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TRANSCRIPT
CISSKNYONZ -
CIS IMAGE-1Drocess As Original ' ^te^,e. 7
Form 990 1 Return of Organization Exempt From Income .j^012
I Under section 501(c), 527, or 4947( a)(1) of the Internal Revenue Code (except black lungbenefit trust or private foundation)
Department of the Treasuryintenat Revenue Sennos ► The organization may have to use a copy of this return to satisfy state reporting requirements
c^
4)
A For the 2012 calendar year , or tax year beginning , 2012 , and e nd ing , 20
B ch...It aoosr.wC Name of organization
BOYS & GIRLS CLUBS OF AMERICA
D Employer Identification number
13-5562976
AOOf .d-V Doing Business As
keen u,.„w Number and street (or P 0. box if mail is not delivered to street address ) Room/suite E Telephone number
1275 PEACHTREE STREET, N.E. (404) 487-5700t,,,,,w,p City, town or post ofice . state . and ZIP code
Aniini.d ATLANTA, GA 30309-3506 G Gross receipts S 255, 175, 720.^poft•tb^o.na0e
F Name and address of principal ofcer JAMES L. CLARK H(a)Isthis egroupreturn
toiRriatm'
Yes X No
1275 PEACHTREE STREET NE ATLANTA, GA 30309-3506 H(b) Are allaln 'atmrduded7 Yes No
I Tax-exempt status . X 501(c)(3) 501 ( c)( ) I (insert no.) 4947(a)(1) or 527 If 'No,'attameust ( seeInVuellans)
d Webalte : ► WWW. BGCA. ORG , H(c) Group a arrpuon number ►
K Form of omamzahon X Corneret,en Trust As.euat,m O her b- I L Year of fnrmal,M 195 M State of lanai dem,eie DC
Summary
I Briefly describe the organization ' s mission or most significant activities ------- -- - --------------- --------------
m TO ENABLE ALL YOUNG PEOPLE, ESPECIALLY THOSE WHO NEED US MOST, TO
p----------------------------------------------------------------------
REACH THEIR FULL POTENTIAL AS PRODUCTIVE, CARING, RESPONSIBLE---- ------ --- -- -
---------------
E- ----- -------- - ------------------------
CITIZENS.---------------- ---------------
0 2 Check this box It the organization discontinued its operations or disposed of more than 25% of its net assets.------------ -------------------------- ----------------------------------------------
.e 3 Number of voting members of the governing body (Part VI, line la) , , , , , , , , , , , , , , , , 3 41.
4 Number of independent voting members of the governing body ( Part VI, line 1 b) . . . . . . . . . . . . . . . . . 4-
40 .
$ Total number of individuals employed in calendar year 2012 (Part V, line 2a), , , , , , , , , , , , 5 423.U 6 Total number of volunteers ( estimate If necessary) 6 160.
7a Total unrelated business revenue from Part VIII, column (C), Ime 12 . . . . . . . . . . . . . . . . . . . . . . 7a 124,453.
b Net unrelated business taxable income from Form 990-T , line 34 . .. . 7b 102,624.
C U)', Prior Year Current Year
104 7498 93 177 45919 58 Contributions and grants (Part VIII, line 1h ) , ., , .,
9 Program service revenue (Part VIII, line 2g).- ,^, ^ 0 C
0 10 Investment income (Part VIII, colum ' m 4^,ar 7 &li^ ^^'' 1 8, 9 98, 579. 9, 833, 995 .
11 -s'`^`Other revenue (Part VIII , umn (;A 9c . 10 11e), 532, 394. -340,454.
12
/
^Total revenue - add lines 8 rou must at Part VIII, u n A:tine 12 . 113,924,722. 149,670,995.
13 Grants and similar amounts d art^°^IUVn A ,Imes 1- 72, 724, 751. 66,065,361.
f C14 Benefits paid to or for mem P IW t^Iumn ( ),.hn
a 15
.
Salaries , other compensation ,
pi
-41 (aR oo lines 5 10), 37, 709, 680 - 9 0, 9 80, 693 .
16a Professional fundraising fees (P IX, co` )^l1e) , , , 751.46, 88,329.
b Total fundraising eenses (Part O)Ime 25) . 273 , 827 .
17 Other expenses (Part IX, column (A), lines 11a-ltd , llf-24e )
.
66, 088. 20, 933, 751 .
18 Total expenses Add lines 13 - 17 (must equal Part IX , column (A), line 25) 47, 270. 127, 568, 134 .
19 Revenue 'tess expenses . Subtract line 18 from line 12 .. . . . . .............. -16, 4 22, 548. 22,102, 861.Z e0 o Beg i nning of Current Year End of Year
s4 20 Total assets (Pan X , line 16) , , , , , 315, 368, 968. 369,127,674.-to) 21 Total liabilities ( Part X , line 26), , , , , , , 607, 691.28, 33, 345, 768 .
22 Net assets or fund balances Subtract line 21 from line 20 ..
.
86, 7 61, 277. 335, 781, 906 .Signature Block
Under penalties of perjury. I de that I have examined this return , including accompanying schedules and statements , and to the best of my knowledge and belief, It istrue, correct , and complete W~~of preparepother than ojVi cer) is based on all information of which preparer has any knowledge
Sign sign otCt rHere ,TAM a c 1 G^.A R..X
T e t name and title
ra name PreDarefa signaturePaid H . FRANKLIN 0144, AtPreparer
e n F' 'e n01"e lie. KPMG LLPUsO
'e d 300 NORTH GREENE STREET , SUITE 400 GREEN;
May the IRS discuss this return with the preparer shown above? ( see tnstruc
rGce,see the
^,,. SAS CITY. 190 CIS IMAGE-Do50ZONY 1985 v 1Z
14
BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Form 9b0(2012) Pape 2
Statement of Program Service Accomplishments
Check if Schedu le 0 contains a response to any question in this Part III n
I Briefly describe the organization ' s missionATTACHMENT 1
2 Did the organization undertake any significant program services during the year which were not listed on theprior Form 990 or 990-EZ? , , , , , , , , , , , , , , , , , , , , ,,, , ,, , , , ,,,,, , ,,, , , ,,,,,, Yes NoIf "Yes," describe these new services on Schedule 0.
3 Did the organization cease conducting, or make significant changes in how it conducts , any programservices? .. ... .... .. .. .... .. .. .... ..... .. .. .. Yes NoIf "Yes ," describe these changes on Schedule 0
4 Describe the organization's program service accomplishments for each of its three largest program services , as measured byexpenses Section 501(c )( 3) and 501(c)(4 ) organizations are required to report the amount of grants and allocations to others,the total expenses , and revenue , if any, for each program service reported.
4a (Code ) (Expenses $ 42, 523 , 165. including grants of $ 38, 829 , 706. ) (Revenue $ 42, 523, 165.SEE SCHEDULE 0
4b (Code ) (E)penses $ 2,135, 019. including grants of $ 1, 094,118 . ) ( Revenue $ 2,400,000SEE SCHEDULE 0
4c (Code ) (Expenses $ 1, 970, 846 . including grants of $ 1,600 , 000. ) (Revenue $ 2,250,000SEE SCHEDULE 0
4d Other program services ( Describe in Schedule 0.)(Expenses $ 61,291 , 630. including grants of $ 24, 541 , 537. ) (Revenue $
4e Total program service expenses ► 107, 920, 660.
261020 000 Form 990 (2012)50ZONY 1985 V 12-6F 430966 n GPAGE.0
0BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Form 990 (2012) ' Pege'3
Checklist of Re uired SchedulesYes No
I Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes,"complete Schedule A ................ .. .. ............. . ............. .. 1 X
2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . ..... .. 2 X
3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to
candidates for public office? If "Yes,'complete Schedule C, Pail t ........... ................ 3 X
4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h)
election in effect during the tax year? If "Yes,"complete Schedule C, Part 11 ..... .. ............ .. 4 X
5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes," complete Schedule C.part /// .......................................................... 5 X
6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors
have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If
'Yes,"complete Schedule D, Part I .. . .. ...... ...... ... ... ... . . ... . . . .... . . .. 6 X
7 Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes,"complete Schedule D, Part 11.. ........ 7 X
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part Ill ... . .. . ..... .. ...... ... ... ... . . .... . .. ... . ... 8 X
9 Did the organization report an amount in Part X. line 21, for escrow or custodial account liability, serve as a
custodian for amounts not listed in Part X, or provide credit counseling, debt management, credit repair, or
debt negotiation services? If "Yes,"complete Schedule 0, Part IV . .......... . ...... . ... .. . 9 X
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted
endowments, permanent endowments, or quasi-endowments' If "Yes,"complete Schedule D, Part V ..... 10 X
11 If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI,
VII, VIII, IX, or X as applicable
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10' If 'Yes,'
complete Schedule D, Part Vl ..... ........................ . ... . .... . . . ..... 11a X
b Did the organization report an amount for investments-other securities in Part X, line 12 that is 5% or more
of its total assets reported in Part X, line 169 If 'Yes,"complete Schedule D, Part W1 . . . . 11b X
c Did the organization report an amount for investments-program related in Part X, line 13 that is 5% or more
of its total assets reported in Part X, line 16' If "Yes, "complete Schedule D, Part VIII . .. . . . ... . . . ... 11c X
d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets
reported in Part X, line 16? If "Yes,"complete Schedule D, Part IX ... ....... . ........... . . 11d X
a Did the organization report an amount for other liabilities in Part X, line 25? If "Yes,"complete Schedule D, Part X lie X
f Did the organization's separate or consolidated financial statements for the tax year Include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? 11 "Yes,' complete Schedule D, Part X . . 11 f X
12a Did the organization obtain separate, independent audited financial statements for the tax year? If 'Yes,"
complete Schedule D, Parts XI and Xtl . . .... ..... .... .... .. .. .. . . .. ... .. . ... . .. 12a X
b was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes," and if
the organization answered 'No' to line 12a, then completing Schedule D, Parts Xi and X11 is optional .. . . . .. .. .. . .. 12b
13 Is the organization a school described in section 170(b)(1)(A)(u)? If "Yes,"complete Schedule E .. . .. ... 13 X
14a Did the organization maintain an office, employees, or agents outside of the United States?. ... . . .. ... .. 14a X
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,
fundraising, business, investment, and program service activities outside the United States, or aggregateforeign investments valued at $100,000 or more? If 'Yes," complete Schedule F, Parts l and IV........... 14b X
15 Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any
organization or entity located outside the United States? If 'Yes," complete Schedule F, Parts 11 and 1V .. . .. 15 X
16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance
to individuals located outside the United States? If 'Yes," complete Schedule F, Parts 111 and IV .......... 16 X
17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services
on Part IX, column (A), lines 6 and 11e? If "Yes,"complete Schedule G, Part I (see instructions) ... ....... 17 X
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on
Part VIII, lines 1c and 8a? If "Yes,"complete Schedule G, Part 11 ...... ...... . ........... ... . 18 X
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a'
If 'Yes, " complete Schedule G, Part ill ... ....................... ........... ... 19
20 a Did the organization operate one or more hospital facilities? If "Yes, "complete Schedule H . ... .. . . . . .. . 20a X
h If "Yes" to line 20a- did the organization attach a coov of its audited financial statements to this return? . ..... 20b
Form 990 (2012)JSA
2E 1021 1 000
50ZONY 1985 V 12-6F 430966 n WhGE .hj -a
BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Form 990(2012) Pepe
MMM Checklist of Required Schedules (continued)Yes No
21 Did the organization report more than $5,000 of grants and other assistance to any government or organization
in the United States on Part IX, column (A), line 1? If "Yes,"complete Schedule 1, Parts ! and 11... ....... .. 21 X
22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United States
on Part IX, column (A), line 2? If "Yes,"complete Schedule 1, Parts 1 and !!! .... ..... ... . . ..... . .. 22 X
23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the
organization's current and former officers, directors, trustees, key employees, and highest compensated
employees? If "Yes,"complete Schedule J .. .. . . ......... . ... .. .. . ... . .. ....... .. 23 X
24 a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than
$100,000 as of the last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b
through 24d and complete Schedule K If'No,'go to line 25 .... ... ... . .. . . .. . . . . . .. ... . . . 24a X
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? ....... 24b X
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds' ... ..... . . . ...... ... ... .. . .. .... . . . .. .... . 24c Xd Did the organization act as an "on behalf or issuer for bonds outstanding at any time during the year?. .... .. 24d X
25 a Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction
with a disqualified person during the years If "Yes,"complete Schedule L, Part I . . .. . ... . .. .. .... . . 26a X
b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior
year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?
If 'Yes, " complete Schedule L, Part I ... ... .. .. ... .... . .. .. . .. . .. .. .. ..... . . . 25b X
26 Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or
disqualified person outstanding as of the end of the organization's tax year? If "es,"complete Schedule L, Part 11 . 26 X
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee,
substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled
entity or family member of any of these persons? If "Yes,"complete Schedule L, Part Ill . .. .. . . . ... .... 27 X
28 Was the organization a party to a business transaction with one of the following parties (see Schedule L,
Part IV instructions for applicable filing thresholds, conditions, and exceptions)-
a A current or former officer, director, trustee, or key employee? If 'Yes, "complete Schedule L, Part IV . . ...... 28a Xb A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete
Schedule L, Part IV . .. . . .... ... .... . .. . . ..... ... . .. . . . .. . ... .. . .. . .... 28b X
c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof)
was an officer, director, trustee, or direct or indirect owner? If "Yes,"comp fete Schedule L, Part IV . ...... . . 28c X
29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M 29 X
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified
conservation contributions? If "Yes,"complete Schedule M ..... . . ... ... . .. .. . . . . ...... . 30 X
31 Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,Partl .......................................................... 31 X
32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes,"complete Schedule N, Part 11 . .. . ... .. . .. . .. ... .... .. . ... . . . . . . .. .. . ... .... 32 X
33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulationssections 301.7701-2 and 301 7701-3? If "Yes,"complete Schedule R Part l ............. ....... . 33 X
34 Was the organization related to any tax-exempt or taxable entity If "Yes," complete Schedule R, Part 11, Ill,or IV, and Pail V. line I . .. . . . . .. . ... .. . . .. .... .. . . . . .. . . . .. . . .. .. . ..... .. 34 X
35 a Did the organization have a controlled entity within the meaning of section 512(b)(13)? .. . . . .. .. . .. 35a Xb If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a
controlled entity within the meaning of section 512(b)(13)? If 'Yes,"complete Schedule R Part V, line 2 , , , . 35b X
36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitablerelated organization? If "Yes," complete Schedule P. Part V, line 2 .. ... . .. .. . .. . .. ... ....... . 36 X
37 Did the organization conduct more than 5% of its activities through an entity that is not a related organizationand that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule RParty! ......................................................... 37 X
38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part Vl, lines 1 lb and
4
19? Note . All Form 990 filers are required to complete Schedule 0 1 38 1 X
For, 990 (2012)
JSA
2 E 1030 1 00050ZONY 1985 V 12-6F 430966 .1 ih
BOYS & GIRLS CLUBS OF AMERICA • 13-55629760
Form 990 ( 2012 ) P.p.'s
Statements Regarding Other IRS Filings and Tax ComplianceCheck if Schedule 0 contains a response to any question in this Part V . . . . . . . . . . . . . . . . . . . . . . . F-1
I a Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable .. , . .... 1a 311
b Enter the number of Forms W-2G included in line 1 a Enter -0- if not applicable. lb 0
c Did the organization comply with backup withholding rules for reportable payments to vendors and
reportable gaming (gambling ) winnings to prize winners?. .. . ........ . ... . ... .. ..... .. .
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax
Statements, filed for the calendar year ending with or within the year covered by this return , 2a 423
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?Note . If the sum of lines la and 2a is greater than 250, you maybe required to e-6!e (see instructions ) .. ... ,
3a Did the organization have unrelated business gross income of $1,000 or more during the year? . . . , . ... ,b If "Yes ," has it filed a Form 990-T for this year? If No," provide an explanation in Schedule 0 .. . . ....... ,
4a At any time during the calendar year , did the organization have an interest in , or a signature or other authority
over , a financial account in a foreign country (such as a bank account , securities account , or other financialaccount)? .................... . ...... . ....
b If 'Yes ,' enter the name of the foreign country ► -ATTACHMENTSee instructions for filing requirements for Form TD F 90-22 1, Report of Foreign Bank and Financial Accounts
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? . ...
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
c If "Yes" to line 5a or 5b , did the organization file Form 8886-T? ....... . ..... . . . . . .. . . . .. . .
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions ? , . , ...... ,
b If "Yes ," did the organization include with every solicitation an express statement that such contributions or
gifts were not tax deductible ? . . ..... .. ... . .. . .. .. ...... ... . . .. .. . . .. .. . . . .
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods -
and services provided to the payor? ........................... . .... ... . .... .
b If "Yes ," did the organization notify the donor of the value of the goods or services provided? . . .. .. , ... ,
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was
required to file Form 8282? .............. ....... ....... ... .... ..... .
d If "Yes ," indicate the number of Forms 8282 filed during the year . . .. . . .. .. . . . .. 7d
e Did the organization receive any funds , directly or indirectly , to pay premiums on a personal benefit contract? . ,
f Did the organization , during the year , pay premiums , directly or indirectly , on a personal benefit contract?
g If the organization received a contribution of qualified intellectual property , did the organization file Form 8899 as required? , ,
h If the organization recei ved a contribution of cars , boats , airplanes , or other vehicles, did the organization file a Form 1098-C?
No
4a X
5a X
Sb X
5c
6a X
6b
7a X
7b X
7c X
7e X
7f X
8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting • - '`:~
organizations . Did the supporting organization, or a donor advised fund maintained by a sponsoring
organization, have excess business holdings at any time during the year? ... . ... . . ... . . . . .. . . . 8
9 Sponsoring organizations maintaining donor advised funds.
a Did the organization make any taxable distributions under section 4966? ............. .. ..... . 9a
b Did the organization make a distribution to a donor, donor advisor, or related person? .. ... . . . . .. . . 9b
10 Section 501(c }( 7) organizations . Enter
a initiation fees and capital contributions included on Part VIII, line 12 10a
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities .. , , 10b
11 Section 501(c )( 12) organizations . Enter
a Gross income from members or shareholders .. . . . .. . . . . . ...... .. . . . .. 11a
b Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them.) . ... . . . . . . . . . ..... . ... .. 11 b A` =
12a Section 4947( a)(1) non-exempt charitable trusts . Is the organization filing Form 990 in -lieu of Form 1041? 12a
b If "Yes," enter the amount of lax-exempt interest received or accrued during the year 12b
13 Section 501(c)( 29) qualified nonprofit health insurance Issuers .
a Is the organization licensed to issue qualified health plans in more than one state? , , , , , , , , , , , , , , , , 13a
Note . See the instructions for additional information the organization must report on Schedule 0
b Enter the amount of reserves the organization is required to maintain by the states in whichthe organization is licensed to issue qualified health plans , , , , , , , , , , , , , , ,,, , .13b ' r•_
c Enter the amount of reserves on hand .. . ..... . ... ...... . .. . ... . . . .. 13c
14a Did the organization receive any payments for indoor tanning services during the tax year? .. ... , . . , .. 14a X
b It "Yes , " has it filed a Form 720 to re p ort these paym ents? If ?'Iq ' provide an explanation in Schedule 0 . 14b
2E10401000 Form 990 (2012)
5OZONY 1985 V 12-6F 430966 liM a LgGF0h.1
Form 990 BOYS & GIRLS CLUBS OF AMERICA ^ 13-5562976 Fe
Governance ,-Management , and Disclosure For each 'Yes' response to lines 2 through 7b below, and for a No'response to line Ba, 8b, or f Ob below, describe the circumstances, processes, or changes in Schedule 0 See instructions.
Check if Schedule 0 contains a response to any question in this Part VI . . .. . . .... . . .. .. .. . . . . .. . . n
Yee No
1a Enter the number of voting members of the governing body at the end of the tax year . . . . . . . . . . . Ia 4
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee , explain in Schedule 0.
b Enter the number of voting members included in line 1a, above, who are independent ..... 1b 4
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with
any other officer, director, trustee, or key employee? ... . .. .. .. .. .. .. . . ..... . .. . ... . 2 X
3 Did the organization delegate control over management duties customarily performed by or under the direct
supervision of officers, directors, or trustees, or key employees to a management company or other person? .. 3 X
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?. ... . . 4 X
5 Did the organization become aware during the year of a significant diversion of the organization's assets?. . . . 5 X
6 Did the organization have members or stockholders? ... . .. .. .. . . . . .. . . ..... . .. . . . . . 6 X
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body? .... ... ... .. .. .... . . . . ...... .. .... . . 73 X
b Are any governance decisions of the organization reserved to (or subject to approval by) members,
or persons other than the governing body? . ... .. ..... . . . . . ..... . . .. .. . ..stockholders 7b X,8 Did the organization contemporaneously document the meetings held or written actions undertaken during
the year by the following
a The governing body? . ....................... .. ................ ...... .. ea X
b Each committee with authority to act on behalf of the governing body? ... . . . .. .... . . . . .. .. . . 8b X9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at
the organization's mailin g address? If "Yes ° rovide the names and addresses in Schedule 0 . 9 X
Section B. Policies (This Section B requests information about policies not re uired by the Internal Revenue CodeYes No
or affiliates? .... ... ... . . ....... . .... ..10a Did the organization have local chapters branches 10a X, ,
b If "Yes," did the organization have written policies and procedures governing the activities of such chapters,
affiliates and branches to ensure their operations are consistent with the organization's exempt purposes? . . . . 10b X,
11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? . . 11 a X
b Describe in Schedule 0 the process, if any, used by the organization to review this Form 99012a Did the organization have a written conflict of interest policy? If 'No "go to line 13 . . . .... . . . .. ... . . 12a X,
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give
rise to conflicts? . . . . . . ... . .. . . .. .. .. .... . . .. .. .... .... ..... .. . . .. .. . 12b X
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes.'
descnbe in Schedule 0 how this was done .. ... . ... .. . . . . . ... . . .. . ..... ... ... .. . 12c X
13 Did the organization have a written whistleblower policy .... .. .......... ............... 1314 Did the organization have a written document retention and destruction policy? . .. . ..... . .. ... .. . 14 X
16 Did the process for determining compensation of the following persons include a review and approval byindependent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a The organization's CEO, Executive Director, or top management official ........ ........ ....... 15a X
b Other officers or key employees of the organization . .... . ... . . ... . ... . . ... .... . .. . . . 15b XIf "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions)
16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangementwith a taxable entity during the year? ... ............... ........ . ............. . 16a X
b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate itsparticipation in joint venture arrangements under applicable federal tax law, and take steps to safeguard theorg anization's exem p t status with respect to such arrangements? . 16b
Section C. Disclosure
17 List the states with which a copy of this Form 990 is required to be filed ATTACHMENT-3 ------------IS Section 6104 requires an organization to make its Forms 1023 ( or 1024 if applicable ), 990, and 990-T (Section 501 (c)(3)s only)
available for public inspection Indicate how you made these available Check all that apply.IX Own websde Another' s website Upon request J Other (explain in Schedule 0)
19 Describe in Schedule 0 whether ( and if so , how), the organization made its governing documents , conflict of interest policy,and financial statements available to the public during the tax year
20 State the name , physical address , and telephone number of the person who possesses the books and records of theorganization ► A AND S . MEHTA 1275 PEACHTREE STREET NE ATLANTA , GA 30309 -3506 (404)467-5713
'SA Form 990 (2012)2 E 1042 1 000
5OZONY 1985 V 12-6F 430966 R,SPPGE ,
F orm 990 (2012 ) BOYS & GIRLS CLUBS OF AMERICA _ 13-5562976
Compensationof Officers, Directors, Trustees, Key Employees, Highest Compensated Employees,andIndependent Contractors
Check if Schedule 0 contains a response to any question in this Part VII .................... q
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees1a Complete this table for all persons required to be listed Report compensation for the calendar year ending with or within theorganization's tax year
• List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount ofcompensation Enter -0- in columns (D), (E), and (F) if no compensation was paid
• List all of the organization's current key employees, if any See instructions for definition of "key employee "
• List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee)who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from theorganization and any related organizations.
