:: ....i:: ................ . : :>»>.. :.:........40...199 XX 23 24 25 66,998. 6,700. 20,099. . 26 824,435. 698,808. 93 534. 32,093. 27 32,724. 26,179. 4,254. 2,291. 28 26,547. 21,238. 3,451. 1,858. 29 77,839. 63,219. 9,090. 5,530. 30 31 16,550. 5,000. 11,550. 32 33 94,430. 86,977. 5,345. 2,108. 34 26,894. 23,095. 2,936. 863. 35 6,139. 4,790. 1,043. 306. 36 108 958. 101 289. 1235. 6 434. 37 4,588. 3,099. 875. 614. 38 24,422. 16,803. 2.646. 4,973. 39 0* 0. 0. 0. 40 41 42 44,987. 44,987. 43 a 43b 7, 143. 7,143. 43c 923. 0. 923. 0. 43dl 33,227. 25,650.1 1,329. 6,248. 44 Total functional expenses (add lines 22 - 43) I _ _ I I ..., . I I Organizations completing columns (B) - (D), �,.., , , . , Reporting of Joint Costs — Did you report in column (B) (program services) any joint costs from a combined educational campaign and fundraising solicitation?............................................................. Yes XD No If 'Yes,' enter (I) the aggregate amount of these joint costs $ ; (if) the amount allocated to program services $ ; (III) the amount allocated to management and general $ ; and (iv) the amount allocated to fundraising $ What is the organization's primary exempt purpose? ► SEE STATEMENT — Program Service Expenses All organizations must describe their exempt purpose achievements. State the number of clients served, publications (Raouirsd for ations501 a and issued, etc. Discuss achievements that are not measurable. (Section 501 c & 4 organizations & section 4947 a 1 () o(9.- Lusts and ( ion) () g ()() 7(a)(1) trusts; but nonexempt charitable trusts must also enter the amount of grants &allocations to others.) optional «others.) a DAY CAMPS —PROGRAM: SEE —STATEMENT --------------------------------------------------- ----------------------------------------------------- ----------------------------------------------------- (Grants and allocations $ ) bCHI LD — —PROGRAMS:— PROGRAMS: — SEE STATEMENT -------------------------------------------------- ----------------------------------------------------- ----------------------------------------------------- (Grants and allocations $ ) c GYMNASTICS AND YOUTH SPORTS PROGRAM: —SEE STATEMENT ------------------------------------- ----------------------------------------------------- ----------------------------------------------------- (Grants and allocations $ ) d ----------------------------------------------------- ----------------------------------------------------- ----------------------------------------------------- (Grants and allocations $ 279.317. 26.733. 7.934. e Other program services ............................. (Grants and allocations $ ) f Total of Program Service Expenses (should equal line 44. column (B), program services) ..................... 0-1 1.353.984. TEEA0102 01/13197 Form990 1996) FAMILY YMCA OF THE pii;tV < Balance Sheets (see instruction 95- 95 Page 3 Note: ccolumn should be for end -of -year lamoues ldnts Only — amounts 45 Cash — non -interest -bearing .................................................. 46 Savings and temporary cash investments ................... . .................. I 47 a Accounts receivable .............................. 4ja 920. b Less: allowance for doubtful accounts ............. 4 48 a Pledges receivable ............................... a b Less: allowance for doubtful accounts ............. 48b 49 Grants receivable............................................................ A 50 Receivables from officers, directors, trustees, and key employees s (attach schedule) ........................................... E 51 a Other notes & loans receivable (attach schedule) .. 51 a s b Less: allowance for doubtful accounts ............. I 51 b 52 Inventories for sale or use ............................................... ..... 53 Prepaid expenses and deferred charges ....................................... ............ 54 Investments — securities (attach schedule) .................................... 55a Investments —land, buildings, & equipment: basis 55a b Less: accumulated depreciation (attach schedule) . 55b 56 Investments — other (attach schedule) • • • • • • • • • • • • •.. • • • • • ' ' ' ' ' ' 57a Land, buildings, and equipment: basis ............ 57a 643,971. b Less: accumulated depreciation (attach schedule) . 57b 365,821. 58 Other assets (describe ► SEE STATEMENT ) 59 Total assets add lines 45 through 58 must equal line 74 ................... . 60 Accounts payable and accrued expenses ...................................... L 61 Grants payable......................................................... ..... A 62 Deferred revenue ........6......... ............................... e 63 Loans from officers, directors, trustees, and key employees (attach schedule) ... 64a Tax-exempt bond liabilities (attach schedule) ................... 6 .............. b Mortgages and other notes payable (attach schedule) .......................... s 65 Other liabilities (describe ► ) " 66 Total liabilities add lines 60 through 65)..................................... . Organizations that follow SFAS 117, check here ► X and complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted..................................................6................. 68 Temporarily restricted...........................6.............................. 69 Permanently restricted .. • • • ..................... Organizations that do not follow SFAS 117. check here ► ❑ and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds ................................... 71 Paid -in or capital surplus, or land, building, and equipment fund .......... 6 ...... gA......... A 72 Retained earnings, endowment, accumulated income, or other funs ... . 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72; column (A) must equal line 19 and column (B) must equal line 21) ........... 74 Total liabilities and net assets/fund balances (add lines 66 and 73) .............. (A) Beginning of year 167.95� 642,864. 219,919. 4.7 4.7 (S) End of year 45 615,771 46 _ 47c 920. 48 c 49 50 51c 52 53 2,500. 54 55 c 56 57c 278 150. 58 212 777. 59 1,110,118. 60 102 286. 61 62 63 64a 64b 65 66 102 286. 924 466. 67 978 588. 16,671. 68 1 10.068. 18,273. 69 19 176. 70 71 72 959,410. 73 1 1 007 832. 034.152. 74 1 1.110,118. TEEA0103 01/13/97 r (2) Donated services and use of facilities $ (3) Recoveries of prior year grants ...... S (4) Other (specify): _SEE___ STMT S. 40,240. Add amounts on lines (1) through (4)..................... ► c Line a minus line b :............ ► d Amounts included on line 12, Form 990 but not on line a: (1) Donated services and use of facilities .... S (2) Prior year adjust- ments reported on line 20, Forrn 990 .. $ (3) Losses reported on line 20, Form 990 ... (4) Other (specify): SEE ____ STM_T _ _ _ _ E 40 , 240 . Add amounts on lines (1) 240 . through (4) ....................... ► 931. c Line a minus line b ............... ► rw z d Amounts included on line 17, Form 990 but not on line a: 40 733 Investment expenses not included 0 line 6b Form 9 $ ci : 2 Other(specify): — ---- Add amounts on lines (1) and (2) ► e Total revenue per line 12, Form 990 pine c plus line d) .............. ► ....................... ::::>::::::>::;»:>;»::»s::>:z:>:<:>:::•:a:<>:::»::>::>::> ...........::..........................:.:........ Yii:•)}:� ..........: .............................................. ............................:... ....... ....d i>i::'r:4:•iii:•iiii:4:•:ii:;iiii:^iY.iii::iti>•i: .....::::..................:.:..... . ............................ .................. Investment not included on line 6b Form 990 ...... $ O Other (specify): ( Pe )� Add amounts on lines (1) and (2) . ► a Total expenses per line 17, Form 990 oine c plus lined ............... ► :•:?<•: d �•..w ........, .,r••: Mom.::.:.;,•:.;:;:.;: . a...: . :•:::::: .. 4�.•'.:::. ;:.w....... .;::�•�`.a:...... K:i:'•• • k. . i. <..ti.... , Kxy: :t . '� .:. e 1,781,931.1 e 1,733,509. pare» List of Officers Directors Trustees and Ke Em to ees (List each one even if not com nsated; see instructions. (A) Name and address (B) Title and average hours per week devoted to position (C) Compensation (if not paid, enter -0-) (D) Contributions to emplo fee benefit plans y& deferred compensation (E) Expense account and other allowances GERALD HUNDT-----_—__—_ PALM DESERT, CA EXEC.DIR 40 66,998. 4,690. --------------------- SEE ATTACHED LIST --------------------- ---------------------- --------------------- --------------------- ---------------------- --------------------- - L — — — — — — — — — — — — — — — — — — — ---------------------- 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the relatedorganizations?................................................................................... ► Yes No If 'Yes,' attach schedule — see instructions. TEEA0104 01/13/97 - 95-3673295 Page5 Form99t' 1996 FAMILY YMCA OF "'�SERT Yes No Park s Other Information (see s V c ructions IRS. if 'Yes,' attach a detailed description of activity not previous) reported to the in y 76 X 76 Did the organization engage any ......................... eachactivity ......................................... ........... ...................... documents but not reported to the IRS? 77 Were any changes made in the organizing or governing If 'Yes,' attach a conformed copy of the changes. income of $1,000 or more during the year covered by this return? ... 78a X 78a Did the organization have unrelated business gross 78b X b If 'Yes,' has it filed a -tax return on Form 990-T for is year?.................... ... »::><::i:>: •••.•....•• ... ............................ dissolution, termination, or substantial contraction during the year? If Yes, attach 79 X 79 was there a liquidation, .................. a statement ............................ ................... 80a Is the organization related (other than by association with a statewide or nationwide organization) through common etc, to any other exempt or nonexempt organization? ....... . 80a X membership, governing bodies, trustees, officers, b If 'Yes,' enter the name of the organization ► _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and check whether it is � exempt or nonexempt. ;.;:;;>:;> :<•:::;•;•; the of political expenditures, direct or indirect, as described in the instructions 81 a 81 a Enter amount b Did the organization file Form 1120-POL for this year? .................... donated services or the use of materials, equipment, or facilities at no charge or at 82a X 82a Did the or anization receive ........ substantia ly less than fair rental value? ........................................................ b If 'Yes,' you may indicate the value of these items here. Do not include this amountas I as an expense in Part II. (See instructions for reporting in Part III.) ..... 82bl ::....: , ..•„_: , • ..,,,,.• 838 X revenue in Part or 83a Did the organization comply with the public inspection requirements for returns and exemption applications? ::::...... • 83b X b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? . 84a Did the organization solicit any conVibutiorls or gifts that were not tax deductible. ...... ........ b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were ........... deductible 84b 85a not tax ................................ n ial.ly Were substantial) all dues no by members? ......::: . 85 501(c)(4), (5), or (6) organizations - a .. make only in-house lobbying expenditures of $2,000 or less? ................... : :::1V .... 85b b Did the organization 'Yes' to either 85a or 85b, do not complete 85c through 85h below unless the organization received a If was answered waiver for proxy tax owed for the prior year. o. pt 0. <°`.� >:<:.>•> c Dues, assessments, and similar amounts from members ........... • • • • • • • • • • • • .... 85 d d Section 162(e) lobbying and political expenditures 85e e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices .................:.. 85 f A ::•:;:•: f Taxable amount of lobbying and political expenditures (line 85d less a ...... . ........ .. 85 g Does the organization elect to pay the section 6033(e) tax on the amount in 85f? .............. h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable expenditures for the following tax year? ............... 85h estimate of dues allocable to nondeductible lobbying and political 86 501(c)(7) organizations - Enter: a Initiation fees and capital contributions included on k< line 12 .................................................. b Gross receipts, included on line 12, for public use of club facilities ....................... ... 86b 87a 87a 501(c)(12) organizations - Enter: a Gross income from members or shareholders ......... •.•+. b Gross income from other sources. (Do not net amounts due or paid to other sources 87 b against amounts due or received from them.) 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? 'Yes, Part IX If complete .................................. 89a 501(c)(3) organizations - Enter: Amount of tax paid during the year under: � ; section 4955 ► ► ;section 4912 ► section 4911 -� b 501(c)(3) and 501(c)(4) organizations - Did the organization engage in any section 4958 excess benefit Vans.. ion 89b during the year? If 'Yes,' attach a statement explaining each transaction ................................... c Enter: Amount of tax paid by the organization managers or disqualified persons during the year under ► e section4958................................................................................... ► 0. d Enter: Amount of tax in 89c, above, reimbursed by the organization ....... • • • • 90 List the states with which a copy of this return is filed ► CAL I FORN IA - - Telephone number ► (760) - - - - 91 The books are in care of ► DEBORAH JONES_ _ _ _—_--- CA ZIP — ► —g226o ---------- -- -- _ Locatedat► 43-930 SAN PABLO AVE, PALM DESERT---------- 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041 -Check here ........ 192 I A -..a nn+ar +hn amount of tax-exempt interest received or accrued during the tax year TEEA0105 12/13196 Form 990 (1996) FAMILY YMCA OF THE DESERT Unrelated business income yJ-JOlJL�J ro:, u -ion 512, 513, or 514 (E) Enter gross amounts unless otherwise indicated. 93 Program service revenue: a DAY CAMPS bCHILD CARE cOTHER PROGRAMS d e f g Fees & contracts from government agencies ... 94 Membership dues and assessments .......... 95 Int on savings & temporary cash invmnts ..... 96 Dividends and interest from securities ........ 97 Net rental income or (loss) from real estate: a debt -financed property .............. b not debt -financed property ........... 98 Net rental income or (loss) from pers prop .... 99 Other investment income ............ Gain or (loss) from sales of assets other 100 than inventory .......................... 101 Net income or (loss) from special events ...... 102 Gross profit or poss) from sales of inventory . 103 Other revenue a b c d e 104 Subtotal (add columns (B), (D). & (E)) ....... 105 Total (add line 104, columns (B), (D), Note: (Line 105 plus line Id, Part 1, should equal (A) Business code (B) Amount (C) Exclusion code (D) Amount Related or exempt function income 03 0. 233 450. 03 618 732. 03 125 146. 31,481. 14,611. <>> 84,712. .::;::: .:•::;:;<.::•::>.<.,:•:;•;:.>•.::�-�;.:<.:••:.:•:::.;;;:<;.. �>>l»��`:�:�<><'. ';: ::::•:;•::•>.•::.::.:::::.::•::::•:::: p . 1 108 132 . and (E)).......................................................... the amount on line 12, Part 1.1. 1, 108, 132. (U ;ai::. <:: D if%nnlsin of Ae4ivi+iae +n +ha At-emmnlichmant of Fxemnt Purnneps m^& inetnietinne N ..................... Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes). SEE STATEMENT Partll?l`>> Information Regarding Taxable Subsidiaries (Complete this Part if the 'Yes' box on line 88 is checked. Name, address, and employer identification number of corporation or partnership . Percentage of ownership interest Nature of business activities Total income End -of -year assets N/A % % % Please Sign Here Under penalties 8f perju I declare that I Iwve exarrlined t is retn�nud. irq aeeon��pia[ryin�tihed�r and statements, and tote t gf my knowlpdas and belief, ft is true, correct, an coin l`&.1 Declaration of reparer other t n o ) based torn t en preparer has any (aas instruct aSS.) ► ► Signature of Officer Date Title Paid Pre- SpPiaatura ► Date Check If self- employed ► Preparees Social Security Number 1564-77-6261 Parer's Use Only GANDHI & SONI. CPAs ________ ______ PIyONS Name (or ► 68-920 ADELINA ROAD andAddreis CATHEDRAL CITY CA EIN ► 33-0686726 ZIP +4 ► 92234 TEEAU106 01113A7 Schedule A (Form 990) Name of the FAMILY of the Treasury organization Exempt Unaer zec(ue cn au i kk.)kQ) (Except Sa Foundation) a9a7(1�) Nonex mp�t charitable Trul tk>-- Supplementary Information See separate msbuctions. ► Must be completed by the above organizations and attached to their form 990 (or 99 THE DE j. L ompensauun •+• •••-- • --- (See instructions. List each one. If there are none, enter 'None') (a) Name and address o f each Title and average )hours per week empfJ�an $50 �000 ore devoted to position NONE --------------------- Total number of other employees paid I over $50,000................................. . ptral<<'} Compensation of the Five Highest Paid Inds (See instructions. List each one (whether individuals or 1996 1-EZ). F7 E.;n yer ldentifieatbn Number 95-36732-95 (c) Compensation (d) Cordributions (e) Expense to employee benefit account and other plans b deferred allowances compensation -nt Contractors for Professional If there are none, enter 'None.') (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service NONE ------------------------------------ Total number of others receiving over I 01 . $50,000 for professional services ...... . BAA For Paperwork Reduction Act Notice, see the instructions to Form 990 (or Form 990-EZ). =nC ^t 01"3197 (c) Compensation Schedule A (Form 990) 1996 Schedule A (Form 990) 1996 FAMILY YMCA OF THE DESERT 95-3673295 Pa e 2 'P lid i*777. Statements About Actil,...es Yes No 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum?...................................................... 1 X If 'Yes,' enter the total expenses paid or incurred in connection with the lobbying activities .. •;`:.<`> ;!,< Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI -A. Other g ' m complete Part VI-B and attach a statement giving a detailed description of the organizations checking 'Yes, must comp g rig p lobbying activities. 2 During the year, has the organization, either directly, or indirectly, engaged in any of the following acts with any of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property?............................................................................... 2a X b Lending of money or other extension of credit? ............. . l c Furnishing of goods, services, or facilities?........................................................................... 2c I X d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? ............................ 2d X e Transfer of any part of its income or assets?.......................................................................... 2e X If the answer to any question is 'Yes,' attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc? ................................... 3 X 4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or loans from it in furtherance of its chartable programs qualify to receive payments.(See instructions.) [P.-AMV. I Reason for Non -Private Foundation Status (See instructions.) The organization is not a private foundation because it is (please check only One applicable box): 5 A church, convention of churches, or association of churches. Section 170(b)(1)(A)(). 6 A school. Section 170(b)(1)(A)(6). (Also complete Part V, page 4.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(ii). 8 A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). 9 A medical research organization operated in conjunction with a hospital: Section 170(b)(1)(A)(ii). Enter the hospital's name, city, and state _____________________________ 10 An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv) (Also complete the Support Schedule in Part IV -A.) 11 a X] An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) MR A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) 12 An organization that normally receives: (1) more than 33113% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc, functions — subject to certain exceptions, and (2) no more than 33113% of its support from gross investment income and unrelated business taxable income (ess section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV -A.) 13 An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the followina information about the supported organizations. (See instructions.) (a) Name(s) of supported organization(s) I (b) Line number from above 14 n An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions.) TEEAN02 1 /27197 Schedule A orm 990 1996 FAMILY YMCA. -OF THE DESERT 95-3673295 ,..s of thod Page 3 P Y: ``:::: Sup PYo Schedulefor converting >�m the arccrual t, a cash me of accounting. a hu eu a eet ., i I Me you Calendar year (or fiscal year ► ((a) 1995 1994 19c43 1992 e Total beginning In) ..................... 15 Gifts, grants, and contributions received. (Do not include 982.347 313 835 . . 236 , 047 . 223 1,794, unusual rants. See line 28.) ... . 28 658. 31 189 . 737 26,813. 23 737 . 110 397 . 10. 16 Membershipfees received ...... 17 Gross receipts from admissions, merchandise sold or services ferformed, or fumishing of acilities in any activity that is not a business unrelated to the organization's charitable, 990,030. 1,080,576. 1,010,397. 764 781. 3.845.784. etc, purpose ................... 18 Gross iv dends, amountsireceived from payments on securities loans (section 512(a)(5)), rents, royalties and unrelated busines taxable income (less 11 taxes) from busi- section nesses acquired b the or an- �o, 3 938 4 269 . 3,887 . 1 918. 14,012. ization after June 1975 ..... , . 19 Net income from unrelated business activities not included in line 18 ...................... 20 Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf, ................... 21 The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to +hn —hlir withnu charge ....... 22 Other income. Attach a schedule. Do not include gain or Coss) from sale of ca ital assets .................. 23 Total of lines 15 through 22 .. 2.004 24 Line 23 minus line 17 .......... 1 014 25 Enter 1 % of line 23 ............ 20 26 Organizations described in lines 10 or 11: 1 77,1 66.7 050. 14,299. 12 771. 10 526. a Enter 2% of amount in column (e), line 24 .............. ► 26 a b Attach a list (which is not open to public inspection) showing the name of and amount contributed by each person (other than a govemmentaunit orpublicl supported organization) whose total gifts for 1992 through 26 b $ 461 62� 1995 exceeded the amount shown) in line 26a. Enter the sum of all these excess amounts .................. ► c Total support fog section 509(a)() 1 test: Enter line 24, column (e).......................................... ► 26 c $ 1 918 79: d Add: Amounts from column (e) for lines: 18 $ 14,012. 19 $ 22 $ 26b $ 461, 624 ._ ► 26 d $ 475 631 e Public support Cine 26c minus line 26d total) .. ' • • ' • • . • • . • . • .. • ' • .. ► 26 e $ 1 443 15' ........... f Public support percentage ine 26e numerator divided line 26c denominator 26 f 27 Organizations described on line 12: N A a amountsuns included a in year from a ch 17 that we person.' Enter the sum olffs cied h amount or each yeason,' attach a list to r how the name of, and total (1995)------------ (1994)------------ (1993) - - - - - - - - - - - (1992) - - - - - - - - - - - - - bFor any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (include in the list and the la ger amount din lines escribed5 (1) or (2). enter r the ell as of these)differenc differences computing the amounts) fohr each yen the ar: received (1995)----------- (1994)---- ------ (1993)----- - - - - - - (1992) - - - - - - - - - - - - - c Add: Amounts from column (e) for lines: 15 $ 16 $ 17 $ 20 $ 21 $ ► 27 c $ and line 27b total ............ $ ... ► 27d $ d Add: Line 27a total . $ ► 27e $ e Public support Cine 27c total minus line 27d total)........................................................ f Total support for section 509(a)(2) test: Enter amount on line 23, column (e) ... ► 27 Ill $ ► 2701 g Public support percentage (line 27e (numerator) divided by line 27t (denominator)) .... to. 27 h t. iine-nme nereentane (line 18. column (e) numerator divided by line 27t denominator ........ 28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1992 through 1995, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and amount of the grant, and a ore( description of the nature o..he grant. Do not include these grants in line 15. (See instructions) .�, A chedule A(Form 990) 1996 FAMILY YMCA 1 THE DESERT Private School Questionnat,- (See instructions.) (ro be completed Only by schools that checked the box on line 6 in Part IV) 95-3673295 Page 4 No 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, 29 other governing instrument, or in a resolution of its governing body? ............................................... 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing wi student admissions, programs, 30 andscholarships?.................................................................................... 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if 1t has no solicltaton program, in a way that 31 makes the policy known to all parts of the general community it serves? ............................................... If 'Yes,' please describe; if 'No,' please explain. (If you need more space, attach a separate statement.) ------------------------------------- --------------------------------------- ------------------------------------ ------------------------------- 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? ......................... 32 b Records documenting that scholarships and other financial assistance are awarded on a racially 32 nondiscriminatory basis? .................................................. c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing 32 with student admissions, programs, and scholarships? .................................. d Copies of all material used by the organization or on its behalf to solicit contributions? ................................. 32 If you answered 'No' to any of the above, please explain. (If you need more space, attach a separate statement.) 33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? """""""""""""...--*- 33 .................................................... b Admissions policies?................................................................................................. c Employment of faculty or administrative staff?........................................................................ d Scholarships or oth,-rfinancial assistance?............................................................................ F33 e Educational policies?................................................................................................. F33 fUse of facilities?..................................................................................................... gAthletic programs?................................................................................................... -- h Other extracurricular activities? ........................................... If you answered 'Yes' to any of the above, please explain. (If you need more space, attach a separate statement.) ------------------------------------ ---------------------------------- 34a Does the organization receive any financial aid or assistance from a governmental agency? ............................. 34a b Has the organization's right to such aid ever been revoked or suspended? .............................................. 34b If you answered 'Yes' to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 135 of Rev Proc 75 50 1975 2 C B 587 covering racial nondiscrimination? If 'No,' attach an explanation.......... . TEEA0404 12/13/96 95-3673295 Page 6 Sch A (Form 990) 1996 FAMILY YMCA rK THE DESERT PartMt1; Information Regarding Trans. s To and Transactions and Relationshi, With Noncharitable Exempt Organizations 51 Did the re orting organization directly or indirectly engage in any of the following with ancaorganizations? idescribed in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No ()Cash........................................................ 51 a X ................................................ (i)Other assets................................................................................................. a ii X bOther transactions: Rj (i)Sales of assets to a noncharitable exempt organization........................................................ b X (i)Purchases of assets from a noncharitable exempt organization ....................................... • . • • • • . ' ' b '11 X (ii)Rental of facilities or equipment........................................................................... b iv X (iv)Reimbursement arrangements................................................................................ b v X (v)Loans or loan guarantees.................................................................................... ..... b vi X (vi)Performance of services or membership or fundraising solicitations .................................:::: c X c Sharing of facilities, equipment, mailing lists, other assets, or paid employees ......................... . d If the answer to any of the above is 'Yes,' complete the. following• schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reportln or arnzation. If the organization received less.than fair market value in g t1e) gge value of the oods, other assets, or services received. an transaction or sharin arrangement, show in cth (d) (a) (b) Line no. Amount involvedName ofnoncharempt organization Description of transfers transactions, and sharing arrangements N/A 52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations Yes X No described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? ................. � ❑ b If 'Yes,' complete the following schedule: (c) Name of organization Type of organization Description of relationship N/A TEEA04M 12/17196 Form 990 Sch ule of Contributors Donating $5,, 0 or 1996 Line 1d More in Money, -Securities, or Other Property Statement Attach to return Name FAMILY YMCA OF THE DESERT Employer ID No. 95-3673295 Contributor's Name and Address Description Date Received Amount Received UNITED WAY 48,122. STATE OF CALIFORNIA 303,617. CHILD CARE & PRESCHOOL PROGRAMS CITY OF RANCHO MIRAGE 103,239. CITY OF PALM DESERT 60,000. 0. TEEW030I.SCR IZ27/% FAMILY YMCA OF THE DESER-i y:)•jd/jctiz) Miscellaneous Statement FORM 990. PAGE 1, LINE 9 �12-31-96 SPECIAL EVENTS - GROSS RECEIPTS 48,450. AMOUNT INCLUDED IN CONTRIBUTIONS-36,247 GROSS REVENUE FROM SPECIAL EVENTS 12,208. DIRECT EXPENSES-12,208. NET INCOME FROM SPECIAL EVENTS O' FAMILY YMCA OF THE DESERT 95-3673295 Additional Information DAY CAMP PROGRAMS FORM 990, PAGE 2, PART III DAY CAMP PROGRAMS COMPRISE OF ACTIVITIES SUCH AS HIKING, CANOEING, HORSEBACK RIDING, ARCHERY AND OTHER GROUP ACTIVITIES. THEIR MAIN FOCUS IS TO BUILD STRONGER KIDS AND PROMOTE MENTAL DEVELOPMENT AND PHYSICAL WELL-BEING. SUCH PROGRAMS ARE OFFERED AT A BELOW -COST BASIS TO PARENTS/FAMILIES UNABLE TO AFFORD THE FULL FEE. FAMILY YMCA OF THE DESERT— 95-3673295 Additional Information CHILD CARE PROGRAMS FORM 990, PAGE 2 PART III THE ORGANIZATION',, CHILD CARE PROGRAMS ARE DEDICATED TO PROVIDING A WARM, CARING WELL-ROUNDED ENVIRONMENT FOR YOUNG CHILDREN. THEY PROMOTE A SPECIAL APPROACH TO LEARNING BY ENHANCING ALL AREAS OF DEVELOPMENT INCLUDING SELF-ESTEEM AND POSITIVE SELF-IMAGE SOCIAL INTERACTION, SELF-EXPRESSION AND COMMUNICATION SKILLS, CREATIVE EXPRESSION LARGE AND SMALL MUSCLE DEVELOPMENT AND COGNITIVE DEVELOPMENT OF EARLY CHILDHOOD EDUCATION. THE GOALS AND OBJECTIVES OF THESE PROGRAMS ARE TO SUPPORT AND STRENGTHEN THE FAMILY UNIT AND CREATE AN ENVIRONMENT THAT FOSTERS THE DEVELOPMENT OF THE SPIRIT MIND AND BODY. Additional Information EXEMPT PURPOSE FORM 990 - PART III STATEMENT OF ORGANIZATION'S PRIMARY EXEMPT PURPOSE THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO PUT JUDEO-CHRISTIAN PRINCIPLES INTO PRACTICE THROUGH PROGRAMS THAT BUILD HEALTHY BODY, MIND AND SPIRIT FOR ALL. Additional Information GYMNASTICS & YOUTH SPORTS PROGRAMS FORM 990, PAGE 2 PART III THE VARIOUS YOUTH SPORTS PROGRAMS PROMOTE AN APPRECIATION OF ONE'S SELF-WORTH. WHATEVER THE SPORT THE FOCUS IS ON FULL AND EQUAL PARTICIPATION BY ALL. THE SPORTS PROGRAMS EMPHASIZE DEVELOPMENT OF SKILLS HEALTH AND FITNESS SAFETY CONSIDERATION, SELF-ESTEEM AND RESPECT FOR OTHERS. THE YMCA GYMNASTICS CENTER OFFERS VARIOUS PROGRAMS FOR CHILDREN RANGING FROM AGES ONE TO EIGHTEEN. THE WIMMINGORTS PRTENNIS INCLUDE SOCCER ETC. ACTIVITIES SUCH AS BALLET, HATHA YOGA, S nn- , v „ ._ `._-.._. Additional Information FORM 990 PART VIII RELATIONSHIP OF ACTIVITIES TO ACCOMPLISHMENT OF EXEMPT PURPOSE LINE 93a b and c AMOUNTS CHARGED TO PARTICIPANTS FOR THE BENEFITS OF PROGRAMS DISCUSSED IN PART III. LINE 94 SINCE THE YMCA IS ESSENTIALLY A MEMBERSHIP ASSOCIATION, MEMBER DUES ARE CHARGED TO MEMBERS. LINE 95 AMOUNTS EARNED ON OPERATING SAVINGS AND CHECKING ACCOUNTS UTILIZED IN THE DAILY OPERATIONS OF THE ORGANIZATION'S FACILITIES AND PROGRAMS. LINE 100 GAIN ON THE SALE OF AN ASSET THAT WAS RECEIVED AS A NON -CASH CONTRIBUTION IN THE PREVIOUS YEAR. Form 990, Page 2, Part II, Line 4"s Other Expenses Other expenses (itemize): a INSURANCE NATIONAL FEES OTHER PROGRAMS EXPS OUTSIDE SERIVES REPAIRS & MAINT. TRANSPORTATION UTILITIES WORKERS COMP INS 52,975. 22,960. 49,278. 59,033. 35,674. 42.074. 48,489. 26.222. 336,705. 41,321. 19,824. 34,858. 33,585. 32,860. 39,518. 44,186. 24.985. 271,137. 11.654. 302. 10,538. 24,768. 2,814. 2,556. 4,303. 747. 57,682. 0. 2,834. 3,882. 680. 0. 0. 490. 7,886. AMILY YMCA OF THE DESERT Supporting Statement of: 95-3673Lyc) Form 990 p 3/Line 58, column (B) Description Amount CAPITALIZED LEASE COST 250,000. LESS: ACCUMULATED DEPRECIATION-41,071. DEPOSITS 3,848. 212,777. Supporting Statement of: Form 990 p 4/Part IV -A, Line b(4) Description I Amount STATE CHILD CARE ALLOCATION TO INCOME & EXP I 28,032. COST OF FUND-RAISING EVENT 12,208. 40,240. Supporting Statement of: Form 990 p 4/Part IV-B, Line b(4) Description I Amount STATE CHILD CARE ALLOCATION TO INCOME/EXPS I 28,032. COST OF FUND-RAISING EVENT 12,208. 40,240. Supporting Statement of: Sch. A, 990 p 3/Line 26b Description I Amount PENINSULA INDUSTRIAL LIMITED PARTNERSHIP 0. S 500,000CONTRIBUTED IN 1995 EXCESS CONTRIBUTION 461,624. 461,624. MAa woo AO NAGERIs DEFT ... V _ . lHooiso�� G�L'� G� OF CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1-907-98 Name of Organization: The La Ouinta Arts Association Amount Requested: $1, 6 5 0 Contact Person: Millie Blansett , President Mailing Address: 79-435 N. Sunrise Ridge Dr. ( P.0. Box 514) City: La Quinta State: OA Zip Code: 92253 Phone No.: (760) 360-2189 501(c)3 Taxpayer I.D. Number: - 5 01(c) 3 is p e n d i n g Date Submitted: August 28, 1997 1 APPLICATION 1. What is the overall purpose or goal of your organization? The overall purpose of the La Quinta Arts Association is to stimulate creative activity, interest, and enjoyment of art among its members through programs presented at regular meetings, sponsor- ship of exhibits and shows that will give its members opportunity to display their work and learn from the process, and to support and promote worthwhile community projects in the area of art. 2. How long has your organization been in existence? 1 Years 6 Months 3. Describe in generai the activities or services of your organization: The La Quinta Arts Association holes regular monthly meetings in the evening hours, where members and the general public can watch an artist (or artists) demonstrate their work and discuss their process of creation. The association also currently maintains a gallery where local artists have the opportunity to display and sell their art work to the general public, while continuing its efforts to 4 provide as m1ny places as possible for its mJpmbers to display art work. Ow many peop a does your organization currently serve. _ The general public, as well as, No. of Youth No. of Adults 60 memberNo. of Seniors 5. How many people do you intend to serve during this Fiscal Year? The general public, as well as, No. of Youth 4.000 No. of Adults 100+ No. of Seniors we do not ask the member age our members 6. How many people served this Fiscal Year will be La Quinta residents? 7 All the youth directly served will be students of La Quinta schools. No. of Youth 4, 000 No. of Adults 100+ No. of Seniors members, as well as the general public How many paid employees/volunteers does your organization employ? No. of full time employees n/a No. of volunteers 21 No. of part time employees n/a Describe how your organization is managed and governed. The La Quinta Arts Association has a governing board of eiqht members that meets monthly to conduct the business of the organization. E 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone Millie Blansett President 79-435 N. Sunrise Ridge Dr. 360-2189 vl7 "e Dcv"rOAC Vir•a_PreCident 49-294 Ave. Vista Bonita 564-1880 Gloria Mucciolo Gallery Chair Toni Biermann Secretary 48-360 Prairie Dr., Palm Desert 346-2815 48-535 Via Amistad,-L. Q. 771-0166 10. What is your annual schedule of everts, and during what months does your organization operate? The association operates a gallery year-round. General meetings are held monthly and gallery Open'House shows held twice a year. Juried Junior Art Shows are to be held annually. 11. Do you charge admission, membership fee, dues, etc.? * Yes No If yps, please describe: The association has membership contributions and receives commissions paid by artists for work sold through association events and special proleets. 12. What are your other sources of revenue for this funding year? Source Amount Commissions from Art Sales $300.00 Donations $400.00 Total Needed Total Received Balance $ 3,750.00 1,900.00 1,850.00 (anticipated) 3 13. Amount of money requested from the City of La Quinta? $ 1,.850_ 14. Has your organization been funded by the City of La Quinta previously? Yes No If yes, when September, 1996 Amount received $900.00 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded These funds will provide the liability insurance and a permanent sign needed to keep the gallery located at La Quinta Plaza open so it can provide a venue for many local artists that have had no other outlet for their work. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. These funds will provide the liability insurance required for the association to continue to occupy the gallery space at Plaza La Quinta as well as, a permanent sign that will let the general public find the gallery. Artists, citizens of La Quinta, and visitors to the area will benefit. Artists can display their creative work for the general public to admire or purchase. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. 4 1 1996 990 Retur—if Organization Exempt From '—come Tax slack lung benefit truor private foundation)lor sectiol' ue n 494n a)((1aCode(lexxee npt charitable le trust °JrY ,,,�,,,° W PAVem &Worlt of 8WV" I Not .' The organaedon may haW to use a Copy of due retum to wash A For the 1996 calendar year, OR tax year period beginning July 1 .11 B Check lf: pwe C Name of orgrrtratim r..as The La Qu.inta Arts Association ❑ Chop d addrm i" or Initial rotthrrl print or Number and sliest (a sa P.O. box It mail is not delivered to street addr b"e Final ratan SM 79-435 N. Sunrise Ridge Drive This Form is Open to Public state reporting reqarernertts• 1 awpecoor Is, and June 30 , 19 9 D En0ovar kMntlaeatron number 331!0717620 Roomhuits E Stelis reowwon number C1974388 ❑ Amrded rob" City. town, or post office, state, and ZIP+4 F Check 0-f ) it mwptin b appl�n (stw � t� La Quinta, CA 92253 G Type of organization.—* ❑ Exempt under section 501(cx ) 4 (nett number) OR ► ❑ section 4947pipit nonexempt Charitable tru. Note: Section 5DOWA) exempt orlpanlssdam arid 4947(aXf) nonexempt chadea7�ble tyrim MUST attach a oartPleted Sctndule A Mom 9901 H(e) Is this a group return filed for affiliates? . . ❑ Yea ONO 1 If ettor bout in H b cocked -Yes.- enter four -digit 9mW exemption number PB4) ► ........................... (b) ff' i tie,' enter the number of affiliates for which this return is filed:. ► J Acoouffl ft meawd: ® Ceti ❑ Accruel (a? :s !fits a separate mturn filed by an organimtion covered by a graW ❑ Yes ❑ No ❑ o"M wow ► K Check two ► [r If the 0WA mtim's gross receipts are normally -- mas ton $25.000. The argantcgow need not file a return with the IRS: but If it e'swived a Form M Package in to mail. It shoukf fib a mtum without fnencid data. Some stases require a complete retrm Note: Form 990-EZ may be used by organisations with grow rwwpts less flan $100,000 8nd total assets Iess then ,$=000 at end of year: rem er,e..ifi,. Inctn rr_tinns nn nave 9.1 • • Revenueexpenses, Una %anan ere rrr 1,40% r%WWW ..• - --- --- - - 1 Contributions, gifts, grants, and similar amounts received: a Direct public support . . . . . . . . . . . . . 18 1b b Indirect public support . . .. . . . . . . . . . 1c c Government contributions (grants) . . . . . d Total (add lines 1a through 1c) (attach schedule of contributors) I (cash $ noncash $ 1 . . . . . . . 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2 3 Membership dues and assessments . . . . . . . . . . . . . . . 3 4 4 Interest on savings and temporary cash investments . . . . . . . . . . . 5 5 Dividends and interest from securities . . . . . . . . . . . . 6a Gross rents . . . . . . . . . . . . . . . . 8a [ b I b Less: rental expenses . . . . . . . . . . 6c c Net rental income or (loss) (subtract line 6b from line 6a) . . . . . . . . . 7 Other investment income (describe ► 7 8a Gross amount from sale of assets other W securities (a) other Ic 88 than inventory . . • 8b b Less: cost or other basis and sales expenses. ac c Gain or (loss) (attach schedule) . d Net gain or (loss) (combine line 8c, columns (A) and (B)) . . . . . . . . 9 Special events and activities (attach schedule) a Gross revenue (not including $ of 98 contributions reported on line 1 a) . . . . . . . . . b Less: direct expenses other than fundraising expenses 9b 90 c Net income or (ioss) from special events (subtract line 9b from line 9a) . . . . . 10a Gross sales of invantoiy, less returns and allowances . 108 b Less: cost of goods sold . . . . . . . . . . . . 10b c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 108) . 10c 11 Other revenue (from Part VII, line 103) . . 12 Total revenue (add lines 1d, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11) . . . . . . . . 12 13 Program services (from line 44, column (B)) . . . . . . . . . . . . 13 14 14 Management and general (from line 44, column (C)) . . . . . . . . . . . . 15 Fundraising (from line 44, column (D)) . . . . . . . . . . . . . . 15 16 16 Payments to affiliates (attach schedule) . . . . . . . . . . . . . . 17 17 Total expenses (add lines 16 and 44, column (A 18 Excess or (deficit) for the year (subtract line 17 from line 12) . .. . . . . . . . 18 19 Net assets or fund balances at beginning of year (from line 73; column (A)) . . . . 19 20 Other changes in net assets or fund balances (attach explanation) . . . . . 19, 20 20 21 21 Net assets or fund balances at end of combine lines 18, and For Paperwork Reduction Act Notice, see page I oT VW sepmum Kwumu" ire. The, La Q�aArts Association Proposed Budget for Fiscal Year 1997-98 Proposed Income: Membership Dues, Donations, Commissions, and Grant $3,750.00 Projected Operating Expenses: Legal Expenses: Taxes and Licenses.. $160.00 Newsletter Expenses: Printing and Postage $350.00 Gallery Expenses: Utilities $350.00 Telephone $550.00 Signage $600.00 Advertizing $250.00 Insurance si.25Q.QQ Total Gallery Expenses $3,000.00 Other Expenses: Bank fees $120.00 Mailbox Rental and Postage $60.00 Hospitality $60.00 Total Other Expenses $240.00 Total Projected Operating Expenses $3.750, The, ha Qwtita Arts AB&ociatian Intended Community Services Grant Expenditures Community Service Grant SM -850.00 Expenditures using Community Service Grant Funds: Signage $600.00 Insurance .tj,2-FO-00 Total Expenditures $1.850.00 o:8w CITY OF LX QU'"TA �-�( g'r10t4 FOP, ERVICES GRp'NT COMMON FISCALYEAR PG west. Volunteer Fire Go• Name of Organization: ana�er nested: station M pSnount Req Gil Barrier Caro} a1Y1 co St 54001 Madison . 92253 p�ddress: Ca Zip CodC. Ma'Img State: -� La gu. to City: 564_ 2'► 22 phone 01 c)3 Taxpayer I.D.. Number: Date 1 1. What is APPLICATION ci ti -,en,� the overall P for t o f Rivers ' "'Pose or goal of . he nreServatio de County those yO org ration? To ids Co»nty n of life emere nrov' services ash vereSSa Deb tnd to brovidv rescue servic Drop nec rV armen Qf e in uR�en eS erty. for the F'1re Prote�-t tation b?'es ervatiQn and Drotechose fire su 2 ction oflife_-moo n ow long has Your organization 3. Des been in e�tence? 1 1 Describe � general the activitiesears or se —_Months Essen tiall v a services of your organization: the same as ho Ve. 4. How many People doeS Your °rgan nation cu'ently serve No. of Youth N—_ N/A 5• How.man NO' of Adults N— Y People do you intend to No. of Seniors N/,q . serve ser No- of Youth_ uring this Fiscal year? 6. How man NO- of.4dtd Q Y people served this Fiscal ye NO. Of Seniors ]VIAN°. Of Youth �N_/� � � be La @uinta re ' . NO- of Adults N�� dents? ?• How many Paid emplO _ yees/vol No. °f Senors N/A unteers does your orga�ation No. of full time employees 0 employ? No. of Volunteers 7 No' °f 0 Part tune employees Describe how 3'olu' organization ' The oren managed and governed. ni�ation the State o is governed „ and otiera f C�ifor»ia nder the laws of t1n� officers• It is managed incornoration of by a board Of directors E F 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone William Bowden Pres. 73373 country club Palm Des. 862-9263 Eric Cisnev V Pres.. 55100 Riviera Ln 9uinta 771- 2605 Jesse Pnvne Treas. 555?6 Hwv 86 Thermal 399-5404 10. What is your annual schedule of events, and during what months does your organization operate? N/A 11. Do you charge admission, membership fee, dues, etc.? Yes X No If yes, please describe: 12. What are your other sources of revenue for this funding year? Annual .fund drive 95.000 Donations for EMS services at various zolf events. $3,000 Total Needed $ 2.500 Total Received $ Balance $ 3 a 13. Amount of money requested from the City of La Quinta? $ 2.500 14. Has your organization been funded by the City of La Quinta previously? Yes X No_ If yes, when Amount received Auurox. V.000 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. To help with purchase of an .Automatic External Defibulator. The price is 9 5.000. It would be a great helu to the volunteer comtianv if we could get a grant to Aav for half of the unit. This cost sharing will allow the PGA West Volunteer Fire Comnanv to provide this ea»inment for service throuehout the communitv. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. The citizens of La Quinta will be provided with health care eauinment considered to be state of the art, Allowine for the most rauid health care aDnlicntion in the emerRencv settine. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. NOTE FROM CITY STAFF: APPLICANT INDICATED THAT THEY ARE TRYING TO FIND THEIR FORM 990. IT IS ANTICIPATED THAT THEY WILL FORWARD IT TO THE CITY WHEN IT IS LOCATED. 0 CITY OF LA QUINTA I . APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR / - J' Name of Vo Amount Requested: A20 0 0 Contact Person: J �� /yloR ; Mailing Address: J/- � eg44 City:_ 114 4',v ,j ca State: Zip Code: lod 93 Phone No.: 74 0 _ fi ` — �/ i 501(c)3 Taxpayer I.D. Number: 2748'39 % Date Submitted: e /3 - , Z 9 APPLICATION 1. What is the overall purpose or goal of your organization? _/o PRd7 V/ D —C, A 41 po t-r of AAAb R�po.2T A9 6 Src950 c / o tJ S ©A-rfy U)MW /V c �O�wzv utit�/ �! /►A t/i,t1Z4 I ��Z�+�ls �% oL, 2. How long has your organization been in existence? : Years S Months 3. Describe in general the activities or services of your organization: �CR��,�.yrA C-'/TZS�✓ �ac.-u��Fts Y�1 �QoLr.�JG '� L -M kw ; _ r Sv ��111MA41AMg,r ,fr,✓A .DIO. 4. How many people does your organization currently serve? /ril L- A &1 V /w1 4 eYzl1 No. of Youth No. of Adults No. of Seniors 5. How many people do you intend to serve during this Fiscal Year? Rw XA Pw-& . &lam No. of Youth No. of Adults No. of Seniors 6. How many people served this Fiscal Year will be La Quinta residents? R L. 4- No. of Youth No. of Adults No. of Seniors 7. How many paid employees/volunteers does your organization employ? No. of full time employees �� No. of part time employees --�� No. of volunteers 1.1 Describe how your organization is managed and governed. / 2 9. Please provide information on your Executive Board members or contact person: L A Q U, -.,-a ya ns 3 Name Title Nome Address � Phone /11o2c�s/ eiCA oCl/i-/t1 X,jk1AJ�I- 3- �6� as'ras u� -7 71- 0-':r,.3 10. What is your annual schedule of events, and during what months does your organization operate? r SRI /O ' Q Uti w /1// /tin✓ 1 I-,Q P Ma/1 e k4- - 6-12e,616f/t ` 11. Do you charge admission, membership fee, dues, etc.? Yes No If yes, please describe: 12. What are your other sources of revenue for this funding year? Source Amount �5 S.^,1,A:1:-" S Total Needed Total Received Balance 3 00 13. Amount of money requested from the City of La Quinta? $ e242d 0. 14. Has your organization been funded by the City of La Quinta previously? Yes_ No k--' If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. WG �6 DSpy e,A` F©� Z �•-L-S Fol2-- Zoeg AS fiS/1. /Tc'S. A/l GffT 0s1 01 �1 �wOU� Foy CA14- rr SA G C'a�usl�.x s A � co,�� 16. Goal Vtat6ment. Indicate who will benefit from the use of these funds, and how they will benefit. Z 11A AQR�StS 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. .D rD fi7G£ £t> 0 3/�i� R Pc_0,q 5� i, hD A7-acME-D ' 3 :BGL, Piece 5�r-+7E7 — fA,#. RE -iz; /Rs ARM. * 0 . 4 u.-l1�ic� ,. LUIVUAPCA State of California � .4ttorney General DEP—`TMENT OF JUSTICE 13001 STREET. SUITE 125 P.O. BOX 903447 SACRAMENTO. CA 94203-4470 (916)445-9555 (916)445-2021 TO OFFICERS OF A NONPROFIT ORGANIZATION: Notify us of address changes This periodic report is required to determine which reporting requirements apply to your organization. Your public benefit organization is required to register with the Attorney General in order to comply with Government Code section 12585. Your assigned file number appears at the upper left of the above address label. Please use this CT file number in all communications with our office. Complete the statements and check the applicable boxes. Keep a copy for your records and return this report to: Registry of Charitable 'Trusts, P.O. Box 903447, Sacramento. CA 94203-4470. Our annual accounting period (fiscal year) ends 1 t�`/(►.�,r_,� S I I q q ) . NOTE: Attach copies of your bylaws and the IRS letter that approves your tax-exempt and reporting status with the IRS. if you have nut sent them to us before. Our gross receipts exceeded $25,000. (Attach a copy of IRS Form 990, 990-EZ, or 990-PF, whichever IRS required ,you to file with them including all attachments.) a-Z We are active and operating with gross receipts of less than $25,000. Fill in: Our total receipts during the last year were: $ ',o5jCj-'-1Y Do you expect future receipts to normally remain below $25,000? WYes [I No Our total assets at the end of last year were: $ 0 Our activities to accomplish our nonprofit purposes last year consisted of. CommLA:1'&A RBI.,tines 4,h 1 ne,.-( :z,he-ri44 Aplop,(`�-(h l �'C• ` SAc C 64 n r L-A- b.d. -, A l'A-` 5 k F-i' T : A A,&) , r4 _ %Ve have no receipts and no assets. We plan to begin operations in the future. (Failure to operate for tax-exempt purposes may lead to loss of tax exemption.) We no longer plan to receive funds or to operate for tax4xempt purposes. 0 We will take no action to dissolve this corporation. 0 We will formally dissolve this corporation at Secretary of State. Q Please send us information on how to dissolve. - If you have reported gross receipts of less than $25,000, you will be placed on extended reporting. Under this program, votl ,re required to file a CT-3 form with the Registry of Charitable Trusts once every 10 YearsPlease note that this is the organization's •,ponsihility and no further notices will be sent by the Registry of Charitable Trusts. Failure to file such a 10-year report may lead loss of tax=exempt status. - In addition, if, in any Year, Your organization's gross receipts exceed $25 000 You are required by law to file a CT-2 report ith the Registry of Charitable Trusts and attach a copy of IRS Form 990, 990-EZ or 990-PF (whichever is applicable) for that year. •:liiure to do so, may lead to loss of tax exempt status. I dc rethat this reportis true and complete to the best of my knowledge. riignature W—.'T Ye-L—L � (,�, T.