• List all of the organization's former officers, key employees, and highest compensated employees who received more than$100,000 of reportable compensation from the organization and any related organizations
• List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of theorganization, more than $10,000 of reportable compensation from the organization and any related organizations
List persons in the following order. individual trustees or directors, institutional trustees, officers, key employees, highestcompensated employees; and former such persons
q Check this box if neither the organization nor any related organization compensated any current officer. director. or trustee.
(C)
(A) (B) Position ( D) (E) (F)Name and Title Average (do not check more than one Reportable Reportable Estimated
hours per box , unless person is both an compensation compensation from amount ofweek gist an officer and a director/trustee) from related other
hours for o > > o z the organizations compensationrelated o z r s a organization (W-2/1099-MISC) from the
organizations isg
C 3 K o (W-2/1099 - MISC) organizationand relatedbelow Boned
ice)m
' g,m °
o8 organizations
oa
-LtGOVERNORSI -
X 0-LLABELE,-CHRIS _____ ____________
--
__2_ 00GOVERNOR X
_@LBACH,ROBERT J--------------------
3.00--
CHAIRMAN EMERITUS X 0
J-LlBROLICK,-EMIL
---- - - ---------------- --2_00
-CHAIRMAN X X 0
J-5LCAPPELLI, GREOGORY-_W___________
-
__ 2_ 00
GOVERNOR X 0ONYA, ANTH PCON Z
(s2.00_ _ _
---- -- -------- -------GOVERNOR X 0
C-(TlCRYSTAL,JEAN----------------------
1_ 00
-------SECRETARY X X 0
--8LDIMOPOULO5,-LINDA-J------------ --3_ 00
GOVERNOR X 0
-gLFALK, -THOMAS J-------------------
-- 2.00
VICE CHAIRMAN X 0
L10,FATTORI,RUTH_A---------------- _- 2.00
GOVERNOR X
i-1IFETTIG, JEFF M-
3.00
REGIONAL CHAIRMAN X 0
L,II,HELENA B
-
.00
GOVERNOR X 0 Cj131GIDWITZ, RONALD J---CHAIRMANELECT X 0 C
i141G0INGS,RICK------------------- -------
3_ 00
CHAIRMAN EMERITUS X 0 C
JSA
2E1041 1 000
50ZONY 1985 V 12-6F 430966
Form 990 (2012)
M A 9AGEA7,fy .p
BOYS 6 GIRLS CLUBS OF AMERICA • 13-5562976
form 990 (2012) Pepe 8
MUM Section A. Officers . Directors . Trustees . Kev Emolovees - and Highest Cmmnencated Fmntovees /cnnr,n„Adr)
(A) (B) (C) (0) (E) (F)Name and title Average Posrtron Reportable Reportable Estunated
hour per (do not Check more than one compensation compensation from amount ofweek iot (ny box , unless person Is both an from related other
hours for officer and a direetor/ trustee the anizationsr compensation
related ° >n >. 0 j ° T "
Iorganization
go(W-2/1099-MISC) from the
orre"ma0r° 0 2 ° oZro 51
(W-211099 - MISC) organizationbelow doped ff m g . = and related
Line) °̂0
° 3 orgaruzehons
o ^, 0 8e C
aCL
15) GOODELL, WILLIAM R 2.00
REGIONAL CHAIRMAN X 016) GRAY, MYRON--
2.00--------------------------------REGIONAL CHAIRMAN
------X 0
17) GRIFFEY JR., KEN 1,00
GOVERNOR X 018) HAWN, GOLDIE 1.00
GOVERNOR X 019) HAYNES, PETER L 2.00
CHAIRMAN EMERITUS X 020) HENLEY, JEFFREY 0 2.00
GOVERNOR X 021) HESSE, DANIEL R 1.00
GOVERNOR X 0LEWIS22)-KATZ,
-------- --2.00
- ----------------------GOVERNOR
------X 0
23)_ LAZARUS, MARK H 1.00
GOVERNOR X 024) LEWIS, EDWARD T 1.00----------------------------------
GOVERNOR------
X 025) LICTINGER, PEDRO 2.00
GOVERNOR X 0
1 b Sub -total . ► 0c Total from continuation sheets to Part VII, Section A ......... . . . ► 3, 156, 424. 504, 934.
d Total add lines 1b and 1c , ► 3, 156, 424. 504,934.
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization ► 81
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line la? If "Yes,"complete Schedule J for such individual ... . .. .. .. ...... . . .. ... .. .
No
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the :, }'1; _•organization and related organizations greater than $150,000? If 'Yes,' complete Schedule J for suchindividual ........................................................... 4 X
5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individual yJfor services rendered to the org anization? If Yes, con p/ete Schedule J for such person 5 X
Section B. Independent Contractors
I Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization. Report compensation for the calendar year ending with or within the organization's taxyear
(A)Name and business address
(B)Description of services
(c)Compensation
ATTACHMENT 4
2 Total number of independent contractors ( including but not limited to those listed above ) who receivedmore than $ 100,000 in compensation from the organization ► 23
2E10553000
5OZONY 1985 V 12-6F 430966Form 99U (2012)
a3^a WGF1
Form 990 (2012)0
BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Pege 8
Section A. Officers. Directors . Trustees. Key Emolover±s and Hinhpf Cmmnancs•e.a ^.....t,..ae^ /,.,,.,f,,,,e,^t
(A) (B) (C)(p )
- (E) (F)
Name and title Average position Reportable Reportable Estimatedhaws Per (do not check more than one compensation compensation from amount of
week 01st any box , unless person is both an from related otherhours for officer and a dtreCtar/ trustee th compensationo _
1m = ,n e orgamzattons
related n s _ & 3 g° I
o organization (W-211099- MISC) from theorganizations a E
.3-m N
a (W-2l1099-MISC) organizationbelow lotted cCA g ^
0and related
line) g mo
organizationsa g e
26) REVEREND MALLOY, EDWARD A- --- -
1.00--- ---------- --------------
GOVERNOR------
X X 0
27) MCNEELY, VALERIE C-------------------------------
2.00-------
GOVERNOR X 0 10 0
28) MEAD, DANA G-------------------------------
1.00-------
GOVERNOR X 0
29) MILBANK III, JEREMIAH=
1.00------------------------------
GOVERNOR------
X 0
30) MORSE, PETER C---------------------------------
2.00------
GOVERNOR X 0
31) DR. RICE, CONDOLEEZZA 1.00------------------------------
VICE CHAIRMAN------
X 0
32) SARGENT, RONALD L---------------------
2.00------------------
VICE CHAIRMAN X 0
33) SCHWAB-POMERANTZ, CARRIE----
4.00-----------t---------------
REGIONAL CHAIRMAN------
X 0
34) SEATON, DAVID T-----------------
1.00---------
REGIONAL^CHAIRMAN X 0
35) STAHL, JACK L---------------------
3.00------------------
VICE CHAIRMAN X 0
36 ) SZOSTAK, ANNE M 2.00__ _
CHAIRMAN EMERITUS X 0
11b Sub-total ►c Total from continuation sheets to Part VII, Section A . . ... ........ ►d Total add lines 1b and 1c ►
2 Total number os individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization ► 81
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated 'employee on line 1 a' If 'Yes,"complete Schedule J for such individual .. . .. ... .. . . . . .. . .. . . . . . . 3 X
4 For any individual listed on line la, is the sum of reportable compensation and other compensation from the -''". 'k--,organization and related organizations greater than $150,000? If 'Yes,' complete Schedule J for such L' :LLindividual ........................................................... 4
X
5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individualfor services rendered to the org anization? If Yes, complete Schedule J for such person 5 X
Section B. Independent Contractors
I Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization Report compensation for the calendar year ending with or within the organization's taxyear.
(A)Name and business address
(B)Description of services
(C)Compensation
2 Total number of independent contractors (including but not limited to those listed above) who receivedmore than $100,000 in compensation from the organization ► - 1 {
'bA Form 990 (2012)2E10553000
5OZONY 1985 V 12-6F 430966 n,&P^AGE63pn s
• BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
990 (2012) Pape 8
Section A. Offir_arc Directnrc Tructees Kev Emnlnveac and Hiehest Cmmnensatert EmnloveeS (continued)
(A) (B) (C) (D) (E) (F)
Name and title Average Position Reportable Reportable Esmna ed
hours per (do not Check more than one compensation compensation from amount ofWeek Qlst any box , unless person is both an from related other
hours for officer and a director/trustee the anizationsor compensation
relatedao w s 3
0 o organizationg
(W-2/1099 MISC) from the
' ^ ° O - e (W-2/1099- MISC)
_
below o c
2
g
' ° 8and related
il ine) g m_ g organ zationsg o g
osn
37) TENNENBAUM, ANDREW--- -- -- - -
2.00------ -- -- ---------- -- ---GOVERNOR
------X 0
38) TESSLER, ALLAN R 1.00
GOVERNOR X 0
39) TONGE, PHILLIP W 3.00----------------------------------
GOVERNOR------
X 0
40) WASHINGTON, DENZEL 1.00
GOVERNOR X 0
41) WENDT, GARY 2.00
TREASURER X X 0
42) CLARK, JAMES L 40.00----------------------------------
PRESIDENT AND CEO------
X X 658,020. 128,398.
43) OFFICERS & OTHERS:---------------------------------- ------
X 044) MEHTA, ANAND 40.00----------------------------------
ASSISTANT TREASURER------
X 308,151. 46,445.
45) MORAIN, KRISTINE-----
40.00- ------------------------- -----
ASSISTANT SECRETARY- ---
X 177,633. 40,105.
46) FIELDEN, NELL 40.00----------------------------------
SR VP, HUMAN RESOURCES------
X 200,287. 38,078.
47) ORR, LORRAINE E 40.00---------------------------------
SR VP, CLUB SERVICES------
X 231,948. 23,661.
lb Subtotal ►c Total from continuation sheets to Part VII, Section A .. ...... . ... . ►d Total (add lines lb and 1c ►
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization ► 81
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1 a? If "Yes,"complete Schedule J for such individual .. ... . .. ... .. . .. .. . ... . . . .
No
4 For any individual listed on line la , is the sum of reportable compensation and other compensation from theorganization and related organizations greater than $150 ,000 If 'Yes,' complete Schedule J for suchindividual ........................................................... 4 X
5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individualfor services rendered to the org anization? If 'Yes," com lete Schedule J for such person 5 X
Section B . Independent Contractors
I Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization Report compensation for the calendar year ending with or within the organization's taxyear
(A) ( e) (C)Name and business address Description of services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who receivedmore than $100,000 in compensation from the organization ►
2 E 1055 3 000
5OZONY 1985 V 12-6F 430966
Form 990 (2012)
dMP6GE ,0n
• BOYS & GIRLS CLUBS OF AMERICA 13-5562976Form 990 ( 2012) • p re 8
Section A. Officers . Directors . Trustees . Kev Emolovees . and Hiahest Cnmruncator ♦ cmnI&wm I,'nnt,n,,Arit
(A) (B) (C) (D) (E) (F)
Name and title Average Posit ion Reportable Reportable E stimatednoun per (do not check more than one compensation compensation from amount of
weak (list any box, unless person is both an from related other
hours for officer and a direclorltrusteeth i i ' compensatione organ zat ons
relatedi
o ;M
, D to 5 organization (W-2/1099- MISC) from theorgan zations 5 . (W-211099- MISC)Boned o c
a 757
0and related
erne)
°
organizations
w ^ o e
ea
48) MCCARTNEY, KEVIN----- ---------------------
40.00- ------SR VP, GOVERNMENT RELATIONS
------X 231,333. 38,489.
49) MCELROY, EVAN 40.00----------------------------------
SR VP, MKT & COMMUNICATIONS--------
X 210,937. 46,661.50) MISHRELL, WILLIAM E.-
40.00---------------------------------
SVP, PLANNING & MEASUREMENT------
X 202,112. 41,187.51) PICKENS, JUDITH--- -
40.00----------------- -------------SVP, PROG & YOUTH DEV SERVICE
------X 205,976. 42,109.
52) RANDOLPH, LYDIA 40.00_ _
VP,-RESOURCE DEVELOPMENT X 220,238. 24,815.53) SPILLETT, ROXANNE---------- --- ---------
40.00
----- --- -------
PRES EMERITUS, SR EXEC VP - 00 X 509,789. 34,986.
---------------------------------- --------
---------------------------------- ------
---------------------------------- ------
---------------------------------- ------
---------------------------------- ------
1b Sub-total ►c Total from continuation sheets to Part VII, Section A .. ... . . ..... . ►d Total add lines 1b and 1c ►
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 ofreportable compensation from the organization ► 81
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensatedemployee on line 1a? If "Yes,"complete Schedule J for such individual ... . . ... .. . .. . . .. . . . . .. .. .
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from theorganization and related organizations greater than $150,0007 If 'Yes,' complete Schedule J for suchindividual ........................................................... 4 X
5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individualfor services rendered to the org anization? If "Yes,'com lete Schedule J for such person 5 X
Section S. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 ofcompensation from the organization Report compensation for the calendar year ending with or within the organization's taxyear
(A)Name and business address
(B)Description of services
(C)Compensation
2 Total number of independent contractors (including but not limited to those listed above ) who receivedmore than $100,000 in compensation from the organization ►
YE 7055 3 000Form VISU (2012)
L q
50ZONY 1985 V 12-6F 430966n&E
^
ifa
Form 990 (2012) • BOYS & GIRLS CLUBS OF AMERICA • 13-5562976 Page 9
Statement of RevenueCheck if Schedule 0 contains a response to any question in this Part VII I
(A) (B) (c) (0)Total revenue Related or unrelated Revenue
exempt business excluded from taxfunction revenue under sections
-. . . ' revenue 512, 513, or 514
Is Federated campaigns . . . . . . . 1a rY
o
E
b Membership dues . . . 1 b 6, 630, 073.
c Fundraising events . . . . . . . I c 7,966,975. ^. ;
52 d Related organizations ..... .. 1d =
o e Government grants (contributions ) . Is 43,214,257.
f All other contribution , gifts, grants ,
p and similar amounts not included above . If 87 , 366 1119 .
g Noncash contnbut,ons Included in lines la- Ir. $ 2, 901 , 320.
v fO It Total . Add lines 1 a- If ► 145 ,177, 454.
Business Code - ' i
2a
m bu
c
ul d
e
o f All other program service revenue . . . . .
J; Total. Add lines 2a-2f . , ► 0
3 Investment income (including dividends, interest, and
other similar amounts) . . . . . . . . . . . . . . . . . . . ► 313,275. 313,275.
4 Income from investment of tax-exempt bond proceeds . . . ► 0
6 Royalties . . . . . . . . ► 101,993. 1 9 101,993.
() Real (ii) Personal
6a Gross rents . . - . . , 756,575 r :;'•.. T
b Less rental expenses . . 577, 854Z^
:A ; t y
c Rental income or (loss) . . 178 ,721
^
d Net rental income or (loss ) . ► 178, 721. 119, 131. 59,590
7a Gross amount from sates ofassets other than inventory
b Less cost or other basis
and sales expenses . . .
c Gan or ( loss) .. . ... .
(t) Securities (ii) Other
107,459,35S . f n ' J^.'••
102,938 , 635.
t- • ^ ~" `4,520 ,720. o - ^ ^ ^
d Net gain or (loss) . . . . . . . . . . . . . ► 4 , 520, 720. 4, 520, 720.
m Ba Gross income from fundraising
m events (not including $ 7, 966, 975.
m of contributions reported on tine 1c).
See Part IV, line 18 . . . . . . . . . . . a
°rL b Less direct expenses . . . . . . . . . . b
' ' ^ ,, -7jr4 + -" _ .•aCS^,! ^'f, k' i s '(,ti {^•{^•
. -
957, 946 . 1' r a •.
1, 988, 236 . f• = .:', e • a =,
0 c Net income or (loss) from fundraising events . ►
9a Gross income from gaming activities
See Part IV, line 19 . . . . . , . . . . . a
b Less direct expenses . . . . . . . . . . b
c Net income or (loss) from gaming activities . ►10a Gross sales of inventory, less
returns and allowances . . . . . . . . . a
b Less. cost of goods sold . . . . . . . . . bc Net income or loss from sales of inventory. . ►
Miscellaneous Revenue Business Code
11a SUPPLY SERVICE 900099
b MANAGEMENT & ADMINISTRATION FEES 900099
c MISCELLANEOUS 900099
d All other revenue . . . . . . . . . . . . .
e Total. Add lines 11 a-11d . . . . . . . . . . . . . . . . . ►
JsA2E 1051 1 000
502ONY 1985 V 12-6F
-1nin -on 1 , • = I I _i nin ,on
.-_tl.-
nl I I
503,213 .
I
503,213.
114, 167 . 114,167.
- 208,258. 5,322 -213,580.
409,122.
149,670 ,995 124 , 453. 4,369,088.
Form 990 (2012)
430966 nAP6E 42h.p
Form 990 (2012) BOYS & GIRLS CLUBS OF AMERICA 13-55629 7 6 Page 10Statement o unctlonal Expenses r
Section 501(c)(3) and 501(C)(4) organizations must complete all columns All other organizations must complete column (A),Check If schedule 0 contains a response to any auestion in this Part IX
Do not Include amounts reported on lines 6b,. 7b,8b 9b and 1t7b of Part Vttl.
( A)Tow e^enses
(B)Program service
expenses
(C)Management andg eneral expenses
(D)Fundraisingexpenses
I Grants and other assistance to governments and
organizations In the United States See Part IV, line 21 66, 013, 006. 66,013,006.
2 Grants and other assistance to individuals in
the United States See Part IV, line 22 ...... 52, 355. 52,355.
3 Grants and other assistance to governments,
organizations , and individuals outside the
United States See Part IV, lines 15 and 16,
4 Benefits paid to or for members ..... .. ,
5 Compensation of current officers , directors,
trustees, and key employees ...... .. , 3, 493, 265. 746, 993. 2, 501, 569. 244, 703.
6 Compensation not included above , to disqualified
persons (as defined under section 4958( f)(1)) and
persons described in section 4958(c)(3)(9)
7 Other salaries and wages . , , , , , , , , , 28, 085, 200. 19, 403, 882. 5, 525, 490. 3, 155, 828.
8 Pension plan accruals and contributions ( include section
......employer contributions ) . . . . 1 , 867, 791,1 , 8 6 7 , 7 9 1 1, 197, 103. 497, 178. 173, 510.
9 Other employee benefits . ... 4 , 899,111. 3,660,759. 873, 922. 365 030.
10 Payroll taxes . . . . . . . . 2, 134, 726. 1, 429, 592. 471, 987. 233,14T
11 Fees for services (non-employees)
.. . .. .... . . .a Management . . . .b Legal .......... . . . ....... 33, 083, 33, 083.
C Accounting ....... ...... ..... 470, 680. 150, 484. 320, 196.
d Lobbying 400, 833, 400, 833.
0 Professional fundraising services See Part IV, line 17 88,329. 88,329.
If investment management fees , , , , , , , 181,515 181, 515 .
8 Other . (n fine 110 amount seeds 10% of m a 25, column
(A)ant,nst line1iggen:eaonSchedule0 )..... 644, 289 3, 848, 223 787, 509. 8, 557.
12 Advertising and promotion .. ....... , 284,118 254, 399 29, 719.
1Oiftceexpenses ..... . ...... ...
.
214, 434 2, 515, 185 509, 613. 189, 636.
14 Information technology ... ......... 757, 095 521, 230 102, 853. 133, 012 .
15 Royalties . . . . . . . . . . . . . . . . . . .
16 Occupancy .. .. ........... ... 198, 402 876, 307 224, 219. 97, 876.
17 Travel ... ......... ........ , 789, 656, 3, 936, 379. 437, 631. 415, 646.
18 Payments of travel or entertainment expenses
for any federal, state , or local public officials
19 Conferences , conventions , and meetings , , . 2, 169, 294. 2, 084, 130. 48, 690. 36,474.
20 Interest ....... ... ....... .. 79, 682. 79, 682.
21 Payments to affiliates . . . . . . . . . . . . .
22 Depreciation , depletion , and amortization . . 1, 126, 528. 727, 258. 319, 917. 79, 353.
23 Insurance ................ . 411, 350. 61,361. 349, 989.
24 Other expenses Itemize expenses not covered
above ( List miscellaneous expenses in line 24e If
line 24e amount exceeds 10% of line 25 , column
(A) amount , list line 24e Pwenses on Schedule O)
SUPPLY SERVICES EXPENSES 403,851. 403,851.
bBANK SERVICES-FEES_______-_-- 116,304. 116,304.
DIRECT MAIL SUPPLIES _____ 44,349. 44,349.
dMISCELLANEOUS________________ 608,288. 397,665. 187,616. 23,007.
e All other expenses _________________
16 ex pe nses . throu g h 24e 127,568,134. ' 107, 920, 660. 14, 373, 647. 5,273,827.
N Joint costs . Complete this line only if theorganization reported in column (B) joint costsfrom a combined educational campaign andfundraising solicitation Check here ► O iffollowing SOP 98-2 (ASC 958- 720) , ,
J5A2E1052 1 000
5OZONY 1985 V 12-6F 430966
Form 990 (2012)
UZ ZAE .1;D3n g
• BOYS & GIRLS CLUBS OF AMERICA
Form 990 (2012)
• 13-5562976
Peae 11
nice SheetCheck if Schedule 0 contains a resnonse to any auestien in this Part X -
(A) (B)Beginning of year End of year
1 Cash - non-interest -bearing , , , , , , , , , , , , , , , , , 1 0
2 Savings and temporary cash investments 6,902, 911 2 8, 216, 289.
3 Pledges and grants receivable , net 1,333,133. 3 55,099,877.
4 Accounts receivable , net , , , , , , ,
.
962, 673. 4 3, 039, 237.
5 Loans and other receivables from current and former officers, directors,
.
trustees , key employees , and highest compensated employees.
Complete Part II of Schedule L ....................... 5 06 Loans and other receivables from other disqualified persons (as defined under section
4958 (f)(1)), persons described in section 4958( c)(3)(8). and contributing employersand sponsoring organizations of section 501(c)(9) voluntary employees ' beneficiaryorganizations (see instructions) Complete Part II of Schedule L 8
0
7 Notes and loans receivable, net .......,. 7 0
8 Inventories for sale or use 320,568. 8 368, 975.
9 Prepaid expenses and deferred charges .. . .. . .. . ... 749, 681. 9 1, 179, 771 .
10 a Land , buildings, and equipment cost or
other basis Complete Part VI of Schedule D 10a 35, 7 6 6, 931 .
b Less accumulated depreciation . .. . .. . . 10b 8, 921, 450. 396, 216. 10c 26, 845, 481 .
11 Investments - publicly traded securities ........... . .... . . 834, 638. 11 31, 942, 330.
12 Investments - other securities . See Part IV , line 11 .........
.
596, 141. 12 224 , 989, 050 .
13 Investments - program - related See Part IV , line 11 .... _ .. ... .. 13 0
14 Intangible assets . . . . .. .. . . . . .. . .. . . ....... .. . .. 14 0
15 Other assets See Part IV. line 11 . .. . , , , , _ _ 273, 007. 17, 446, 664 .
16 Total assets . Add lines 1 throu h 15 must a ual line 34 368, 968. 16 369, 127, 674 .
17 Accounts payable and accrued expenses .. . ..... 924, 275. 17 12, 989, 450.
18 Grants payable. , , , , , , , , , , , , , , , , , , , , , , , , , , , 18 0
19 Deferred revenue .............................. 19 0
20 Tax-exempt bond liabilities , , , , ,, , 5,187,500. 20 4, 781, 250.
21 Escrow or custodial account Lability. Complete Part IV of Schedule D 0, 965, 444. 21 11, 788, 799.
22 Loans and other payables to current and former officers, directors,
.
j trustees, key employees , highest compensated employees, and
disqualified persons Complete Part II of Schedule L 22 0
23 Secured mortgages and notes payable to unrelated third parties 23 0
24 Unsecured notes and loans payable to unrelated third parties , , 24 0
25 Other liabilities ( including federal income tax payables to related third
parties , and other liabilities not included on lines 17-24) Complete Part X
of Schedule D ... . 3, 530, 472. 25 3, 786, 269.
26 Total liabilities . Add lines 17 through 25.. . . . . . . . . . . . . . . . . 28, 607, 691. 26 33, 345, 768.
Organizations that follow SFAS 117 (ASC 958 ), check here ► X andd complete lines 27 through 29 , and lines 33 and 34.
27 Unrestricted net assets 151,678,367. 27 162, 016, 211.m 28 Temporarily restricted net assets
.
101 ,616,801. 28 140, 299, 086.
29 Permanently restricted net assets ................. . 33,466,109 . 29 33,466,609.
U. Organizations that do not follow SFAS 117 (ASC 958 ), check here 10, [J and
.
o complete lines 30 through 34.
30 Capital stock or trust principal , or current funds 3031 Paid - in or capital surplus , or land , building, or equipment fund 3132 Retained earnings , endowment , accumulated income , or other funds 32
Z 33 Total net assets or fund balances 286 ,761,277. 33 335, 781, 906.34 Total liabilities and net assets /fund balances .
.
315, 368, 968. 34 369, 127, 674 .
Form 990 (2012)
JSA2E1053 1 000
50ZONY 1985 V 12-6F 430966 FIE ^y4^ .^
r• BOYS & GIRLS CLUBS OF AMERICA •
Form 990 (2012)
13-5562976
P.. 12
Reconciliation of Net Assets
Check if Schedule 0 contains a response to any question in this Part XI .................. X
I Total revenue ( must equal Part Vlll, column (A), line 12) .... ..... .... . . .. . ... . . 1 149,670,995.
2 Total expenses (must equal Part IX, column (A), line 25) ..................... .. 2 127, 568, 134 .
3 Revenue less expenses . Subtract line 2 from line 1 ........ ... . ..... .. 3 22,102,861.
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ... . 4 286, 761, 277 .
5 Net unrealized gains (losses ) on investments .. .......... .... .. 5 27,378,078.
6 Donated services and use of facilities ........................ .... ... .. 6 0
7 Investment expenses ..... ........................... . .. .. ... .. 7 0
6 Prior period adjustments ... . .. .. .. ..... .. ... . . . ..... ... . . .. . ... . 8 0
9 Other changes in net assets or fund balances (explain in Schedule 0) ....... ......... 9 -460,310.
10 Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line33 , column B 10 335, 781, 906.
Financial Statements and ReportingCheck if Schedule 0 contains a response to any question in this Part XII ........ . ,
Yes No
1 Accounting method used to prepare the Form 990 E] Cash F-XJ Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other ," explain in
Schedule 0.
2a Were the organization's financial statements compiled or reviewed by an independent accountant?
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or
reviewed on a separate basis , consolidated basis , or both.
q Separate basis q Consolidated basis q Both consolidated and separate basis
b Were the organization ' s financial statements audited by an independent accountant) ....... ...... .
If "Yes," check a box below to indicate whether the financial statements for the year were audited on ase crate basis , consolidated basis , or both'
M Separate basis Xq Consolidated basis q Both consolidated and separate basis
c If 'Yes" to line 2a or 2b , does the organization have a committee that assumes responsibility for oversight
of the audit , review , or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in
Schedule 0
3a As a result of a federal award , was the organization required to undergo an audit or audits as set forth in
the Single Audit Act and OMB Circular A-133? .. . .. . .. .. ....... . . . . .. . .... .. . . . . .
b If "Yes ," did the organization undergo the required audit or audits? If the organization did not undergo the
2a X
2b X
2c X
3a X
3b X
Form 990 (2012)
JSA2E1054 1 000
50ZONY 1985 V 12-6F 430966 n d9AAE ,a
SCHIEDULE A(Form 990 or 990.EZ)
Department d the TreasuryInternal Revenue Service
•
Public Charity Status and Public SupportComplete If the organization Is a section 601(c )( 3) organization or a section
4947( a)(1) nonexempt charitable trust
► Attach to Form 990 or Form 990- EZ. ► See separate Instructions.
OMB No 1 545-0047
2012
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Reason for Public Charity Status All organ iz ations must complete this part . ) See instructions.The organization is not a private foundation because it is (For lines 1 through 11 . check only one box)
1 A church , convention of churches , or association of churches described in section 170 ( b)(1)(A)(i).2 A school described in section 170(b )( 1)(A)(ii). (Attach Schedule E )3 A hospital or a cooperative hospital service organization described in section 170(b )( 1)(A)(11l).4 A medical research organization operated in conjunction with a hospital descnbed in section 170(b )( 1)(A)(iii). Enter the
hospital ' s name , city, and state
5 E An organization operated for the benefit of a college or university owned or operated by a governmental unit described insection 170(b )( 1)(A)(iv). (Complete Part II )
6 A federal , state, or local government or governmental unit described in section 170 ( b)(1)(A)(v).7 An organization that normally receives a substantial part of Its support from a governmental unit or from the general public
described in section 170(b)(1)(A)(vi). (Complete Part II )8 A community trust described in section 170(b )( 1)(A)(vi). (Complete Part 11 )9 X An organization that normally receives . ( 1) more than 331,3 % of Its support from contributions , membership fees , and gross
receipts from activities related to its exempt functions - subject to certain exceptions , and (2 ) no more than 331/3% of itssupport from gross investment income and unrelated business taxable income (less section 511 tax) from businessesacquired by the organization after June 30, 1975 See section 509(a )( 2). (Complete Part 111.)
10 a An organization organized and operated exclusively to test for public safety . See section 509(a)(4).11 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the
purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a )(2). See section509 a ) 3). Check the box that describes the type of supporting organization and complete lines 11e through 11 ha Type l b EJ Type II c E] Type Ill- Functionally integrated d F I Type III- Non-functionally integrated
e E-1 By checking this box , I certify that the organization is not controlled directly or indirectly by one or more disqualifiedpersons other than foundation managers and other than one or more publicly supported organizations described in section509(a)(1) or section 509(a)(2)
f If the organization received a written determination from the IRS that it is a Type I , Type II, or Type III supportingorganization , check this box . . ... El
g Since August 17 , 2006 , has the organization accepted any gift or contribution from any of thefollowing persons
(I) A person who directly or indirectly controls , either alone or together with persons descr ibed In ( n) fYes No
and (In) below, the governing body of the supported organization? , . ... . . .. 11g(i)( ii) A family member of a person described in (I) above ? 119(11)
(Ill) A 35% controlled entity of a person described in (I) or (ii) above? 119111//h Provide the following information about the supported organization(s)
(i) Name of supportedorganization
(II) EIN (ill) Type of organization(described on lines 1-9above or IRC section(see Instructions))
(lv) is theore nll"n inoat 0) lamed nyour ao emmp
umem9
(v) Did you notifythe organization
In col (I) ofur suyo pport9
(vi) Is theorganization in
cif p) organizedin the U S 9
(VIl) Amount of monetarysupport
Yes No Yes No Yes No
(A)
(B)
(C)
(D)
(E)
TotalFor Paperwork Reduction Act Notice, see the Instructions forForm 990 or 990-EZ.
JSA
2E1210 1 000
50ZONY 1985
Schedule A (Form 990 or 990-2) 2012
V 12-6F 430966 n daP GE
0 BOYS 6 GIRLS CLUBS OF AMERICA 13-5562976Schedule A (Form 990 or 990-EZ) 2012 • Pa2
JIM Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to quality underPart Ill. If the organization fails to qualify under the tests listed below, please complete Part III )
Section A. Public Suonort
Calendar year (or fiscal year beginning In) ► (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
I Gifts, grants, contributions, andmembership fees received. (Do notinclude any 'unusual grants.) . ... .
2 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . . . . .
3 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge .. ... .
4 Total. Add lines 1 through 3. . . . . .
5 The portion of total contributions byeach person (other than agovernmental unit or publicly
• ;+ r" .
supported organization) included online 1 that exceeds 2% of the amount - ,shown on tine 11, column (I). . . . , .
6 Public support Subtract line 5 from line 4. =
Section 13. Total support
Calendar year (or fiscal year beginning In) ► (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4 . . . . . . . . .
8 Gross income from interest, dividends,payments received on securities loans,rents, royalties and Income from similarsources ........ ...... . .
9 Net income from unrelated businessactivities, whether or not the businessis regularly carried on . . . . . . . . .
10 Other income Do not include gain orloss from the sale of capital assets(Explain in Part IV) . . . . . . . . . ,
11 Total support. Add tines 7 through 10 . -
12 Gross receipts from related activities , etc (see instructions ) ..... . ... ... ..... .. ..... . 12
13 First five years . If the Form 990 Is for the organization ' s first, second, third, fourth , or fifth tax year as a section 501(c)(3)organization , check this box and stop hero ►n
Section C. Computation of Public Support Percentage
14 Public support percentage for 2012 ( line 6, column ( f) divided by line 11 , column ( f)) .. , ... • 14 %
15 Public support percentage from 2011 Schedule A, Part II, line 14 .. . .. . • . . . .. . ... . , 15 %
16a 33113% support test - 2012 . I f the organization did not check the box on line 13, and line 14 is 331/3 % or more, check
this box and stop here . The organization qualifies as a publicly supported organization . ... . . . . . .... ... .. .. ► q
b 33113 % support test - 2011 . If the organization did not check a box on line 13 or 16a, and line 15 Is 33113 % or more,
check this box and stop here . The organization qualifies as a publicly supported organization . . • . . . . .. . . . . . . .. ►17a 10%-facts -and-circumstances test - 2012 . If the organization did not check a box on line 13, 16a, or 16b, and tine 14 is
10% or more , and if the organization meets the " facts -and-circumstances" test, check this box and atop here. Explain in
Part IV how the organization meets the " facts-and -circumstances ' test The organization qualifies as a publicly supported
organization ... . ...... ........................... ..... ...... ......... .... ► qb 10%-facts -and-circumstances test - 2011 . If the organization did not check a box on line 13 , 16a, 16b , or 17a , and line
15 is 10% or more , and if the organization meets the "facts-and-circumstances " test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances " test The organization qualifies as a publicly
supported organization . .. . ... ... ... ... . ..... ... ... .. .... .. .. .. .. . . ... ... . . . . . ► q
18 Private foundation . If the organization did not check a box on line 13 , 16a. 16b , 17a, or 17b, check this box and see
instructions qSchedule A (Form 990 or 990-EZ) 2012
JSA
2E1220 1000V 12-6F 430966 E5OZONY 1985 ^ ^^ jj7^y,
• BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Schedule A ( Form 990 or 990- EZ) 2012 Page 3
Support Schedule for Organizations Described in Section 509(a)(2)(Complete only if you checked the box on line 9 of Part I or If the organization failed to qualify under Part II.If the organization fails to qual ify under the tests listed below , please complete Part II )
Section A. Public Suooort
Calendar year ( or fiscal year beginning in) ► (a) 2008 (b) 2009 (c) 2010 (d) 2011 (9)2012 (f) Total
1 Gdta, grants . contributions . and membership fees
received (Do not include any 'unusual grants ') 104, 602, 746 . 101, 681 , 077. 117, 534, 072. 104, 093, 749. 145, 177, 454. 573, 899,100.
2 Gross receipts from admissions , merchandise
sold or sereces performed, or facilities
fumished in any activity that is related to the
organization 's tax-exempt purpose . 447, 301. 426, 371. 581, 325. 705, 875. 957, 946. 3,118, 818
3 Gross receipts from activities that are not an
unrelated trade or business under section 513 0
4 Tax revenues levied for the
organization 's benefit and either paid
to or expended on its behalf . , . . D
6 The value of services or facilities
furnished by a governmental unit to the
organization without charge , , , , 0
6 Total. Add lines 1through 5, , • , 105,050,049 102,107,448. 118,115,397. 105,599,624 146,135,400. 577,007,918.
7a Amounts included on lines 1, 2, and 3
received from disqualified persons . . ob Amounts included on lines 2 and 3
received from other than disqualified
persons that exceed the greater of $5,000
or 1% of the amount on line 13 for the year 0
c Add lines 7e and 7b. . . . . . . . . 0
8 Public support (Subtract line 7c from
line 6. 577, 007, 918
Section B. Total Support
Calendar year ( or fiscal year beginning In)
9 Amounts from line 6. . . . . . . . . .10a Gross income from Interest, dividends,
payments received on securities loans,
rents, royalties and Income from similar
Sources . . . . . . . . . . . . . . . .
b Unrelated business taxable income (less
section 511 taxes) from businesses
acquired after June 30. 1975 , • , • , •
c Add lines 10a and 10b
11 Net Income from unrelated businessactivities not included in line 10b,whether or not the business is regularlycarried on • • • • • • • • • • • • •
12 Other Income Do not include gain or
loss from the sale of capital assets
(Explain in Part IV) ATCH .1. _ . .
13 Total support (Add lines 9, 10c• 11,
and 12) . . . . . . . . . . . . . . . .
( a) 2008 (b) 2009 (c) 2010 (d) 2011 ( e) 2012 ( f) Total
105,050 , 049 102 , 107,448. 118,115 , 397. 105 , 599,624 . 146,135,400 577,007,918.
2,550 , D21. 1 , 876,512 . 721,071 . 641,092. 1,171 , 843. 6 , 960,539.
02,550 , 021. 1 , 876,512 . 721,071 . 641,092 . 1,171, 643. 6 , 960,539.
708,637 . 611,642 . 102,632. 1,422,911.
997,536 . 1,182 , 981. 1 , 439,213. 1,381,739. 409,122. 5,410,591.
109,306 , 243. 105 , 778,563 . 120,275 , 681. 107,622,455 . 147,818 , 997.
►
590 , 801,959.
14 First five years . If the Form 990 is for the organization 's first, second, third, fourth , or fifth tax year as a section 501(c)(3)
organization , check this box and stop here. • ► n
Section C. Computation of Public Support Percentage
16 Public support percentage for 2012 ( line 8, column ( f) divided by line 13 , column (f)) 16 97.67%
16 Public support percentage from 2011 Schedule A, Part III, line 15 . . . . . . . . . . . . . . . . . . . . . . . 16 96.58%
Section D . Computation of Investment Income Percentage
17 Investment income percentage for 2012 ( line 10c, column ( f) divided by line 13 , column (f)) , , , , . . . 17 1.16%
18 Investment income percentage from 2011 Schedule A, Part 111, line 17 _ . . . . . is 2.01%
19a 331 13% support tests - 2012 . If the organization did not check the box on line 14, and line 15 is more than 331 /3%, and line
17 is not more than 331 / 3 %, check this box and stop here . The organization qualifies as a publicly supported organization ►b 33113% Support tests - 2011 . It the organization did not check a box on line 14 or tine 19a, and line 16 Is more than 33113%• and
line 18 is not more than 331 / 3 %, check this box and stop here. The organization qualifies as a publicly supported organization ►20 Private foundation . If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ►
2E1221 I 000
50ZONY 1985Schedule A (Form 990 or 990.EZ) 2012
V 12-6F 430966 n ZPA5E,^
• BOYS & GIRLS CLUBS OF AMERICA is 13-5562976.Schedule A (Form 990 or 990-EZ ) 2012 Page 4
Supplemental Information . Complete this part to provide the explanations required by Part II, line 10,Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (SeeInstructions)
ATTACHMENT 1
SCHEDULE A, PART III - OTHER INCOME
DESCRIPTION 2006 2009 2010 2011 2012 TOTAL
MISCELLANEOUS REVENUE 997 , 536. 1,182,981 1,439,213. 1 , 381,739 . 409,122 . 5,410,591.
TOTALS 907. 536_ 1 , 182.981 . 1,439 . 213. 1 . 391.739 . 409.122. 5.410,591.
JSASchedule A (Form 990 or 990.EZ) 2012
2 E 1225 1 000
5OZONY 1985 V 12-6F 430966 APOE 9
SCHEDULE C 0 Political Campaign and Lobbying Activitiell(Form 990 or 990-EZ) I
For Organizations Exempt From Income Tax Under section 501(c) and section 527
► Complete If the orgentzatfon Is described below . ► Attach to Form 990 or Form 990-EZ.Department of the TreasuryInternal Revenue Semca III- See separate instructions.
OMB No 154 5-0047
2012
If the organization answered "Yes," to Form 990, Part IV, line 3, or Form 990-E7, Part V , line 46 (Political Campaign Activities), then• Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C
• Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below Do not complete Part I-B
• Section 527 organizations Complete Part I-A only
It the organization answered "Yes," to Form 990, Part IV, line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
• Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A Do not complete Part II-B
• Section 501(c)(3) organizations that have NOT filed Form 5788 (election under section 501(h)) Complete Part II-B Do not complete Part II-A
If the organization answered "Yes," to Form 990, Part IV, line 5 (Proxy Tax) or Form 990-EZ , Part V, line 35c (Proxy Tax), then• Section 501(c)(4), (5). or (6) organizations Complete Part III
Name of organ ization E'mdevar ident,fic. llnn number
BOYS & GIRLS CLUBS OF AMERICA 1 13-5562976
Complete if the organization is exempt under section 501 (c) or is a section 527 organization.1 Provide a description of the organization's direct and indirect political campaign activities in Part IV2 Political expenditures . . . . .. . .. . . ......... ... . . . . . .. .. . . .. .. .. ► $3 Volunteer hours .. .. .. ... ... .. . . . .. .. . . ... ... .. . ... . ... ..... .
ORM; Complete if the organization Is exempt under section 501 (c)(3).
I Enter the amount of any excise tax incurred by the organization under section 4955. . .... ► $2 Enter the amount of any excise tax incurred by organization managers under section 4955 . ► $3 If the organization incurred a section 4955 tax, did it file Form 4720 for this year? , , , , , , , , , , , , , , , , Yes H No4a Was a correction made? . ... ... . ... Yea Nob If "Yes," describe in Part IV
1;M-11@1 Complete if the organization is exempt under section 501(c ), except section 501 (c)(3).
I Enter the amount directly expended by the filing organization for section 527 exempt functionactivities ....... ... ...... ............... .. .. .... ........ ► $
2 Enter the amount of the filing organization's funds contributed to other organizations for section527 exempt function activities . . . . . . . . . . . . . . . . . . . . .. .. .. . . . . . .... ► $
3 Total exempt function expenditures Add lines 1 and 2 Enter here and on Form 1120-POL,line 17b ............................................... $
4 Did the filing organization file Form 1120-POL for this year? . .. . . . . .. .. .. . . . .. . . . . . . . . . Yes U No5 Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments For each organization listed, enter the amount paid from the filing organization's funds Also enterthe amount of political contributions received that were promptly and directly delivered to a separate political organization, suchas a separate segregated tuna or a political action committee (PAC). If additional space is needed , provide information in Part IV
(al Name (b) Address (c) EIN (d ) Amount paid from (e) Amount of politicalfiling organization ' s contributions received and
funds . If none, enter -0- promptly and directlydelivered to a separatepolitical organization. If
none, enter -0-
(1) ----------------------
(2) ---------------------
(3) ---------------------
(4) -----------------------
-----------------------
16) ---------------------
rur raperwom Kecucaon Act nonce , see me Instructions for Form 990 Or 990-EL
JSA2 E 1264 1 000
Schedule C (Form 990 or 990-E2) 2012
50ZONY 1985 V 12-6F 430966 aPAGEdIa ,2
Schedule C ( Form 990 or 990-EW2 BOYS & GIRLS CLUBS OF AMERICA _ 13-55629 7 6 Page 2Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election undersection 501(h)).