�'. S. Title /•2 ot,a•t�i Tint Name -.lternate T-3 (7/96) — (SEE OTHER SIDE FOR USEFUL INFORMATION) 1 ou wu► neeu iu cuawiy vyl►►► ►►m w,. . -y- ---- --- -- or correspondence which informs y of the action to be taken. To avoid confi►sion and unnecessary penalties, you should maintain a separate file for %. _:h agency to organize the information i ived and copies of your replies and reports to each agency, such as the Attorney General's- Registry of Charitable Trusts, the Franchise Tax Board, the Secretary of State, and the Internal Revenue Service, etc. Information regarding some of the agencies with which you may be involved, in addition to the Attorney General's Registry of Charitable Trusts -- FRANCHISE TAX BOARD, Exempt Organization Section; Telephone (916) 845-4171; 9645 Butterfield Way, Sacramento, CA 95827 Application for exemption from California franchise or income tax is made to the Franchise Tax Board. Upon dissolution of corporations, a Tax Clearance Certificate is needed. Exempt Organization Information Return (Form 199) may need to be riled annually. INTERNAL REVENUE SERVICE (IRS) (For address/telephone number, refer to your local directory) Employer Identification Number (EIN) is obtained from the IRS. Application for exemption from federal income tax is made to the IRS. An annual return is usually required on Form 990, 990-EZ, or 990-PF. SECRETARY OF STATE, 1500 Eleventh Street, Third Floor, Sacramento, CA 95814-5701; Telephone (916) 657-5251. California corporations file Articles of Incorporation and amendments with the Secretary of State. Upon dissolution, certificates of dissolution should be filed. Corporations formed outside California need to "Qualify to Transact Intrastate Business" in California with the Secretary of State, and "Withdraw" when California business ends. Corporation numbers are assigned by the Secretary of State. California corporations must annually file information on their current officers on "Statement by Domestic Corporation" with the Secretary of State. BOARD OF EQUALIZATION, 450 N Street, Sacramento, CA 95814; Telephone (916) 445-6464 The collection of sales taxes is a function of the State Board of Equalization. Exemptions from property taxes are controlled by this agency. SOLICITATIONS Various city and county governments have enacted laws regulating charitable solicitations. Permits and fees may be required. You should contact each local government before conducting any charitable solicitations in their jurisdictions. _. We have a listing available of cities and counties indicating whether permits to solicit are needed and giving contact addresses and telephone numbers. To request our listing, write or call us. Our address and telephone number are on the other side. There may be other governmental agencies which require information or reports from you depending upon the nature of vour activities, sources of income, etc. The information provided herein is not. intended to cover all of the entities which may require information from you. •a9�- 31 cL a3s5 a(5.gy 00. CD too. on Ic-)o.co I! jl 2 i i 2 j3 3 I. 5 Ij 6 6 1 I II �i 8 9 8 9 10 Ill 10 I12 11 12 13 13 14 14 I !15 i 15 116 16 C II t d,113 to C°P1- ° C L14 P -- ,^T L00*4 ' � � D AUG 2 51997 Q CITY MANAGER'S DEFT OF CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997/ 8 Name of Organization: La Quinta, Indio S.H.A.R.E. of the Desert Amount Requested: $ 3 , 000.00 Contact Person: David orme La Quinta Senior Center P.O. Box 1504 Mailing Address: . City: La Quinta State: Ca. Zip Code: 92253 Phone No.: 564-0096 501(c)3 Taxpayer I. D. Number: 95-329 3901 Date Submitted: August 21, 1997 1 APPLICATION 1. What is the overall purpose or goal of your organization? Provide food on monthly base's for low income people 2. How long has your organization been in existence? 13 Years Months 3. Describe in general the activities or services of your organization: All volunteer organization providing low cost food for low income people from La Quinta, Indio and surrounding areas. 4. How many people does your organization currently serve? 7 2 0 No. of Youth 10 0 No. of Adults 14 0 No. of Seniors 4 8 0 5. How many people do you intend to serve during this Fiscal Year? No. of Youth 110 No. of Adults 150 No. of Seniors 500 6. How many people served this Fiscal Year will be La Quinta residents? No. of Youth 2 0 No. of Adults 3 o No. of Seniors 100 7. A How many paid employees/volunteers does your organization employ? No. of full time employeesbj., No. of volunteers 15 No. of part time employees Ng Describe how your organization is managed and governed. With elective President, Secretary, Treasure, Coordinator, Transportation coordinator, 3 at large members of board 2 9. Please provide information on your Executive Board members or contact person: Dauid—Or= prPSldent 78 910 SinQinq palms Dr. 564-4640 Edyth L. Morrison Secretary 55230 Rue Marne Thermal 398-0881 Arlena Lee Treasure 43-791 Towne Indio 92201 347-5625 Marilyn Knecht Coordinator 52 -975 Rubio La Quinta 92253 564-4128 10. What is your annual schedule of events, and during what months does your organization operate? Each year we have 3 events monthly as follows. Sign up day, Board meeting, Distributation day. 11. - Do you charge admission, membership fee, dues, etc.? x Yes No If yes, please describe: Each participant pays $15 per box of food plus 2 hours of community service per box 12. What are your other sources of revenue for this funding year? Donations Total Needed $ l 1, 6 7 4.4 3 Total Received $ 11,713.5o Balance $ 1, 960.93 Anwimt $215.00 3 13. Amount of money requested from the City of La Quinta? $ ; , n n n _ nn 14. Has your organization been funded by the City of La Quinta previously? Yes ;_ No_ If yes, when About 1989 Amount received 0 n n n n 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. S.H.A.R.E. of the Desert will use these funds to pay for transportation expenses needed to pick up the food boxes from Beaumont California and deliver to Coachella Valley. Part of these funds are used for office supplies. These funds are needed since the $15 pays for the food only. Without these additional funds we would have to raise the cost of these boxes beyond what low income families could pay. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. The goal of this organization is to provide food boxes to low income families at minimum cost. To promote community service. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. See attached sheet for our projected operating budget for July 1997 thru June 1998 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. Our IRS form 990 is "ID No. 95-329 3901 n N.A.R.E. OF THE DESERT ELF HELP AND RESOV RcE ExcHANCIE INDIO ❑❑❑❑❑❑❑❑❑LA QUINTA Additional Information Number 9 Carol Mc -Michael 81801 Shadow Palm Apt. 237 Indio, Ca 92201 347- 2893 Bobby and Jean Munoz 81920 Victoria Indio, CA 92201. 347-1041 Lucia Gomez P.O. Box 948 La Quintal CA 92253 564-0689 Dana & Cliff Larson 78705 Via Corrido La Quinta, CA 92253 564-2561 Number 17 Operating Expenses for June 1997 thru July 1998 Shares Food Boxes -------- $11,500.00 Truck Rental------------- 1,260.00 Gasoline----------------- 360.00 Money Order-------------- 48.00 Operating expenses------- 50_ 13,674.43 InI�� rb CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR Name of Organization: San norgonio Girl scout council $3150 Amount Requested: Contact Person: Jeannie Burns, Executive Director Mailing Address: 1 751 Plum Lane Y Redlands 92374 City: State: CA Zip Code: Phone No.: (909) 307 6555 extension 228 501(c)3 Taxpayer I. D. Number: 9 5 12 6 7 7 2 7 Date Submitted: s 2 i 9 7 - 1 1 2. 3 4. 5. A 7 8. APPLICATION What is the overall purpose or goal of your organization? How long has your organization been in existence? 38 Years Months Describe in general the activities or services of your organization: How many people does your organization currently serve? 19.300 No. of Youth 14.000 No. of Adults 5300 No. of Seniors not aolicable How many people do you intend to serve this Fiscal Year? No. of Youth 16.000 No. of Adults 5400 No. of Seniors not annlicable How many people served this Fiscal Year will be La Quinta residents? No. of Youth , j,QzS No. of Adults J jj No. of Seniors no�licable How many paid employees/volunteers does your organization employ? No. of full time employees 2Q No. of volunteers S, M No. of part time employees J5 Describe how your organization is managed and governed. 2 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone Jeannie Burns Executive Director 1751 Plum Lane (909) 307 6555 X 228 Redlands_ CA 92374 (This is business address home address not available.) 10. What is your annual schedule of events, and during what months does your organization operate? The Council grates on a year- Wd schedule Girls and adult volunteer leadersarran_ gP their own meetin.c Council 3 WM=d DLQgms ATM' offered through out the council -jurisdiction. Resident camas and da cy�ma ns are offered throu&bQW the summer. Extension Mgrams are offered year round to girls who do not have the opnoMmM to 11. Do you charge admission, membership fee, dues, etc.? _Yes No describe:If yes, please membership into theGirl ScoutMovementmg--- d/ .t no girl or adult 12. What are your other sources of revenue for this funding year? 1�1 , " •: ' Total Needed Total Received $ 450 Balance $3150 3 13. Amount of money requested from the City of La Quinta? $3150 14. Has your organization been funded by the City of La Quinta previously? Yes_ No _2L If yes, when, Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. Program Costs @ $60 per girl X 60 girls = $3600 (Includes all materials needed for the contemporary issues program, snacks and recognitions.) 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. n Membership Extension Budget-1997-98 Total Gross Revenues: Zip Scouting Enrollment 4,020 Contributions/Grants 50,000 Cookie Sales (15 sites @ 50 boxes per site) 1,125 Total Revenues 55,145 Salaries: 7001 Exempt Staff (60% of Annual Wages) 30,000 7004 Non Exempt Staff @ $6 per hr (44 Weeks) 52,800 7203 Employee Benefits (15% of Gross Wages) 9,036 Subtotal Expenses 91,836 Supplies: 8107 Printing 2,154 8150 Program Supplies 8,305 8151 Training 285 8155 Tokens of Appreciation 1,225 8301 Postage & Shipping 1,865 8104 Food/Beverages 1,840 Subtotal Expenses 15,674 Professional Fees: 8011 Advertising/Marketing 485 Subtotal Expenses 485 Occupancy: 8702 Travel 1,200 8707 Mileage 1,650 8707 Hotel/Meals 400 Subtotal Expenses 39250 Total Expenses 111,245 �— Addresses any to: P.O. Box 231, Los Angeles. Calif. 90053 , M�3 ��ad� Dopar��©w4 JAN 2 8 1969 DD Bo M DOv%eQoQ Internal Revenue Service o•t.: in reply nhr to: 688:4888 January 27, 1969 L-225r Code 414:&O:EDJ p San norgonio Girl Scout Council Formerly, De Anza Council of Girl Scouts P. O. Box 655 Colton, California 92324 Deis of Exemptions Jul , 1959 IRC Sections 501rc( 3 1 Materiel SYboiltNJs Amend to change name as in address above Gentlemen: Thank you for submitting the above material. We have made it a part of your file. Any future change in the character, purpose, method of operation, name, or address of your organization should be brought to our attention. This is a requirement for retaining your exempt status. Our determination letter of July 30, 1959, applies to you under your new name. Very truly yours, 414 i..e-s✓ B. D. Johnson Examiner fonw L•22S Ire'tl CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-1998 Name of Organization: Humane Society of the Desert/Orphan Pet Oasis Amount Requested:_ 'hh.,1 ti 0 00 Contact Person: Marilyn Baker Mailing Address: F.0. Box 798 City: north Palm Fprings State: (1, 4 Zip Code: 92258 Phone No.: 760 329-79d4 - 501(c)3 Taxpayer I. D. Number: Date Submitted 95-2122004 august 13, _1997 APPLICATION 1. What is the overall purpose or goal of your organization? l-de provide education on human care of animals. vie serve pet owners and their dogs and/ or cats and oiler an alternative to the "death row" of a pound, - for none ess, unwanted, abandoned or abused pets at our Orphan' Pet Oasis - wnere no pet is ever destroyed. 2. How long has your organization been in existence? 4 5 Years Months 3. Describe in general the activities or services of your organization: we oiler a safe haven where owners can relinquish a pet without the trauma of turning it into a pound. We provide more than 3 dozen Free Tip ee s, coverIng a wide range 5!,sutjects. Ourconstant goal is pets and people living together in harmony. 4. How many people does your organization currently serve? 101,750 people No age breakdown No. of Youth No. of Adults No. of Seniors 5. How many people do you intend to serve during this Fiscal Year? 150,000 No age breakdown No. of Youth No. of Adults No. of Seniors 6. How many people served this Fiscal Year will be La Quinta residents? 2 , 2000 directly All re PPAD, Attch A No. of Youth No. of Adults No. of Seniors 7. How many paid employees/volunteers does your organization employ? No. of full time employees 7 No. of volunteers 40 No. of part time employees 1 8. Describe how your organization is managed and governed. our Orphan Pet Oasis is managed by an on -site full time volunteer. "pare are governed by a Board of Directors and Executive committee that meets monthly year-round. 2 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone lhyllis Dewey, fires -Tres 1293 Rose Ave. Talm Springs 325-6073 iVerncn i Pn!7,er Zr r I.O.—Box 11,ld Rancho Mirage 321-9848 rdie Salzano Sec. 39886 Desert Angel 3t0-0380 10. What is your annual schedule of events, and during what months does your organization operate? .We operate year -around Orphan het Oasis open d days every week plus all major holidays. See Attch. 11. Do you charge admission, membership fee, dues, etc.? Yes . XLX _No If yes, please describe: 12. What are your other sources of revenue for this funding year? city of Palm Desert A!11,135 Wills in Probate 78,000 Private sector donations 12509000 Potential foundation grants 4r25,000 Total Needed $ P333,655 July lst starts fiscal year - no report at Total Received $ this date Balance $ 3 13. Amount of money requested from the City of La Quinta? $ gr , i tir__ � nn__ 14. Has your organization been funded by the City of La Quinta previously? YesXX No If yes, when 1987 Amount received F 1, 200.:UU 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. In 1996-1997 we took in 68 La Quinta pets, altering and vaccinating each. We adopted to La Quinta citizens 55 pets, all altered and vaccinated. Actual cost . Lur ttuese, ,pius num and supplies. La .-�uinta funds would be applied only to offset cost of care for La (,uinta pets. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they willbenefit. LaQuinta citizens will enjoy peace of mind by relinquisning a pet to a no -kill shelter. 'Those adopting will know tney(and their city)is getting a pet that's altered and 1 disaster(see Attacnment A). Senior citizens and working -poor families can benefit by naving a pet at no cost. All La Quinta residents can benefit from our Froe Tip Sheets. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach. a copy of the organization's current IRS Form 990. 4 CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR • 1 -QP, Name of Organization: f Media Arts Foundation Amount Requested: •� Contact Person. n i a n e R ed Mailing Address: 78130 Cortez Lane No. 68, Indian Wells, CA 92210 City: Indian Wells State: CA Zip Code: 92210 Phone No, (760) 772-0712 501(c)3 Taxpayer I.D. Number: 77-0423366 Date Submitted: For Sept. 1, 1997 1 APPLICATION 1. What is the overall purpose or goal of your organization? yiApn nr film that benefits humanity through educational or cultural means. 2. How long has your organization been in existence? —1—Years _Months 3. Describe in general the activities or services of your organization: ]de—= rnA»eP vi APns nr film_ The form can becorporate video, documentaries, drama or art film. If produced for individuals or organizations, the recipients must also have a purpose which benefits the community or the larger community of humanity. 4. How many -people does your organization currently serve? potentially No. of Youth No. of Adults No. of Seniors 5. How many people do you intend to serve during this Fiscal Year? No. of Youth No. of Adults No. of Seniors 6. How many people served this Fiscal Year will be La Quinta residents? Numbers of viewers of television or private (corporate) video in La Quinta No. of Youth No. of Adults No. of Seniors 7. How many paid employees/volunteers does your organization employ? No. of full time employees No. of volunteers 2 No. of part time employees 1 8. Describe how your organization is managed and governed. We are a small organization requiring only one person to carry out services. Diane Reed, Exec. Director has this responsibility. When assistance with editing or audio is required, others are consulted. E 9. Please provide information on your Executive Board members or contact person: 10 11. Diane Reed Exec Director 78130 Cortez Ln #68,IW(760) 7720712 (310) 453-8487 Mark Devendorf V.P., 1331 18th St.#2,Santa Monica, CA Eugene Ray, Director 1699 Nautilus, La Jolla,CA (619)456-0854 Ida Urso,PhD, Director 604 Jersey Ave.#1,Jersey City,NJ (210 What is your annual schedule of events, and during what months does your organization operate? We operate all year long Do you charge admission, membership fee, dues, etc.? Yes no No If yes, please describe: 12. What are your other sources of revenue for this funding year? Satyajit Ray In America Conference_... Total Needed Total Received Balance M $ ' 475a_0D 3 13. Amount of money requested from the City of La Quinta? $ 47 0 0.0 0_ 14. Has your organization been funded by the City of La Quinta previously? Yes_ Now. If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. Ah ove -all;* we .need:; editing . eq.uipitlEnt r_The 3or ,.Rortion•-of- funds. received wou-l& Vc toward that pny remainder would cjo toward the purchase of video tape an: small salary. 16. Goal Statement.. Indicate who. will benefit from the use of these funds, and how they will benefit. A member of the Cultural Arts Commission of La Quinta expressed a similar goal To encourage. foster and be a catalyst for new cultural directions in La Ouinta" o►G� d , , , through videos Mduced for (I) television - to in form greater numbers of the Pyad,�c��q public about culture and the arts in La Quinta on Cable TV Public Access (2) cor - v, oleos taor_ate video - to &d&= the visual cxnression of The Cultural Arts Commn issio fv r V 4riJV philosophy for a master lnfor La uinta: (3) to record the various cultural and 4ras -- _ arts events in La Quinta so that thee n&ht serve as historical documenta of the evolution of new cultural directions in La Quinta (4) others as needed 17. Attach a copy of your Program Operating Budget; and a separate detailed, concise list of intended Community Services grant expenditures. 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. We are not required to file (that we are aware of) due to income Level.. 4 r,ZoL, 17D, i r*T,,--M—Afl tP . .. 1. One Radius Video Vision editing card - approx cost of 54400. or an hourly rate of 540.00 for 110 hours to go toward all phases of production and post -production (editing) of videos. 2. $200 for Hi-8, VHS and SVSH tapes We are currently working on a video for the La Quinta Arts Assoc. to announce its opening and as well we have done videography of public art by Louis DiNfartino to announce the dedication of his "jewel" sculpture and also work by John Kennedy to more generally cover public art in La. Quinta. We have also been documenting work in progress of the file mural by muralist Marsha Gibbons as she works with La Quinta High School students toward completion of the mural. COMMUNITY SERVICES GRANTS GRANT RECONCILIATION REPORT Due Date: 30 days following expenditure of grant funds. Final Date to Submit: May 15' Organization Name: Name of Person Completing Report: Mailing Address: Phone: Period of Report (Mo/Yr to Mo/Yr): to Date Your Organization Received Funds: "Describe Your Expenditure of Grant Funds: Reconciliation: Grant Amount $ Funds Expended $ Balance . $ Return unspent funds to "City of La Quinta" by check with this form. ** Attach supporting documentation (receipts for purchases, canceled checks,. payroll records, billing statements) that is in accordance with the original grant request. All questions regarding this form or the grant process should be directed to the City Manager's Office at 777-7100. Mailing Address: City of La Quinta, City Manager's Office, P.O. Box 1504, La Quinta, CA 92253. C: \MyData\ WPDoes\GRANTS\CI?YORANTAPP.wod n CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR ' 99. Name of Organization: Shelter From The Storm, Inc. Amount Requested: $ 5 , 000 Contact Pemon: Hilary Bendon , Executive Director Mailing Address: P.O. Box 14155 Palm Desert 22 41 City: Dt state: Code: 9 55- 55 Phone No.: (760) 328-7233 Sol (c)3 Taxpayer I.D. Number:. 33-0293124 Date Submitted: August 29, 1991 Shelter From The Storm, Inc. CITY OF LA QUINTA CON94UNITY SERVICE GRANT APPLICATION 1. What is the overall purpose or goal of your organization? Shelter From The Storm is dedicated to providing a safe haven for victims of domestic violence, offering them protection from their abusers, as well as empowering them through counseling, training and education to create a life for themselves and their children free of violence. 2. How long has your organization been in existence? 7 Years 3. Describe in general the activities or services of your organization: Shelter From The Storm operates a 60-bed facility to house women and children who are victims of domestic violence, giving them the opportunity to participate in our 6 week Domestic Violence Recovery Program. We provide lodging, meals, clothing and other personal items as part of an integrated counseling and case management program created to empower women to make better choices for themselves and their children. Upon graduation from our program, women anad their failies are able to participate in a one- year Aftercare Program. Shelter From The Storm also offers a Childreds Program which includes full in-house schooling and preschool for children while in shelter. Our extensive Aftercare Program provides continuing guidance and support to help a woman maintain a new, violence -free life for her family when they leave shelter. Two outreach offices located in Indio and Palm Desert provide legal, health and other advocacy for women who choose not to go into shelter; and through our Community Education activities, we inform the community about the issues of domestic violence and the services available. 4. How may people does your organization currently serve? During 1996 we served 322 women and 545 children in our shelter and handled approximately , and 4,661 domestic violence crisis hotline calls. Presently in shelter we are serving: No. of Youth 36 No. of Adults 27 No. of Seniors -0- 5. How many people do you intend to serve during this Fiscal Year? In Shelter: No. of Youth 525 No. of Adults 250 No. of Seniors 25 Through our Hotline and Outreach programs, we will serve over 4,500 people. Shelter From The Storm, Inc. 6. 7. 8. 9. 10. 11. How many people served this Fiscal Year will be La Quinta residents? Our various programs service 25 3n T a Ouinta residents ner month_ or approximately 300-360 La Quinta residents per year. No. of Youth No. of Adults No. of Seniors How many paid employees/volunteers does your organization employ? No. of full time employees 14 No. of part time employees 1,L No. of volunteers: 27 *rained vQIUUt=MAG= Describe how your organization is managed and governed. Shelter From The Storm is a non-profit 501(c) (3) corporation. The Board of Directors serves as the governing body creating policy and taking primary responsibility for fundraising and fiscal health of the agency. The Executive Director is responsible for all shelter, outreach and business operations and reports to the Board of Directors. The Shelter Director is directly responsible for shelter and outreach operations. Please provide information on your Executive Board members or contact person: Please see the attached list of the Board of Directors. What is your annual schedule of events, and during what months does your organization operate? Shelter From The Storm operates the shelter 24-hours a day, 365 days a year. The 24- hour Crisis Hotline is staffed 24-hours-a day, 365 days a year. Outreach Offices are open Monday through Friday, 9:00 a.m. to 5:00 p.m. (except for legal holidays). A satellite office is open at the Palm Springs Police Department on Tuesdays and Wednesdays, 9:00 a.m. to 5:00 p.m. (except for legal holidays). Support Groups designed to assist victims of domestic violence who do not choose to go into shelter meet three times a week on Tuesday 6:00-7:30 p.m., Wednesday 12:00-1:30 p.m. and Thursday 6:30-8:00 p.m. Aftercare Program participants meet once each week on Tuesday evenings from 6:30-9:00 p.m. Do you charge admission, membership fee, dues, etc.? Yes .�._ No No, there are no fees charged for the women and children participating in our shelter or outreach programs. 2 Shelter From The Storm, Inc. 12. 13. 14. What are your other sources of revenue for this funding year' Source Amount City of Palm Desert $ 15,930 City of Cathedral City $ 10,400 ------------- City of Desert Hot Springs $ 3,000 City of Indio $ 7,000 City of Indian Wells $ 10,000 City of Palm Springs $ 6,000 City of Rancho Mirage $ 5,000 Riverside County Domestic Violence up to $ 85,000 Trust Fund Riverside County 4th District CDBG $ 22,425 Riverside County Emergency Shelter $ 42,705 Grant State of California Maternal & Child $129,000 Health Program United Way $ 40,000 Investment Income $ 8,000 (not yet earned) Fundraising* Unknown. Goal: $363,000 Total Needed $ 870.000 Total Received $3$4.9Q Balance $ 485.540 Amount of money requested from the City of La Quinta? $ 5.000 Has your organization been funded by the City of La Quinta previously'Yes--No-X 3 Shelter From The Storm, Inc. 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. Domestic violence is of major concern in � he State of Clde County has the fifth alifornia (Office of Criminal highest incidence of domestic violence per capita Justice Planning: Crime Index Report 1991). From January to december 1996, local law enforcement filed 1,645 domestic violence police reports, and Victim Witness had over Y accepted It is widely 2,000 contacts in the Coachella Valley. in domestic violence service that children who witness domestic violence in their homes suffer greatly, and if left untreated, often perpetuate that violence in their adult lives. Working in harmony with local law enforcement, healthcare providers and social service agencies in the Coachella Valley, Shelter From The Storm provides a much needed safety net for women and children who are victims of domestic violence. We are requesting $5,000 to assist with the expenses related to emergency shelter for women and children who need to escape a violent situation. If awarded, funds will be used to cover expenses associated with the 72-hour Emergency Program to provide emergency housing, food and clothing and other personal needs. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they will benefit. The population which we serve consists of women and children who are victims of domestic violence. We accept children of clients up to age 16 at the shelter. Approximately 95% of our clients are low and moderate income; approximately half are Hispanic. We service all victims of domestic violence who can benefit from a domestic violence recovery program, and we provide referrals and advocacy for other victims for whom shelter is not the answer. This 72-hour Emergency Program provides a safe haven in which a woman can make better choices about the lives of her family and their future. 17. Attach a copy of your Program Operating Budget and a separate detailed, concise list of intended Community Services grant expenditures. 19. Non-profit organizations must attach a copy of the organization's current IRS Form 990. See attached IRS Form 990 for FY•1995-96. 4 Shelter Phone: 760-328-7233 Outrawh — palm Desert Phone: T" 341-9785 Fax:' 760-341-0775 Fax: 760-770-7582 Address: 74-877 Jo.__, Suite #11, Palm Desert 92260 Address: P.O. Box 14155 (l i""nh — Indio Phone: 760-347-3771 Fax: 760-347-2616 Palm Desert 922554155 Address: 82-365 Hwy.111, Suite. #103, Indio 92201 Shelter From The Storm, Ina TORS 7/1/97 - 6/30/98 officen: president Janet Newcomb Owner, Newcomb Enterprises 73-965 Highway 111, Ste. B (o) 836-1844; (Fax) 568-9600 Palm Desert, CA 92260 (h) 345-7864 1st Vi a President Gene Kulander Retired, Police Chief 255 N. El Cielo Rd., Ste. 126 (h) 323-1886 Palm Springs, CA 92262 Ind Vice President Edra Blixseth Author, Philanthropist Three Mozart Lane (o) 776-6622 (Secretary, Corinne) Rancho Mirage, CA 92270 (h) 779-9115; (Fax) 779-9213 Treasurer Robert J. Baltes Maryanov Madsen Gordon and Campbell 74-774 Highway 111, Suite A Indian Wells, CA 92210-7135 Secr 7 Mary M. Heckmann 72-551 Clancy Lane Rancho Mirage, CA 92270 Michael Berkow South Pasadena Police Dept. 1424 Mission Street South Pasadena, CA 91030 Certified Public Accountant (o)568-0032 (Fax) 773-3981 Business Owner (o) 568-4445 (Fax) 773-0314 Chief of Police, South Pasadena, California (o) 626-403-7272 (Fax) 818-403-7271 Page 1 of 2. - Rev. 07/22/97 Board\1997-98.brd Directors: (Continued) Tina Cohen 4 Vista Santa Rosa Rancho Mirage, CA 92270 Alyss Dorese 37965 Palo Verde Drive Cathedral City, CA 92234 (o) 341-7799 Business Owner (o) 323-4204 (Fax) 320-6090 (h) 321-1115 (Fax) 321-1049 Clifton Harris Riverside County Sheriffs Deputy P.O. Box 1784,Victorville, CA 92393 (h) (760) 955-7020, (Fax) (760) 955-8739 4095 Lemon Street (o) (909) 341-8893, (pgr) (909) 512-7613 Riverside, CA 92501 (o) (909) 341-8894, (Fax) (909) 341-8898 Evelyn Lewis 75-840 Altamira Indian Wells, CA 92210 Lee M. Manuel 374 Desert Holly Drive Palm Desert, CA 92211 Kevin McGuire 73-745 El Paseo Palm Desert, CA 92260 Lianne Rogers 72-080 Palm Crest Drive Rancho Mirage, CA 92270 Robert A. Spiegel 73-510 Fred Waring Dr. Palm Desert, CA 92260 President, Angels Alliance Auxiliary (h) 773-4448 (Fax) (760) 773-3768 Auxiliary 776-6142 College of the Desert Board Member, Retired Banker (h) 360-1923 (Fax) 360-1336 President, Palm Desert National Bank (o) 340-1145 (Fax) 340-1387 Philanthropist (o) 568-4313 (Fax) 568-0470 Palm Desert City Council (o) 346-0611 (Fax) 340-0574 Board meetings are held on the third Thursday of every month beginning at 6:00 p.m., at the Palm Desert National Bank located at 73-745 El Paseo, Palm Desert. Page 2 of 2_ Rev. 07/22/97 Hoard\1997-98.brd Form 990 I Return of Organization Exempt Fron...lcome Tax No. Under section 501(c) of the Internal Revenue Code (except black lung beneAt trust or private foundation) or section 4947(axt) nonexempt charitable trust Department of the Treasury Internal Revenue Service Note: The organization may have to use a copy of this return to satisfy state reporting regl 1995 TM Fermi is open"Pbbfo A For the 1995 calendar yew. OR tax year period I 7 01 , 1995, and endft 6 / 3 0 .19 96 B Check if: F%sse C Name ofarfamnbon =3772 e"t� ❑ thanpe of address `�« SHELTER FROM THE STORM, INC. 3124 ❑ Initial return printer Numce, a^c street(or P.O. boxif maitis not delivered to street aaoress, Roomiswts E Sfaterepekrs4eweresier ❑ Final return s i P.O. BOX 781 CT 71419 ❑ Amended return in City, town, orpost4offi4m state, end ZIP code jreawred also for Yisrro- IF check P. ❑ if ssaaption Statertporting) e-- PALM DESERT, CA 92260 awboation w penc G Type of organization ► ® Exempt under section 5o1(c) ( 3 ) �4 0,00 number) OR ► ❑ section 4947(a)(1) nonexempt charitable trust Note: Section 501 c)(3 exenWt organizations and 4947 a 1 non"charitable trusts MUST attach a coinplated Schedule A 990 H(a) is this a group return filed for affiliates? ........................ ❑ Yes ® No 1 If either box in H is checked 'Yes,' enter four -digit gro (b) If 'Yes," enter the number of affiliates for which this retum is filed:. ► exemption number (GEN) IN- (c) Is this a separate return filed by an organization covered by a J Accounting method: ❑ Cash ® Accrual group ruling? ..❑ Yes ® No ❑ Other ( P. K Check here ► ❑ If the organization's gross receipts we normally not more than =,000. The organization need not file a rmm with the IRS; but If It received a Form 990 Package in the mail, it should file a retum without financial data. Some states roWire a complete return. Note: Form 990-E7 may be used by orannaatk3m with arose monk fs less than ltno_nnn and tntal aeeefe tame than exn rot at 4 ..s — KV&W Revenue, Expenses, and Changes in Net Assets or Fund Balances See instructions on 9-14. R E v N e 1 Contributions, ghfrs, grants, and similar amounts received: a Direct public support .................................................. to 283,186 b Indirect public support ............................................... lb 111,445 c Government contributions (grants) ...................................... /c 159,265 d Total (add lines 1a through 1c) (attach schedule of contributors) (cash $ 553,896 noncash $ ) ............ SEE . STATEMENT..1. 2 Program service revenue including government fees and contracts (from Part VU, fine 93) ................... 3 Membership dues and assessments............................................................ 4 Interest on savings and temporary cash investments ................................................ 5 Dividends and -interest from securities ................................... .. ................. 6a Gross rents ........................................................ I ea b Less: rental expenses ................................................ I 6b c Net rental income or (loss) (subtract line 6b from line ea) ............................................. 7 Other investment income (describe ► A Securities ) Other Be Gross amount from sale of assets other than inventory.... ea b Less: cost or other basis and sales expenses ........... 8b c Gain or (loss) (attach schedule) ..................... Be d Net gain or (loss) (combine line Sc, columns (A) and (B))............................................ 9 Special events and activities (attach schedule) SEE STATEMENT 2 a Gross revenue (not including $ of contributions reported on line 1a).................................................. 98 121 070 b Less: direct expenses other than fundraising expenses ...................... 9b c Net income or loss from 'al events subtract line 9b from line 9a ..... . (loss) special ( ) • ........................... 10a Gross sales of inventory, less returns and allowances ........................ I ion 2,047 b Less: cost of goods sold .............................................. 10b j 782 c Gross profit or (loss) from sales of inventory (attach schedule) (subtract line lob from line loa)SEE..ST..3 ... 11 Other revenue (from Part VII, line 103)........................................................... 12 Total revenue (add lines id, 2, 3, 4, 5, 6c, 7, 8d, 9c, 10c, and 11) . .................................... 5 5 3 , 8 ! '"M 1d 2 3 4 4 9! 5 6C»: 7 .... ......... <x<::?. """ ...I ::•. 121 0 , 9c 1,2( L.......:.:. 10c 11 1,22 12 682,4( E P p E 8 13 Program services (from line 44, column(B))....................................................... 14 Management and general (from line 44, column (C))............................................... 15 Fundraising (from line 44, column (D)) ............. ............................................ 16 Payments to affiliates (attach schedule).......................................................... 17 Total nses (add lines 16 and 44, column (A ................................................. 13 452,21 14 107,8 15 41 8 16 17 601,9( A. E g T T s 18 Excess or (deficit) for the year (subtract line 17 from line 12) ......... _: ............................... 19 Net assets or fund balances at beginning of year (from One 73, column (A)) .............................. 20 Other changes in net assets or fund balances (attach explanation) ..................................... 21 Net assets or fund balances at end of yew (combine fines 18, 19, and 20) . 18 80,43 19 1,285,04 20 21 1,365,4 rur raperrwom rteaticuon Act noDCe, see pegs i Or the separate msvucuons. Form 990 (u EXTENSION ATTACKED urm sac iiaesl SHELTER FROM 3 STORM, INC. 3 3 - 0 2 9 312 4 ' pa Statement of All organizations must complete column (A). Columns (6), (C), and (D) are required for section 501(c)(3) anc Functional Expenses organizations and section 4947(a)(1) nonexempt charitable trusts but optional for others. (See lnstr on page Do not include amounts reported on line 6b, eb, 9b, 10b or 16 of Part I. (A) Total (B) Program s (C Management and general N) Fundraisin 22 Grants and allocations (attar schedule) (cash noncash S S 23 Specific assistance to individuals(attachschedule) ......... 24 Benefits paid to or for members (attach schedule) .......... 25 Compensation of officers, directors, etc ......_.............. 26 Other salaries and wages .............................. 27 Pension plan contributions ............................ 28 Other employee benefits .............................. 29 Payroll taxes ....................................... 30 Professional fundraising fees....... .. .. ........ 31 Accounting fees .................................... 32 Legal fees ......................................... 33 Supplies .......................................... 34 Telephone ......................................... 35 Postage and shipping ................................ 36 Occupancy ........................................ 37 Equipment rental and maintenance ...................... 36 Printing and publications .............................. 39 Travel ............................................. 40 Conferences, conventions, and meetings ................. 41 Interest ........................................... 42 Depreciation, depletion, etc. (attach schedule) ............. 43 Other expenses (itemize): a SEE STATEMENT 4 b 22 23 24 ......................................_.......__. _ _... ......................................................................................... _ - - - 25 40,000 28,658 11,342 26 222,925 159,713 63,212 27 28 11,808 8, 0 2 5 3,783 29 27,005 19, 9 8 6 7, 019 30 31 5,200 :::::�•::::�::::::.:••::::::::::�::•::....:;••::•::::.,...,::•;••::•:::::�:::::::::::•:::•::::::•: 5, 200 32 33 10,384 6,406 3,978 34 35 6,034 848 547 4 , 6. 36 37 38 8,527 3,326 1,693 3,51 39 40 41 41,153 41,153 42 1 42,162 42,162 43a 186,768 142,000 11,061 33, 7 I 43b c 43c d 43d e 43e 44 Total functional expenses (add lines 22 thru 43) Organizations cornplatin columns (B)-(D), carry these totals to lines 13 - 15. 44 601,966 452,277, 107,8357 41,81 Reporting of Joint Costa. - Did you report in column (B) (Program services) any joint costs from a combined educational campaign and fundraising solicitation?..................................................................................... ► ❑ yes If "Yes;' enter (1) the aggregate amount of these joint costs $ ; (II) the amount allocated to Program services $ (III) the amount allocated to Management and general $ ; and Iv the amount allocated to Fundraising $ 'sP81't>:Ilid Statement of Program Service Accomplishments (See instructions on page 17.) What is the organization's primary exempt purpose? ► SEE SUPPLEMENTAL INFO. STMT . 1 All organizations must describe their exempt purpose achievements. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) Prognion Serrfa (gaouireddffor r501(c) and(4)orps.and be 4p47(al(1)or others optional f a SHELTER OPERATIONS-24HR CRISIS COUNSELING,EMERGENCY HOUSING, 3 81, 17 DOMESTIC VIOLENCE PROG,ACCREDITED IN-HOUSE SHELTER SCHOOL, CHILD DEV PROG,LEGAL ASSIST,COUNSELING,LIVING SUPPORT SERV. (Grants and allocations $ ) b OUTREACH CENTER -ASSIST IN COMPLETING & FILLING TEMPORARY 71,111 RESTRAINING ORDERS,CRISIS COUNSELING,SUPPORT GROUPS, COMMUNITY SERVICE REFERRALS, -'HOW TO" TRAINING (Grants and allocations S c (Grants and allocations $ d (Grants and allocations S e Other program services (attach schedule) (Grants and allocations S f Total of Program Servlce Expenses (should equal fine 44, column (8), Program services) ............................ ► 4 5 2 , 2 i Farm ,no(1995) SHELTER FROM 7 STORM, INC. 3 3 — 0 2 9 3 1 2 4 'Pac Balance Sheets (See instructions on pages 17-19.) Note: Where required, attached schedules and amounts within the description column should be for end -of -year amounts only. (A) Beginning of year (B) End of year A S s E T S 45 Cash - non -interest -bearing ..................................................... 46 Savings and temporary cash investments ........................................... 47 a Accounts receivable ...................................... 47al 14,169 b Lem: allowance for doubtful accounts. -...-.... ............... 47b ........... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........ ........ I ..... ... ....... . 48a Pledges receivable ...................................... 48a 23,600 b Less: allowance for doubtful accounts....... ................. 4M 49 Grants receivable .............................................................. So Receivables from officers, directors, trustees, and key employees (attach sch) ............... 51 a Other notes and loans receivable (attach schedule) ............. 51a b Low: allowance for doubtful accounts ........................ 511b 52 Inventories for side or use ....................................................... 63 Prepaid expenses and deferred charges ............................................ 64 Investments - securities (attach schedule) .................. SEE .STATEMENTI.S. 55a Investments - land, buildings, and equipment: basis................................................. Ina b Less: accumulated depreciation (attach schedule) ................ 65b 56 Investments - other (attach schedule) .............................................. 67 a Land, buildings, and equipment basis ....................... 1,728,722 b Ldepreciation Less: accumulated depreation (attach schedule) ... STMT.. , . r.. I s7b 1 101,219 56 Other assets (describe IIN- 59 Total assets (add lines 45 through 58) (must equal line 74) ............................. 61,265 4s 23 8 , 3: 46 49,996 14 , 1E 4 7 e 42,400 23, 6C 46c 49 so sic —4,655 52 3,8 5,336 s3 7,85 41,230 s4 43,35 SSc 56 1,620,084 1,627,50 57c 1,824,966 sg 1,958,67 L 1 A L I T 1 E S 60 Accounts payable and accrued expenses ........................................... 61 Grants payable ............................................................... 62 Deferred revenue .............................................................. 63 Loans from officers, directors, trustees, and key employees (attach schedule) ............... 64 a Tax-exempt bond liabilities (attach schedule) ........................................ b Mortgages and other notes payable (attach schedule) ......... SEE - STATEMENT.7. 65 Other liabilities (describe 110 66 Total liabilities (add lines 60 through 65) ............................................ 10,518 so 7,46 11111 42,400 e2 105,05 63 6" 487,008 e& 480,67 66 539,926 Ge 593,19 E T A a 3 E 3 T 0 R F N D 0 A L A N c E 3 Organtmillons tint follow SFAS 117, check here 0- J@ and complete lines 67 through 69 and lines 73 and 74. 67 Unrestricted .................................................................. N Temporarily restricted .......................................................... 69 Permanently restricted .......................................................... Organizations OW do not follow SFAS 117, check hem 0, [3 and complete lines 70 through 74. 70 Capital stock, trust principal, or current funds ........................................ 71 Paid -in or capital surplus, or land, bldg., and equipment fund ........................... 72 Retained earnings, accumulated income, endowment, or other funds ...................... 73 Total not assets or fund balances (add lines 67 through 69 OR lines 70 through 72; column (A) must equal line 19 and column (B) must equal One 21) ......................... 74 Total lialbIlMes and not assetsMund balances (add lines 66 and 73) ..................... . 1,203,669 1,209,48 81,371 - 155,99 99 . ........ 70 71 72 1,285,040 1,365,47' 73 1,824,966�74, 1,958,67 33-0293124 p• enciliation of Expenses per Audited f srtancial Statements with Expenses per Return a Total expenses and losses per audited ... _ ........ financial statements .................... ► a 599,6 b Amounts included on lute a but not on - line 17, Form 990 - (1) Donated services - and use of faciNties ... $ (2) Prior freer adjuatnterl3 a}' repoftd on kne 20,a*u:x -•... Form 990........... (3) Losses reported on �xr `<#` line 20, Farm 990 .�.. ,.:• •:.: :: ; 5 \ RE. .... $ ,?: r 4 Other S Add amounts on lines (1) through (4) ...... ► c Line a minus fine b..................... ► d Amounts included on One 17, Form 990 but not on line a: (1) investment expenses not included on One eb, Form ego........... _ (2) Other (spay) $ :::::.:.tl >s:>T:�:#<�s.. :'>ss<> SEE ST. 8 >:: ........:....::......c..:. t 2,327 Add amounts on lines (1) and (2) ........ ► d Add amounts on Ones (1) and (2).......... ► ::d,•:. 2„,:•:3; e Total revenue per One 12, Form 990 • Total expenses per line 17, Form 990 line c plus fine .................... ► e 682,403 line c plus line ..................... List of Officers, Directors, Trustees, and Key Employees (Ust each one even ff not compensated; we insift rm nn nano ,0 t ('/yNameandaddnss (B)Titlaandawra hours per W P weak devoted to position (C)Componsation (Mwstpaid, awasr-� �% Contributions to amployee benefit plans S deferred compensation (t7Eapansa account and other allowances SEE STATEMENT 9 ro uia any onicer. Orector, trustee, or Key employee receive aggregate compensation Of more than $100,000 from your organization and all related organizations, of which more than $10,000 was provided by the related organizations? ......................... ► ❑ yes if "Yes," attach schedule -see instructions on page 20. !'RUlvi THE STORM, INC. 33-0293124 1 .[TaiMMd Uther Information vs 76 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of eachactivity ........................................................................................... 76 77 Were any changes made in the organizing or governing documents but not reported to the IRS? ............................ 77 If "Yes," attach a conto, copy of the changes. 79a Did the organization have unrelated business gross income of $1,000 or more during the year -covered by this return? ........... b If "Yes," -has it fled a tax return on Form 990-T, Exempt Organization Business Income Tax Return, for this yew? ............... 79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If"Yes," attach a statement.................................................................................. . 80a Is the organization related (othsrthan by association with a statewide or nationwide organization) through common rrrembership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? ................................. b If 'Yes,* enter the name of the organization No, N /A and check whether it is ❑ exempt OR ❑ rnonexempt 21 a Enter the amount of political expenditures, direct or indirect, as described in the instructions for fine 81... 41a b Did the organization file Form 1120-POL, U.S. Income Tax Return for Certain Porftal Organizations, for this year? .............. 82 a Did the organization receive donated services or the use of materials, equipment or facilities at no charge or at substantially less than fair rental value?.................................................................................. b If "Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part 11. (See instructions for reporting in Part III.) ........................ I asb I N/A 63a Did the organization comply with the public inspection requirements for returns and exemption applications? .................. b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? ........................ 84a Did the organization solicit any contributions or gifts that were not tax deductible? ....................................... b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not taxdeductible?........................................................................................... a4b 85 Section 501(c)(4), (5), or (6) organizations. - a Were substantially all dues nondeductible by members? ...................... aSa b Did the organization make only in-house lobbying expenditures of s2,000 or teas? ....................................... 85b If -Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. c Dues, assessments, and similar amounts from members ...................................... esc N/A d Section I62(e) lobbying and political expenditures ........................................... and N/A e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices ........................... a" N A f Taxable amount of lobbying and political expenditures (fine 85d less 85s) ......................... am N/A g Does the organization elect to pay the section 6033(e) tax on the amount in 85f?........................................ h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 85f to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year? ........................... 86 Section 501(c)(7) organizations. - Enter: a Initiation fees and capital contributions included on line 12..................................... oft N/A b Gross receipts, included on line 12, for public use of club facilities ............................... alb N A 87 Section 501(c)(12) organizations. - Enter. a Gross income from members or shareholders ........... a7a N/A b Gross income from other sources. (Do not not amounts due or paid to other sources against amounts I I due or received from them.)............................................................ 97b N/A 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership? If "Yes," complete Part IX................................................................................... ....ae.. ........................ 89 Public interest law firms. - Attach information described in the instructions. 90 list the states with which a copy of this return is filed ► CALIFORNIA 91 The books are in care of ► KATHY CLARK Telephone no. ► (619) 3 2 8 - 72 3 Locatedat 0-74877 JONI DR., STE 11, PALM DESERT, CA ZIP code ► 92260 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in Neu of Form 1041, U.S. Income Tax Return for Estates and Trusts. - Check here► and enter the amount of tax-exempt interest received or accrued during the tax year .............. ► 1 92 1 N/A norm n.�itby�, �n>✓Ll�x rx�Ji�, 1,C,t. ivxi��, T =P8t3`tF> Analysis of Income-F fucin Activities Enter gross amounts unless otherwise indicated. 93 Program service revenue: a b c d e f g Fees and contracts from government agencies ....... 94 Membership dues and asseserrients ............... 96 Interest on savings and temporary cash investments ... 96 Dividends and interest from securities ............. . 97 Net rental income or(loss) from real estate: a debt -financed property ......................... b not debt -financed property ...................... 96 Net rental income or (loss) from personal property.... . 99 Other investment income ........................ 100 Gain or (loss) from sales of assets other than inventory . 101 Net income or (loss) from special events ............ 102 Gross profit or (loss) from sales of inventory.......... 103 Other revenue: aMISCELLANEOUS b C d e 104 Subtotal (add (columns (B), (D), and (�)............ 105 Total (add fine 104, columns (B), (D), and(q)........................................................ Note: (Line 105 plus line 1d. Part 1. should eaual the amount on ..ivL 33-0293124 ps (See instructions on p 14.) income Excluded by section 512. 513. or 51• Related or _ (B) R (o) tunction incom Amount Exclusion code Amount (See instruction: Unrelated business (A) Business code 14 4,95 121,07 1,2( 1 2: >;:-:>':::><::>:<:>s>:::::: ::.::;•::::.::.::::::.::::::::;:;;::::. 4,9 51 t 123 , 5_ line 12. Part 1.1 ► 128,507 r IaFtIE Relationship of Activities to the Accomplishment of Exempt Pumoses Une No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes). (See instructions on page 24.) 101 THE ABOVE INCOME PRODUCING ACTIVITIES ALL CONTRIBUTE TO THE PURPOSE TO OF THIS ORGANIZATION, WHICH IS TO RAISE FUNDS TO OPERATE A SHELTER 103 FOR VICTIMS OF DOMESTIC VIOLENCE. at' IX Information Regarding Taxable Subsidiaries (complete this Part If the "Yes" box on line Be Is checked) Name, address, and employer identification number of corporation or partnership Percentage of ownership interest Nature of business activities Total income End -of -year assets N/A % x x x Please Sign Here Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the beat of F knowledge and belief, It is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which prepan has any knowledge. (See Specific Instructions, page 9.) Signature of officer Date Type or print name and tltle. Paid Propuees, gnature signal. Date Cheek if 9 seN - employed ► ❑ Prspaws social security no. 5 54 - 3 3 - 815 0 Preparers VN only LUND & GUTTRY , CPA' S EIN ► 9 5 - 21013 2 7 Firm's name (or if yours.e"-employed) 1111 TAHQUITZ CANYON WAY, #110 and address PALM SPRINGS, CA ZIP code ► 92263�714 rganization Exempt Under Sectio-- 501(cx3) SCHEDULE A tfcxospt Prlvab Foundation) and Section rroi(e), d J, 1i01(k), or OMB No. tSaS-OW (Form 990) Section 4947(aKt) Nonexempt Charitable Trust Supplementary Information 1995 Department of the Treasury Se9 bl*UctlOns. Internal Revenue Service ► Must be completed by the above orgaIlations and attached t0 their Form 990 (or 99o-fEZ). Name of the oroanimton Employer identification number SHELTER FROM THE.ETORM, INC. 33-0293124 =: Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (Sea instructions on page 1. List each one. tf two are none, enter "None.') a) Name and address of each employee paid more than t60,000 (b) Tim and average hours per week devoted to position is; Gomparuution jecontributions to employee benefit plans l deferred compensation N Expense aceountand oth allowanoes NONE Total tier f other I aid over t�0 . ruin o 0 0 S5o � P • ::::::.:::::::::•::.:.:.::..::..............:...: .. ,:........ - _..iiZh7ri iiii'riiiii{iiiv:{;?rj}j5it ••r'i i S{ i 5tt6 ........... 1v,+:. - Yy ...... 2 �G: •�..:. {�. .. ivb:4:F.i4 a :• � 'N� .a�_vti :iiSki: t'.j �:x{.: F:;ri z?l:i{`7:nJ.••r• �. . .v'.`r: '`• MEN-4 _.:.y'fiisgx..iix:...;..:.�Y•::.:..5....: \;,.; Y..:.. ....L .. S.viwiR-R s..s;{:.>>.:.:•:-...:{}::n: •. Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instructions on page 1. List each one (whether individuals or firms.) If there are none, enter "None.") (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service to compensatic NONE Total number of others receiving over =SO.000 for professional services ................................ ► ii4Y{;i!••li'!CiiyiYi�Jf..:k. •: •.: r•::::•�w :.. ¢:.....:•:: r .. 4rtt;> .:;�:ii+i{:+kv:'i{Y. .';H�.�•. '• . : ! : s:;•:..:•..`??:;::r.:..::{; vwi .. ::: %> s' f:•:,..: . •::::. s» a For Paperwork Reduction Act Notice, ace page 1 of the Instructlotts 10 Form t1Y0 (or Form 990-EZ). Schedule A (Form 98% 11 J riz-.1 trn r tcul•i 1 mrJ J A. Jiily� A NC -Schedule A (Form 990)1995 >artSf Statements About Activities 33-0293124 I. — Yes 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? ....................... ............................ . if 'Yes," enter the total expenses paid or incurred in connection with the lobbying activities. ► S Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI -A. Other organizations checking "Yes," must complete Part VI-8 AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary,. aSale, exchange, or leasing of property?........................................................................ 2a b Lending of money or other extension of credit?.................................................................. 2b c Furnishing of goods, services, or facilities?...................................................................... 2c d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)?SEE . FORK . 99 Q, ..PART..V 2d X a Transfer of any part of its income or assets?.................................................................... . If the answer to any question is "Yes," attach a detailed statement explaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student bans, etc.? ..................................... 4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or bans in furtherance of its charitable proarams ouatifv to receive payments. (See instructions on peas 2.) <a#>11/< Reason for Non —Private Foundation Status (See instructions on pages 2 through 5.) The organization is not a private foundation because it is (please check only ONE applicable box): 5 ❑ A church, convention of churches, or association of churches. Section 170(b)(1)(A)(1). 6 ❑ A school. Section 170(b)(1)(A)(ii). (Also complete Part V, page 4.) 7 ❑ A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)Cii). 8 ❑ A Federal, state, or local government or governmental unit Section 170(b)(1)(A)(v). 9 ❑ A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(111). Enter the hosplial's name, city, and state oil 10 ❑ An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV -A.) 11 a ® An organization that normally receives a substantial part of Its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) 11b ❑ A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) 12 ❑ An organization that normally receives: (a) no more than 33 113% 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, and (b) more than 33113% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions - subject to certain exceptions. See section 509(a)(2). (Also complete the Support Schedule in Part IV -A.) 13 ❑ An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6). if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions on page 4.) (a) Name(s) of supported organization(s) I (b) Una nurnber from above 14 ❑ An organization organized and operated to test for public safety. Section 509(a)(4). (See Instructions on page 4.) �ni.��Lt� rtcVl, stir✓ S'luxri. iNC. _ 33-0293124 Schedule A (Form 890) 1995 Pa IIF-f Support Schedule (complete only if you checked a box on line 10, 11, or 12.) use cash method ofaccounting. Note: You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting. Calendar year (or fiscal year beginning In) ...... ► (a) 1994 (b) 1993 (c) 1992 ( 1991 (e) Total 15 Gifts, grants, and contributions received. (Do not include unusual grants. see line 28.)... 513,306 600,889 284,162 140,048 1,538,4 16 Membership fees received ................. 5,842 7,350 8,870 22,0 17 Gross receipts from admissions, merchandise sold or services perfo... , or furnishing of facilitiss in any activity that is not a business unrelated to the organi?"n's charitable, etc., purpose........................... 44,021 133,793 72,285 250,0 is Gross income from interest, dividends, amounts received from payments on securities bans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (leas section 511 taxes) from business acquired by the organization after June 30,1975 ....... 3,342 3,285 11,984 6,265 24,8 19 Net income from unrelated business activities not included in line 16 ............. 20 Tax revenues levied for the organization's benefit and either paid to It or expended on its behalf. . 21 The value of services or facilities furnished to the organization by governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge..... . 22 Other income. Attach a sch. Do not include gain (loss) from sale of capital assets . STMT..10 1,996 185 1,790 1,425 5, 3! 23 Total of lines 15through 22................ 518,644 654,222 439,079 228,893 1, 840, 8: 24 Una 23 minus line 17 ..................... 518,644 610,201 305,286 156,608 1,590 7: 25 Enter 1%of line 23....................... 5,186 6,542 4,391 2, 289 »'sr<"` ........................................... 26 Organbmtlons described In lines 10 or 11: a Enter 20% of amount in column (e), line 24...................... ► 26a 31 8: b Attach a list which is not open to public ins action showing the name of and amount contributed peso ( Pe P inspection) n9 by each n (other than a govemmeM unit or publicly supported organization) whose total gifts for 1991 through 1994 exceeded 'c<%'''{> >'''.......................... .ks:: :O:'.. IN- ! •` ' "x the amount shown in line 26a. Enter the sum of all these excess amounts here ...... SEE. .STATEMENT .11. ► 26b 8,11 .s 26c 1, 590, 7: c Total support for section 509(a)(1) test: Enter line 24, column (9)............................................ ► d Add: Amounts from column (e) for lines: 18 $ 24,876 18 $ 22 $ 5,396 26b s 8,185 ............... 11, M $ 38 4! me $ 1, 552, 21 e Public support (line 26c minus line 26d total)........................................................... ► i Public support percentage line 28e (numerator) divided by line 26c (denominator)) ... ► 28f 97.51 27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person," attach a list to show the name of, and total amounts received in each year from each "disqualified parson." Enter the sum of such amounts for each year. N/A (1994) (1993) (1992) (1991) b For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in Ines 5 through 11, as well as individuals.) After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of all these differences (the excess amounts) for each year- (1994) (1993) (1992) (1991) c Add: Amounts from column (e) for lines: 15 $ 16 $ 17 $ 20 $ 21 $ .......... ► 27c d Add: Line 27a total .. $ and One 27b total ......... $ .......... * 27d a Public support (line 27c total minus line 27d total) ................................... ....... ► 27a f Total support for section 509(a)(2) test: Enter amount on fine 23, column (e) ............. No 27f S 7M g Public support percentage (line 27e (numerator) dlvldsd by line 277 (denominator)) .......................... ► 27a h Investment Incomepan»ntage pine 18, column (a) (numerator) divided byline 271 (donor I............. ► 28 Unusual Grants: For an organization described in One 10, 11, or 12 that received any unusual grants during 1991 through 1994, attach a Not (which is riot open to pubic inspection) for each year showing the name of the contributor, the date and amountLAI grant, and a brief description of the nature of the grant. Do nTriot include these grants in line 15. (See instructions on page 5.) N anL�ir.r� riwm Trig: STODRYI !NC:. Schedule A (Form NO)1995 Private School Questionnaire (See instructions on page 5.) (To be completed ONLY by schools VW checked fhe box on line 6 In Part IV) 33-0293124 Pa W 29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, other governing instrument, or in a resolution of its governing body? ........................................................ 30 Does the organization include a statement of Its racially nondiscriminatory policy toward students in all Its brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships? ................. 31 Has the organization publicized Its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period If it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? ...................................................... If "Yes," please describe; 0 "No; please explain. (If you need more space, attach a separate statement.) 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? ............................... b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis? .......... c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships? ........................................ ............................. . d Copies of all material used by the organization or on its behalf to solicit contributions? ................. ....... . ......... . If you answered "No" to any of the above, please explain. (If you need more space, attach a separate staternem) 33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges?................................................................................. bAdmissions policies?........................................................................................ Employment of faculty or administrative staff?.................................................................... . d Scholarships or other financial assistance?...................................................................... . eEducational policies?...............................:........................................................ fUse of facilities?............................................................................................ gAthletic programs?.......................................................................................... h Other extracurricular activities?................................................................................. If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.) 34a Does the organization receive any financial aid or assistance from.a governmental agency? .................................. b Has the organization's right to such aid ever been revoked or suspended? ............................................... If you answered "Yes" to either 34a or b, please explain using an attached statement. 35 Does the organization certify that it has complied with applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50, 1975-2 C.B. 587. coverino racial nondiscrimination? If "No," attach an explanation ...................................... ..,._�..r�.r.. _,.�.. �..L, J+.�iu•.l ��... 33-0293124 SchowN A (Four 990) 1995 Pa! Lobbying Expenditures by Electing Public Charities (See instruc.- as on page 5.) N/A (To be completed ONLY by an eligible organization that filed Form 5768) Check here ► a ❑ if the organization belongs to an affiliated group. Check here ► b ❑ if you chucked 'a' above and "limited contror provisions apply. Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.) 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) ...................... 36 37 Total lobbying expenditures to influence a legislative body (direct lobbying) ....................... 37 36 Total lobbying expenditures (add fines 36 and 37)........................................... 36 39 Other exempt purpose expenditures..................................................... 39 40 Total exempt purpose expenditures (add fines 38 and 39)..................................... 40 41 Lobbying nontaxable amount Enter the amount from the following table - If the amount on line 40 Is - The lobbying nontaxable amount Is - Not over $500,000 ...................... 20% of the amount on fine 40 ................ Over $500,000 but not over $1,000,000 ...... $100,000 plus 15% of the excess over $500,000.. .. Over $1,000,000 but not Over $1,500,000 ... $175,000 plus 10% Of the excess over $1,000,0oo 41 Over $1,500,000 but not over $17,000,000 ... $225.000 plus 5% of the excess over $1,500,000 . M Over$17,000,000....................... $1,000,000 .............................. #:? 42 Grassroots nontaxable amount (enter 25% of fine 41)........................................ 42 43 Subtract line 42 from line 36. Enter -0- If line 42 is more than line 36 ............................ 43 44 Subtract line 41 from line 38. Enter -0- If line 41 is more than fine 38 ............................ 44 Caution: It there is an amount on either line 43 or line 44, file Form 4720. (a) I (b) Affiliated group To be complete totals for ALL electirx 4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50 on page 7.) Lobbying Expenditums During 4-Year Averaging Period Calendar year (or fiscal ysu beginning In) ► I (a) I (b) I (c) I (d) I (e) 1995 1994 1993 1992 Total 45 LobbVin9 nontaxable amount ................ 46 Lobbying ceiling amount (15016 of line 45(e)). . 47 Total lobbying expenditures . 48 Grassroots nontaxable amount. . 49 Grassroots ceiling amount (150% of line 48(e)).. . 50 Grassroots lobbying expenditures ............ Lobbying Activity b Nonelectin Public Charities N/A Y 9 hY Y 9 (For reporting only by organizations that did not complete Part VI -A) (See instructions on page 7.) During the year, did the organization attempt to influence national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of: aVolunteers.................................................................................... b Paid staff or management (Include compensation in expenses reported on lines c through h.).................... c Media advertisements........................................................................... d Mailings to members, legislators, or the public......................................................... e Publications, or published or broadcast stalements..................................................... f Grants to other organizations for lobbying purposes .................................................... g Direct contact with legislators, their staffs, government officials, or a legislative body ............................ h Rattles, demonstrations, seminars, conventions, speeches, lectures, or any other means ........................ Total lobbying expenditures (add fines c through h)..................................................... If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities. SHELTER FROM THE STOW INC. 33-0293124 Schedule A(Form 990)1995 Pa£ Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Ya I p) Cash............................................................................................... 51 gn (1l) Other assets......................................................................................... b Other transactions: p) Sales of assets to a noncharitable exempt organization......................................................... bM pq Purchases of assets from a nonchadtable exempt organization................................................... (Ill) Rental of facilities or equipment.......................................................................... . Qv) Reimbursement arrangements............................................................................ (v) Loans or ban guarantees............................................................................... v (vl) Performance of services or membership or fundraising solicitations ............................................... c Sharing of facilities, equipment, mailing lists, other assets, or paid employees ........................................... I c d If the answer to any of the above is "Yes; complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. ff the organization received less than fair market value in any transaction or sharing arrangemeK show in column (d) the value of the goods, other assets, or services received. (a) (b) (c) (d) Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, and sharing arrangernei N A 52a Is the organization directly or indirectly affiliated with, or related to. one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527?.......................................................... ❑ Yas b If "Yes." corrmlete the following schedule. (a) I (b) I (c) Name of organization Type of organization Description of relationship EfffI For., 2758 (Rev. May 1995) Department of the Treasury Internal Revenue Service Please type or print. File the original and one copy by the due date for filing your return. See ins- tructlons on back. \pplication for Extension of Tirr —To File Certain Excise, Income, Information, ano Other Returns ► File a separab appiballom for each re0um. Name SHELTER FROM THE STORM, INC. Number, street, and room or suite no. (or P.O. box n7. if mail is not dai vered to stroot address) P.O. BOX 781 City, town or post office, StILWand ZIP code. For a foreign address, see matructions. PALM DESERT, CA 92260 OMB No. 1645-0t4e EMPWW a 33-029312� Nob: Corporate income tax return filers must use Form 700410 request an extensiDn of time tD file. Partnerships, REMICs, and trust nwe use Form 9736 to request an extension of time to Is Form 1005, 1086, or 1041. 1 1 request an extension of time until 02 /18 .19 97 , to file (check only one): ❑ Form 706-GS(D) ❑ Form 990-T (401(a) or 406(111) oust) ❑ Form 112D-ND (4951 taxes) ❑ Form 8812 ❑ Form 706-GSM ❑ Forth 990-T (trust other than above) ❑ Form 3520-A ❑ Forth 6813 ® Form 990 or 990-EZ ❑ . Form 1041 (estate) (see instructions) ❑ Form 472D ❑ Form a= ❑ Form 990-SL ❑ Form 1041-A ❑ Form 5227 ❑ Form am ❑ Form 990-PF ❑ Form 1042 ❑ Form em ❑ Form ea31 If the organization does not have an office or place of business in the United Stales, check this box ...... ........................... . 2a For calendar year 19 , or other tax year beginning 7 / 01 / 9 5 and ending 6 / 3 0 / 9 6 b If this tax year is for less than 12 months, check reason: ❑ Initial return ❑ Final return ❑ Change in accounting period 3 Has an extension of time to The been previously granted for this tax yeah ................................................ ❑ Yes Q 4 State in deWl why you need the extension ADDITIONAL -TIME —IS NEEDED TO ACCUMULATE THE NECESSARY INFORMATION Sa If this form is for Form 706-GS(D), Form 706-GS( ), 990-BL, 990-PF, 99o-T, 1041 (estate), 1042, 1120-ND, 4720, 6069, 8612, 8613, 8725, 8804, or 8831, enter the tentative tax, less any nonrefundable credits. See instrucons........... S b If this form is for Form 990-PF, 990-T, 1041 (estate),104Z or 8804, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit ........................................ S e Balance due. Subtract line 5b from line 5a. Include your payment with this form, or deposit with FM coupon if required. Sesinstructions : Signature and Verrtic0on Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete; and that 1 authors=ed to prepare this form. Signature ► �� Title ► �' • Dab ► FILE ORIGINAL ONE COPVJ. The IRS will show below whellm or not your application Is approved and will return the copy, Notice to Applicant - To Be Complated by the IRS ❑ We HAVE approved your application. Please attach this torn to your return. ❑ We HAVE NOT approved your application. However, we have granted a 10-day grace period from the later of the date shown below or the due date of your return (including any prior extensions). This grace period is considered to be a valid extension of time for elections otherwise required to be made on a timely rewm. Please attach this forth to your return. ❑ We HAVE NOT approved your application. After considering the reasons stated in item 4, we cannot grant your request for an o t nsion of time to file. We are not granting the 10-day grace period. ❑ We cannot consider your application because it was filed after the due date of the return for which an extension was requested. ❑ Other or. Director Dab If you want a copy of this form to be returned to an address other than that shown above, please enter the address 1D which the copy shouid be tart Please Type or Print 1 Name LUND & GUTTRY, CPA'S Number, street, and room or suits no. (or P.O. boa no. if mail is not delivered to street address) 1 Y, #110 City, town or post office, stab, and ZIP code. For a foreign address, see instructions. PALM SPRINGS, CA 92263-2714 KFA For Paperwork Reduc*m Act Notice, see back of form. Form 2766 (Now. i FEDERAL STATEMENT` PAGE 1 Client 4176 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 1 FORM 990, PART 1, LINE 1D CONTRIBUTIONS, GIFTS, AND GRANTS NOT OPEN TO PUBLIC INSPECTION ----------------------------- DIRECT CONTRIBUTIONS: AMOUNT CONTRIBUTOR'S NAME CONTRIBUTOR'S ADDRESS OF CONTR. ---------------------------------------------------------------------- MARY S. ROGERS FOUNDATION $ 50,000 TIMOTHY NORTON CONRAD HILTON FOUNDATION DIRECT CONTRIBUTIONS LESS THAN $5,000 TOTAL DIRECT CONTRIBUTIONS, LINE lA 5,000 5,000 223,186 $ 283,186 INDIRECT CONTRIBUTIONS: AMOUNT CONTRIBUTOR'S NAME CONTRIBUTOR'S ADDRESS OF CONTR. ------------------------------------------------- ---------------- PRESLEY FUND $ 78,541 CITY OF PALM DESERT CITY OF CATHEDRAL CITY INDIRECT CONTRIBUTIONS LESS THAN $5,000 TOTAL INDIRECT CONTRIBUTIONS, LINE 1B 24,449 6,455 2,000 $ 111,445 1.995 Client 4176 FEDERAL STATEMENTP PAGE 2 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 1 (CONTINUED) FORM 990, PART 1, LINE 1D CONTRIBUTIONS, GIFTS, AND GRANTS GOVERNMENT GRANTS: AMOUNT CONTRIBUTOR'S NAME CONTRIBUTOR'S ADDRESS OF CONTR. ---------------------------------------------------------------------- DEPARTMENT OF HEALTH SERVICES $ 159,265 TOTAL GOVERNMENT GRANTS, LINE 1C $ 159,265 TOTAL CONTRIBUTIONS, LINE 1D $ 553,896 sssssssass STATEMENT 2 FORM 990, PART 1, LINE 9 NET INCOME (LOSS) FROM SPECIAL EVENTS SPECIAL EVENTS: A) HOLIDAY FANTASY B) C) OTHER: SPECIAL EVENTS A B C OTHER TOTAL ---------- GROSS RECEIPTS $ 121,070 --------- 0 --------- 0 ---- - ---- 0 --------- 121,070 LESS: CONTRIBUTIONS 0 0 0 0 0 ---------- GROSS REVENUE 121,070 --------- 0 --------- 0 --------- 0 --------- 121,070 LESS: DIRECT EXPENSES 0 0 0 0 0 ---------- NET INCOME (LOSS) $ =-c=oss.cc 121,070 --------- 0 o=ess---� --------- 0 -----=.as --------- 0 sss-_--as --------- 121,070 asccssasa 1995 Client 4176 FEDERAL STATEMENT.!` PAGE 3 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 3 FORM 990, PART 1, LINE 10 GROSS PROFIT (LOSS) FROM SALES OF INVENTORY ITEMS SOLD ---------------------------------------- SALE OF COOKBOOKS .......................................... GROSS SALES LESS RETURNS & ALLOWANCES NET SALES LESS: COST OF GOODS SOLD GROSS PROFIT FROM SALES OF INVENTORY STATEMENT 4 FORM 990, PART II, LINE 43 OTHER EXPENSES OTHER EXPENSES CONTRACT LABOR RENT UTILITIES INSURANCE PROPERTY TAXES FOOD -SHELTER REPAIRS & MAINTENANCE FOOD & BEVERAGE DECORATIONS ENTERTAINMENT AUCTION MISCELLANEOUS TOTAL (A) TOTAL $ 25,605 17,610 25,596 10,997 6,393 24,937 16,298 12,781 7,334 5,422 3,240 20,555 $ 186,768 (B) PROGRAM SERVICES 25,605 16,500 33,791 10,997 6,393 24,937 16,298 AMOUNT $ 2,047 $ 2,047 0 $ 2,047 782 $ 1,265 zszssazsss (C) MANAGEMENT & GENERAL 1,805 (D) FUNDRAISING 1,110 12,781 7,334 5,422 3,240 7,479 9,256 3,820 142,000 11,061 33,707 ===cs=s=z zazzzzzszz zasassaazaa 11995 FEDERAL STATEMENT" PAGE 4 IClient 4176 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 5 FORM 990, PART IV, LINE 54 INVESTMENTS - SECURITIES VALUATION U.S. GOVERNMENT OBLIGATIONS METHOD AMOUNT ----------------------------------------------------------- U.S. TREASURY BILLS COST $ 43,357 TOTAL STATEMENT 6 FORM 990, PART IV, LINE 57 LAND, BUILDINGS, AND EQUIPMENT $ 43,357 $ 43,357 c a= s s s s s a s ACCUMULATED BOOK ASSET BASIS DEPRECIATION VALUE ----------------------------------- FURNITURE AND FIXTURES ---------- $ 40,209 ------------ 4,466 --------- 35,743 MACHINERY AND EQUIPMENT 41,042 1-1,654 29,388 BUILDINGS 1,188,398 83,798 1,104,600 IMPROVEMENTS 45,073 1,301 43,772 LAND 414,000 414,000 TOTAL ---------- $1,728,722 ------------ 101,219 --------- 1,627,503 STATEMENT 7 FORM 990, PART IV, LINE 64B MORTGAGES AND OTHER NOTES PAYABLE MORTGAGES PAYABLE ------------------ PALM DESERT NATIONAL BANK TOTAL BALANCE DUE $ 480,676 $ 480,676 $ 480,676 asaaaa:ssss 1995 FEDERAL STATEMENTo PAGE 5 Client 4176 SHELTER FROM THE STORM, INC. 33-OM124 STATEMENT 8 FORM 990, PART IV-B, LINE D(2) OTHER AMOUNTS DEPRECIATION EXPENSE ....................................... $ 2,327 TOTAL $ 2,327 eaaaaaaa:a STATEMENT 9 FORM 990, PART V LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES EMPLOYEE EXPENSE TITLE & AVG. BEN. PLN ACCOUNT/ NAME AND ADDRESS HRS/WK DEVOTED COMP. CONTRIB. OTHER ------------------------------- KEVIN MCGUIRE --------------- PRESIDENT --------- 0 -------- 0 -------- 0 5 JANET NEWCOMB 1ST VICE PRES. 0 0 0 5 EDRA BLIXSETH 2ND VICE PRES. 0 0 0 5 CHERYL HAMER MACKELL SECRETARY 0 0 0 5. BOB BALTES TREASURER 0 0 0 5 ROBIN SPENCER DIRECTOR 0 0 0 5 JOHN ROGERS DIRECTOR 0 0 0 5 1995 FEDERAL STATEMENT~ PAGE 6 IClient 4176 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 9 (CONTINUED) FORM 990, PART V LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES EMPLOYEE EXPENSE TITLE & AVG. BEN. PLN ACCOUNT/ NAME AND ADDRESS HRS/WK DEVOTED COMP. --------- CONTRIB. OTHER ------------------------------ JOYCE WAYMAN --------------- DIRECTOR 0 -------- 0 -------- 0 5 CLIFF HARRIS DIRECTOR 0 0 0 5 GENE KULANDER DIRECTOR 0 0 0 5 MICHAEL LEITMAN DIRECTOR 0 0 0 5 LIANNE ROGERS DIRECTOR 0 0 0 5 BARBARA MCCLURE DIRECTOR 0 0 0 5 FRAN FERGUSON EXEC. DIRECTOR 40,000 0 0 40 TOTAL $ 40,000 0 0 ========= ======== ===___== STATEMENT 10 SCHEDULE A, PART IV -A, LINE 22 OTHER INCOME DESCRIPTION (A) 1994 (A) 1993 (A) 1992 (A) 1991 (E) TOTAL -------------------------------------------------------------------- MISCELLANEOUS $ 1,996 185 1,790 1,425 5,396 ---------------------------------------------- $ 1,996 185 1,790 1,425 5,396 1995 FEDERAL STATEMENTO- PAGE •7 4 Client 4176 SHELTER FROM THE STORM, INC. 33-0293124 STATEMENT 11 SCHEDULE A, PART IV -A, LINE 26B EXCESS CONTRIBUTORS 1994 1993 1992 1991 TOTAL ----------------------------------------------- KATHERINE REDDING $ 40,000 40,000 $ 40,000 LINE 26A X 1 - 31,815 EXCESS CONTRIBUTIONS $ 8,185 1 2/03/96 , Client Notes - Statement<c- Client 4176 SHELTER FROM THE STORM, INC. Page 1 33-0293124 STATEMENT 1 FORM 990, PART III ------------------ THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE A SHELTER FOR BATTERED WOMEN AND THEIR CHILDREN IN THE COACHELLA VALLEY. r N W Wol , W • d � • wr J • 8 S • ti pp�� O C d OC W 6 C r 0. ul W J W-C o m lu W , InV� V/ (� Z Z W C cW L� ccO O Q N I gn z a W mo• WM li a Vl 02.1 W C mLU o L6 I J Q . NLLI W = w W LL L \ N m a V r ' W O H J c N O W OL C V 81 u M W W ,A W T- G ed P O Z \ `! W �p O aD M � � v f.