A Check ► if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member'sname, address, EIN, expenses, and share of excess lobbying expenditures)
B Check ► if the filin g org anization checked boxA and "limited control" p rovisions aLimits on Lobbying Expenditures (a) Filing (b) Affiliated
(The term " expenditures" means amounts paid or incurred .) organization 's totals group totals
Is Total lobbying expenditures to influence public opinion (grass roots lobbying) , , , ,
b Total lobbying expenditures to influence a legislative body (direct lobbying) , , . , ,
c Total lobbying expenditures (add lines la and 1b) , , , , , , , , ,, , , , , , , , , ,
d Other exempt purpose expenditures , ,,,,, , , , , , , , , , , , , , , , , , , ,
e Total exempt purpose expenditures (add lines 1c and 1d), , , , , , , , , , , , , , ,
If Lobbying nontaxable amount. Enter the amount from the following table in both
If the amount on line 1e , column (a) or (b) Is:l The lobbying nontaxable amount Is:
Not over $ 500,000 20% of the amount on line le
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 $1,000,000
Over $1 , 500,000 but not over $ 17,000 , 000 $225 ,000 plus 5% of the excess over $ 1 , 500,000
Over $17,000 , 000 $1 , 000 ,000
g Grassroots nontaxable amount (enter 25% of line 1 f) , , ,,, , , , , , , , , , , ,
h Subtract line 1 g from line 1 a If zero or less, enter -0
i Subtract line If from line 1c If zero or less, enter -0- , , , , , , , , , , , , , , ,, , ,
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 -I I--Ireporting section 4911 tax for this year? ,
I-
I I Yes ' I No
4-Year Averaging Period Under Section 501(h)(Sonme organizations that made a section 501(h) election do not have to complete all of the five
columns below . See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal yearbeginning in)
(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
2a Lobbying nontaxable amount
b Lobbying ceiling amount
(150% of itne 28, column (e))
c Total lobbying expenditures
d Grassroots nontaxable amount
e Grassroots ceiling amount
(150% of Iine 2d, column (e))
-
I Grassroots lobbying expenditures
Schedule C (Form 990 or 990-EZ) 2012
JSA2E 1265 1 000
50ZONY 1985 V 12-6F 4309660 fflw 25n 'o
• BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Schedule C (Form 990 or 990-E2) 2012 Page 3
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768(election under section 501(h)).
F "Y "(a) Ib)
or each es, response to lines la through. 1 t below, provide in Part IV a detaileddescription of the lobbying activity Yes No Amount
I During the year, did the filing organization attempt to influence foreign, national, state or locallegislation, including any attempt to influence public opinion on a legislative matter orreferendum, through the use of
a Volunteers? ......... X.... .................................
b Paid staff or management (include compensation in expenses reported on lines 1 c through 11)? X -
c Media advertisements? -........................................ X
d Mailings to members, legislators, or the public? ..... X 6,352.......................
e Publications, or published or broadcast statements? X.......................f Grants to other organizations for lobbying purposes? . , . X 202, 500.g Direct contact with legislators, their staffs, government officials, or a legislative body? X 360,872.
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means9. X
I Other activities? ................................... ... X. ....gh 11j Total Add lines 1c throu 569,724.
2 a Did the activdles in line 1 cause the organization to be not described in section 501(c)(3)? . ,b If "Yes," enter the amount of any tax incurred under section 4912 , , , , , , , , , , , , , ,
.
c If "Yes," enter the amount of any tax incurred by organization managers under section 4912d -If the filin g org anizationanization incurred a section 4912 tax, did it file Form 4720 for this year? . .
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section501 (c)(6).
I Were substantially all (90% or more) dues received nondeductible by members? 12 Did the organization make only in-house lobbying expenditures of $2,000 or less?' - - - - - - - - - 2
3 Did the organization agree to carry over lobbying and political expenditures from the prior year? 3
JjM3M Complete if the organization Is exempt under section 501 ( c)(4), section 501(c)(5), or section
501(c )( 6) and if either (a) BOTH Part III-A, lines I and 2 , are answered "No," OR (b) Part III-A, line 3, isanswered "Yes."
I Dues, assessments and similar amounts from members 1............................2 Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of
political expenses for which the section 627( f) tax was paid).
a Current year .. .... ..... ...... ............... ........ . .......... 2ab Carryover from last year . .. . . ... .. ... ......... ... . .. .. .... .... 2b
c Total . .. ... . ... . . . ... 2c3 Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues , .. 34 If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the
excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying
and political expenditure next year? .. 45 Taxable amount of lo bbying and political expenditures (see instructions) . . . . . .. .... .. ... ... 5
enta
Complete this part to provide the descriptions required for Part I-A, line 1, Part I -B, line 4 , Part I-C , line 5, Part II-A (affiliated grouplist), Part 1l-A, line 2 , and Part II - B, line 1 Also, complete this part for any additional information
-S-9f-PA---GE--
4-----------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------
JSA Schedule C (Form 990 or 990-EZ) 20122E1266 1 000
50ZONY 1985 V 12-6F 430966 PANE o?a6^.^
BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Schedule C (Form 99D or 990•EZ) 2012 Page 4
Supplemental Information (continued)
DESCRIPTION OF LOBBYING ACTIVITIES
PART II-B, LINE 1
FEDERAL LOBBYING PAYMENTS - PAID TO LOBBYISTS $155,833
STATE LOBBYING PAYMENTS - PAID TO LOBBYISTS $ 42,500
STATE LOBBYING PAYMENTS - PAID TO AFFILIATED ORGANIZATIONS $202,500
POSTAGE AND SHIPPING EXPENSES $6,352
OTHER $162,539
TOTAL LOBBYING EXPENSES $569,724
SSA Schedule C (Form 990 or 990-EZ) 2012
2E1500 1 00050ZONY 1985 V 12-6F 430966 AaE .4^7n .1
•SCHEDULED
Supplemental Financial Statements(Form 990)If the organization answered "Yes," to Form 990.
Departmentof the TreasuryPart IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, lid, lie, 11f, 12a, or 12b.
Internal Revenue Service ► Attach to Form 990. ► See separate instructions.Name of the organization
BOYS & GIRLS CLUBS OF AMERICA
Employer Identification number
13-5562976
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts . Complete if theorganization answered "Yes" to Form 990. Part IV. line 6.
(a) Donor advised (b) Funds and other accounts
I Total number at end of year ....... ... .2 Aggregate contributions to (during year) .. .3 Aggregate grants from (during year) ...... .
4 Aggregate value at end of year...... ... .5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ... . . .. ... . q Yes q No6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used
only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose
Conservation Easements . Complete if the organization answered "Yes" to Form 990, Part IV, line 71 Purpose(s) of conservation easements held by the organization (check all that apply)
Preservation of land for public use (e g , recreation or education) Preservation of an historically important land areaProtection of natural habitat Preservation of a certified historic structure
l-1 Preservation of open space2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation
easement on the last day of the tax year.
Held at the End of the Tax Year
a Total number of conservation easements ... ...... . . .. ... . ... ... ... 2a
b Total acreage restricted by conservation easements ...... .... ........... 2b
c Number of conservation easements on a certified historic structure included in (a) .. . .. 2c
d Number of conservation easements included in (c) acquired after 8/17106, and not on ahistoric structure listed in the National Register ... ... . .. . . . . . ... .. . .. . .. 2d .
3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during thetax year ► _________________
4 Number of states where property subject to conservation easement is located ► _________________5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds? . .. .... .... ... ... . . . .. . q Yes q No6 Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
-----------------No-
7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .. ... .. ........... ... .. .... . ... . ... ... ... ... q Yes q No
9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, andbalance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes theorganization's accounti ng for conservation easements
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheetworks of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance ofpublic service, provide the following amounts relating to these items(i) Revenues included in Form 990, Part VIII, line 1 .... . . . .. . . . .... . .. .. .... . . . . ► $ -------------(h) Assets included in Form 990, Part X . ...... .. . .. . .. . .. .... .... ... ..... . ► $_____________
2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide thefollowing amounts required to be reported under SFAS 116 (ASC 958) relating to these items
a Revenues included in Form 990, Part VIII, line 1 ... ... ... .. . . ..... ... . ...... ... ► $__________---b Assets included in Form 990, Part X $
For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule D (Form 990) 2012JSA
2E 1268 1 000
50ZONY 1985 V 12-6F 430966 PAGEn2;A
OMB No 154 5-004 7
X012
Schedule D (Form 990) 2012
i BOYS & GIRLS CLUBS OF AMERICA • 13-5562976.
ons Maintaining Collections of Art , Historical Treasures, or Other Similar Assets (co,
3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of itscollection items (check all that apply)
a Public exhibition d Loan or exchange programs
b Scholarly research e 8 Other--------------------------------------
c Preservation for future generations
4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part
XIII
5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar
assets to be sold to raise funds rather than to be maintained as part of the or amzatlon's collection? . Yes NoEscrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990, Part IV,line 9, or reported an amount on Form 990, Part X, line 21
Is Is the organization an agent , trustee , custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? .. , .. , , U Yes 11 Nob If "Yes ," explain the arrangement in Part XIII and complete the following table
Amount
c Beginning balance .. . ... . . .... ... .... .. ... . . . ... . . Ic
d Additions during the year ............................. Id
e Distributions during the year .. ..... .... ... .. .. . ...... . . 1e
f Ending balance ....... ............................ it
2a Did the organization include an amount on Form 990 , Part X , line 217 .. .. X Yes No
b If "Yes ." explain the arrangement in Part XIII Check here if the explanation has been provided in Part XIII. X
fff lVJ Endowment Funds . Complete if the oraanization answered "Yes" to Form 990. Part IV. line 10
1a Beginning of year balance .. .
b Contributions .......... .
c Net investment earnings, gains,
and losses ... . ... ... . .
d Grants or scholarships ......
e Other expenditures for facilities
and programs ........ .. .
f Administrative expenses .... .
g End of year balance . . ... ..
(a) Current year ( b) Prior year (c) Two years back ( d) Three years back (e) Four years beck
2 08, 120, 980. 239,393,023. 216,895,687. 174,055,008. 91,576,863500. 500. 500. 1,000.
32,193,419. -20,769,532. 34,009,065. 46,865,949. -20,513,302169,785. 359,134. 659,500. 307,300.
14,928,082. 10,143,877. 10,852,729. 3,718,970. 3,434,148
225, 217, 032. 208, 120, 980. 239,393,023. 216, 895, 687. 67, 629, 413
2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as
a Board designated or quasi-endowment ► 60.0000%
b Permanent endowment ► 15.0000 %
c Temporarily restricted endowment ► 25.0000 %
The percentages in tines 2a, 2b, and 2c should equal 100%.
3a Are there endowment funds not in the possession of the organization that are held and administered for the
organization by Yes No
(1) unrelated organizations ............................................... 3a(i) X
(ii) related organizations ..... . .. .. .... . .. .. . . .. ... .. . . . .. . . ... . . . . .. . . . . 3a(U) X
b If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? . .... ..... . . .. . . . . 3b
4 Describe in Part XIII the intended uses of the organization's endowment funds
IMIM 1 and_ Ruildlnas. and Eauiement. See Form 990. Part X line 10
Description of property ( a) Cost or other basis(investment )
( b) Cost or other bests( other)
(c ) Accumulateddepreciation
(d) Book value
1a Land ..... ... ........... 10, 848, 690 10, 848, 690.
b Buildings ........... ..... • 18, 229, 740 3,073,903 . 15,155, 837.
c Leasehold improvements.......... 404, 583 212, 440 192, 143.
d Equipment ... ............. 3,650, 944 3,323,503 327, 442.
e Other 2,632, 974 2,311,604 321, 369.
Total . Add lines I a throug h le (Column (d) must equal Form 990, Part X, column (B) , line f 0(c) . ► 2 6, 845, 481.
Schedule D (Form 990) 2012
JSA
201269 1 000
50ZONY 1985 V 12-6F 430966 nAASE L49jy^
BOYS & GIRLS CLUBS OF AMERICA
Sa.dule 0 (Form 99012012
• 13-55629763
Investments - Other Securities . See Form 990, Part X line 12.( a) Description of security or category ( b) Book value (c) Method of valuation.
(including name of secunty) Cost or end-of-year market value
(1) Financial derivatives . .... . . .. . . . .. . .
(2) Closely-held equity interests .. . ... . ... , ,
(3) Other------------------------------(A)LIMITED PARTNERSHIPS --------- FMV
(B)ALTERNATIVEQUITY INVESTMENTS 19,6B0,599. FMV
(C)INVESTMENTS IN TRUSTS 43,222,983. FMV--D)FIXEDINOME SECURITIES 41,068,946. FMV
(EINVESTMENTS IN COMMUNITY FDN 32,555. FMV---(F)
(G)(H)
Total. (Column (b) must equal Fomf 990, Parr X, col (8) dne 12 )
-120,983,967.
224, 9B9, 050 4
FUNWM investments - Proaram Related . See Form 990- Part X line 13
(a) Description of investment type (b) Book value (c) Method of valuationCost or end-of-year market value
(1}
(2)(3) -(4)(5)(8)(7)
(8)(9)
(10)
Total . (Column (b) must equal Form 990, Part X, cot (B) bne 13) ►
nM.NVO Other Assets . bee Form 990. Part X. line 15
(a) Description ( b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)(9)
(10)
Total. (Column b must equal Form 990, Part X, col (B) line 15 ) ►Other Liabilities . See Form 990 , Part X, line 25.
1. (a) Description of liability ( b) Book value^ }^F•: ^ It ^'•
( 1 ) Federal income taxes^ ^Y _ ,`
4M CHARITABLE ANNUITI ES PAYABLE 2,297,679 .
4,`,^gs-'f -
( 3 ) DEFERRED COMPENSATION
AGREEMENTS 457(Bq ) 1, 407, 424. _ '• -,,,.:K. .^ ^.a(5)CAPITAL LEASE OBLIGATIONS 81,166.
r10 pw. . '
Total (Column (b) must equal Form 990, Part X, col (B) Ane 25.) ► 3,786,269.
2. FIN 48 (ASC 740) Footnote In Part XIII, provide the text of the footnote to the organization ' s financial statements that reports the organization'sliability for uncertain tax positions under FIN 48 (ASC 740) Check here if the text of the footnote has been provided in Part XIII. . n
1270 1 000 Schedule D (Form 990) 20125OZONY 1985 V 12-6F 430966 n AA E
Schedule D (Form 990) 2012
Reconciliation of Revenue per Audited Financial Statements With Revenue per ReturnI Total revenue, gains, and other support per audited financial statements 1 177, 166, 629.2 Amounts included on line 1 but not on Form 990, Part VIII. line 12.a Net unrealized gains on investments .. .............. 2; 27,378,078.b Donated services and use of facilities 2bc Recoveries of prior year grants 2cd Other (Describe in Part XIII) . . . 2d 606,177.
e Add lines 2a through 2d . .... . ....... . ............... ... ......... 2e 27, 984, 255.3 Subtract line 2e from line I ......................... 3 149, 182, 3646--T-4 Amounts included on Form 990, Part VIII, line 12, but not on line 1,
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4ab Other (Describe in Part XIII) 4b 488,631.c Add lines 4a and 4b 4c 488, 631.
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part 1, line 12. 149, 670, 995.ONM. Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
I Total expenses and losses per audited financial statements .......... ...... 1 128, 145, 990.2 Amounts included on line 1 but not on Form 990, Part IX, line 25.
........
a Donated services and use of facilities 2a
b Prior year adjustments .. 2b
c............................
Other losses 2c
d....................................
Other (Describe in Part XIII.) 2d 577, 856.
e Add lines 2a through 2d 2e 577, 656.3 Subtract line 2e from line I ....... ..... ............... .. . .
. .... . .. 3 127, 568, 134 .
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b 4ab Other (Describe in Part XIII) . . .... 4bc
.. . ..................Add lines 4a and 4b 4c
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part!, line 18) .. . . .
...... ... . . . ......... 5 127, 568, 134.
Supplemental InformationComplete this part to provide the descriptions required for Part II, lines 3 , 5, and 9 , Part III, lines la and 4 : Part IV, lines lb and 2b,Part V, line 4, Part X, line 2, Part XI, lines 2d and 4b , and Part XII, lines 2d and 4b Also complete this part to provide any additionalinformation.
SEE PAGE 5
• BOYS & GIRLS CLUBS OF AMERICA
-- --------------------------------------------------- -----------------------------
• 13-5562976
Pace 4
Schedule D (Form 990) 2012
JSA
2 E l 271 1 000
50ZONY 1985 V 12-6F 430966 n ^ i
Schedule D (Form 12 _ BOYS & GIRLS CLUBS OF AMERICA
Information
ENDOWMENT FUNDS
F 13-5562976 Pape 5
SCHEDULE D, PART V, QUESTION 4
BOYS & GIRLS CLUBS OF AMERICA'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED
FOR A VARIETY OF PURPOSES, INCLUDING BOTH DONOR-RESTRICTED AND
UNRESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF
GOVERNORS TO FUNCTION AS ENDOWMENTS. INCOME FROM THE ENDOWMENTS IS USED
IN ACCORDANCE WITH THE DONOR STIPULATIONS FOR PROGRAMS; IN THE ABSENCE OF
ANY DONOR STIPULATIONS, THE INCOME IS USED TO SUPPORT THE MISSION OF THE
ORGANIZATION, ACCORDING TO THE SPENDING POLICY ESTABLISHED BY BGCA'S
BOARD OF GOVERNORS.
INVESTMENT MANAGEMENT
SCHEDULE D, PART VII
BGCA HAS A SOPHISTICATED AND ACTIVE INVESTMENT COMMITTEE COMPRISED OF
BOARD VOLUNTEERS (GOVERNORS AND TRUSTEES) WHO HAVE EXTENSIVE INVESTMENT
MANAGEMENT EXPERIENCE. THE COMMITTEE MEMBERS RECEIVE NO COMPENSATION, PAY
THEIR OWN EXPENSES AND ARE SUBJECT TO THE "ETHICS AND CONFLICT OF
INTEREST POLICY" FOR BOARD MEMBERS AS ESTABLISHED BY BGCA'S BOARD OF
GOVERNORS. THE COMMITTEE WORKS CLOSELY WITH A LEADING NATIONALLY
REPUTABLE INDEPENDENT CONSULTING FIRM IN MAKING APPROPRIATE ASSET
ALLOCATION DECISIONS AND HIRING INVESTMENT MANAGERS WITH CONSISTENT AND
PROVEN TRACK RECORDS.
Schedule D (Forth 990) 2012
JSA
201226 2 000
50ZONY 1985 . V 12-6F 430966 ^A E E12n
Schedule D
FIN 48 FOOTNOTE
SCHEDULE D, PART X, QUESTION 2
BOYS & GIRLS CLUBS OF AMERICA IS RECOGNIZED AS AN ORGANIZATION EXEMPT
FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE
CODE ( THE CODE) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C )(3) WHEREBY
ONLY UNRELATED BUSINESS INCOME , AS DEFINED BY SECTION 512(A )( 1) OF THE
CODE, IS SUBJECT TO FEDERAL INCOME TAX . DURING 2012 AND 2011, $137,715
AND $-0-, RESPECTIVELY , WERE PROVIDED FOR INCOME TAXES.
RECONCILIATION OF REVENUE
SCHEDULE D, PART XI, QUESTION 2D
RENT EXPENSE RECLASS $577,853
CHANGE IN VALUE - CHARITABLE GIFT ANNUITY $ 28,324
TOTAL $606,177
SCHEDULE D, PART XI, QUESTION 4B
RENT PER FASB RULES $488,631
RECONCILIATION OF EXPENSES
SCHEDULE D, PART XII, QUESTION 2D
RENT EXPENSE RECLASS $577,856
Schedule 0 (Form 990) 2012
JSA
2E1226 2 000
5OZONY 1985 V 12-6F 430966 ZIWE S13d',
Schedule 0 (Form 990) 2012 BOYS & GIRLS CLUBS OF AMERICA F 13-5562976 page 5
CUSTODIAL FUNDS
SCHEDULE D, PART IV, LINE 2B
BOYS & GIRLS CLUBS OF AMERICA HAS CUSTODY OF CERTAIN ASSETS WHICH ARE
BEING HELD AND DISBURSED ONLY ON INSTRUCTIONS OF THE PERSON OR
ORGANIZATION FROM WHICH THEY WERE RECEIVED. THESE CUSTODIAL FUNDS AND
RELATED OBLIGATIONS ARE INCLUDED IN THE STATEMENT OF FINANCIAL POSITION;
HOWEVER ADDITIONS TO/DISBURSEMENTS FROM THESE FUNDS ARE NOT CONSIDERED
PART OF BGCA'S OPERATIONS.
Schedule 0 (Form 990) 2012
JSA
2E 1220 2 000
5OZONY 1985 V 12-6F 430966 n &W Hn -a
0 •SCHEDULE F Statement of Activities Outside the United States(Form 990)
► Complete If the organization answered "Yes" to Form 990,Part IV, line 14b , 15, or 16.
Department of the Treasury ► Attach to Form 990. ► See separate Instructions.Internal Revenue SeanceName of the organization
BOYS & GIRLS CLUBS OF AMERICA
OMB No 1545.0047
X012
Employer IdentJficatlon number
13-5562976
.+a,........ .. W.•' • ...•_,- •---•--^ ...` ......ww vaa%w . -111FIcte " Lira uiyarnediwn anaweueru Ias wForm 990, Part IV, line 14b
I For grantmakers . Does the organization maintain records to substantiate the amount of its grants and otherassistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award thegrants or asslstance& . . . . ................ . ..... .. . .. . . . . . ..... . . . .. . . Yes No
2 For grantmakers . Descnbe in Part V the organization's procedures for monitoring the use of its grants and otherassistance outside the United States.
3 Activities Der Reglon . (The following Part I. line 3 table can be duollcated if additional space is needed )(a) Region ( b) Number of
offices in theregion
(c) Number ofemployees,agents , andindependentcontractors
In region
(d) Activities conducted inregion (by type ) (e p.,
fundraising, program services ,investments.
grants to recipientslocated in the region)
(a) If activity listed in (d) isa program service ,
describe specific type ofservice ( s) in region
(f) Totalexpenditures forand investments
in region
1 CENTRAL AMERICA/ CARIBBEAN INVESTMENTS 9,558,512.
Z
( 3 )
4
( 5 )
( 6 )
( 7)
8
( 9 )
( 10 )
( 11 )
( 12 )
13
( 14 )
( 15 )
( 16 )
( 17)
3a Sub - total, , ... .. , , . . 9, 558, 512.
b Total from continuation
sheets to Part I . .. .. . .
c Totals (add l ines 3a a nd 3b ) 9, 558, 512.For Paperwork Reduction Act Notice, see the Instructions for Form 990.
JSA2 E 1274 1000
50ZONY 1985 V 12-6F
Schedule F (Form 990) 2012
430966 R aE1GEUj*,-a
BOYS & GIRLS CLUBS OF AMERICA 13-5562976Schedule F (Form 990 ) 2012 Page 2
Grants and Other Assistance to Organizations or Entities Outside the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 15, for any recipie nt who received more than $5,000 Part II can be duplicated if additional space is needed
1 (a) Name of (b) IRS code (c) Region ( d) Pu rpose of ( Amount of (f) Manner of (g) Amount of (h) Description0) Method ofvalk
organization section and EIN grant cashh gran t cash non-=It of non-cash (book. FMV,(if applicable ) disbursement assistance assistance appraisal,
other
1 - '
( 2)
3
4
5 -
6 •
-( 9 ) .. •
• f( 10 )
«`
.."
18
E
•
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exemptby the IRS, or for which the grantee or counsel has provided a section 501 (c)(3) equivalency letter. • • • • • • • • • • • • • • • • ►
3 Enter total number of other organizations or entities .. ►Schedule F (Form 990) 2012
JSJ,
]2 E t 275 1 000
50ZONY 1985 V 12-6F 430966 PAGE 36
BOYS & GIRLS CLUBS OF AMERICA 13-5562976Schedule F (Form 990 ) 2012
Pape 3
jj= Grants and Other Assistance to Individuals Outside the United States . Complete if the organization answered "Yes" to Form 990, Part IV, line 16.Part III can be duplicated if additional space is needed.
Z
(a) Type of grant or assistance (b) Region (c) Number ofrecipients
(d) Amount ofcash grant
(a) Manner ofcash
disbursement
(1) Amount ofnon-cashassistance
(g) Descriptionof non-cashassistance
(h) Method ofvaluation
(book, FMV,appraisal.oth er)
1
( 2 )
3
4
5
( 6 )
7
( 8 )
( 9 )
10
11
12
13
14
15
( 16 ) *
( 17 )
( 18 )
Schedule F (Fomr 990) 2012
JSA
n 2 E 1276 1 000
A 50ZONY 1985 V 12-6F 430966 PAGE 37
•
0
0 BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule F(Form 990 ) 2012 page 4
Foreign Forms
I Was the organization a U S transferor of property to a foreign corporation during the tax year? If Yes,'
the organization may be required to file Form 926, Return by a US Transferor of Property to a Foreign
Corporation (see instructions for Form 926) . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . Yes q No
2 Did the organization have an interest in a foreign trust during the lax year? If 'Yes.' the organization
may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and
Receipt of Certain Foreign Gifts , and/or Form 3520-A, Annual Information Return of Foreign Trust With a
U S Owner (see Instructions for Forms 3520 and 3520 -A) . . . . . . . . . . . . . . . . . . . . . . . q Yes No
3 Did the organization have an ownership interest in a foreign corporation dunng the tax year? If Yes.'
the organization may be required to file Form 5471, Information Return of US Persons With Respect To
Certain Foreign Corporations (see Instructions for Form 5471) , , , , , , , , , , , , , , , , , , , , , q Yes No
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a
qualified electing fund during the tax years If 'Yes,' the organization may be required to file Form 8621,
Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing
Fund (see Instructions for Farm 8621 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Yes q No
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If Yes,'
the organization may be required to file Form 8865, Return of US Persons With Respect To Certain
Foreign Partnerships (see Instructions for Form 8865) , , , , , , , , , , , , , , , , , , , , , , , , . q Yes a No
6 Did the organization have any operations In or related to any boycotting countries during the tax year? If
'Yes,' the organization may be required to file Form 5713 , International Boycott Report (see Instructions
for Form 5713) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q Yes a No
Schedule F (Form 990) 2012
JSA
2E1277 1 000
50ZONY 1985 V 12-6F 430966 n ZA^E A%
• BOYS & GIRLS CLUBS OF AMERICA • 13-5562976Schedule F (Form 990 ) 2012 Page
Supplemental InformationComplete this part to provide the information required by Part I, line 2 (monitoring of funds ), Part I, line 3, column (f)(accounting method , amounts of investments vs expenditures per region ), Part It, line 1 ( accounting method), Part III(accounting method), and Part Ill , column (c) (estimated number of recipients ), as applicable Also complete this part toprovide any additional information (see instructions)
Schedule F ( Form 990) 2012!SA
4E1502 1 .000 A
5OZONY 1985 V 12-6F 430966 E1
SCHEDULE G Supplemental Information Regarding •(Form 990 or 990-EZ) Fundraising or Gaming Activities
Complete If the organization answered -Yea" to Fonn 990, Part IV, lines 17, 18, or 19, or if theDepartment of the Treasury organization entered more than $ 16,000 on Form 990-EZ, line 6a.Internal Revenue Service ► Attach to Form 990 or Form 990-EL ► See separate Instructions.
Name of the organization
OMB No 154 5-0047
2012
Employer IdentIficatIon number
BOYS & GIRLS CLUBS OF AMERICA 13-55629 7 6
Fundraising Activities . Complete if the organization answered "Yes" to Form 990 , Part IV, line 17.
Form 990- EZ filers are not required to complete this part
I Indicate whether the organization raised funds through an of the following activities . Check all that apply
a X Mail solicitations e
ESpecial
of non-government grants
b X Internet and email solicitations f X Solicitation of government grants
c Phone solicitations g X Special fundraising events
d X In-person solicitations
2a Did the organization have a written or oral agreement with any individual ( including officers , directors , trusteesor key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? Q Yes q No
b If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to becompensated at feast $5,000 by the organization
0) Name and address of individualil Activity
011) Did fundralser haveorcustody or control m') Gross receipts
(v) Amount paid
to(or retained by) (W) Amount paid to
(or retained by)or entity (tundraoer)
contributions?from activity fundraiser listed in
organizationcol 0)
Yes NoI EVENT
LEVY, PAZZANTI & ASSOCIATES COORDINATOR X 981,289 22,500 958,789.
2
MURAD AUCTION GROUP AUCTION X 293,500 7,800 285,700.
3 TEXT TO
SOPHIST PRODUCTIONS, INC. PLEDGE X 94,900 10,200 84,700.
4 DONOR
BREWER DIRECT, INC. CULTIVATION X 147,453 30,000 117,453.
5 ONLINE
GREATER GIVING, LLC FUNDRAISING X 213,165 9,273 203,892.
6
7
8
9
40
Total ► 1,730,307 79,773 ] 1, 650, 534.3 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from
registration or licensing
AL,AK,AZ,AR,CA,CO,CT,DE,DC,FL,GA,HI,ID,IL,IN,
KS, KY, LA, ME, MD, MA , MI, MN , MS, MO, MT, NV , NH, NJ, NM, NY, NC, ND, OH,OK,OR,PA,RI,SC,5D,TN,TX,UT,VT,VA,WA,WV,WI,
Paperwork Reduction Act Notice . see the Instructions for Form 990 or 990-EL Schedule G (Form 990 or 990-M 2012JSA
2E12811000
50ZONY 1985 V 12-6F 430966 0^ ®PGErv4A
BOYS & GIRLS CLUBS OF AMERICA • 13-5562976.Schedule G (Form 990 or 990-EZ) 2012 Pape 2
Fundraising Events . Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported morethan $15,000 of fundraising event contributions and gross income on Form 990- EZ, lines I and 6b . List events withgross receipts greater than $5,000
( a) Event # 1 (b) Event #2 (c) Other events (d) Tota l eventsSW DINNER NE DINNER 11 . (add col j a) through
(e-0 type ) ( evait type ) ( toad number)cot (c))
a)
I Gross receipts , , , , , , , , , , , , 1, 986, 634. 1, 336, 499. 5, 601, 788. 8, 924, 921.
2 Less Contributions , , , , , ... 1, 869, 634. 1, 186, 499. 4, 910, 842. 7, 966, 975.3 Gross income ( line 1 minus
line 2 ................. 117, 000. 150, 000. 690, 946. 957, 946.
4 Cash prizes . . ........... 401. 77,455. 77,856.
5 Noncash prizes ... .... ... ,
ui 6 Rent/facility costs .. 38,571. 246, 981. 407, 327. 692, 879.
7 Food and beverages ... , .... 121, 817. 150. 440, 062. 562,029.td
8 Entertainment ........... 3,113. 50,000. 700. 53,813.
9 Other direct expenses .. , , , ... 37, 853. 60, 850. 502, 956. 601, 659.
10 Direct expense summary Add lines 4 through 9 in column (d) ..... . . .... . . ...... . ► 1, 988, 236.)
11 Net income summary Combine line 3 , column d and li ne 10 . . ► -1,030,290.
Gaming . Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported morethan $15 ,000 on Form 990-EZ, line 6a
a) (a) Bingo ( b) Pull tabsrnstant (c) Other gaming (d) Total gaming (add
abingo/prograse ive bingo col ( a) through col (c))
aD
X I Gross revenue
CD 2 Cash prizes , , , , , , , , ,,,, ,CD
c 3 Noncash prizes .. . ... . . . .w16e 4 Rent/facility costs ....... ,0
.IH Yes ° Yes % Yes %
6 Volunteer labor , , , , , No No No
7 Direct expense summary Add lines 2 through 5 in column (d) . . . . . . . . ... .. . ... . .. . ► ( )
8 Net gaming income summary . Combine line 1, column d, and line 7 . . ►
9 Enter the state(s ) in which the organization operates gaming activities. ___ _ __
a Is the organization licensed to operate gaming activities in each of these states? .. . . . , Yes F-1140b If "No," explain
--------------------------------=--------------------------------------------------------
10 a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? , . .. fYes Q Nob If "Yes," explain. _-___-__--_
------------------------------------------------------------------
-----------------------------------------------------------------------------------------
Schedule d (Form 990 or 990.EZ) 2012
JSA
2Et282 1 000
50ZONY 1985 V 12-6F 430966
BOYS & GIRLS CLUBS OF AMERICAis
13-5562976
Schedule G (Form 990 or 990- EZ) 2012 Pape 3
11 Does the organization operate gaming activities with nonmembers? .. Yes No
12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? .... ... .... ..... ...... . . .... . ... . rYes a No13 Indicate the percentage of gaming activity operated in-
a The organization's facility .... .. .. ... . ....... ... . . . ... .. . . . ... .. .. 113a 9rob An outside facility .. . . ... . .. ... .. . . . . .... ... . . . .. . .. . . . ... ... .. 13b %
14 Enter the name and address of the person who prepares the organization's gaming/special events books andrecords:
Name ►----------------------------------------------------------------------------------
Address ►
15a Does the organization have a contract with a third party from whom the organization receives gamingrevenue? ........................................................ EJYesF-]No
b If "Yes," enter the amount of gaming revenue received by the organization ► $---------------
andtheamount of gaming revenue retained by the third party ► $
----------------c If "Yes ," enter name and address of the third party
16
17
Name ►----------------------------------------------------------------------------------
Address ►--------------------------------------------------------------------------------
Gaming manager information
Name ►----------------------------------------------------------------------------------
Gaming manager compensation ► $ -
Description of services provided ►---------------------------------------------------------------
El Director/officer El Employee LI Independent contractor
Mandatory distributions
a Is the organization required under state law to make charitable distributions from the gaming proceeds toretain the state gaming license ?, , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , , , ,,, ,, ,,, ,, , , Dyes No
b Enter the amount of distributions required under state law to be distributed to other exempt organizationsor spent in the organization ' s own exempt activities during the tax year ► $
Supplemental Information . Complete this part to provide the explanation required by Part I, line 2b,columns ( ni) and ( v), and Part III, lines 9, 9b , 10b, 15b , 15c, 16 , and 17b , as applicable Also complete thispart to provide any additional information (see instructions).
Schedule G (Form 990 or 990-EZ) 2012
JSA
2E1 503 1 000
50ZONY 1965 V 12-6F 430966 PAC EnAT gnu
SCHEDULE I Grants and Other Assistance to Organizations ,OMB No , 1545-OD47
(Form 990) c2012Governments, and Individuals in the United States
Department of the Treasury CompSats 1 the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • ' • •
Internal Revenue Service ► Attach to Form 990. • •
Name of the organization Employer Identification number
-BOYS & GIRLS CLUBS OF AMERICA 13-5562976
on
A
I Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? • , • , , , - , , , • ...... . • ..... . . . . .. . . ... .... . ....... . . Q Yes q No2 Descr i be in Part IV the organizat i on's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organ iz ation answered "Yes" to Form 990,Part IV, line 21 , for any recip ient that received more than $5 , 000. Part II can be duplicated if additional space is needed
1 (a) Name and address of organization ( b) EIN (c) nc so"n (d) Amount of rain (e ) Amou nt m non.k FM of valua6mMethod(
^ F ofnh (h) P urpose of grantor government if plicaoieaP grant
aon
hesalataice
c1 r9
Ph
in non-cashssat
taneeass istance or assistance
-L^^ A;G _G_A S TON _B C G_C _______ _
2900 S PARK DRIVE SW BIRMINGHAM , AL 35211 63 -0514348 SO1(C ) 3 39,828 . / A N/A SUPPORT BGCA PROGRAI
2 ABERDEEN AREA BiGC
1111 SE FIRST ST ABERDEEN , SD 57401 63 - 0514346 5011C ) 3 22,980 /A N/A SUPPORT BGCA PROGRAI
_(3) AXwEsASNE B&GC, ST. REGIS MOHAVK TRIBE-----------------------------
P 0 BOX 490 HOGANSBURG , NY 13655 16-1607731 501(C ) 3 29,703 . / A N/A SUPPORT BGCA PROGRAI
_(4) PJ.PMDA BeGC-----------------------------
P 0 BOX 1069 ALAMEDA , CA 94501 94 - 1312299 501(C ) 3 17,750. /A N/A SUPPORT BGCA PROGRAI
$ ANDERSEN YOUTH CENTER
36 SVS / SVYY UNIT 14004 APO, AP 96543 00 -0000000 GOVT 10,012. N/A N/A DPPORT BGCA PROGRAI
s ANDREWS AIR FORCE BASE YOUTH CENTER
4700 YUMA CIRCLE ANDREWS AFB, MD 20762 00-0000000 GOVT 19 , 573 /A N /A SUPPORT BGCA PROGRAI
( 7 ) ANTELOPE VALLEY B&GC, THE- ------------------------------
P 0 BOX 10047 LANCASTER , CA 93584 95-7290055 501(C ) 3 83,164 N/A N/A SUPPORT BGCA PROGRAI
-l$! ARLINGTON BeGC
60 POND LANE ARLINGTON , MA 02474 04-2149320 501(C)3 10,165 . / A N/A SUPPORT BGCA PROGRAI
_L9) ASSOC OF BOYS CLUB _CAMP FIRE 0F000KECOD
315 N HIRD STREET GAINESVILLE TX 76240 75 -2255185 501 ( C)3 17 , 750. /A N/A SUPPORT BGCA PROGRAM
L10 H&GC OF ABILENE. _--------"------ -------------P 0 BOX 2013 ABILENE , TX 79604 75-1001991 501(C ) 3 56,490 . /A N/A SUPPORT BGCA PROGRAM
L1I! HccC of ACADIANA----------------------
P 0 BOX 62166 LAFAYETTE , LA 70596 72-0940072 501(C ) 3 66,874 . N/A N/A UPPORT BGCA PROGRAI
12 HiGC OF ADA
915 SOUTH HICKORY ADA , OK 74820 73-0724464 501(c ) 3 28,750 . /A N/A UPPORT HGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ... .. ......... ...... . ........ ► ___________
-
_
3 Enter total number of other organizations listed in the line 1 table . ... . . . ......... .... . . . . .. .. . . ..... . . . .. . . .. .For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
•
Sj J&A
.2E1288 1 000 50ZONY 1985 V 12-6F 430966 PAGE 43a
SCHEDULE ! Grants and Other Assistance to Organizations,OMB No 1545.0047
(Form 990) ^1Jn^^
Governments , and Individuals in the United StatesDepartment of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . • • '
► Attach to Form 990. • ' •Internal Revenue serviceName of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ......... ... . .. . ... ............ .... .......... . ... 0 Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part 11 can be duplicated if additional space is needed.
A
1 (a) Name and address of organization (b) EIN (a) 1RC seam (d) Amount d can (a) Amount d non (t) Msthod of rN6uon(book. Fes, (g) Description of (h) Purpose of grant
or government It applicable gram cash assmance Gino) non-cash assistance or assistance
_`1! BLGC OF ADA COUNTY---------------------------
610 E 42ND STREET BOISE, ID 83714 82-0481687 5011C)3 51,915. N/A N/A SUPPORT BGCA PROGRA?
_L21 B6GC OF ADAIR COUNTY SCHOOLS
RR 6 BOX 2840 STILNELL, OK 74960 90-0632014 501(C)3 94,700. IA N/A SUPPORT BGCA PROGRAF
`31BLGC of ADAns coUn------------------------
410 SOUTH WINCHESTER DECATUR, IN 46733 35-1807774 5D1(C)3 34,531 N/A N/A SUPPORT BGCA PROGR"
4 BLGC O_F ALACHUA COUNTY- •_----^^--------------------
P 0 BOX 532 GAINESVILLE, FL 32602 59-6002181 501(C)3 73,317. /A N/A SUPPORT BGCA PROGRAM
-152 HiGC OF ALAHO-SAN JDAN---------------------------
501 N 13TH STREET ALANO, T% 78516 74-2713813 501(C)3 15,000. /A N/A SUPPORT BGCA PROGAAA.
8 BiGC OF ALBANY ------ - --_
1215 SE HILL STREET ALBANY, OR 97322 93-0549842 SO1(C)3 121,250. /A N/A SUPPORT BGCA PROORAT
7 HiGC OF ALBANY ---------^----
P 0 BOX 1130 ALBANY, GA 31702 58-6046393 5014C)3 115,694. /A N/A SUPPORT BGCA PROGRA!
8 BiGC OF ALBANY ---- -- ---
21 DELAWARE AVENUE ALBANY, NY 12210 14-1338303 501(C)3 111,583. IA N/A SUPPORT BGCA PROGRAI
9 BiGC OF ALBUQOERQDE i RIO RANCIfO - -
3333 TRUMAN NE ALBUQUERQUE, NM 87110 85-0106943 501(C)3 92,983. /A N/A SUPPORT BGCA PROGRAt
10 BcGC OF ALICE - - - - - - - - - - - - - - - - - - - - - -
P 0 BOX 689 ALICE, TX 78333 74-1463071 501(C)3 19,917. /A N/A SUPPORT BGCA PROGRAI
11 BcGC OF ALbe TOWN __- _---_
720 N SIXTH STREET ALLENTOWN, PA 18102 23-1352042 501(0)3 30,500 /A NIA SUPPORT BGCA YROGRA
12 BiGC OF 0.LNA AREA
410 EAST MAIN ST ALMA, AR 72921 74-3072145 501(0)3 23,836. /A N/A UPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . ............................ ► ___-_-___-___3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) (2012)
0
JSA:12EI2e81000 SOZONY 1985 V 12-6F 430966 PAGE 44
a
SCHEDULE I Grants and Other Assistance to Organizations , OMB No 1545-0047
(Form 990)012Governments , and Individuals in the United States
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . Open to PUblic
Internal Revenue Service ► Attach to Form 990. Inspecti o n
Name of the organ ization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
IIEP General Information on Grants and Assistance
I Does the organization maintain records to substantiate the amount of the grants or ass istance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? , , , , , , , , , , , , , • , .. .... _ ... . . . .. .. ... .. _ . ........ . . 1 -1 Yes q No2 Describe in Part IV the organizat ion's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
1 (a) Name and address of organ ization ( b) EIN (C ) (RC section (d) Amount or cash (fl) Amount of non. ( r) Method of valuation(yam FMy, ^p^^^, (g) Description of (h) Purpose Of giant
or government It applicable grant rash assistants o^ non-cash assistance or assistance
_l11 B^G^ of ALPENA------------------------
601 RIVER STREET ALPENA , MI 49707 38 - 1405280 501 ( C)3 44 , 321. N/A N/A SUPPORT BGCA PROGRAI
2 B&GC OF ALTON------------------------------P O BOX 532 ALTON , IL 62002 36 - 4142577 501(C)3 75,390 . N/A N/A SUPPORT BGCA PROGRA
131 B&GC of AMERICAN SAMOA------------------------
LUTALI EXEC BUILDING PAGO PAGO , AS 96799 66 - 0759053 501 ( C)3 154 , 816. /A N /A SUPPORT BGCA PROGRAJ
4 RcGC OF AMERICUS / SUMPER COUNTY------------------------------P 0 BOX 1192 AMERICUS , GA 31709 31-1576239 501(C ) 3 14,500 . /A N/A SUPPORT BGCA PROGRAI
$ BcGC OF ANAHEIM------------------------------
BROADWAY ANAHEI I4, CA 92805 33 -0356284 501(C ) 3 43,364 . / A N/A SUPPORT BGCA PROGRAI-
`6) BLGC OF ANNAPOLIS i ANNE ARUNDEL COUNTY------------------------
121 SOUTHVILLA AVE ANNAPOLIS , MD 21401 52 - 1736346 501 ( C)3 294,056. /A N /A SUPPORT BGCA PROGRAI
7 BGGC OF ARLINGTON-------------------------------606 N ELM STREET ARLINGTON , TX 76011 75 - 1046644 501(C)7 124,774. /A N/A SUPPORT BGCA PROGRAJ
_ 6 BiGCOFASSABET VALLEY--- - --- ------ - ---------------- -
212 GREAT ROAD MAYNARD , MA 01754 25-7105393 501(C ) 3 28,415. /A N/A SUPPORT BGCA PROGRAI
`91 B&GC OF-- - -HENS- -------- -- ----------
P 0 BOX 546 ATHENS, GA 30603 58 -0830065 501 ( C)3 33 , 100. /A N/A SUPPORT BGCA PROGRAI
10 BcGC OF ASLANTIC CITY ---------------
317 N PA AVE ATLANTIC CITY , NJ 08401 23 - 7253748 5021C ) 3 156 , 344. /A N/A SUPPORT BGCA PROGRAI
11Z--BGGC OF AUGUSTA-.---------------------------1903 DIVISION STREET AUGUSTA , GA 30904 56-0610382 5011C ) 3 70,610 /A N/A SUPPORT BGCA PROGRA
1_Y BLG_C_OF A_UGUSTA_/WA_YNE_S_BO_R_0 -__-___ - ---
P 0 BOX 382 WAYNESBORO , VA 22980 54 - 1846714 SOliC ) 3 24,062 . /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► ____-_-__----3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
JSAM2012881 000 50ZONY 1985 V 12- 6F 430966 PAGE 45a
L_J
SCHEDULEI(Form 990)
Department of the TreasuryInternal Revenue Service
Grants and Other Assistance to Organizations,OMB No 1545.01
Governments, and Individuals in the United States P.©12Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. OOpen to Pu^
► Attach to Form 990. InspectioiName of the orgamzaion Employer identification numberBOYS & GIRLS CLUBS OF AMERICA 13-5562976
Does the ocgarnzaltn mamtam records to substantiate the amount of the grants or assistance , the grantees' ellglbikty for the grants or assistance, andthe selection criteria used to award the grants or assistance? , , ... ...... . Yes q No
2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) PC section {d} Amount of can (a) Amount at nom{r) Method of ^uaaa,( book
-prehal
p
(g) Oescnpuon of (h) Purpose of gruntor government If eppl Gable grant cesh assIslanoe
.r.4 non-cash assistance or assistance
1 ) B&GC OF AUSTIN COUNTY-------------------------------
P O BOX 1145 BELLVILLE , TX 77418 76 - 0640686 501 ( C)3 17 , 195. /A N/A SUPPORT BGCA PROGRA)
_`21 BGGC OF-Bt^NDERA COUNTY-----------------------
P 0 BOX 3155 BANDERA , TX 78003 74 - 2728659 501 (C13 17, 830. IA N/A SUPPORT BGCA PROGRAI
_C3.1 BiGC OF-BARRON COUNTY, INC
P 0 BOX 734 RICE LAKE, WI 54068 39 - 2025211 501 ( C)3 25,758. /A N/A SUPPORT BGCA PROGRAI
- 41 BcGC OF BARTLESVILLE---------------------------401 S SEMINOLE AVE BARTLESVILLE, OK 74003 73 - 0618201 503 ( C)3 62 , 225. /A N/A SUPPORT BGCA PROGRA)
$ BiGC OF RATTLE CREEK
450 N WASHINGTON BATTLE CREEK , MI 49037 20 - 3936388 501 ( C)3 42 , 828. /A N/A SUPPORT BGCA PROGRAI
_ 6 _Bi_G_C _O_F B_AY OU_N_TY_ _ _
300 N LAFAYETTE STREET BAY CITY , MI 48706 38 - 1648580 501(C ) 3 70,599 . / A N/A SUPPORT BGCA PROGRAI
_ 7 8i_G_C __F_BAY _C OU_NTY I N_C .