- f- A A A f- A 1- U% W% N N �t IH O r r r O r N A O m A A oZ M W N Q us i r s o W ^ W f9 46 ps t~ � J N i7 t� i w RSi a P cc N N N N N .". MN P 1� A• P N •O M b A � r Go N M O N O m •O J J J J J J J J J J J J N N N N h N N N N N N N A O P! t 0 M N N ^ N N Y�4-0 � � N •O �f — N Ifs t 'f 1R .f M pn N • o . O O O . o N •O �T � � � N If .Mf �f I�ff J 0-1 A H i f. H F y W S S S S s N • ! W W OC W W W� W! d d d A IL N �O A r- � O N N M •I � p LL EL J i Y/ O Q W w a uj MMJ Ir LU W LL to a) 0) r `,I a i N � M M C W J r- W ti W OC OC W a O N OC o.1c , W C7 i N • ci m ac O d O N � OL d coo. N � m W ppaC W f� CA .- V1 1- m n \ N In IA m CI W O H J 0 O N O M oc O M V : \ O. t 4 y K v N US U. O • d fGO7 _ _ s s � N� M� � O p• .p M r- n N N .t u Uft M M M Cp M O• M J y J J J J \ \ \ \ N N N a) •O M cO M Y1 N InM a1 in O a O� a • N u ' N O A N O d M Y1 �t a �ONy M • �N O O O p N N • N ' • N 0 0 to o a M N • M ' a a p O IS O O O O a M • no • N O O O O M a ua a N M N rr p : N N A a Y1on a N • u Pyyy •' N in O � � M t A O .\O \ c� W e: 40 W O _ = K H N aaape� a.Go s M .r in 4 Djjj - IIIMZ907 CM OF U WINTA CITY MANAGEEWS DEFT. CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR R 7 - 95 Name of Amount Requested: `-`� o0 Contact Person: tln;»}_ Mailing Address:- n / 1 city: �W,44, v If State: jfj!�Z_ Zip Code: -- Phone No.: 71AO -3y c2 9� 501(c)3 Taxpayer I.D. Number: Date S 1 APPLICATION What is the overall purpose or goal of your organization? Family Service of Coachella Valley strives to improve the au&y of life by strengthening families neighborhoods and the desert community The agency responds to a diversity of ethnicities social issues and family structures within the community by offering a wide range of services including: Individual Family Couples Counseling_ Family Violence and Anger Management Groups Critical Incident Debriefing- parenting Instruction and Support Groups child and Adolescent Therapy Play Therapy Family and Custody Assessments and Child Abuse Treatment. 2. How long has your organization been in existence? 39 Years 11 Months 3. Describe in general the activities or services of you organization: FSCV is a community based agency providing_counselim specialized treatment programs and psycho education for families and individuals living in the desert region The main office is located in Indio and services are also provided at satellite locations in Palm Springs Desert Hotorings and 25 school sites. 4. How many people does your organization currently serve ? Est. 550 individuals per month No. of Youth 150 No. Of Adults 350 No. Of Seniors 50 5. How many people do you intend to serve during this fiscal year? No. Of Youth 1800 No. Of Adults 4200 No. Of Seniors 600 6. How may people served this Fiscal Year will be La Quinta Residents? No. Of Youth 450 No. Of Adults 1050 No. Of Seniors 100 7. How many paid employees /volunteers does your organization employ? No. Of full time employees 5 No. Of part time employees 17 No. Of volunteers 22 8. Describe how your organization is managed and governed. FSCV is a private non profit 501(� 3 organizationlroverned bYa 13-15 member Board of Directors made up of community volunteers The A&M employees an Executive Director that reports directly to the board A licensed MFCC clinician oversees all clinical activities of the agency 9. Please provide information on your Executive Board members or contact person: Name Title Home Address Phone Janine Smith Executive Director Please see Attachment (1) 54-017 Avenidia Vallejo 771-0155 La Quint& 10. What is your annual schedule of events, and during what months does your organization operate. FSCV offers a full range of services year round. All services are provided Monday - Saturday with appointments available between 9:00 AM and 7:00 PM on weekdays. The agency also participates in many community' events during the year and offers special presentations for the community on family related issues. Many professional development seminars are provided by agency staff. Agency representatives are actively involved in community organizations such as the Desert Child Abuse Prevention Council, SARB, Healthy Start, Youth Alliance etc. Please see Attach (2) 11. Do you charge admission, membership fee dues, etc? X Yes No If yes, please describe: Clients are charged for services using a sliding scale fee schedule based on annual income and number of dependents Children and youth are not declined services due to inabflb to vav Fees and Co-�avments range from $5 00-$50.00. 12. What are your other sources of revenue for this funding year? Please see attachment (3) Program Specific Needs Total Needed Total Received $ 5000.00 galanc $ (5000.00) 13. Amount of money requested from the City of La Quinta? $ 5000.00 14. Has your organization been funded by the City of La Quinta previously? Yes No x 15. Need Statement . Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. FSCV is the only community based non profit mental health/social service in the east end of the valley providing services described previously in this application The statistics for this area regarding child abuse/neglect divorce drop out rates family violence etc are significant. (Attached) Many families especially those will limited incomes struggle with issues directly relating to family relationships children achieving academic potential. substance abuse etc.. (AttachmentLNianv families do not have insurance to cover mental health services or they do not have adequate income to nay for mental health services. Family Service is the local counseling service rig services with a low slidin f�, ee range. Transportation needs also creates a barrier for accessing services. Twenty five percent of the agencies clients live in the city of La eta. 16. Goal Statement. Indicate who will benefit from the use of these funds, and they will benefit. Approximately six hundred La Quinta residents will receive counseling and crisis intervention services in the form of individual/family sessions conducted at school sites and two 8 week parenting groups conducted at a site located in the city. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. Please see attachment (4) 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. Please see attachment ( 5) J. _ /IILY SERVICE OF COACHELLA JLLEY BOARD OF DIRECTORS 1997 J.M. Evosevich PRESIDENT Psychologist/MFCC P.O. Box 1456 Palm Springs, Ca. 92263-1456 (760) 323-8319 Personal Sec. (760) 773-7202 Voice Mail (760) 321-8983 Fax Michael Avriette 70415 Cobb Rd. Rancho Mirage, Ca. 92270 (760) 202-0023 Home (760)863-8534 Irene Anthony, Treasurer Desert Aids Project Director of Program Services 750 Vella Rd. Palm Springs, Ca 92264 (760) 323-2118 Work (760) 323-9865 Fax (760) 329-3578 Home Ilise Garvin Assistant Development Director The Palm Valley School 35-525 DaVall Drive Rancho Mirage, Ca 92270 (760) 328-0861 Work (760) 7704541 Fax Janine Smith Executive Director Non Board Member 54-017 Avenida Vallejo La Quinta, Ca 92201 (760) 347-2398 Work (760) 771-0155 Home rev 8/21/97 fs039 Florence Holdsworth Personal Business Mgr. P.O. Box 804 Palm Desert, Ca 92261-0804 (760) 346-6528 Home Linda Grossmann, Secretary 39151 Desert Greens Drive East Palm Desert, Ca. 92260 (760) 568-0671 Home (760) 773-8362 pger Pam Trotter, Vice -President Dir. Of Human V.P , Resources -Hemet Federal Savings 445 E. Florida Ave. Hemet, Ca. 92543 2560 San Mateo Circle (Home) Palm Springs, Ca 92264 (909) 658-4418 Ext.2300 (909) 652-2460 Fax (760) 323-2505 Home (760) 779-6761 Pager (760) 835-8599 Mobile Hilary Bendon P.O. Box 499 -Consultant Rancho Mirage, Ca. 92270 (760) 770-7897 Home (760) 228-7248 Pager Enter # and # Michael C. Hilgenberg RE/MAX of the Desert 72-608 El Paseo, Suite 4 Palm Desert, Ca 92260 (760) 776-1568 (760) 341-9606 Fax 1-800 464-2430 Carl Ingram 78625 Sanita Dr. La Quinta, Ca. 92253 (760) 772-1367 Home (call) (760) 398-2651 Work Jeffrey Flashman Attorney Tuverson & Hillyard 1800 East Tahquitz Canyon Way Palm Springs, Ca 92262 36-705 Jasmine Lane (Home) Rancho Mirage, Ca 92270 (760) 322-7855 (760) 328-4838 (760) 322-5121 Fax Steve Brown Owner/Home Concierge Services Analyst C.V.H.0 54-205 Avenida Ramirez La Quinta, Ca 92253 (760) 564-4438 Focus Area Descripti Locations Eligii ry Fee Other Ind/Couples/ Counseling services provided for Indio All persons S23-SSO U- Way Family individuals and families. Fes Desert Hot eligible or co -pay supports Counseling based on sliding scale determined Springs for pr. this prog. at intake based on income and •-Palm Desert ins.. Family Family and individual counseling Indio Familieswherenow or Counseling - targeting children "at cis:: of Desert Hot children are at co -pay of DPSS abuse". Funded through DPSS and Springs risk of abuse or 55.00 reierred to as CAPIT. Referrals Palm Desert neglect come the community. Some - :Schools Family Clients are referred by DPSS Child _Indio•-- Speciacally �NoTee /Individual Protection Services., .. .:. Desert Hot refaced by Counseling- normally have had substantiated Springs - - DPSS-CPS CPS abuse in the home or serious. Palm Desert, neglect Parents and children are. seen for a designated period -of time. - School Based Funds received from Community - Palm Desert: Low. or . No Fee Referred Counseling Block grata allow for counseling at. -.East. _ - moderate to as risk children, youth and parents in: Riverside Income. "At CDBG school or c ai m minty setting. Cry. Risk" -Head Start: Provide direct mental health - . - -Des. Sands Headsrart pre- No Fee Mental Health services to Head Start Students and Coach. Unit school Consulting Parents, training for teaches & patent groups. Classroom observation. Parenting Classes provided using Step as - == _ ` -ESC V-, Indio. No eligibility $20 per Classes modeL Classes Tuesdays & requirements- session Wednesdays 6-8. English and Spa; Scholarships avail Domestic 52 and 32 week sessions FSCV: Indio Convicted- $35 int. Violence kwompliaace with probation _ _ ..barterers/ fee . Batterer contract for convicted banana or:.` .. _ -others- S20 per Treatment other interested indiv. English and` , . ' - session Program Spanish sessiot s are held on Mondays 6-8 pm.. HIV/AIDS Individual cottaseling and support -DAP_ off= HIV/AIDS no fee support gip group for Spy spealmg AIDS in£�tcd victims. Contract with DAP Friends of the Integrated Services provided to "at EastValley, Referrals of minimal Family Risk" families re: child abuse and DHS, Cat umsubstatiated co -pay negicet. In -home services, case : City calls to CPS or no fee management, community volunteer... stWort and counseling provided 1/11/97 J Attachment. (3) 1997 Funding Sources Client Fees California Wellness Foundation $90,000 58,000 (restricted) United Way Department of Social Service- FOF 85,500 90,000 (restricted) Department of Social Service-CAPIT 41,000 (restricted) CDBG Grants 16,000 (restricted) Foundations 15,000 (5000 restricted) Special Events 10,000 Individual Donations 15,000 TOTAL $420,500 Attachment (4) Program Budget Budget Summary I. Personnel Clinician Wages $4,250.00 170 hrs of direct counseling services @ $25.00 per how Fringe Benefits H. Non Personnel Parenting Books MOM & Therapeutic Aids M. Administration Phone calls, payroll, coordination of services $250.00 Liability Insurance etc. TOTAL $5000.00 b/ll �V/2 Vnr J gamily Services of Coachella Valle,,, - Proposed 1997 Budget INCOME Carryover Fees TPPI United Way DPSS /FOF Capit Grant CDBG/City Grant Foundations Special Events Donations mis TOTAL INCOME EXPENSES 1996 1197-8/11197 1997 DIFFERENCE ANNUAL ACTUAL ACTUAL BETWEEN BUDGET BUDGET 1997 ACTUAL &1997 PROPOSED - 23,529 25,000 1,471 84,000 73,470 90,000 16,530 58,000 58,000 97,000 57,712 85,500 27,788 93,000 44,591 90,000 45,409 22,000 11,320 33,083 21,763 18,500 21,711 26,000 4,289 19,000 8,261 15,000 6,739 4,000 4,715 10,000 5,285 10,000 2,529 15,000 12,471 347,500 305,838 447,583 141,745 Regular Employees 117,000 55,791 125,680 69,889 3,000 Employee Incentives (Bonus) - 61,800 - 30,502 3,000 66,000 35,496 Contract Clinicians 24,000 43,933 72,471 28,538 Interns Payroll Tax 14,400 9,216 14,228 5,012 Employee Benefits 9,000 7,872 14,000 6,128 8,990 Audit/ACC Service 8,000 1,200 10 956 9,000 1,500 544 ADP Bank Charges 200 590 - (590) 230 Check Return Expense - 470 700 (2,115) Consulting - 2,300 2,115 836 - 1,163 327 Credit Line Equipment 3,516 246 5,624 5,378 Equip Maintenance 1,000 3,440 1,650 7,000 (1,790) 5,469 Event Expense 5,500 1,531 Dues 50 50 Family Services of Coachella Vp"-.y Proposed 1997 Budget 1996 1 /97-8/11197 1997 ANNUAL ACTUAL ACTUAL BUDGET BUDGET FOF Emergency 1,250 837 773 Reserve Acct - - 22,377 Insurance (CO) 6,329 8,509 6,701 Grant Writing - 1,850 10,000 Legal & Prof Fees 250 250 258 Meals 200 - 1,015 Mileage 2,500 3,402 5,593 Misc 150 6,157 1,237 Office Maintenance - 1,452 5,000 Office supplies 2,100 1,375 3,562 Operating Reserve - - 15,000 Postage 3,000 1,567 2,690 Printing 1,600 371 4,701 Publications - 1,075 - Publication Ads 3,276 2,332 1,031 Rent 18,000 13,274 22,680 Staff Development 3,500 118 4,000 Telephone 4,800 4,922 6,155 Theraputic Aids 1,300 976 4,535 Utilities 2,000 2,436 3,093 Accounts Payable 26,000 946 4,500 TOTAL EXPENSES 324,171 209,407 446,967 TOTAL INCOME - TOTAL EXPENSES 23,329 96,431 616 DIFFERENCE BETWEEN 1997 ACTUAL &1997 PROPOSED (64) 22,377 (1,808) 8,150 8 1,015 2,191 (4,920) 3,548 2,187 15,000 1,123 4,330 (1,075) (1,301) 9,406 3,882 1,233 3,559 657 3,554 237,560 (95,815) Form 990 Re'—Ti of Organization Exempt From, —,come Tax - Under section 501(c) of the Internal Revenue Code (except olack lung benefit trust or private foundation) or section 4947(a)(1) nonexempt charitable trust Department of Treasury of this return to satisfy state reporting requ 12— C ,...e...e� tzorvice Note: The organization may have to use i copy A F the 1995 calendar ear. OR tax vear period beginning 1 or B Check if: Please C Name of organization, number and street, city, town, state, and ZIP code Change of use IRS FamilyService of Coachella Valley address I�nt or Initial return Ptype Final return See 81-713 Highway 111, Amended rtm specific Indio, CA 92201 (required also for tions. State reporting) G Type of organzation -► IN Exempt under section 501(c)(3 Note: Section 501(c)(3) exempt organizations and 4947(a)(1) nonexem H(a) Is this a group return filed for affiliates? ..................... Suite C OMB No. 1545-0047 1995 This Form Is Open to Public rements. Inspection .19 D Employer Identlflcation number 95-2549152 E State registration number 12506 F Check ► Lj it exemption application is pending ) -o (insert number) OR No Lj section 4947(a)(1) nonexempt charitable trust pt charitable trusts MUST attach a completed Schedule A (Form 990). Yes No I If either box iii H is checked "Yes," enter tour -digit group exemption no. (GEN)► h d® Cash fl Accrual (b) If "Yes," enter number of affiliates for which return is filed: ► J Accounun g met o (C) Is this a separate return filed by an organisation covered by a group ruling? .. Yes W NO Other (specify) ► than $25,000. The organization need not file a return with the IRS; K Check here ► Lj if the organization's gross receipts are normally not more financial data. Some states require a complete return. but If it received a Form 990 Package in the mail, it should file a return without less than $100,000 and total assets less than $250,000 at end of year. Note: Form 990-EZ may be used by organizations with gross receipts Expenses, and Changes in Net Assets or Fund Balances see instructions on pages s -1a.) 11.P.Jrt`Illj Revenue, 1 Contributions, gifts, grants, and similar amounts received: a Direct public support ................................... 1a 1b 16 026 . Ij1lt (li b Indirect public support .................................. 1c 256 430. C Government contributions (grants) ......................... d Total (add lines 1a through 1c) (attach schedule of contributors) 1d 272 456. (cash$ 272, 456. noncasn$ )....................... 2 Program service revenue including government fees and contracts (from Part VII, line 93) ...... 70615. 3 3 Membership dues and assessments ............................................... 4 4 Interest on savings and temporary cash investments ................................... 5 5 Dividends and interest from securities • • ' ' ' ' ' ' ' ' • ' ' • • • • 68 Gross rents ........................................... 68 b Less: rental expenses ................................... 6b 6c C Net rental income or (loss) (subtract line 6b from tine 6a) ................................ Revenue 7 Other investment income (describe ► ) 7 8a Gross amount from sale of assets other A) Securities (B) Other than inventory ...................... 88 8b b Less: cost or other basis & sales expenses C Gain or (loss) (attach schedule) ........ 8C ii;i;`•lIili 8d d Net gain or (loss) (combine line 8c, columns (A) and(B))................................ 9 Special events and activities (attach schedule)? a Gross revenue (not including $ of ,.:.n, :.,contributicns reported on line 1a).....................• Rb b Less: direct expenses other than fundraising expenses ......... C Net income or (loss) from special events (subtract line 9b from line 9a) ..................... 9C 10a Gross sales of inventory, less returns and allowances .......... 10a b Less: cost of goods sold ................................. 10b 1OC C Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 10a) 1,440. 11 Other revenue (from Part VII, line 103).............................................. 11 12 344,511. 12 Total revenue (add lines 1d, 2, 3, 4, 5. 6c, 7, 8d, 9c, 10c, and 11) ........................ 204,716. 13 Program services (from line 44, column (B))......:................................... 13 14 149,112. 14 Management and general (from line 44, column C Expenses ........................... 15 Fundraising (from line 44, column (D)) .............................................. 15 16 Payments to affiliates (attach schedule) ............................................. 16 17 3 5 3 828. 17 Total expenses (add lines 16 and 44, column (A)) .................................... 18 -9 317 . 18 Excess or (deficit) for the year (subtract line 17 from line 12) ............................. 19 620699. Net 19 Net assets or fund balances at beginning of year (from line 73, column (A)) .................. Assets 20 Other changes in net assets or fund balances (attach explanation) ........................ 20 5 3 3 82. 21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) .... • • • • • • • • • • • • • . 21 Form 990 (1995) For Paperwork Reduction Act Notice, see page 1 of the separate instructions. cnn 99012 NTF 3756 Form 99C (1995) !,am i.-LJCZ v 1L:C U- sP.artlal _ Statement of All - --anizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) and (4) Functional Expenses or, nations and section 4947(a)(1) nonexempt chantat fists but optional for others. (See inst. on page 14.) Do not include amounts reported on line 6b, 8b, 9b, 10b, or 16 of Part I. (A) Total (B) Program services (C) Management and general (D) Fundraising 22 Grants and allocations (attach schedule) ... non- lush$ ush$ ) 23 Specific assistance to individuals (att. sch.) . 24 Benefits paid to or for members (att. sch.) .. 25 Compensation of officers, directors, etc .... 26 Other salaries and wages ............... 27 Pension plan contributions .............. 28 Other employee benefits ................ 29 Payroll taxes ......................... 30 . Professional fundraising fees ............ 31 Accounhng fees ...................... 32 Legal fees ........................... 33 Supplies ............................ 34 Telephone ........................... 35 Postage and shipping .................. 36 Occupancy .......................... 37 Equipment rental and maintenance ....... 38 Printing and publications ............... 39 Travel .............................. 40 Conferences, conventions, and meetings ... 41 Interest ............................. 42 Depreciation, depletion, etc. (attach sch.) ... 43 Other expenses (itemize): a Stmt Att b 22 23 24 25 0. 0. 0. 0. 26 184,583. 79,371. 105, 212. 27 2,031. 873. 1,158. 28 29 16,193. 6,963. 9,230. 30 " 31 13,013. 13,013. 32 200. 200. 33 5,313. 2,657. 2,656. 34 8,844. 7,075. 1,769. 35 1,249. 999.1 250. 36 18,845. 15,076.1 31,769. 37 5,309. 2,655. 2 654. .38 7,099. 5,679. 1,420. 39 1 9 9 4. 997. 997. 40 41 499. 499. 42 43a 88,656.1 8 2 171. 6,485. 43b C 43c d 43d e 43e 44 Total functional expenses (add Jones 22 througgh 43) Organizations completing cols. (B)-(D), carry these totals to lines 13-15.... 44 353,828. 204,716. 149,112.1 0. Reporting of Joint Costs. -- Did you report in column (B) (Program services) any joint costs from a combined educational campaign and fundraising solicitation?......................................................................... ► 0 Yes a No If "Yes," enter (1) the aggregate amount of these joint costs ... $ ; (II) amt. allocated to Prog. services .. $ (111) the amount allocated to Management and general ...... $ ; and (Iv) arm. allocated to Fundraising $ 11ftitill1fl Statement of Program Service Accomplishments (See instructions on page 17.) What is the organization's primary exempt purpose? ► All organizations must describe their exempt purpose achievements. State the number of clients served, publications issued, etc. Discuss achievements that are not measurable. (Section 501(c)(3) and (4) organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others.) a See schedule #3 (Grants and allocations $ ) b (Grants and allocations $ ) C (Grants and allocations $ ) d (Grants and allocations $ ) Program Service Expenses (Required for 501(cK3) and (4) orgs. and 4947 (axt) trusts: but optional 204,716. e Other program services (attach schedule) .................... (Grants and allocations $ ) f Total of Program Service Expenses (should equal line 44, column (B), Program services) .......................... ► 2041716. CAA 99012 NTF3757 Coovnoht Forms Software Only. 1995 Nelco. Inc. N959902 Family ,ervice of Paqe 3 Form 990(1995) PactlH Balance Sheets (See instructions on pages 17-19. ) _T Note: Where required, attached schedules and amounts within the description column should be for end -of -year amounts only. 45 Cash -- non -interest -bearing .................. . .................. 46 Savings and temporary cash investments ..... • . • . • • • • • • • • . • .. • .. • • . Beginning of year 15,643. 45 B End(of)year 22,688. 46 478 Accounts receivable .................... 47a 2,799. b Less: allowance for doubtful accounts....... 47b 47c 2,799. 488 Pledges receivable ..................... 488 b Less: allowance for doubtful accounts....... 48b 49 Grants receivable ............................................... 50 Receivables from officers, directors, trustees, and key employees 48C 4 303. 49 13 005. 50 (attach schedule) ............................................... 518 Other notes and loans receivable (attach A schedule) ............................. 51a S S b Less: allowance for doubtful accounts....... 51 b E 52 Inventories for sale or use ....................................... . T S 53 Prepaid expenses and deferred charges ............................. 54 Investments -- securities (attach schedule) ........................... "?€ ? 51c 52 53 54 558 Investments -- land, buildings, and equipment: basis ....................... 8 b Less: accumulated depreciation (attach schedule) ............................. 55b 56 Investments -- other (attach schedule) .............................. 57a Land, buildings, and equipment: basis ...... 5781 48,567. 55C 56 b Less: accumulated depreciation (attach schedule) ............................. 57b 58 Other ) assets(describe ► 48,123. 57C 48,567. 58 59 Total assets (add lines 45 through 58) (must equal line 74) .............. 60 Accounts payable and accrued expenses ............................ 68,069. 153. 59 60 87,059. 28,884. 61 61 Grants payable............................... L 62 Deferred revenue ....................... . ................. A 63 Loans from officers, directors, trustees, and key employees (attach B 1 schedule)..................................................... I64a Tax-exempt bond liabilities (attach schedule) ......................... T b Mortgages and other notes payable (attach schedule) .................. S 65 Other ► Stmt Attchd I liabilities (describe 66 Total liabilities (add lines 60 through 65) ............................ Organizations th=t follo:•. SFAS 117, check here.. ► Li and complete lines 67 62 63 64a 1,582. 64b 3,635. 65 4,793. 5,370. 66 is 33,677. through 69 and lines 73 and 74. 67 Unrestricted................................................... N 68 Temporarily restricted ........................................... TF 69 Permanently restricted ...:...................... A N Organizations that do not follow SFAS 117, check here.. ► ® and complete S D lines 70 through 74. EB 70 Capital stock, trust principal, or current funds ......................... T A 71 Paid -in or capital surplus, or land, bldg., and equipment fund ............ gL A 72 Retained earnings, accumulated income, endowment, or other funds....... RN C 73 Total net assets or fund balances (add lines 67 through 69 OR lines 70 gthrough 72; column (A) must equal line 19 and column (B) must equal line21)................................................... . . 68 69 `" 70 ' 44,004. 71 44,004. 18,695. 72 9,378. 62,699 . 73i 53,382. 74 Total Ilabllltles and net assets/fund balances (add lines 66 and 73) ...... 6 8 069 . 74 87,059. CAA 99034 NTF3758 Copyright Forms Software Only, 1995 Nelco, Inc. N959903 rZ;LM Form 990(1995) Paoe 4 I!P8rt!ilV-'A: Reconciliation -r Revenue per Audited pert 1V:`B" conciliation of Expenses per Audited Financial Statements with Revenue per Financial Statements with Expenses per Return Return a Total revenue, gains, and other support ;° a Total expenses and losses per per audited financial statements ..... ► a N/A audited financial statements .......... ► a N/A b Amounts included on line a but not on b Amounts included on line a but not line 12, Form 990: on Gne 17, Form 990: (1) Net unrealized gains (1) Donated services & on investments .. $ use of facilities ... S (2) Donated services & (2) Prior year adjust- use of facilities... S ments reported on (3) Recoveries of prior year grants ..... $ '° (3) Losses reported on (4) Other (specify): in 20, Form 990 . $ (4) Other (specify): $ Add amounts on lines (1) through (4) .. ► b $ Add amounts on lines (1) through (4) ... P. b C Line a minus line b ................ ► C C Line a minus line b ................. ► C d Amounts included on line 12, d Amounts included on line 17, Ii? i line a• Form 990 but not on e 0 i€I of on line a: .:.3......:..:......:.::€.i:.,....i............ en ses 1 Investmentexpenses 1 Inv tment ex enses 1 es ::? ! i . not included in A uded on line not included E i i I ' 3• i , ,. I ? 6b, Form 990.... $ s€li ?3'ii##i!€3;!i}#?##!',€i€?? i?:i:i?€€#;} } :#:};!??#?i€?€ili####?##?#?!?}€,€?�? 6b, Form 990 .... $ i# i# #i i`#I'` #'I i #I #, :• •i: ' !I Milli �I�!iii�• �; !' it#:`•€ j}jj ()2 Other (specify): ills# €iittti(i::,y � # ii ?#iii!!ii!#€i??#EEi+''?. :} :::???}i#,?=i :? • ; :i •...:..._ :,lii,! (2) Other (specify)' ii#il; i ii?i}i{i 1#i� Ili jj I Iljl IIfI I i !E'lIs?'r:'€iifl??i?€i3?[?!i E!Eji;:!e; �}i :li tll .� Iii##ij itilil?€i#?{[`i#i!tt'i ,!! #• {? ` ##'?E?i? $ fra� l'f2l�li:� i#Gill a#j#tiar,?H, I i Add amounts on lines (1) and (2) ..... P.d Add amounts on lines (1) and (2) ...... ► d e Total revenue per line 12, Form 990 a Total expenses per line 17, Form 990 (line c plus line d) . ► e pine c plus lined . ► e Ust of Officers, Directors, Trustees, and Key Employees (Ust each one even if not compensated; see instructions nn nano 19_1 (A) Name and address (B) Itie and average hours per week devoted to position () Compensation (If not paid, enter -0-) ( Contributions to employee benefit plans & deferred comp. ) Expense account and other allowances See Schedule #4 0. 0. 0. 75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, of which more than $1o,000 was provided by the related organizations?.... P. 0 Yes 0 No If "Yes," attach schedule -- see instructions on page 20. CAA 99034 NTF3759 Copyright Forms Software Only, 1995 Nelco, Inc. N959904 5 Did the organization engage In any activity not previously reported to the IRS? If "Yes;' attach a detailed description of each activity.................................................................... Were any changes made in the organizing or governing documents but not reported to the 1 ..... . ...... ..... If "Yes," attach a conformed copy of the changes. Did the organization have unrelated business gross income of $1,000 or more during the year covered by thisreturn?....................................................... ............................... If "Yes," has it filed a tax return on Form 990-T, Exempt Organization Business Income Tax Return, for this year?.......................................................................................... Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach astatement ................................................... .................................. Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?.................................................................................... If "Yes," enter the name of the organization ► and check whether it is U exempt OR 1i nonexempt. Enter the amount of political expenditures, direct or indirect, as described in the ,Did the organization file Form 1120-POL, U.S. Income Tax Return for Certain Political Organizations, for thisyear?....................................................................... ............ . Did the organization receive donated services or the use of materials, equipment, or facilities at no charge or at substantially less than fair rental value? ................. .......................... • • • • .. " " " " If 'Yes," you may indicate the value of these items here. Do not include this amount as revenue in Part I or as an expense in Part II. (See instructions for reporting in Part III.) ..... 1 82b Did the organization comply with the public inspection requirements for returns and exemption applications? .......... Did the organization comply with the disclosure requirements relating to quid pro quo contributions? ................ Did the organization solicit any contributions or gifts that were not tax deductible? .......... ..................... If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ............................. ................................. . Section 501(c)(4), (5), or (6) organizations. -- 8 Were substantially all dues nondeductible by members? ............. Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................... If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless the organization received a waiver for proxy tax owed for the prior year. Dues, assessments, and sirniliar amounts from members Section 162(e) lobbying and political expenditures ................................ --- Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices ................ 859 Taxable amount of lobbying and political expenditures (line 85d less 85e)............... 85f Does the organization elect to pay the section 6033(e) tax on the amount in 85f? ................................ .................. If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount in 851 to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following Initiation fees and capital contributions included on line 12 .......................... Gross receipts, included on line 12, for public use of club facilities .................... Section 501(c)(12) organizations. -- Enter: 8 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.) • • • • • • • • • • • • • • • • • • • • ..... I — - I 88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or ..:. partnership? If "Yes," complete Part IX ........................................................ 89 Public interest law firms. -- Attach information described in the instructions. 90 List the states with which a copy of this return is filed ► California 91 The books are in care of ► Janine Smith, Exec. Dir. . Telephone no. ► (619) 347-2398 Located at ► 81-713 HWy 111, Suite C, Indio, CA ZIP code ►92201 92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041, U.S. Income Tax Return for Estates 1-0and Trusts. -- Check here .......................... rued ......._ ........:..... ............. . and enter the amount of tax-exempt interest received or accrued during time tax year.......I .......... ► 92 CAA 99056 NTF3760 Copyright Forms Sottware Only. 1995 Nelco. Inc. N959905 Form 990(1995) Part VV. l Analysis of Inco--Producing Activities (See instructions on pAnes 23-24.) Enter gross amounts unless otherwib.. Unrelated business income Exclu by section 512, 513. or 514 (E) indicated. (A) (B) (C) (D) Related or exempt Business function income 93 Program service revenue: code Amount Exclusion code Amount a Counseling Fees 70,615. b c d e f g Fees and contracts from govt. agencies ... 94 Membership dues and assessments ..... 95 Interest on savings and temporary trash investments ..................... 96 Dividends and interest from securities ... 97 Net rental income or (loss) from real estate: a debt -financed prop arty ............. b not debt -financed property .......... 98 Net rental income or (loss) from personal property.......... .......... 99 Other investment income ........... . 100 Gain or (loss) from sates of usets other than inventory ................... 101 Net income or (loss) from special events . . 102 Gross p►ofitmoss►from sales of inventory . 103 Other revenue: a Misc . 1,440. b c d e 72 104 Subtotal (add cols. (B), (D), & (E)) . . 055. 105 Total (add line 104, columns (B), (D), and(E) ................................................ ► 72,055. Note: (Line 105 plus line td. Part I. should eaual the amount on line 12. Part I.) ;Pert mil' Relationship of Activities to the Accomplishment of Exempt Purposes Line No. Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment of the organization's exempt purposes (other than by providing funds for such purposes). (See instructions on page 24.) 93A Fees for family and individual counseling dealing with issues as parenting, divorce spousal and child abuse. 103A Miscellaneous income generated through program activities utilized for the program and services provided by Family Service of Coachella Valley. talsrfAM tntnrmatinn aaonarninn i avnnia titlinSrnlArtac r[.mmntrare rots Part it --yes- nox On Itne 68 IS GnBCICBO.r Name, address, and employer identification -Percentage of ownership. Nature of Total End -of -year number of corporation or partnership interest business activities income assets e 0 o� 0 Under pens s of peryury, I declare th I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and Please belief, it i u wrract, and complet . eclaratt preparer (other than officer) is based on all information of which preparer has any knowledge. (See Sign Specific stru ons, page 9.) Here , Si a re of officer ate T or print name and title. Prep Date Check if Preparees social security no. Paid signature e�� 05 15 96 :*" ► 454-11-2362 Preparer's Firm's name (or scar G. Armi o CPA EIN P. 33-0278891 Use Only yours if self-employed74-133 El Paseo Suite 8 ZIP code ► and address Palm Desert CA 92260 CAA 99ubb NTF 3761 Cnnvnnht Fnrms Software Only. 1995 Nelco. Inc. N959906 SCHEDULE A 0—anization Exempt Under Section-501(c)(3) OMB No. 1545-0047 Form 990 :ept Private Foundation) and Section 501(e), 50 501(k), or ) t Section 4947(a)(1) Nonexempt Charitable Trust 1995 Supplementary Information See separate Instructions. Department of the Treasury ► Must be completed by the above organizations and attached to their Form 990 (or 990-E2). Internal Revenue Service Employer Identification number m Nae of the organization 9 5— 2 5 4 915 2 Famil Service of Coachella Valle partg: Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See instructions on page 1. List each one. If there are none, enter "None.") (d) contnbuvons to (e) Expense (a) Name and address of each employee paid more (b) Title and average hours (c) Compensation empl. banef't plans o account and than $50,000 per week devoted to position deferred compensation other allowances --- NONE ---- Total number of other employees paid over )000.................... art:11 Compensation of the Five Highest Paid Independent Contractors for Professional Services (See instructions on page 1. List each one (whether individuals or firms). If there are none, enter "None.") c Compensation (a) Name and address of each independent contractor paid more than $50,000 (b) Type of service ( ) None Total number of others receiving over $50,000 for professional services i'' ' `•'',i''i For Paperwork Reduction Act Notice, see page 1 of the Instructions for Form 990 (or Form 990-EZ). CAA 99DA12 NTF 3762 ZOOS N-,-.. ,-n N0400na1 Schedule A (Form 990) 1995 Schedule A (Form 990) 1995 -:`Part!iii Statements About Activities .2 Yes I No 1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? .............................................. 1 X If 'Yes," enter the total expenses paid or incurred in connection with the lobbying activities►$ Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI -A. Other organizations checking "Yes," must complete Part VI-B AND attach a statement giving a detailed description of the lobbying activities. 2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with any of its trustees, directors, officers, creators, key employees, or members of their families, or with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority owner, or principal beneficiary: a Sale, exchange, or leasing of property?................................................................ 2a X b Lending of money or other extension of credit?.......................................................... 2b X C Furnishing of goods, services, or facilities?............................................................. 2c X d Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? ....................... 2d X e Transfer of any part of its income or assets?............................................................ ce A If the answer to any question is "Yes," attach a detailed statement e*plaining the transactions. 3 Does the organization make grants for scholarships, fellowships, student loans, etc.? ............................. 3 X '!€iilt f,liti�;l'� 4 Attach a statement to explain how the organization determines that individuals or organizations receiving grants or bans !illililllll�fllli!j Iill;iillilt! from It in furtherance of its charitable programs quality to receive payments. (See instructions on page 2.) i=RrCli11?i Reason for Non —Private Foundation Status (See instructions on pages 2 through 5.) The organization is not a private foundation because it is (please check only ONE applicable box): 5 A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i). 6 A school. Section 170(b)(1)(A)(fi). (Also complete Part V, page 4.) 7 A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(ii). 8 A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v). 9 A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state ► 10 a An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section 170(b)(1)(A)(iv). (Also complete the Support Schedule in part IV -A.) 118 ® An organization that normally receives a substantial part of its support from a governmental unit or from the general public. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) 11b 8 A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV -A.) 12 An organization that normally receives: (a) no more than 33 1/3% of its support from gross investment income and unrelated busincsc arable income (less section 511 tax) from businesses acquired by the organi7,etion eher Jung 30, 1975, and (b) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its charitable, etc., functions -- subject to certain exceptions. See section 509(a)(2). (Also complete the Support Schedule in Part IV -A.) 13 0 An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations described in: (1) lines 5 through 12 above; or (2) section 501(c)(4), (5), or (6), if they meet the test of section 509(a)(2). (See section 509(a)(3).) Provide the following information about the supported organizations. (See instructions on page 4.) (a) Name(s) of supported organization(s) I (b) Line number from above 14 n An organization organized and operated to test for public safety. Section 509(a)(4). (See instructions on page 4.) CAA 990Al2 NTF 3763 f n......nnr c...".. nm.. i005 Nolen Inr NQ4,;QQOA7 Page 3 Schedule A (Form 990) 1995 Support Schedule t,-rt'IPlete only it you checked a box on line 10, 11, or Use cash method of accounting. the accrual to the cash method of accounting. Vpartijl..V,L;Athe I,_ meet Note: You may use in the instructions for conveninq from (d) 1991 (e) Total Calendar year (or fiscal year begin. in)► (a) 1994 (b) 1993 lc ) 1992 15 Gifts, grants, and contributions received. (Do not include unusual 305, 839. 201, 260. 201, 260. 143,790. 852 , 1 - grants. s.e line za.).......... 16 Membership fees received ..... 17 Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is not a business unrelated to the organiaabon's charitable, ate, 141, 0 9 0. 9 6, 0 5 9. 96,059. 145,441. 478,649. purpose ................ 18 Gross income from interest, dividends, amounts received from payments on securities loans (section 512(aX5)), rents, royalties, and unrelated business taxable income (less section 611 taxes) from businesses acquired by the organization after June 30. 1 8 8 9. 1 8 9 9. 3,466. 7,254. 1975 . 19 Net income from unrelated business activities not included in fine 16 .................. 20 Tax revenues levied tar the organization's benefit and either paid to it or expended on its behalf . 21 The value of services or facilities furnished to the organization by Igovernmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge . 22 Other income. Attach a schedule. Do not include gain or (loss) from sale of capital assets....... . 446 929. 299 208. 299 218. 292 697. 1 338 0 23 Total of lines 15 through 22 .. 305, 839. 203 149. 203 159. 147 256. 859 403. 24 Line 23minus line t7......... 4,4691 2 992.2 992.2 927. . 25 26 Enter i% of line 23 .......... Organizations described In lines 10 or 11: a Enter 20/6 of amount in column (e), line 24 ......... ► 26a b. Attach a list (which is not open to public inspection) showing the name of and amount contributed by each (other than a governmental unit or publicly supported organization) whose total gifts for 1991 through person 1994 exceeded the amount shown in line 26a. Enter the sum of all these excess amounts ............... ► 26b C Total support for section 5o9(a)(1) test: Enter line 24, column (e)................................... ► 26c $ 859,403 . 7,254. 19 $ :i�??'s ??? E�li?E !iilllfll??ifii. il d Add: Amounts from col. (e) for lines:l8 $"•I 22 s 26b $ ► 26d s 7,254. e Public support (line 26c minus line 26d total).. .... • • • • • • • • • • • • • • • • ' ' • • ' ' ' . ' ' ' ' ' ' ' . ' ' ' ....... ► 26e $ 852,149. 1► 26f 99.1559 4x f Public support percentage (line 26e (numerator) divided by line 26c (denominator)) ................ 27 d person," Organizations hoceele12: a For amounts included lines l5,16, and 17 that were received hm h listto show hname ofad total amounts received n each yearfromeach "disqualified personnter he sum of such for each year. (1994) (1993) (1992) (1991) b For any amount included in line 17 that was received from a nondisqualified person, attach a list to show the name of ,and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000. (Include in the list organizations described in lines 5 through 11, as well as individuals.) After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) lot each year: (1994) (1993) (1992) (1991) C Add: Amounts from col. (e) for lines: 15 $ 16 $ 17s 20$ 21 s ► Add: Line and line 27b total ........... $ ► d 27a total $ ► e Public support (line 27c total minus line 27d total) .................... • • • • • • • ' ' ' ' ' ' ' ' ' ' ' ' . ' f Total support for section 509(a)(2) test: Enter amount on line 23, col. (e). ► 127f I s g Public support percentage (line 27e (numerator) divided by line 27f (denominator)) ............. a. t ent Income percentage (line 18, column (e) (numerator) divided by line 271(denominator)). ► 27c Is 27d s .ti env es m 28 Unusual Grants: For an organization described in line 10, 11, or 12 that received any unusual grants during 1991 through 1994, attach a list (which is not open to public inspection) for each year showing the name of the contributor, the date and the amount of the gram, and a brief description of the nature of the grant. Do not include these grants in line 15. (See instructions on page 5.) CAA 99OA34 NTF 3764 rnnvrinht Forms Software Only, 1995 Nelco Inc. N95990A3 Schedule A (Form 990) 1995 Paae 4 ,,Part::. Private School O.-stionnaire (See instructions on page (To be completed ONLY by schools that checked the box on line 6 in Part IV) _ No 29 Does the organization have a racially nondiscriminatory policy toward students by statements in its charter, bylaws, other governing instrument, or in a resolution of its governing body? .............................................. 30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all its brochures, catalogues, and other written communications with the public dealing with student admissions, programs and scholarships?.................................................................................... 31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves? ............................................... If "Yes," please describe; if "No," please explain. (If you need more space, attach a separate statement.) 32 Does the organization maintain the following: a Records indicating the racial composition of the student body, faculty, and administrative staff? ..................... b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory basis?......................................................................................... C Copies of all catalogues, brochures, announcements, and other written communications to the public dealing with student admissions, programs, and scholarships?.................................................... d Copies of all material used by the organization or on its behalf to solicit contributions? ............................ If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement.) 33 Does the organization discriminate by race in any way with respect to: a Students' rights or privileges? .................................. :.................................... b Admissions policies?............................................................................. . C Employment of faculty or administrative staff?........................................................... d Scholarships or other financial assistance?............................................................. e Educational policies?.............................................................................. fUse of facilities?................................................................................. . gAthletic programs? .................................................................... .......... h Other extracurricular activities?....................................................................... If you answered "Yes" to any of the above, please explain. (If you need more space, attach a separate statement.) 34a Does the organization receive any financial aid or assistance from a governmental agency? ........................ b Has the organization's right to such aid ever been revoked or suspended? ..................................... If you answered "Yes" to either 34a or b, please explain using an attached -statement. 35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05 of Rev. Proc. 75-50, 1975-2 C.B. 587, coverinq racial nondiscrimination? If "No" attach an explanation .................... . CAA 990A34 NTF3765 Copyright Forms Sottware Only, 199S Neico, Inc. N95990A4 Paoe 5 Schedule A (Form 990) 1995 Pt3tta11Zl""-l4' Lobbying Expent..-.jres by Electing Public Charities (see it. .coons on page 5.) (To be completed ONLY by an eligible organization that fled Form 5768) 8 if the organization belongs to an affiliated group. Check here ► Check here ► b if you checked -a" above and "limited contror provisions apply. (b ) (a) To be completed Limits on Lobbying Expenditures Affiliated group for ALL electing (The term "expenditures" means amounts paid or incurred.) totals organizations 36 Total lobbying expenditures to influence public opinion (grassroots lobbying) ........ 36 37 Total lobbying expenditures to influence a legislative body (direct lobbying) .......... 37 38 Total lobbying expenditures (add lines 36 and 37) ............................ 38 39 39 Other exempt purpose expenditures ........................................ 40 40 Total exempt purpose expenditures (add lines 38 and 39) ...................... 41 Lobbying nontaxable amount. Enter the amount from the following table If the amount on ime 40 is -- The lobbying nontaxable amount Is -- Not over $500,000................... 20% of the amount on line 40 ....... iil€!'€iiii Over $50o,000but not over $1,000,000... sto0,000plusis%ofthe excessOver $500,000 Over $1,000,o00 but not over $1,500,000 . $175,000 plus tOY. of the excess over It,000,000 41 5 000 plus 5% of the excess over $1,500,000 jlll llll F Over $1,500,000 but not over $17,000,000 $zz . 11, :7:. Over $17,000,000 ...............:... $1,000,000..................... ii € € ........................ ........ ' 42 42 Grassroots nontaxable amount (enter 25% of line 41) ........................... 43 0 • 0 43 Subtract line 42 from line 36. Enter -0- if line 42 is more than line 36............... 0 0. 44 line 38. Enter -O- if line 41 is more than line 38. . ...... . ..... Subtract line 41 from itliili;!y;;l i;liiitttljlili}{i';Illft,;,;iil,;,t};.1, • ; .:.i . ,.•.5,.,..:;:.•, iii ;::... , i.:iii:.: i� liiii ii ,:�:i.,:: ,:::! ? Ilil �ll� itil'lllrll?iiii,•!i �:: �:.:.::: iie: I:i! ; �}i';1 iiiilltliilitiil?ieil� !� Ei!iti37 !;::.. !.:...I :il�;ii� .::.......i.,. 3,:::i::f•..:.. t....;.. _:....;. i.•. Caution: If there is an amount on either line 43 or line 44, file Form 4720.:•• 4—Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 45 through 50 on page 7.) Lobbying Expenditures During 4-Year Averaging Period Calendar year (or fiscal (a) (b) M (d) 1993 1992 (e) Total year beginning In) ► 1995 1994 45 Lobbying nontaxable amount. 4fi Lobbyin ceilin amount 50of line 4I., (e)) ...... 47 Total lobbying expenditures ...... 48 Grassroots nontaxable amount. 49 rassroots ceiling i 11iii5 iii '�";`:?liHi... : Eli:i'. ! amount 150°k lii1mili€ of line 4 (e)) ..... 50 Grassroots lobbying c;;penditures ...... :Pert YIB` Lobbying Activity by Nonelecting Public Charities (For reporting only by organizations that did not complete Pan VI -A) (See instructions on pa a 7.) During the year, did the organization attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of:,,""„ j, •i fli�l II�Ilj�lj i a Volunteers........................................................... ............. lines c through It.) ........ a 11il,iiilIM11! l jj llili i;;......1��IIIli4il,lii�;+�{��illii!illi,,}!. b Paid staff or management (Include compensation in expenses reported on C Media advertisements............................................................... d Mailings to members, legislators, or the public ............................................. e Publications, or published or broadcast statements ......................................... f Grants to other organizations for lobbying purposes ........................................ g Direct contact with legislators, their staffs, government officials, or a legislative body ................ h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means ............ Total lobbying expenditures (add lines c through h).......................................... it "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities. CAA 990A56 NTF3766 copyright Forms Software Only, 1995 Nelco, Inc. N95990A5 Schedule A (Form 990) 1995 Paae 6 Part'II' information Reg Jing Transfers To and Transactions a► relationships With Noncharitable Exempt Organizations 51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described In section 501(c) of the Code (other than section 501(c)(3) organizations) or. in section 527, relating to political organizations? a Transfers from the reporting organization to a noncharitable exempt organization of: Yes No (1) Cash..................................................................................... aIntl) n (11) Other assets................................................................................ a li X b Other transactions: (1) Sales of assets to a noncharitable exempt organization ............................................... b i X (11) Purchases of assets from a noncharitable exempt organization ......................................... b ii X (111) Rental of facilities or equipment................................................................. b iil X (Iv) Reimbursement arrangements.................................................................. b iV X (v) Loans or loan guarantees...................................................................... b v X (vl) Performance of services or membership or fundraising solicitations............ • ....... LNyk X C Sharing of facilities, equipment, mailing lists, other assets, or paid employees .................................. I C X d If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets, or services given by the reporting organization. If the organization received less than fair market value in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received: (a) I (b) I (c) I (d) Line no. Amount involved Name of noncharitable exempt organization Description of transfers, transactions, & sharing arrangements Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 5277.................................. P. 11 Yes ® No Cenvneht Fnrms Software Only, 1995 Nelco. Inc. N95990A6 ^ Supporting Schedules - 5 Page: EIN: 95-2549152 Company: Family Service of Coachella Valley Form 990 - Exempt Organization Tax Return Line 43 - Other Expenses Description (A) Total (B)Program (C) Mgmt. & (D)Fund- services General raisin ---------------------------------- Advertising 2,449. 1,625. 1,959. 1,300. 490. 325. Bank Charges 55. 43. 12. Dues & Sub Emergency-Nictim 59E • 59-6'— Contractors 54,074. 19,355. 54,074. 15,484. 3,871. Insurance Therapeutic Aids 425. 425. Training 1,142. 5,611. 1,142, 4,489. 1,122. Utilities Miscellaneous 31324. 2,659. ----------- ------- ------------- TOTAL ----------- 88,656. 82,171_ 6,485. Form 990 - Part IV - Balance Sheets Line 65 - Other Liabilities Amour Description ____________ -------------------------------------- Employee benefits 2,4E ,33 Line of credit _--------- 4,75 TOTAL Supporting Schedules - 995 Page: Company: Family Service of Coachella Valley EIN: 95-2549152 Form 990 - Exempt Organization Tax Return Line 43 - Other Expenses Description (A) Total (B)Program (C) Mgmt. & (D)Fund- Services General raisinc ------------------------------------------------------------------------- Advertising Bank Charges Dues & Sub Emergency Vic"Cim Contractors Insurance Therapeutic Aids Training Utilities Miscellaneous TOTAL 2,449. 1,625. 55. 596. 54,074. 19,355. 425. 1,142. 5,611. 3,324. 88,656. 1,959. 1,300. 43. 596. 54,074. 15,484. 425. 1,142. 4,489. 2,659. 82,171. 490. 325. 12. 3,871. 1,122. 665. --------------------- 6,485. Form 990 - Part IV - Balance Sheets Line 65 - Other Liabilities Description --------------------------------------------------------- Employee benefits Line of credit TOTAL Amoum ------------- 2, 48: 2,31( ------------ 4, 79: FAMILY SERVICE OF COACHELLA VALLEY FIN #95-2549152 Form 990 (1995), Part III, A Schedule 3 Program Service Accomplishments Family Service of Coachella Valley provides needed psychotherapy for adults, children, and their families who otherwise cannot afford professional help for depression, family crisis, anxieties, phobias and eating disorders, substance abuse, parent -child relationships, parenting and divorce problems, job -related problems or behavior/attitudes affecting work or school performance, and relationships between adults and children. Name and Address FAMILY SERVICE OF COACHELLA VALLEY FIN #95-2549152 Form 990 (1995), Part V Schedule 4 Contribution to Expenses Avg hours per employee benefit Accounts & week devoted Plans & deferred Other Title to position Compensation Compensation Allowances Jeff Patterson President 4-5 hrs S -0- S -0- ID -0- 71-650 Sahara Road Rancho Mirage, CA 92270 (619) 346-7880 J.M. Evosevich Desert Hospital 1150 N. Indian Canyon Way Palm Springs, CA 92262 (619) 323-6877 John Hyma 346 Desert Falls Palm Desert, CA 92260 (619)346-4826 Irene Anthony Desert AIDS Project 750 Vella Road Palm Springs, CA 92264 (619)323-2118 Secretary , 4-5 hrs Treasurer 4-5 hrs Interim 4-5 hrs Treasurer -0- -0- -0- -0- -0- -0-. -0- -0- -0- Form 2758 Application for Extension of Time To File (Rev. May 1995) I Certah. .xcise, income, Information, ant. )ther Returns I OMB No. 1545-0148 Department of the Treasury internal Revenue Service Please type or print. File the original and one copy by the due date for filing your return. See instructions on page 2. ► File a for each return. Name Family Service of Coachella Valley Number, street, and room or suite no. (or P.O. box no. it mail is not delivered to street address) 81-713 Highway 111, Suite C City, town or post office, state, and ZIP code. For a foreign address, see instructions. Indio CA 92201 Note: Corporate income tax return filers must use Form 7004 to request an extension of time to file. Partnerships, REMIUS, ano trusis must uses Form 8736 to request an extension of time to file Form 1065, 1066, or 1041. 1 1 request an extension of time until 0 8 15 ,199 6 to file (check only one): Form 706-GS(D) Form 99o-T (401(a) or 408(a) trust) Form 112o-ND (4951 taxes) Form 8612 Form 706-GS(n Form 990-T (trust other than above) Form 3520-A Form 8613 Form 990 or 990-F.Z Form 1041 (estate) (see instructions) Form 4720 Form 8725 Form 8804 Form 990-BL Form 1D41-A Form 5227 Form 990-PF Form 1042 Form 6069 Form 8831 Li If the organization does not have an office or place of business in the United States, check this box ............................. ► 28 For calendar year 19 9 5 , or other tax year beginning and ending b if this tax year is for less than 12 months, check reason:........ Initial return Final return Q Change in accountin0gyes d® No 3 Has an extension of time to file been previously granted for this tax year? ................ .. ............................ 4 State in detail why you need the extension All of the inf ormation needed to f ile a complete tax return is not available at this time. Sa If this form is for Form 706-GS(D), 7o6-GSM, 990-BL, 990-PF, 990-T, 1041 (estate),104Z 112o-ND, 4720, 6069, 8612, 8613, 8725, 8804, or 8831, enter the tentative tax, less any nonrefundable credits. See instructions......... $ b If this form is for Form 990-PF, 990-T, 1041 (estate), 1042, or 8804, enter any refundable credits and estimated tax payments made. Include any prior year overpayment allowed as a credit .............................. $ C Balance due. Subtract line 5b from line 5a. Include your payment with this form, or deposit with FM coupon if required. See instructions...... ...... ' ......... $ Signature and Verification Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete; and that I am authorized to prepare this form. Title •► C - Date IN- S h r4 Employer ID number 95-2549152 FILE ORIGINAL AND ON COPY The IRS will show below whether or not your application Is approved and will return the copy. Notice to Applicant — To Be Completed by the IRS 8 We HAVE approved your application. Please attach this form to your return. We HAVE NOT approved your application. However, we have granted a 10-day grace period from the later of the date shown below or the due date of your return (including any prior extensions). This grace period is considered to be a valid extension of time for elections otherwise required to be made on a timely return. Please attach this form to your return. nWe HAVE NOT approved your application. After considering the reasons stated in item 4, we cannot grant your request for an extension of time to file. We are not granting the 10-day grace period. 0 We cannot consider your application because it was filed after the due date of the return for which an extension was requested. 0 Other: Director By: Date If you want a copy of this form to be returned to an address other than that shown above, please enter address to which the copy should be sent. Please Type or Print Name Oscar G. Armijo, CPA Number, street, and room or suite no. (or P.O. box no. it mail is not -delivered to street address) '7A-1 '11 1» 1 Paseo . Suite 8 City, town or post office, state, and ZIP code. For a foreign address, see instructions. Palm Desert CA 92260 For Paperwork Reduction Act Notice, see page 2 of form. H733 27581 NTF9660 roan (Rev. 5-95 oti o AUG 2 9199T r> oFu 11016T V ti5 G� OF 1'O CITY OF LA QUINTA APPLICATION FOR COMMUNITY SERVICES GRANT FISCAL YEAR 1997-98 Name of Organization: FISH of the Lower Coachella Valley Amount Requested: $ 3, 0 0 0 Contact Person: Norma Branson Mailing Address: P • 0 • Box 458 City: Indio State: C A Zip Code: 92202 Phone No.: a4 7 - 719 5 501(c)3 Taxpayer I.D. Number: 956100111 Date Submitted: August 29 1997 APPLICATION 1. What is the overall purpose or goal of your organization? To help meet certain immediate basic needs which people in the Eastern Coachella Valley cannot satisfy by themselves. 2. How long has your organization been in existence? 2 5 Years 6 Months 3. Describe in general the activities or services of your organization: Programs 1) no feed the hungry 2) Provide volunteer transportation for medical care for resident of our service area ' 3) Enable elderly and handicapped to remain independent as long as possible. 4. How many people does your organization currently serve? Average 8,088 n e a r (unduplicated) No. of Youth 4, 0 4 4 No. of Adults 3, 7 2 0 No. of Seniors 3 2 4 5. How many people do you intend to serve during this Fiscal Year? No. of Youth s, on o No. of Adults 4 ^s 0 o No. of Seniors a 0 0 6. How many people served this Fiscal Year will be La Quinta residents? No. of Youth 5 0 No. of Adults 4 5 No. of Seniors 5 7. How many paid employees/volunteers does your organization employ? No. of full time employees 0 No. of part time employees 2 Half-time + 1 Half-time paid by Office on Aging No. of volunteers 5 0 8. Describe how your organization is managed and governed. Governing Board of 12 members oversees paid k-time Co-ordinator, who is responsible for �-time paid nta a Facilitator! ;-time— trainee doing office work, 50 volunteers who help secure food supplies phone inquiries, drive people for their medical appointments or essential shopping, etc. A Board member writes the Grant requests. 2 9. Please provide information on your Executive Board members or contact person: Nain.e litk Home Address Phone Norma Branson President 81-291 Alberta Ave. 347-7195 Indio CA 92201 Sam Ritter Vice President 48-100 Desert Grove#34 775-7292 Indio, CA 92201 Dorotha Engle Secretary 1451 Ninth St. 398-5585 Coachella CA 92236 Tom Hunt Treasurer 47-770 San Salvador 347-6718 Indio, CA 92201 10. What is your annual schedule of events, and during what months does your organization operate? We operate 12 months per year M-F, 1-5 p.m. (except Holidays)-- as we find people need food and transportation the year round. We do have an Information and Volunteer Recruiting Booth at the Indio Tamale Festival December 6 & 7, 197 as well as the Vol- unteer Fair held at Sun City -Palm Desert in April, 1997. 11. Do you charge admission, membership fee, dues, etc.? Yes x Nox If yes, please describe: 12. What are your- other sources of revenue for this funding year? Source Amount CDBG funds --Indio, Indian Wells, Palm Desert, Riverside County $25,750 AIDS Subsidies Churches, Organizations, Businesses & Individuals 13,800 36,200 Interest & Miscellaneous 1,100 76,850 Total Needed $ a i .. S O Hoped For 76,850 Total RWWWa $ Balance $ 5,000 3 13. Amount of money requested from the City of La Quinta? $ 3, 0 0 n 14. Has your organization been funded by the City of La Quinta previously? Yes_ No X If yes, when Amount received 15. Need Statement. Clearly and plainly state the reason or need for the requested funds and how these funds will be used, if awarded. Purchase of Food Supplies $2,000 Reimburse some gasoline costs for volunteer drivers $1,000 Requests for food has increased 25% this year. We had to cut back our Transportation Program a year ago by eliminating gas vouchers and bus tickets for clients to go to County Hospital and Loma Linda for medical care. So now we have only the one Transportation Program using volunteer drivers using their own vehicles. 16. Goal Statement. Indicate who will benefit from the use of these funds, and how they willbenefit. About 100 La Quinta residents will benefit -from the two Programs of receiving food supplies each time sufficient to prepare 12 meals per family member --and can receive the food two times per month, if needed. who The Transportation Program especially helps the Seniors and handicapped e. have These help: 1)meet some basic needs of low income persons; 2) improve or maintain a reasonable level of health and self-esteem to better enable persons to acquire and continue productive earnings --and thereby decrease the absolute need to steal for existence. 3)Prevent premature institution- alization. 4)Strengthen the unity of family life. 17. Attach a copy of your Program Operating Budget, and a separate detailed, concise list of intended Community Services grant expenditures. Food Supplies Purchase $2,000 (1 meal costs about 500 Gas reimbursement for Volunteer Drivers $1,000 (average trip costs $5) 18. Non-profit organizations must attach a copy of the organization's current IRS Form 990. 4 FISH Audited INCOME CASH ACTUAL Indian Wells . . . . • • • • • • $ 5,000 Indio Block Grant . . . . . . . . 5,000 Palm Desert to of . . . . . . . 7,000 Riverside Co. of It . . . . 5,000 Consortivam on AIDS . . . . . . . 10,201 Desert AIDS Project . . . . • . . 2,886 Donation from Organizations . . . 21,486 •to Churches . . . . . 12,428 it Business & Individual 7,385 Transportation Recipients 875 T.R.I.P. 944 Interest 233 Miscellaneous 1,932 Harris Co. Fund Raiser 65 To Be Raised Z7,549 EXPENDITURES_ 7,749 Co-ordinator . . . . . . . . 3, 526 Intake Facilitator . . . . 892 Maintenance Worker . 3,682 Taxes (Payroll) ... . . . . . Transportation for Clients .......17,759 Volunteer Administration . . . . . it Drivers . . . . . . . . It Office Workers . . Office Space & Electricity • :10,097 . . 1,169 Phone . . . . . . . . . . . . 1,006 Office Costs . . . . . . . . . . 75 Audit ... . . . . . . . . . . . . . . 1,608 Insurance . . . . . . . . . 1,079 Medicines for Clients . . . . . 910 Occasional Worker . . . . . . . . . 2,680 Equipment . . . . . . . . . Food & Supplies for Clients . . . 33,360 Miscellaneous . . . . . . . . . 772 86,364 GRAND TOTAL (Cash and In -Kind) 5 IN_KIND 1997 PROJECTED $ 5,000 6,000 7,500 7,250 10,600 3,200 18,000 10,000 7,000 900 0 100 1,000 300 5,000 81.850 Mw_ 7,800 4, 7 0.0 960 3,800 $ 2,000- 5,000 30,960 2 6.,.2 9.0 18,750 10,100 900 1,000 75 1,750 0 500 1,000 50, 000 43,205 1,000_' 128,000 81,,850 Short Form - 990-EZ Return of ..ganization Exempt From Inco,..s Tax Form under section M(c) of the internal Revenue Code (exoW black lung benefit fruet Or private foundation) or section 4947(.)(1) nonexempt dwftble trust ► For -organizations with gross receipts less than $100,000 and total assets less than $250.000 at the end of the year. Domb ovrhow"M�„�,,.� Trs@@ yWWM ► The have to may hato use a co of this retum to satisfy state reportingrequiremeY 1998, and ending A For the 1998 calendar year, OR tax year beginning . Piew c NM— of --n'l1°^. n • . A D EmrfM a Check it m m HT 95-3641184 9612 29 03 15 ❑ ChM of eddroes WM or ❑ h�a *r FISH OF THE LOWER COACHELLA [3 Find return PO sox 458 IN010 CA ❑ Mwided return intruo- (required also for Isom State reporting) OMB No. 1545-1150 1296 This Form is Open to Public Inspection .19 3 I B q5 ;(o'�O" VALLEY RE Catra�t , "r I — 92202 51 F Check ► ❑ if exemption H Enter four -digit group exemption number (GEM - (I Accountingmethod: CA Cash ElAccrual ❑ Others ) It I Type of organization— ► Exempt under section 501(c)( 3 ) .4 (insert number) OR 1,. [3 section 4947(ax1) nonexempt charitable trust Note: Section 5DOOM OMMIMP 6" and section 4947(a)(1) nonexempt dMffable trusts Ml1ST attach a coatpiebd Schedule A (Form SM J Check ► ❑ R the organization's gross receipts are nomialy not more than $25,000. The organization need not file a retirm with the IRS; but if the organaation received a Form 990 Package in the mail, the organization should file a mWm without financial data. Some state:require a eom lefe return. K Enter the organization's 1996 gross receipts (add back Rrwo 5b, 9b, and 7b, to line 9) . . . . . ► $ N S7oo.000 or more, the organimition must file Form 990 irrstsad of Fonn 990-EZ -- --- -- ---- Ac ` In 1 Contributions, gifts, grants, and similar amounts received (attach schedule) . . . . . . . 9 2 Program service revenue including government fees and contracts . . . . . • • • • 5 3 Membership dues and assessments . . . . . . . . . . . . . . . . . 4 4 Investment income . . . . . . . . . . . . . . . . 5a . . . . . . 5s Gross amount from sale of assets other than inventory . . . . 5b b Less: cost or other basis and sales expenses . . . . . . . c Gain or (loss) from sale of assets other than inventory pine 5a less line 5b) (attach schedule) 5 6 Special events and activities (attach schedule): a Gross revenue (not including $ .. of contributions 8a cc reported on line 1) . . . . . . . . . . . . . . . . . Ob b Less: direct expenses other than fundraising expenses . . . . . c Net income or pose) from special events and activities pine 6a less line 6b) 6 7a Gross sales of inventory, less returns and allowances . . . . . 7a 7b /. b Less: cost of goods sold . . . . . . . . . . . . . . . c Gross profitor (loss) from sales of inventory pine 7a less line 7b) . . 7 � 8 Other revenue (describe ► ) 9 Total revenue add lines 1, 2, 3, 4, 5c, 6c, 7c, and 8 • ► 10 Grants and similar amounts paid (attach schedule) . . . . . . . . . . . . . 1 1 11 Benefits paid to or for members . . . . . . . . . . . . . . . . . . . . . . 1 12 Salaries, other compensation, and employee benefits . . . . to independent contractors . . . . . . . . 1 13 Professional fees and other payments . . 1 • 14 Occupancy, rent, utilities, and maintenance . . . . . . . . . _ . . . 15 Printing, Publications, postag , and shi PPin - � 18 Other expenses (describe ► 17 Totals add lines 10 throw h 6 , !g 18 Excess or (deficit) for the year pine 9 less line 17) . . . . . . . . . • • • • 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with end -of -year figure reported on prior year's retu •• yf. , Z 20 Other changes in net assets or fund balances 21 Net assets or fund balances at and of ear combi a li 18 through 20 ► • . (Balance Sheets --If Total assets on line 25, column are $250,000 or more, file Form 990 instf (See Specific Instructions on page 29.) W BeQa'"r"g of : / 22 Cash, savings, and investments . . . . . . . . • . . . . 23 Land and buildings . . . . . . . . . . . p 24 Other assets (describe ► ) 25 Total assets Z 26 27 Total liabilities (describe ► Net asset nces(line 27 of column 8 must agree with line 21 For Paperwork Reduction Act Notice, ass peps 1 of the separate instructions. Cet. No. 106421 I& of Form 99 (a) End of Form 990-FZ n9" • Statement of Program Serv, Aeaom Its me What is the organization's primary exempt purpose? Describe what was achieved in carrying out the organizatioos aE services provided the mbar of persons bens , or other re 26 _.... _Mel, 29 )n purposes. Fully describe the nformation for each pmgram_tide. Page 2 29. (Required for 501(c)(3) end (4) anizations and 4947((a 1) trusts; optional for others.) .ice �O�S ......................... 30.................................................................................................. ..................................................... •..... 4....--•-----•--•--------•-- .(Greats $ ................................... 31 Other program services (attach schedule) (Grants 32 Total pro ram service expenses add Imes 28a through 31 a . . • Litt of Officers, Directors, Trustees, and Key Erm ileyea List each one even if not com Wo mho ss W wee ek of (Al Nsms sad address dwioW to a�i��t%i\�r7n/I✓--hil�l:ri�.:fii,riL �_� 1 ions on page zu. Is MW nt nd 33 Did the organization engage in any activity not Previously reported to the IRS? If'Yea,' attach a detailed deecxom of each activity . 34 were any donges made to the orgv=q or governing domm eras but not reported io the IRS? II'Yes,' attach a condom W copy of the cherQK 35 ff the orgw*adw had income from business activities, such as dim reported on Ones z 6, and 7 (among others), but NOT / reported on Form 990-T, attach a statement explaining your reason for not reporting the income on Forth 990-T x. a Did the organization have unrelated business gross income of $1,000 or more or section 6033(e) taxfor lobbying expenditures? b If "Yes,' has it filed a tax retum on Form 990-T for this year? . . . . . . . . . s, .•Ye . attach a statement.) 36 was there a liquidation, dissolution, termination, or substantial contraction during the year? .(if S7a / 37a Enter amount of political expenditures, direct or indirect, as described in the instructions. ► b Did the organization file Form 112D•POL for this year? . . . . . . . . . . . . . . . . wereany 36a Did the organization borrow from, or make any loans to; any officer, director, trustee, or key employee such loans made in a prior year and still unpaid at the start of the period covered by this retum? . . . . . . b 'Yes,' attach the schedule specified in the line 38 instructions and enter the amount involved. 38b ff 39 501(c)(7) o►ganizatiorm—Enter. a Initiation fees and capital contributions included on line 9 308 b Gross receipts, included on line 9. for public use of club facilities . . . . . . . . 39b 40e 501(c)(3) organastions•—Enter: Amount of tax paid during the year under section 4955 ► section 4911 ►_— section 4912 ► b 501(c)(3) and 501(cX4) organhations.—Did the organization engage in any section 4958 excess benefit transaction during the year? If 'Yes,' attach a statement explaining each transaction . . . . . . . . . . . .. . c Enter Amount of tax paid by the orgenizetmrs managers or dbqualified persons duliM under section 4958 ► d Enter. Amount of tax in 40c, above, reimbursed by the on 41 List the states with which a this return is filed. ► 42 The books are in carerJ5. ► ... Located at ►.��....{�-,"`_--- no. Op, ► �' _ ... ZIP + 4 ..��'.�%� � - -} t .... 43 Section 4947(a)(1) nonaxempt trews trusts Ming Form 990-EZ in lieu of Forrrr 1041—Check here IN. ❑ and enter the amount of tax Pt ins Mat received or accrued during the tax year . . . ► 1 43 Under psnsMiss of perjury, I dsolan that I haw soosrnirrsd fhb rohm kwkx irq a000mperift schedules and stdo- +b. and to the bast of Inv larowbdgs Please . end , it b tof p aon.ct, and oomplsls. Osdar.tion of plWou 00M than orlfosr) b based on sa InfonaaW of whfd, PrWNW has any Isrowlsdps. Sign aj �- q� �OV rr �- �� Y'a Y2 son 82�S Here ' ag,,,b,ra Daa ' Typs or P" harm and tide. Oab Cho* d Prsparsr's 88N Paid ' sir- ► Prsparvat R Ws ratms (or BN ► Use Only yours B ssM.mploy d) , ZIP + 4 ► i W 1L40iAW"1R1%41i*AR4A1 INS rkawki You are welcome to order any of these at no charge but please, only one copy of each. Just put a check in front of what ones you want. You are free to make copies of any. If you can, do send some stamps. Many require extra -large envelopes and take several stamps. Battling Killer Bees — they're here so know what to do! Beat The Cold — for outdoor dogs in winter Beat The Heat — for outdoor dogs in summer Bringing Up Baby with Your Dog California Beaches & Parks — where pets are welcome, what rules apply Car -Chaser— yes, you can cure them! Cat Tips — everything to help your feline friends Checking On Charities — how to tell the truly humane from the hustlers Continuing Care — providing for your pet's care after your demise Dealing With Grief — help for you on your pet's demise Earthquake Tips — get ready now for the Big One Fence Climbers — secrets to stopping this Fighting Fleas — it's not easy but you can win Free To Good Home Safeguards — screening a new home for a pet Good Neighbor Pets — how to make your pet loved by neighbors Holiday Hazards — keeping your pet safe during any holiday Introducing A New Dog To Your Dog It's The Law — some California laws that protect pets Low Cost Spay or Neuter Clinics — where they are in So.CA. and what they charge Open Doors — help for landlords and pet -owning tenants Parvo-Virus — how to protect your dog from this national epidemic Pet Request — tell us what you want, we'll tr5y and find it Pet Sitter Registry — your home or theirs in Coachella Valley only Pet's "Sunset Years", caring for an older pet Picking The Perfect Pet — what to look for and what to beware Picky Eaters — tempting a pet's appetite Poisons Vs. Pets — symptoms, what you can do and list of poisons Sherlock Bones — hints on finding a lost pet Stop Cancer & Littering — why altering saves your pet's life Stop Pound Slaughter — what you can do to help close these killing fields Stop Wandering Ways — training dogs to stay home Tackling Ticks — how to find and really kill them Teaching A Child Puppy Love — yes, young children need training with pets too! Training Tips — common sense ways to train a pet, no matter what age Travel Tips — where pets are welcome & how to travel in safety Water -Proof Your Pet — be it pool, lake, river, ocean or flood Where $$ Really Go! - we'll have ANIMAL PEOPLE send you its annual report on charities Name Mailing Address City Please Print Clearly State Zip Code, ORPHAN PET OASIS... where no pet is ever destroyed PO Box 798, North Palm Springs, CA, 92258 FAX (760) 329-3602 e-mail MBaker30l5@AOL.com Office (760) 329-0203 A 501( C ) 3 non-profit group since 1954 Federal ID # 95-2122004 T4ht 4 4a Qu 1� K ro MEMORANDUM TO: CULTURAL COMMISSION 1 FROM: MARK WEISS, ASSISTANT CITY MANAGER M1 DATE: OCTOBER 27, 1997 SUBJECT: DISTRIBUTION OF COMMISSION PACKETS Distribution of Commission meeting packets is done through the U.S. Mail. In the event you do not receive your packet in Monday's mail (3 days prior to your regularly scheduled meeting) please contact Cristal Spidell, Commission Secretary at 777-7090 and one will be delivered to you as soon as possible. If you have pre-printed information for distribution to the Commission to be included in a packet it must be delivered or mailed to the Commission Secretary no later than 5:00 p.m. Monday (10 days prior to your regularly scheduled meeting) for packet preparation. Please contact us in advance at 777-7090 if you anticipate providing this type of information. The attached calendar should clarify the above information. If you have any questions regarding the time line for Agenda items feel free to contact me. Thank you. C:\MyData\CRISTAL\CAC\MEMO.003.wpd N N IN Co w O 00 0o N �- O v0 c m0 -1 m •J � m N N N om2 N O�-i W 0 G) 00 Z � 0 0 K N IN Cal N ob W 0X c_ mI m 0 (31 �•3 O -., N W 0 —nl K co w