3404 WEST 19TH ST PANAMA CITY , FL 32405 59-1114292 501(C ) 3 18,658 . / A N/A SUPPORT BGCA PROGRAI
-(-S1L,LC
OF BAY MILLS-----------------------
12099 N LAKESHORE DR BRIMLEY , MI 49735 20 - 3534536 501(C ) 3 45,385. N/A N/A SUPPORT BGCA PROGRAI
`91 BiGC_O_F B_EAU_FOR_T_C_0_ON_T_Y
-P 0 BOX 2331 WASHINGTON
_
NC 278B9 56-1720315 501(C ) 3 16,702 . /A N/A SUPPORT BGCA PROGRA)
1 j`B--iGC OF BEEVI LLE
_---------------- ---------P 0 BOX 131 BEEVILLE , TX 78104 51-0211273 501(C)3 17,000 . /A N/A SUPPORT BGCA PROGRAJ
11 BiGC OF BELLEVUE
209 - 100TH AVENUE NE BELLEVUE , WA 98004 91-0776451 501(C)3 100 , 796. /A N/A SUPPORT BGCA PROGRA
12 SiGC OF BENTON AND FRANKLIN COUNTIES
P 0 BOX 1322 PASCO , WA 99301 91 - 1673327 5D1 ( C)3 60 , 736. /A N /A SUPPORT BGCA PROGRA
49 cuter total number OT section 5Ul(c)(3) and government organizations listed in the line 1 table ,, , , , , , , , , , , , , , ,, , , , ► ___-----_----3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I ( Form 990) ( 2012)
•
•
D JSA
02E12881 0005020NY 1985 V 12-6F 430966 PAGE 46
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) c)^012Governments, and Individuals in the United States _
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' •
Internal Revenue Sennoe ► Attach to Form 990.
Name of the orgemzatton Employer identification numbor
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? . . .... .............. .. . ..... .... . ......... . .. .... 0 Yes q No2 Describe in Part IV the organization' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5 ,000. Part II can be duplicated if additiona l space is needed.
1 (a) Name and address of organization (b) EIN (c) RC section (d) Amount of cash (e) Amount d non-Method of vpu sal
(book Fo (g) DesenpLon of (h} Purpose of grantor government H applceble grant cash aulstance
.
other) non-cash assistance or assistance
Bi GC_OF BENTON COUNTY ___ __
P 0 BOX 448 BENTONVILLE , AR 72712 71-0713904 501(C)3 41,346 . N/A N/A SUPPORT BGCA PROGRIU
I Q BLGC OF 8ENTON HARBOR -- - ----- - ----- -
1200 E MAIN ST BENTON HARBOR , MI 49022 38 - 3461586 501(0 ) 3 35,168 . N/A N/A SUPPORT BGCA PROGRAI
-`3) B&GC 0F_BETRALTO ------------------
324 E CENTRAL AVENUE BETHALTO , IL 62010 37 -0911129 501(C)3 10,663 . / A N/A SUPPORT BGCA PROGRAI
4 Bf.GC OF BETHLEHEM^ -----------------------------1430 FRITZ DRIVE BETHLEHEM, PA 18017 23-6298476 501 ( C)3 30 , 000. N /A N/A SUPPORT DGCA PROGRAI
@1 BiGC OF BINGHAMTOH -----------------
P 0 BOX 639 BINGHAMTON, NY 13902 15-0539040 501(C ) 3 28,659 / A N/A SUPPORT BGCA PROGRAI
_L61 ! _°!_BISBEE405 AROZPMA ST BISBEE , AZ 85603 86-0986317 501 ( C)3 25,906 . N/A N/A SUPPORT BGCA PROGRAI
( T B&rC OF BLACK HAWK COUNTY----------------------------515 LIME STREET WATERLOO , IA 50703 42-6083723 501(C ) 3 36,500. N/A N/A SUPPORT BGCA PROGRAI
$ BiGC OF BLOOMINGTON
P 0 BOX 1716 BLOOMINGTON , IN 47402 35 - 0997525 501(C)3 30,667. /A N/A SUPPORT BGCA PROGRAI
(9) Br GC OF BLOOMINGTON-NORMAL_ _ _ __ ____________
1615 V ILLINOIS ST BLOOMINGTON , IL 61701 37-1308723 501 ( C)3 27,681. N/A N/A SUPPORT BGCA PROGRAI
10 BiGC OF BOSTON
50 CONGRESS ST STE 730 BOSTON , MA 02109 04 - 2103922 501 ( C)3 217 , 129. /A N/A SUPPORT BGCA PROGRAI
^11! BiGC OF BOWLING G R_E_EN_,_K_Y__WAR _MM T_INC
P 0 BOX 872 BOWLING GREEN , KY 42102 61-0482974 501(C ) 3 42,451 N/A N/A SUPPORT BGCA PROGRAI
12 BGGC OF BRRTTLEBORO INC
L 17 FLAT STREET BRATTLEBORO, VT 05701 03 - 0309528 501 ( 0)3 185 , 000. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , ........... .. . .. .. . .. ,
3 Enter total number of other organizations listed in the line 1 table .... .. ..... ........... ... ... . .... . . . . .. ... ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) 42012)
V JSA
OE12ea t OOD 5OZONY 1985
a
V 12-6F 430966 PAGE 47
0
SCHEDULE I OMB NO 1545-0047(Form 990)
Grants and Other Assistance to Organizations,Governments, and Individuals in the United Statres
Department of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, line 21 or 22.
690Internal Revenue Sennc e ► Attach to Form 990.
Name of the organization Employer Idontlficatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-55 62976
2 Enter total number of section 501 (c)(3) and government organizations listed in the line 1 table . ....... . . . . . . . . . . . . ... ...... ► -------------3 Enter total number of other organizations listed in the line 1 table ►
A For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
I07M General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance. and
the selection criteria used to award the grants or ass istance? , , , .. ....... ... .. .. ...... II Yes U No2 Describe in Part IV the organ ization ' s procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, Ilne 21 , for any recipient that received more than $5 , 000. Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (c ) NRC section (d) Amount of cash (a) Amount of non- (n Method of valuation( book
Ff ems" .
(g) Description of (h) Purpose of grantor government If applicable grant cash asswunce ory' non-cash assistance or assistance
1 BLGC OF BRAZORIA COUNTY
202 W FIRST FRESPORT, TX 77541 74-1688545 501(C ) 3 28,257 . N/A N/A SUPPORT BGCA PROGRAP
2 BiGC OF BRAZOS VALLEY
P 0 BOX 524 BRYAN, TX 77806 74 - 6079584 501(C ) 3 36,037. N/A N/A SUPPORT BGCA PROGRAI
I $ BiGC OF BREA- PLACEITIA- YDRBA LINDA - - - - --
P 0 BOX 112 PIACENTIA , CA 92871 95 -2428410 S01 ( C)3 39,646. /A N / A SUPPORT BGCA PROGRAT
4 BcGC OF BRIGHAlt CITY-- - -------- - ----
271 N 100 WEST BRIGHAM CITY , UT 84302 87 - 0529606 501(C ) 3 104,333. N/A N/A SUPPORT BGCA PROGRA?
5 BiGC OF BRISTOL- - - - - - - - - - - - - - - - - ---
334 REBECCA STREET BRISTOL. VA 24201 54 - 0653489 5011C ) 3 67,892 . /A N/A SUPPORT BGCA PROGRA)
s BiGC OF IL of r. 'I'ON
233 WARREN AVENUE BROCKTON , HA 02301 22-2963214 501(C ) 3 17,415 . /A N/A SUPPORT BGCA PROGRA)
T BGGC OF--------
OO-K-IN-G-S------------------
1126 SOUTHLAND LANE BROOKINGS , SD 57006 73-1630215 501(C ) 3 110,255. N/A N/A SUPPORT BGCA PROGRA8
/ 8 BiGC OF BRONARD COU27TY
877 N W 61ST ST FORT LAUDERDALE , FL 33309 59 - 1108790 501 ( C)3 193 , 645. N /A N/A SUPPORT BGCA PROGRAI
1-91 2 EIC OF BROtrN COUNTY ----- ----------
901 AVENUE B BROBNWOOD , TX 76801 74-2721815 501(C)3 22,974. /A N/A SUPPORT BGCA PROGRAI
1_0_Bi CCC_oF_0_RYA_NT --- -------------- -
P 0 BOX 1294 BRYANT , AR 72089 94 -3417100 $02(C ) 3 38,813 . /A N/A SUPPORT BGCA PROGRAJ
11 BLGC-
OF BUENA PARK^- ---------------------------
7758 KNOTT AVE BUENA PARK , CA 90620 95 - 1808525 501 ( C)3 8,652 . /A N/A SUPPORT BGCA PROGRAI
121 8 iGC OF BUFFALO T292 BABCOCK ST BUFFALO , NY 14210 16 - 0849516 501 ( C13 240,708. /A N / A SUPPORT BGCA PROGRAI
0
0
Z) JSA50Z0NY 1985 V 12-6F 430966 PAGE 48
't2E7268 1 000
SCHEDULE I Grants and Other Assistance to Organizations, OMB No 1545-0047
(Form 990) 2012Governments, and Individuals in the United States
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV, tine 21 or 22. • '
Internal Revenue Service ► Attach to Form 990.
Name of the organization
jEmployer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
jj= General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . ... ....... . . , , - .. .. . . Ei Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part 11 can be duplicated if additional space is needed.
1 61 Name and address of organization( b EIN(1 (c) INC section (d) Amount of cash (e) Amount of non-(r) Method or valuawnb F^ty ginitsal(bock (p) Description of (h) Purpose of grant
or government if applicable grant cash assistance,
_____oth non-sash assistance or assistance
-`11 860 OF-BULLOCH COUNTY
515 DENMARK ST STATESBORO , GA 30458 56 -260695I 501 ( C)3 24 , 662. /A N/A SUPPORT BGCA PROGRAI
2 BAGC OF BURBANX
2244 N BUENA VISTA BURBANK , CA 91504 95 - 4485745 501 ( C)3 140 , 248. N/A N/A SUPPORT BGCA PROGRA)
3 B&GC OF BURLINGTON
62 OAK STREET BURLINGTON , VT 05401 03-0179307 SO1(C)3 327 , 949. N/A N/A SUPPORT BGCA PROGRA)
`l4 BGGC OF BUTLER COUNTY
-------------------------------P 0 BOX 1368 MORGANTOWN , KY 42261 61 - 1271292 501 (C)3 19, 250. /A N/A SUPPORT BGCA PROGRAJ
-(5) BiGC OF-CABARRUS COUNTY----------------------
P 0 BOX 1405 CONCORD , NC 28026 56 -0577630 SOI ( C)3 52 , 470. /A N/A SUPPORT BGCA PROGRA)
`6) BLGC OF CAMARILLO-----------__-•--_-_------
1500 TEMPLE AVE CAMARILLO , CA 93010 95 - 6194547 501 ( C)3 73 , 063 /A N/A SUPPORT BGCA PROGRN
``7) BiGC OF CAMDEN COUNTY
1709 PARK BLVD CAMDEN , NJ 08103 22 - 3670D25 SDI(C)3 175 , 313. N/A N/A SUPPORT BGCA PROGRAI
8 BiGC OF CAMPBELL COUNTY------------------------------707 BRIDGER STREET GILLETTE , NY 82716 86 - 1006303 501(C)3 5,824 . /A N/A SUPPORT BGCA PROGRA)
9 BfiGC OF CAPE COD- ------------------------------
P 0 BOX 895 MASHPEE , MA 02649 04 - 3273141 501 ( C)3 11 , 215. /A N/A SUPPORT BGCA PROGRAI
(101 BaGC of CAPE_ G I RARD_EA_U__ _ __ ___ __
-1913 WHITENER ST CAPE GIRARDEAU , MO 63701 43-0817669 501(C ) 3 21,332 . N/A N/A SUPPORT BGCA PROGRAI
`1^^ BiGC-OF CAPISTRANO VALLEY - - - - - - - - - - - - - -
ONE VIA POS SAN JUAN CAPISTRANO , CA 92675 33 - 0529575 501 ( C)3 80,377. /A N/A UPPORT BGCA PROGRA)
1121 66GC OF C_ARSONDA_LE
- - - - - - - - - - - - - - -- IS250 N SPRINGER ST CARBONDALE, IL 62901 1 37-1391223 1 501([ ) 3 23,933. / A N/A UPPORT BGCA PROGRRI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . . ...................... ► -------------3 Enter total number of other organizations listed in the line 1 table . ...... . . .......... . ............... . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990 ) ( 2012)
Z) JsA
:12EU861000 5OZONY 1985
a
V 12-6F 430966 PAGE 49
0
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)2012Governments, and Individuals in the United States
Department of the Treasury Com p lete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' •
Internal Revenue Service ► Attach to Form 990. ' ' •
Name of the organ ization Employer identi fication number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
A
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or asslstance'7 ...... . Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
llj^
0
1 (a) Name and address of organization (b) EIN (c) IRC section (d) Amount of cast (0) Ivnaunt of non-(f) Method of valuation
(bock FMV appresyy, (g) Descnption of (h) Purpose of grantor government if eppliewe grant ,mn a me other) non-cash assistance or assistance
_l1j BiGC OF-CAALSBAD
P 0 BOX 536 CARLSBAD, NIt 88221 85-0159171 501(C)3 51,250. /A N/A SUPPORT BGCA PROGRAM
-`22 B&GC OF CARLSBAD------------------------
P 0 BOX 913 CARLSBAD, CA 92018 95-2131503 501(C)3 24,345. /A N/A SUPPORT BGCA PROGRAP
-`32 LI C OF-CARSON------------------------
2255 EAST 220TH ST LONG BEACH, CA 90810 33-0475452 501(C)3 153,203. /A N/A SUPPORT BGCA PROGRAP
-41 BLGC OF-CASCADE COUNTY
600 1ST AVE SW GREAT FALLS, M 59404 81-0475269 501(C)3 43,523. /A N/A SUPPORT BGCA PROGRAM
$ HiGC OF CATHEDRAL CITY ------- - ---- `----------------32-141 WHISP PALMS Tit 95-3507225 501(C)3 25,000. /A N/A SUPPORT BGCA PROGRAM
-ls! 84GC OF CECIL-COONTY_ MARYLAND---__----
300 CHERRY STREET NORTH EAST, pw 21901 52-2190263 501(C)3 16,829. /A N/A SUPPORT BGCA PROGRA?
7 BiGC OF CEDAR RAPIDS
1501 ELLIS BLVD CEDAR RAPIDS, IA 52405 42-1434056 501(C)3 7,791. /A N/A SUPPORT BGCA PROGRA)
_LB^ ecGC or cENrRAI ALABnru---------------------
P 0 BOX 10391 BIRMINGHAM, AL 35202 63-0302102 50l(C)3 61,801. N/A N/A SUPPORT BGCA PROGRA)
9 B&GC OF CENTRAL APPALACHIA------------
P 0 BOX 1505 GRUNDY, VA 24614 20-5511073 501(C)3 32,610. /A N/A SUPPORT BGCA PROGRAI
1Q BiGC OF CENTRAL ARIZONA -------------
335 E AUBREY STREET PRESCOTT, AZ 86303 86-0964489 501(C13 69,982. N/A N/A SUPPORT BGCA PROGRAI
1_1 _ecGC_o_F-_eNr_R____K_AN_s___ __ _ ______
P 0 BOX 530 NORTH LITTLE ROCK, AR 72115 20-8095568 501(C)3 81,075. /A N/A SUPPORT BGCA PROGRRI
12 24GC OF CENTRAI, FLORIIU\ INC.
2510 N TRACKER AVENUE KISSIMIe E, tZ 34741 59-0951807 501(C)3 297,383 N/A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line I table ................ ......... .... ► --------------
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule ) ( Form 990) (2012)
0
•
:1 JSASOZONY 1985 V 12-6F 430966 PAGE 502)2E1280 1 000
SCHEDULE-I(Form 9900)} Grants and Other Assistance to Organizations,(Form 9
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
interna l Revenue Service ► Attach to Form 990.
V
2®12
Name of Lie aganltcat 3n Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
• General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ...... ........... . . . . . . . . . . . . . . .. . . . . . . ... . . . . . . . Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds (n the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) IRC seaban (d) amount of cash ( e) Amount of non. (f) Method of vatuat-
(book FMV' apP^^Description of
(g)(h) Purpose of grant
or government It Bp c2ble Qrani m,n assistance othen non-cash assistance or assistance
1 B&GC OF CENTRAL GEORGIA---------------------------277 MI.K JR BLVD SUITE 101 MACON, GA 31201 58-0621444 S01(C)3 71,898. N/A N/A SUPPORT BGCA PROGRAI
2 B1GC OF CENTRAL ILLINOIS
P 0 BOX 2592 SPRINGFIELD, IL 62708 37-0752849 501(C)3 10,000. N/A N/A SUPPORT BGCA PROGRA
113) B&GC OF CENTRAL IOWA
1350 E WASHINGTON AVE DES MOINES, IA 50316 42-6075130 501(C)3 40,174. /A N/A SUPPORT BGCA PROGRAI
-14) BGGC OF CENTRAL LOUISIANA
P 0 BOX 5247 ALEXANDRIA, LA 71307 72-0845372 501(C)3 34,998. /A N/A SUPPORT BGCA PROGRAI
`$ B&GC OF CENTRAL MINNESOTA------------------------------345 30TH AVENUE NORTH ST CLOUD, mN 56303 41-1245177 501(C)3 111,126 N/A N/A SUPPORT BGCA PROGRAJ
B&GC OF CENTRAL MISSISSIPPI
1450 v CAPITOL STREET JACKSON, MS 39204 64-0331635 S01(C)3 158,576. /A N/A SUPPORT BGCA PROGRAI
BLGC OF CENTRAL NEBRASKA
P 0 BOX 368 GRAND ISLAND, NE 68802 26-0704734 501(C)3 10,421. N/A N/A SUPPORT BGCA PROGRAJ
`8) B&GC OF CENTRAL OREGON-------------"_-----
404 SW 7TH STREET REDMOND, OR 97756 93-1127536 SO1(C)3 43,215. /A N/A SUPPORT BGCA PROGRAI
(9) B&GC OF CENTRAL PENNSYLVAN IA
1227 BERRYHILL STREET HARRISBURG, PA 17104 23-1352043 501(C)3 37,692. /A N/A SUPPORT BGCA PROGRA)
1 BcGC OF CENTRAL SONOlfA COUNTY
P 0 BOX 7460 SANTA ROSA, CA 95407 68-0309534 50110)3 232,793. N/A N/A SUPPORT BGCA PROGRAI
I11 BGGC OF CENTRAL TEXAS, INC
304 WEST AVENUE B KILLEEN, TX 76541 06-1638374 501(C)3 956,522. /A N/A SUPPORT BGCA PROGRA
2 BGGC OF CENTRAL VIRGINIAL- -----------------------------1P 0 BOX 707 CHARLOTTESVILLE, VA 22902 54-1602004 _ 501(C )3 86,603 /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501 (c)(3) and government organizations listed in the line 1 table ............................. ► --- - ---------3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
n JSA
-02EI288 t 000 50ZONY 1985a
V 12-6F 430966 PAGE 51
•
SCHEDULE I MB No 1545-0047
(Form ULEGrants and Other Assistance to Organizations,
Governments, and Individuals in the United States ©12
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV , line 21 or 22. • ' ' ' '
Internal Revenue Service ► Attach to Form 990. • '
Name of the organu:aton
I
Employer Identification number
BOYS & GIRLS CLUBS O F AMERICA 13-5562976
i3
ty
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . .. ....... . .. ....... ............... . .... .. ... .... Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c( RC sect,on (d) Arnount d cash (s) nmouns or non- ( r) Method 01 veWotbn(per FMV epp ,^
p of(g) Descn (h) Purpose of grantpor government epplcmeif
t9 cah Mflstmue Oth er) non-cash assistance or assistance
1 aiGC OF CENTRAL NYOMING -------------
1701 EAST K STREET CASPER , WY 82601 23 - 7060727 501 ( C)3 48,486. /A N /A SUPPORT BCCA PROGRAM
L21Btic OF CENTRAL- SOUTHNEST IONA - - - - _
607 BROAD ST ADAIR , IA 50002 42-1506920 501(C ) 3 10,000. /A N/A SUPPORT BGCA PROGRA9
I BiGC OF CHAPFEE COUNTY
P 0 BOX 1430 SALIDA, CO 81201 55-0907901 501(C)3 47,250 . / A N/A SUPPORT BGCA PROGRA!
C41 BtcS OF CHAMBERS COUNTY----------------------------P 0 BOX 1097 VALLEY , AL 36854 58-2300432 501(0)3 23,000. /A N/A SUPPORT BGCA PROGRAI
_L51 BGGC OF CHAl1BERSBURG SHIPPENSBDRG-------------------------440 W WASHINGTON ST CHANBERSBURG , PA 17201 27 - 1658752 S01 ( C)3 29,986 / A N/A SUPPORT BGCA PROGRAI
-L--6 BtGC OF CHAISPION VALLEY----------------------------
101 WEST JACKSON WEIHAR , Tx 78962 06 - 1674854 501(C ) 3 24,867. /A N/A SUPPORT BGCA PROGRAI
7 BiGC OF CHARI,O7'fE COUNTY ----_
21450 GIBRALTER DR PORT CHARLOTTE, FL 33952 65-0725247 501(C ) 3 13,313. N/A N/A SUPPORT BGCA PROGRA)
I 8 BGGC OF CHATTANOOGA
P 0 BOX 11567 CHATTANOOGA , TN 37401 62-0557179 501(C)3 143 , 082. /A N/A SUPPORT BGCA PROGRAI
9 BcGC OF CHELSEA -------------------
P 0 BOX 81 CHELSEA , OX 74016 73-1533089 5D1(C ) 3 26,769 N /A N/A SUPPORT BGCA PROGRAI
1Q BSGC OF CHESTER -------------------
425 FRONT ST CHESTER , PA 19013 23 - 1490049 501(C)3 17,348 /A N/A SUPPORT BGCA PROGRAI
11 BiGC OF CNEYF27NE , 1rY0MIN(j- --_---_----
1700 SNYDER AVENUE CHEYENNE , WY 82001 83 - 0306118 501 ( 0)3 56 , 635. /A N/A SUPPORT BGCA PROGRAI
Lj BiGC OF CHICAGO ---------------- -
550 W VAN BUREN ST CHICAGO , IL 60607 36 -2166997 501tC ) 3 534 , 881. /A N /A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► ---__________3 Enter total number of other organizatioris listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
n JSA
-52E1288 1 000 50ZONY 1985a
V 12-6F 430966 PAGE 52
is
SCHEDULE I Grants and Other Assistance to Organizations,OMB No. 1545.0047
(Form 990)^^12Governments, and Individuals in the United States
Department 01 the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • - •
tntEmat Revenue strvice W. Attach to Form M. • • •
Name of the organu: eteon Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ral Information on G
ps
V
1 Does the organ ization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? . . . . . . . . . . . . . . . ..... ... ...... ... . . . ......... . . . .. . Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000. Part 11 can be duplicated if additional space is needed.
(a) Name and address of organization (b) EIN (c) IRC section (d)Amount of cash oUM or non-ran(a)
( Method of vdIYWOn(Flty. apprsisaj a (h) Purpose of grant
or government e apW,cable grant ^n w.
other) cash65313
non-cashc
safatance or assistance
1 !t2c OF CITRUS CODNTY
3814 SOUTH LECANTO HMY LECANTO, FL 34461 59-3124840 501(c)3 40,371. /A N/A SUPPORT BGCA PROGRAI
-`21 BiGC OF-CLER?tON_T_CO_UN_T_Y---- ` ---- - ----
212 MARKET STREET NEW RICHMOND, OH 45157 31-1463574 501(C)3 53,674. /A N/A SUPPORT BGCA PROGRA!
3 _Bi_G_C__F_CEV_ELAND--- - ------- - ------
6114 BROADWAY AVENUE CLEVELAND, OH 44121 34-D770686 501(C)3 113,228. /A N/A SUPPORT BCCA PROGRAI
-(41 BiGC-OF CLEVELAND--- - ---- - ---------
385 3RD STREET SW CLEVELAND, TN 37311 62-0729406 501(C)3 105,720. /A N/A SUPPORT BGCA PROGRA!
$ BGGC OF CLEVELAND COUNTY -----_-----
P 0 BOX 2001 SHELBY, NC 28151 56-0858863 501(C13 20,512. /A N/A SUPPORT HGCA PROGRAI
`6) B&GC OF CLIFTON
822 CLIFTON AVE CLIFTON, NJ 07013 22-1589371 501(C)3 61,680. N/A N/A SUPPORT BGCA PROGRAI
7 BBGC OF COACHELLA VALLEY
42600 COOK ST PALM DESERT, CA 92211 95-6122699 501(C)3 49,241. N/A N/A SUPPORT SGCA PROGRAI
BLGC OF COASTAL CAROLINA _
P 0 BOX 1514 MOREHEAD CITY, NC 28557 31-1516947 501(C)3 27,500. /A N/A SUPPORT BGCA PROGRN
9 BiGC OF COFFE YVILLE- ---------------
615 ELLIS STREET COFFEYVILLE, KS 67337 48-0625535 501(C)3 11,250. N/A N/A SUPPORT HGCA PROGRAI
1Q BLGC OF COLLIER COUNTY
P 0 BOX 8896 NAPLES, FL 34101 65-0279110 501(C)3 150,977. /A N/A SUPPORT HGCA PROGRA
11 SiGC OF COLL_I_N COIINTY
P 0 BOX 3166 MCKINNEY, TX 75070 75-1296869 501(C)3 353,460. /A N/A SUPPORT OGCA PROGRA
Lj HaCC OF COLUMH3U
115 SOUTH GIFT STREET COLUMBUS, OH 43215 31-4387575 501(C)3 77,633 /A N/A SUPPORT HGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -33 Enter total number of other organizations listed in the line 1 table .......... . .... . . . ..... .. ......... ...... . 111,For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I ( Form 990 ) (2012)
Z) JSA-5261288 1 000 50ZONY 1985
a
V 12-6F 430966 PAGE 53
L
SCHEDULEI OMB No 1545.0047
(Form ULEGrants and Other Assistance to Organizations, 012
Governments, and Individuals in the United States
Departmem rA Vie T reasu ry Comptete it the otgantizat;,on answsTed "Yes" to Form 9%, Part W, line 21 or 22 . Ope n to Public► Attach to Form 990. Ins pe ctio nInternal Revenue ServKa
Name of the organization Employer Identi fication number
BOYS & GIRLS CLUBS OF AMERICA 1 3-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . .... ... ..... . ...... ...... Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, Iine 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) IRC Seim d Amount of cash( ) (e) Amount of non.(Q Method of valuation(boob FMV, appre".
(g) Description of (h) Purpose of grant
or government 11 apWrable grant cash usoistence other non-cash assistance or assistance
1 BiGC OF cONEJO lAS VIRGENES, NS.
CLARETON DR AGOURA HILLS, CA 91301 91-2151731 501(C)3 31,117. /A N/A SUPPORT BGCA PROGRAM
2 Bt(C OF CORPUS CHRISTI --- - ----------
3902 GREENWOOD DR CORPUS CHRISTI, TX 78416 74-1294586 5011C)3 47,067 /A N/A SUPPORT BGCA PROGRAM
L31 2C OF tip! LIS---- - -------------
1112 NW CIRCLE BLVD CORVALLIS, OR 97330 23-7153987 501(C)3 78,073. /A N/A SUPPORT BGCA PROGRA9
4 BiGC OF COVINGTON COUNTY
P 0 BOX 2559 COLLINS, MS 39428 72-1376423 501(C)3 52,000. /A N/A SUPPORT BGCA PROGRAt
5 B^GC OF CRITIENDEN COUNTY- ------------------------------
P O BOX 383 WEST MEMPHIS, AR 72303 71-0352307 501(C)3 17,500. N/A N/A SUPPORT BGCA PROGRA?
J61 BiGC OF CUMBERLAND COUNTY - - -
P 0 BOX 48155 CUMBERLAND, NC 28331 56-0896317 501(C)3 68,068 N/A N/A SUPPORT BGCA PROGRA)
-C71 BLGCO_F CtM8E_RLAND-LI_N_CO_L_N---- - -------
P 0 BOX 7505 CUMBERLAND, RI 02864 05-0280121 501(C)3 15,833. /A N/A SUPPORT BGCA PROGRA)
B L_G_C_O_F C_Y P A_E 59----------- - --------
10161 MOODY AVENUE CYPRESS, CA 90630 95-2920990 501(C)3 46,210. IA N/A SUPPORT BGCA PROGRAI
9 BcGC OF DANE COUNTY
2001 TAFT STREET MADISON, WI 53713 39-1925617 501(C)3 78,784. N/A N/A SUPPORT BGCA PROGRAI
10 BEgc OF DANVILLE --------------
850 NORTH GRIFFIN STREET DANVILLE, IL 61832 37-1275690 501(C)3 6,475. /A N/A SUPPORT BGCA PROGRA)
0-1 1 2tRc OF DARLINGTON -- - --------------
4408 NORTH HIGHWAY 81 EL RENO, OK 73036 73-1535032 501(C)3 75,500. /A N/A ISUPPORT BGCA PROGRA
12 BGGC OF DAi7SON COUNTY -__----
LP 0 BOX 875 GLENDIVE, MT 59330 81-0516733 501(C)3 20,000 /A N/A PPORT SGCA PROGRAJ
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------3 Enter total number of other organizations listed in the line 1 table • ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990) (2012)
•
0
JSA
fl2 E1288 10005OZONY 1985 V 12-6F 430966 PAGE 54
a
SCHEDULE I Grants and Other Assistance to Organizations,0Me No 1545.0047
(Form 990)Governments, and Individuals in the United States 2012
Department of the Treasury Complete W the organization answered "Yes" to Form 990. Part IV, line 21 or 22. • • '
Internal Revenue Seance ► Attach to Form 990. • •
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13 -556297 6
on Grants and Assistance
I Does the organization maintain re cords to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or ass istance, and
the select ion criteria used to award the grants or assistance? .. . ........... .. . . ......... .. . . ... . . .. . ... ...... . . Yes q No2 Descr ibe in Part IV the organization's procedures for mon itoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organ iz ation answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5 , 000. Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (C) utc section (d) Amount of cash(a as;s^
methoobook. FM of ^^ se.(r)(
t nPp'^oM
°ram(h) o u o(
or government If app(eb(e grail lCash thois e
non-cashassist ^
11-11B4GC OF DAYTON
1820 5 STEWART STREET DAYTON, OH 45400 31-0536657 501(C)3 95,094. /A N/A SUPPORT BGCA PROGRA)
11 2 ) BLGC OF DECATUR
P 0 BOX 744 DECATUR, IL 62525 23-7350999 501(0)3 10,038. /A N/A SUPPORT BGCA PROGRAI
_(31 SiGC OF DEEP EAST TEXAS--------------------------
P 0 BOX 631345 NACOGDOCHES, TX 75963 75-2254579 501(C)3 61,596. N/A N/A SUPPORT BGCA PROGRAI
I4 BLGC OF DEER LODGE COUNTY ------- -
116 E 7TH ST ANACONDA, NT 59711 01-0453993 501(C)3 13,500. /A N/A SUPPORT BGCA PROGRAI
$ BiGC OF DEL NORTE
311 COUNTY ROAD 93 CHIMAYO, NH 87522 02-0636404 501(C)3 28,570. /A N/A SUPPORT BGCA PROGRAJ
-62 BGGC_Ot' DELAYARE__ ________ _ _
-669 S UNION STREET WILMINGTON, DE 19805 51-0068712 501(C)3 490,635. /A N/A SUPPORT BGCA PROGRAI
7 86GC OF DELAWARE COUNTY
P 0 BOX 1260 JAY, OK 77346 73-1214669 501(C)3 125,000. /A N/A SUPPORT BGCA PROGRAI
8 BLGC OF DENISON ------- - -----------
P- 0 -BOX 23 DENISON, TX 75021 75-6056229 501(C)3 40,750. /A N/A SUPPORT BGCA PROGRAI
/9 a6GC OF DETROIT LAKES------------------------------P 0 BOX 83 DETROIT LAKES, MI 56502 41-0871442 501(C)3 37,657. N/A N/A SUPPORT BGCA PROGRA(
10 BcGC -!:!! -DORCHESTER,- INC
35 DEER ST DORCHESTER, MA 02125 23-7076465 501(C)3 147,057. N/A N/A SUPPORT BGCA PROGRAI
/L1 BGGC OF DUB ISL- ------------------------------
P 0 BOX 65 DUBOIS, WY 82513 32-0229317 501(C)3 15,000. /A N/A SUPPORT BGCA PROGRA
12 BES OF DUMPLIN VALLEY__ . . .. . . . . . . . . . . . ]
218 N HWY 92 JEFFERSON CITY, TN 37760 26-1475216 501(C)3 72,297, /A N/A UPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------
3 Enter total number of other organizations listed in the line 1 table . ............ . . .. ............... . .. . .. ... . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
JSA
5201288 1 000 5 0ZONY 1985a
V 12-6F 430966 PAGE 55
0
0
SCHEDULE IGrants and Other Assistance to Organizations,
OMB No 1545-0047(Form 990) 0.12
Governments, and Individuals in the United StatesDepartment of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • ' ' • '
Internal Re enue Ser,ce ► Attach to Form 990. • ' •
Name of the organization1Enpoyer {dtMif)catfon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
LE General Information on Grants and AssistanceI Does the organ i zation ma i ntain records to substantiate the amount of the grants or ass i stance, the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or ass istance? . ......... .............. . ..... ....... ....... ..... Q Yes q No2 Descr i be in Part IV the organ ization ' s procedures for monitoring the use of grant funds in the Untied States
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recip ient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization ( b) EIN 1c) RC sea a, ( d) Amount or cash (e) Amount or non - 10 Method of valuebon(book re"I
F o(9) Description of (h) Purpose at grant
or government it epphKab ( e grant cash assistance. .
oin' non-cash assistance or assistance
-1 B&GC OF DUNDEE TOWNSHIP------------------------------P 0 BOX 173 CARPENTERSVILLE , IL 60110 36 - 4184937 501 ( C)3 33 , 450. N /A N/A SUPPORT BGCA PROGRAM.
2 Bicc OF DURANT
PO BOX 1516 DURANT , OK 74702 27 -2922456 501(C ) 3 20,000 . / A N/A SUPPORT BGCA PROGRAP
-`3^ BLGC OF-EAST AURORA- - - - - - - - - - - - - - - -- -
P 0 BOX 36 EAST AURORA , NY 14052 16 - 0755732 501(C ) 3 25,871 . /A N/A SUPPORT BGCA PROGRAM
O BiGC OF EAST CENTRAL ALABAMA
920 NOBLE STREET ANNISTON , AL 36201 63 - 0516163 S011C ) 3 29,000 . /A N/A SUPPORT BGCA PROGRAM
-61 BiGC OF EAST COUNTY------------------------
8820 TAMBERLY WAY SANTEE , CA 92071 95 -2088013 501 ( C)3 62 , 582 /A N/A SUPPORT BGCA PROGRA?
A 6 1 BJGC OF EAST MISSISSIPPI, INC.
1717 45TH AVENUE MERIDIAN , MS 39307 64 -0728662 SO1 ( C)3 28 , 840. /A N/A SUPPORT BGCA PROGRA!
T 1 8iGC OF EAST PROVIDENCE _ ^ _
115 WILLIAMS AVE EAST PROVIDENCE , RI 02914 05-0278988 501(C)3 14,750 . /A N/A SUPPORT BGCA PROGRA!
J-81 BaGC OF-EASTERN N O_R_TH__CA_ROLINA ---------
P 0 BOX 146 JACKSONVILLE , NC 28541 58 - 1953679 501(C ) 3 13,527. /A N/A SUPPORT BGCA PROGRA)
J91 B&GC OP EASTONINC________
- -
______
P 0 BOX 741 EASTON , PA 18044 23-1941228 501(C ) 3 74,661 . /A N/A SUPPORT BGCA PROGRAI
10 BtlC OF EDEN 1HC------------------------------P 0 BOX 4628 EDEN , NC 27289 56 -0711026 501(C)3 23 , 821. /A N/A SUPPORT BGCA PROGRA)
71 BLGC OF EDINBURG RIO GRANDE VALLEY ---_--
P O BOX 1079 EDINBURG , TX 78540 74 - 2549652 501 ( C)3 121,147. /A N/A SUPPORT BGCA PROGRAJ
12 Bi ! OF EL CAMI 2 REAL -----
715 6TH STREET NATCHITOCHES , LA 71457 72 - 1166548 501 ( C)3 10 , 000. N/A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► ----_____----3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990 . Schedule I ( Form 990) (2012)
•
JSA50ZONY 1985 V 12-6F 430966 PAGE 562et2eetooor
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the Treasury Complete If the organization answered "Yes" to Form 990 , Part IV, line 21 or 22.
Internal Revenue SerMce ► Attach to Form 990.
2012
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
1 Does the mamMain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ........ . .. ..... . ...... .. .. .. ........ .... .. FE Yes No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
EMU Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
(a) Name and address of organization IN EIN (c) section} (d) Amount of cash(} (e) Amou nt of non-( Mk. of values an(book. FMV pralsal. (g) Description of (h) Purpose of grant
or government It applicable gran cash asabtence other non-cash assistance or assistance
01 2iGC OF EL DORADO
1201 NORTHWEST AVE EL DORADO , AR 71730 71- 0264300 501 ( C)3 26 , 078. N/A N/A SUPPORT BGCA PROGRA)
2 HiGC OF EL PASD --- --------- -----
801 S FLORENCE EL PASO, TX 79901 74-1145974 5011C ) 3 250,683. /A N/A SUPPORT BGCA PROGRA)
-L31 BiGC OF-EL SOSRANTE - - - - - - - - - - - - - - - - - -
P 0 BOX 20090 EL SOBRANTE , CA 94820 94 - 1525614 501(C )3 40,506 . /A N/A SUPPORT BGCA PROGRSI
4 BiGC_0F ELGIN INC -- ----- - ---------
P 0 BOX 416 ELGIN , IL 60120 36-3832212 501 ( C)3 24 , 748. /A N/A SUPPORT BGCA PROGRA?
(6j) BLGC OF ELK RIVER
905 6TH STREET ELK RIVER , MN 55330 I1-1888447 501(C)3 226 , 272. /A N/A SUPPORT BGCA PROGRA1
lsl Bi GC of EMERALD VALLEY --------------
1545 WEST 22ND AVENUE EUGENE , OR 97405 93-1264722 501(C)3 44 , 983. /A N/A SUPPORT BGCA PROGRAt
7 1 BLGC OF EKPORIA/GREENSVILLE COUNTY
P 0 BOX 972 EMPORIA , VA 23847 31 - 1592524 501(C ) 3 16,073. /A N/A SUPPORT BGCA PROGRAI
8 BLGC OF ENNI5
P 0 BOX 722 ENNIS, TX 75120 75-2746070 501 ( C)3 47,750 . / A N/A SUPPORT BGCA PROGRA)
BlGC OF ERIE -----
1515 EAST LAKE ROAD ERIE , PA 16511 25 - 1265501 501 ( C)3 26 , 000. /A N / A SUPPORT BGCA PROGRA)
1O B^GC OF ERIE COUNTY
P 0 BOX 626 SANDUSKY , OH 44871 20 -3534536 501(C)3 16,031. /A N/A SUPPORT BGCA PROGRAI
11 1 BLGC OF EVANSVILLE ------ - ---- - ---- -
716 V ILLINOIS STREET EVANSVILLE , IN 47719 35-1007558 501(C ) 3 56,119. /A N/A SUPPORT BGCA PROGRAI
12 BiGC OF FALLS COUNTY-'-----.-------------------------
-I ]P 0 BOX 1356 MARLIN , TX 76661 20 - 4832685 501 ( C)3 26 , 000. /A N/A SUPPORT B=A PROGRAI
2 Enter total number of section 501 (c)(3) and government organizations listed in the line 1 table ............................. ► __-_-__-__--_
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I ( Form 990) (2012)
•
0
n- JSA
6i2s8 i oao 5OZONY 1985 V 12-6F 430966 PAGE 57a
SCHEDULE I Grants and Other Assistance to Organizations ,OMB No 1545-0047
(Form 990)2012Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered " Yes" to Form 990, Part IV , line 21 or 22. • • '
((tam5 Revenue se'ecp f Attach to Form M. • ' •
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance) .. . ............ ...... ....... . ................... . ^ Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
5
1h
17
1 (a) Name and address of organization ( b) EIN (C) RC seas, d) Amount of cash( (e) Nnounf of non (I Method of valuation( book FMy, appraisal (g) Description of (h) Purpose of grant
or government if epplimble grant cash assatance ot haf) non-cosh esabtance or assistance
-`11 BLGC O_F_FARM_INGTON__ _____ _ __
1825 E 19TH STREET FARMINGTON NM 87401 85-0161421 501 ( C)3 48,333. /A N/A SUPPORT BGCA PROGRAM
B!LC OF FAULKNER COUNTY _
P 0 BOX 488 CONWAY , AR 72033 71 -0678783 501 ( C)3 10 , 931. /A N/A SUPPORT BGCA PROGRA)
3 BLGC OF FAU(EIER -----
9 N THIRD ST WARRENTON , VA 20186 54-1815587 501 ( C)3 31 , 461. /A N/A SU PPORT BGCA PROGRA?
_ 4 _BiG_C O_F_FOND DO_ LA_C ---------- - ---- -
P 0 BOX 562 FOND DU LAC, WI 54936 39 - 1896496 501(C)3 18,612 . / A N/A SUPPORT BGCA PROGRA?
-@j BcGC OF_FONTANA-----------------------
P 0 BOX 3712 FONTANA , CA 92334 33-0443344 501(C ) 3 56,203 N/A N/A SUPPORT OGCA
A-61 aLRC OF FORT NAYNE -------------
2609 FAIRFIELD AVE FORT WAYNE , IN 46807 35 - 1778767 501 ( C)3 44,959. N/A N/A SUPPORT OGCA PROGRA!
] BiGC OF FOX VALLEY- -----------------------------
117 S LOCUST STREET APPLETON , VI 54914 39-1225709 501(C ) 3 54,931 . N/A N/A SUPPORT BGCA PROGRA)
BaGC OF FRANKLIN-SIMPSON COUNTY , KY_ INC
P 0 BOX 898 FRANKLIN, KY 42135 61-1423661 501(C)3 32 , 415 /A N/A SUPPORT BGCA PROGRA)
_Bi_G_C_O_F_F_RE_D_ERI_C_K_C_OIIN_TY ______ __
-413 BURCK ST FREDERICK , MD 21701 26-3424855 501(C ) 3 115 , 217. /A N/A SUPPORT BGCA PROGRAI
1e BiGC OF FRESNO COUNTY
540 N AUGUSTA FRESNO , CA 93701 94 - 1149171 S01(C ) 3 239,577. N / A N/A SUPPORT BGCA PROGRA)
( 1.BLGC OF FULLERTON _-__ -__--_-
BL11C----
2200 E CCIe4ONWEALTH AVE FULLERTON , CA 92031 95 - 1855645 501(0)3 13,028 . /A N/A SUPPORT BGCA PROGRA
C!21
BiGC OF GALLUP
- - - - - - --]400 W PRINCETON GALLUP , NM 87301 31-1650341 50l i c)3 125 , 640. /A N/A SUPPORT DGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .. . ......... .... . ... ....... . . ► -____________3 Enter total number of other organizations listed in the line 1 table • ►For Paperwork Reduction Act Notice, see the Instructions for Form 990 . Schedule I ( Form 990) (2012)
•
0 JsA
22121288 1 00050ZONY 1985 V 12-6F 430966 PAGE 58
ca
SCHEDULE I Grants and Other Assistance to Organizations, °Ma No 1545•0047
(Form 990) 2©12Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to ' Form 990, Part IV, line 21 or 22 . •' •
► Attach to Form 990. • •Internal Revenue Samoa
Name of the organization Employer Identification number
BOYS 6 GIRLS CLUBS OF AMERICA 13-5562976
General Information on
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , , , .. ► _____________
3 E nter total number of other organizations listed in the line 1 table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ►V For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
1) ISA
:)012881000 50Z0NY 1985
A
V 12-6F 430966 PAGE 59
•
•
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........ _ . ... . . . . . . . . . . . . . .. . ..... . . . . .. .. L1 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (c) RC seaan (d) Amount of cash Amount of non.(e) I( ustnoa at vmueam(per rrty fvymsai (g) Deacnptl0n of (h) Purpose of grant
or government if appnrabte grant ash assistance Oth er) non-cash assistance or assistance
BiGC OF GARDEN GROVE
10540 CHAPMAN AVE GARDEN GROVE, CA 92840 95-6112702 501(C)3 168,301. /A N/A SUPPORT BGCA PROGRAI
-C21!PP 0 BOX 151 GARFIELD, NJ 07026 22-1660518 501(C)3 24,337. N/A N/A SUPPORT BGCA PROGRA)
C31 EVA
I GOODMAN ST GENEVA, NY 14456 16-1481026 S01(C)3 15,000. /A N/A SUPPORT BGCA PROGRAI
4 HiGC OF GEORGIA HEARLI - - - - - - - - - - - - - -
P 0 BOX 1808 FORT VALLEY, GA 31030 58-2471514 501(C)3 16,250.1 IA N/A SUPPORT BGCA PROGRAI
5 BLGC OF GLACIER COUNTRY HALISPELL)
P 0 BOX 7475 KALISPELL, MT 59904 81-0531133 501(C)3 15,000. N/A N/A SUPPORT BGCA PROGRAI
B(,GC OF GLOUCESTER COUNTY
2 CENTER STREET GLASSBORO, NJ 08028 54-2075655 501(C)3 69,653. /A N/A SUPPORT BGCA PROGRAI
7 BiGC OF GORDON, HURRAY i IrHITFIELD CO.- ------------------------------
P 0 BOX 309 DALTON, GA 30722 26-0725291 501(0)3 104,074 /A N/A SUPPORT BGCA PROGRAM
8 BcGC tT GRAND RAPIDS YOUTH COTMON4TEA.LTH
235 STRAIGHT AVE. NN GRAND RAPIDS, MI 49507 38-0593958 501(C)3 28,630. /A N/A SUPPORT BGCA PROGRAI
BcGC ty GRANT COUNTY
3402 S MERIDIAN STREET MARION, IN 46953 35-1065247 501(C)3 30,930. N/A N/A SUPPORT BGCA PROGRAM
Ll HLGC OF GREATER BATON ROUGE- -'--------------------------
6281 G00DWOOD BLVD BATON ROUGE, LA 70806 72-0928014 SDI(C)3 91,617. /A N/A SUPPORT BGCA PROGRAI
{11j BcGC OF_GREATER HI LLERICA INC
19 CAMPBELL ROAD BILLERICA, MA 01821 23-7106468 501(C)3 14,332 /A N/A SUPPORT BGCA PROGRA
L1---BiGC OF GREATER CINCINNATI
---------------------------600 DALTON AVENUE CINCINNATI, OH 45203 31-0536965 SDI(C)3 65,584. N/A N/A SUPPORT BGCA PROGRAI
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 154500047
(Form 990) ^rn112Governments, and Individuals in the United States V
Department of the Treasury Complete it the organtization answered "Yes" to form 990, Part TV, line 21 or 22. e • '
Internal Revenue Service ► Attach to Form 990. • e
Name of the organ¢afon Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
LEM General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? . .. ..... ............................... .... .. . . .. 0 Yee q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5 , 000. Part II can be duplicated if additional space is needed.
A
1 (a) Name and address of organization ( b) ElN (c ) Rc teeth (d) Amount of cash (a) Amount of non -(r) Method of valuation( book FyV p,a" (g) Description of (h) Purpose of grant
or government it evpheaoie grant cash e,eistence otne non-cash assistance or assistance
1 scGC of GREATER DALLAS
4816 WORTH STREET DALLAS, TX 75246 75 - 1152657 S01(C)3 1,265 , 800. N /A N/A SUPPORT BGCA PROGPAF
2 Btl C OF GREATER FLINT - --
3701 N AVERILL AVENUE FLINT , 17I 48506 38 - 3381908 501(C)3 30 , 481. /A N/A SUPPORT BGCA PROGRA?
`31 BcGC OF GREATER FORT !OATH -------
2000 ELLIS AVENUE FT WORTH , TX 76106 75 - 0808785 S01 ( C)3 208,273. /A N/A SUPPORT BGCA PROGRAF
4 1 BiGC OF GREATER GAADI NER -------------
14 PRAY STREET GARDINER , ME 04345 60-0001275 501(C ) 3 30,000 . /A N/A SUPPORT BGCA PROGRA?
-SlBiGC OF GREATER GASTON ---- - ---- - --------------------P 0 BOX 23 GASTONIA , NC 28053 56 - 1419498 501 ( C)3 84 , 256 /A N/A SUPPORT BGCA PROGRAI
L61 BiGC OF GREATER GOSHEN - ---- -
P 0 BOX 614 GOSHEN, IN 46527 35-1033735 % 501(C1 3 55,063 /A N/A SUPPORT BGCA PROGR111
7 BtGC OF GREATER HAVERHILL
P 0 BOX 483 HAVERHILL , MA 01831 04-2111215 501 (C)3 13 ,415 /A N/A PPORT BGCA PROGRA)
_BGG_C _0_F_GREA_7 EA HI_G_H _PO I NT _ --- ` -_-
P 0 BOX 2834 HIGH POINT , NC 27261 56 - 2094591 501(C)3 81,099 . N/A N/A SUPPORT BGCA PROGRJU
_C91 _!.C_OF_GREATER HOLLAND
435 VAN RAALTE AVE HOLLAND , HI 49423 38-2756671 501(C)3 21,716 . N/A N/A SUPPORT BGCA PROGRAI
'L0B&GC OF GREATER HOLYOKE
P O BOX 6256 HOLYOKE, MA 01041 04 -2103792 501(C)3 13,257 . /A N/A SUPPORT BGCA PROGAN_
11 BLGC OF GREATER HOUSTON ------
1520-A AIRLINE DRIVE HOUSTON , TX 77009 76 - 0270942 501 ( C)3 289 , 263. /A N /A UPPORT BGCA PROGRA
L!21
8 0c OF GREATCR )U\LATWZ 20
915 LAKE STREET KALAMAZOO , MI 49001 38 - 1627080 SO1(C ) 3 84,296. / A N/A SUPPORT 80cR PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ....... .............. . . . .. . . . ► ____-_--_----3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990) (2012)
•
•
JSA
EI288 1 000 50ZONY 1985 V 12-6F 430966 PAGE 60
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
( Form 990) 2012Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. e • •
Internal Revenue Serwoe ► Attach to Form 990. • • •
Name of the organization Employer IdentN(catlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
and Assistance
ci
V
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, andthe selection criteria used to award the grants or assistance? . . . ... . . . . . . . . . .. . . ... 0 Yes q No
2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part 11 can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) IRC season (d) Amount of cash Amount naryin Hamm of valuation(book h (h) sose of grant
or government If applicablegrant
cash assistanceance oln
asnon-cashh assista n ce
o
o
rr assistance
_8c_G_C_OF_G_REATE R__KAN_SA_S__I_TY__ ________
6301 ROCERILL RD KANSAS CITY, MO 64131 43-6072065 501(C)3 338,065. /A N/A SUPPORT BGCA PROGRAI
-12) B&GC OF GREATER KINGSPORT
P 0 BOX 784 KINGSPORT, TN 37662 62-0481370 501(C)3 35,256. /A N/A SUPPORT BGCA PROGRA7
-`3) BiGC OF-GREATER LACROSSE___ _________
^1331 CLINTON STREET LACROSSE, MI 54602 39-6084791 501(0)3 14,447. /A N/A SUPPORT BGCA PROGRA
4 B&GC OF GREATER LEE COUNTY
1365 GATEWOGD DR 4221 OPELIKA, AL 36830 58-1875904 501(C)3 26,063. /A N/A SUPPORT BGCA PROGRAI
_15) B&GC OF GREATER LOWELL
657 MIDDLESEX STREET LOWELL, MA 01851 04-2104396 501(C)3 50,715. /A N/A SUPPORT BGCA PROGRAI
_`s) B&GC OF GREATER LYNCHBURG_ ___ ___
1101 MADISON STREET LYNCHBURG, VA 24504 20-0199894 501(C)3 39,473. N/A N/A SUPPORT BGCA PROGRAI
_(71 B6GC OF GREATER MEMPHIS-----------------------
189 SOUTH BARKSDALE MEMPHIS, TN 38104 62-0646371 5011C)3 165,191 /A N/A SUPPORT BGCA PROGRAI
8 BLGC OF GREATER MILWAUKEE
3000 N. SHERMAN BLVD MILWAUKEE, WI 53210 39-0806292 501(C)3 291,789. N/A N/A SUPPORT BGCA PROGRAI
_Lqj B&GC OF GREATER NASHUA
47 GRAND AVENUE NASHUA, NH 03060 23-7058376 501(C)3 124,750. /A N/A SUPPORT BGCA PROGRA(
L10]_8•GC OF-GREATER NEW BEDFORD--------------'---------
166 JENNEY STREET NEW BEDFORD, MA 02740 04-2104752 501(C)3 10,071. /A N/A SUPPORT BGCA PROGRAI
1111 pt C OF_GRFATER OX_N_ARD_ i PORT H_UEN_E_ME_--__
1900 WEST 5TH STREET OXNARD CA 93030 95-1785162 501(C)3 250,755. /A N/A SUPPORT BGCA PROGRAI
12 !LIC OF GREATER PEORIA, INC.
805 EAST KANSAS STREET PEORIA, IL 61603 37-0800010 501(0)3 7,444. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , , , . . . - - - - - - - - - - - - -33 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
0
•
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AE1288 1 000 50ZONY 1985 V 12- 6F 430966 PAGE 61A
OMB No +54s-0D.7SCHEDULE I Grants and Other Assistance to Organizations ,(Form 990)
Governments, and Individuals in the United States 20 12LDepartment of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, line 21 or 22. Open to Public
Internal Revenue Sennce ► Attach to Form 990. Inspection
Name of the organ iz ation Employer IdontNhatlon number
BOYS & GIRLS CLUBS OF AMERICA t1 3-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . ................................................ El Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated d additional space is needed.
1 (a) Name and address of organization (b) EIN (C) IRC section (d) Amount of cesn (e) Amount of nor in Metnoe of valuation(book FttV,off,
Descnphon(g} of (h) p urpose of grantor government9 H ePP^^^e gram cash ®shunce of non-cash assistance or assistance
B6_G_C OF GREATER SACRAMENTO-- - ----__---
-5212 LEMON HILL AVENUE SACRAMENTO, CA 95824 68-0338324 501(C)3 232,284. N/A N/A SUPPORT BGCA PROGRAM
2 BcGC OF GREATER SALEH INC
13 HAWTHORNE BLVD SALEM, MA 01970-3709 04-2104912 501(C)3 30,415. /A N/A SUPPORT BGCA PROGRAM
_(31 BLGC-OF GREATER -SALT--
S 200 E SALT LAKE CITY, UT 84111 87-0278627 501(C)3 113,000. /A N/A SUPPORT BGCA PROGRAM
I4 BcGC OF GREATER SAN DIEGO
115 N WOODWARD AVENUE ESCONDIDO, CA 92025 95-1865988 501(C)3 496,033. /A N/A SUPPORT BGCA PROGRAM
$ BiGC OF GREATER SANTA ROSA ----------
1011 HAHMAN DRIVE SANTA ROSA, CA 95405 94-1498233 501(C)3 32,407. /A N/A SUPPORT BGCA PROGRAM
_L61.!!. C OF GREATER SCOTTSDALE -------_--_
10515 E IAKEVIEW DR SCOTTSDALE, AZ 85258 86-0133718 501(C)3 158,975. /A N/A SUPPORT BGCA PROGRAI
7 !LCC Or GREAT- --- - -- -- ------- - ---
P 0 BOX 356 VERGENNES, VT 05491 03-0359691 5011C)3 115,399. /A N/A SUPPORT BGCA PROGRA)
8 BcGC OF GREATER IiASHINGTON • ------
8380 COLESVILLE RD SILVER SPRING, MD 20910 53-0236759 501{C)3 329,515. N/A N/A SUPPORT BGCA PROGRAI
9 B[GC Or GREATER WATERBURY ----------
1037 E MAIN STREET WATERBURY, CT 06705-1040 06-0646551 5D1(C)3 58,143. /A N/A SUPPORT BGCA PROGRA)
10 BLGC OF GREATER RESTFIELD ---- - ---
2B W SILVER ST WESTFIELD. MA 01095-3627 04-2464259 501(C)3 101,665. /A N/A SU PPORT BGCA PROGRAI
^1 _BL_G_C_0_F GREE_N_BA_Y__ ---- -- ------
311 SOUTH ONEIDA STREET GREEN BAY, 54303 39-6102943 S01(C)3 83,842. /A N/A SUPPORT BGCA PROGRN
12 BiGC OF GREEN COUNTRY ---------------
1478 S ELLIOTT PRYOR, OK 74361 73-1521045 501(C)3 100.385. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ......... ................. ... ► -------------3 Enter total number of other organizations listed in the line 1 table ........ ....... ........ .... .. . . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
0E
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2F1288 1 000 5OZONY 1985 V 12-6F 430966 PAGE 62
a
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
2012
Name of the organization Employer identification number
BOYS 5 GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance •I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and ^
the selection criteria used to award the grants or assistance? . .. ..... .... .. . . .. .. . .. . . . . . .. ..... . . . .... . . .. . .. 1E Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN IQ SRC section (d) Amount of cash (e) Amount of non- ( t) Method of valuation(per FMV. appraisal (g) Description of (h) Purpose of grant
or government if applicable pn cash aeautance ot her) non-cash assistance or aaaistance
-01BcGC OF GREENVILLE c GREENE COUNTY ------
_
P 0 BOX 1977 GREENEVILLE, TN 37744 62-1706248 501(C) 3 34,438 . /A N/A SUPPORT BGCA PROGRAI
2 B6GC OF GREENWICH
4 HORSENECK LANE GREENWICH, CT 06830 06-0646655 501(C)3 7,167. /A N/A SUPPORT BGCA PROGRA)
-3- BLGC OF GREGG COUNTY, TEXAS------------------------------610 GARFIELD LONGVIEW, TX 75602 75-2695D31 501(C)3 14,837. /A N/A SUPPORT BGCA PROGRA)
_L41 BccC oF-HALIFAX COUNTY------------------------
P O BOX 1023 ROANOKE RAPIDS, NC 27870 56-1900740 501(C)3 23,343. /A N/A SUPPORT BGCA PROGRA)
$ BiGC OF HALL COUNTY------------------------------1 POSITIVE PLACE GAINESVILLE, GA 30501 58-0656890 501(C)3 104,281 /A N/A SUPPORT BGCA PROGRA)
16) B&GC OF HARLEM------------------------
425 W 144TH ST NEW YORK, NY 10031 13-3102951 501(C)3 103,750. /A N/A SUPPORT BGCA PROGRA!
B&GC OF HARLINGEN----------------------------
P 00 BOX 1982 HARLINGEN, TX 78551 74-1546529 501(C)3 60,355. N/A N/A SUPPORT BGCA PROGRA!
Bl BLGC OF HARRISONBURG---------------------------P 0 BOX 1223 HARRISONBURG, VA 22803 54-1652418 S01(C)3 56,684 /A N/A SUPPORT BGCA PROGRAJ
1 9) B&GC OF HARTFORD
170 SIGOURNEY STREET HARTFORD, CT 06105 06-6026005 501(C)3 159,750. /A N/A SUPPORT BGCA PROGRAI
/1() Bi GC OF HAWAII
1523 XALAKAUA AVE HONOLULU. HI 96826 99-6005407 501(C)3 738,232. /A N/A SUPPORT BGCA PROGRA)
11 BcGC OF HAWTHORNE -----------------
150 MAITLAND AVENUE HAWTHORNE, NJ 07506 23-7112349 5O1(C)3 55,640. /A N/A UPPORT BGCA PROGRN
I12 BiGC OF HENDERSON
JP 0 BOX 26689 LAS VEGAS, NV 89126 88-0095779 501(C)3 196,618. /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .. . ......... . . .. . ... ......... ► -------------
-3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
.7
`) JSA
2261298 t 000 50ZONY 1985 V 12-6F 430966 PAGE 63
a
SCHEDULE I _ No is.s-oo.7OMB
(Form 990)Grants and Other Assistance to Organizations,
BN01 ZGovernments, and Individuals in the United StatesDepartment of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV , l ine 21 or 22. Open to Public
Internal Revenue Service ► Attach to Form 990. Ins pecti o n
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ation on Grants and Assista
V
1 Does the flrgantzation mamtam records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, andthe selection criteria used to award the grants or assistance' , ..... . . ..... ............... ... ... ......... . . . Ii Yes q No
2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5 , 000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization() Ofg (b) EIN (e) RC section (d) Amount of rash (a) Amount of non-(q Melnoa of Valuation(per Pity, apprawal (g) Description of (h) Purpose of grant
or government If applicable grant cash aesIstance other non-cash assistance or assistance
1 BLGC Oi HENDERSON CUTBENDERSO11 LE- ----------------------------
P 0 BOX 146D HENDERSONVILLE, NC 28793 56-1803125 501(C)3 38,032. ,/A N/A SUPPORT BGCA PROGRAM
2 BLGC OF IL ANDO COUNTY -__-_------ -
5404 APPLEGATE DR. SPRING HILL, PL 34606 59-3550575 501(C13 43,019. /A N/A SUPPORT BOCA PROGRAM
_ 3 _BL_G_C_O_F_HI 2TtL _DS C_OU__T______ _ _______
111 N HIGHLANDS AVE SEBRING, FL 33870 59-3468588 501(C)3 27,297. /A N/A SUPPORT BGCA PROGRAR
_IQ4jTt1jC_RF HILL COUNTY, TEXAS, INC _--_----
315 EAST ELM STREET HILSBORO, TX 76645 74-2801002 501(C)3 16,000. /A N/A SUPPORT BGCA PROGRA!
t) BLGC OF HOCA!( NISCO HACI------------------------------HWY 77 L 75 WINNEBAGO, NE 68071 77-0648527 501(C)3 31,737. N/A N/A SUPPORT BGCA PROGRA!
_`s1 HLGC QF HOLLAND -------------------
51 SOUTH MAIN ST HOLLAND, NY 14080 38-2756671 501(C)3 15,500. /A N/A SUPPORT BGCA PROGRAF
_ 7 _HL_G_C_OF H_OL _Y110_O_D______ __ _______
850 N CAHUENGA BLVD HOLLYWOOD, CA 90038 95-1775142 501(0)3 111,546. /A N/A SUPPORT BGCA PROGRA!
_ Jg _H L_G_C O_F_H_OPKINS_V II.L_E-C_HRIS T I_AN _-- -__ _-,
1600 5 WALNUT ST HOPKINSVILLE KY 42240 20-2103260 501(C)3 115,641. /A N/A SUPPORT BGCA PROGRAI
_ 9 _H L_G_C 0_F_HD D _ON _COUNTY _ -___`__--_`_
ONE CANAL STREET JERSEY CITY, NJ 07302 22-1918943 501(C)3 132,060. /A N/A SUPPORT BGCA PROGRA)
1Q BLGC OF HUNT INGTON COVNTY -----_-----_
P 0 BOX 673 HUNTINGTON, IN 46750 35-2094506 501(0)3 49,569. N/A N/A SUPPORT BGCA PROGRA7
! :L ALLEY
16582 BROOKHURST ST 95-6192466 501(C)3 28,052. IA N/A SUPPORT BGCA PROGRAI
121 2 LGC OF HUTCHINSON !LDS RFTER SCHOOL
PO BOX 1967 HUTCHINSON, KS 67504 48-1088026 501(013 55,602. /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . . . .... ... .. ............. .. . . ► -------------
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I ( Form 990 ) ( 2012)
n
•
rV ISA
Et288 1 000 50ZONY 1985 V 12-6F 430966 PAGE 64-22a
SCHEDULE I OMB No 1545.0047
(Form 990) Grants and Other Assistance to Organizations,Governments , and Individuals in the United States 2012
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. S ' ' •
interna l Revenue seance ► Attach to Form 990. • •
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
EM. General Information on Grants and PssistameI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and q
the selection criteria used to award the grants or assistance? , , , , , , • , , ..
q
, , , , , , • , , • x Yes No2 Describe in Part IV the organizat i on's procedures for monitoring the use of grant funds in the Unrted States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
D
1 (a) Name and address of organization (b) EIN (c ) IRC section (d) Amount of cash (e) Amount or nar( r) Method of Valuation( book. Flay, apps (g) Deacnptron of (h) Purpose of grant
or government it appi cable grant cash assistance of s non-cash assistance or assistance
1 B&GC OF IMPERIAL VALLEY
P 0 BOX 1277 BRAWLEY , CA 92227 95 -2470230 501(C)3 25 , 822. N /A N/A SUPPORT BGCA PROGRAI
2 B6GC OF INDIAN RIVER--^-"-----------------------
P 0 BOX 643068 VERO BEACH , FL 32964 - 3068 59 - 3623298 501 ( C)3 39 , 481. N/A N/A SUPPORT BGCA PROGRAI
_ 3 B 6_G_C O_F_I_ND I_ANA_P_OLIS ______________ _
2236 E 10TH ST INDIANAPOLIS , IN 46201 -2006 35-OB88754 501(C)3 167 , 250. /A N /A SUPPORT BGCA PROGRAJ
86GC OF IWAKUNI-L41------------------------------PSC 561 BOX 1863 FPO, AP 96310 00 -0000000 GOVT 9,575. N/A N/A SUPPORT BGCA PROGRAI
A-51_86_GC_OF_J_AC KS ON_ __ __ _ _ ___
832 LEXINGTON STREET JACKSON , TN 38301 62 - 7123003 501 ( 0)3 58 , 700. /A N / A SUPPORT BGCA PROGRAI
B&GC OF JACKSON COUNTY
P 0 BOX 8522 MOSS POINT , MS 39562 58 - 2016844 501 ( 0)3 33,824 /A N/A SUPPORT BGCA PROGRA!
7 B6GC OF JACKSON COUNTY-
412 GORDON STREET JEFFERSON, GA 30549 26 - 1889B25 501 ( C)3 26,130. N / A N/A SUPPORT BGCA PROGRAI
$ B6GC OF JACKSON COUNTY
P 0 BOX 832 BLACK RIVER FALLS , WI 54615 39 - 2003535 501 ( C)3 15 , 000. /A NIA SUPPORT BGCA PROGRAI
9 B6GC OF JACKSONVILLE
I BOYS CLUB DR JACKSONVILLE , AR 72076-5001 27-2480374 501(C 1 3 15,779 . N/A N/A SUPPORT BGCA PROGRA7
1O B&GC OF JJt0t ILLS
200 WEST COURT STREET JANESVILLE , WI 53545 39 - 1645796 501(C ) 3 27,757 . / A N/A SUPPORT BGCA PROGRAI
r 11 B6GC OF JEFFERSON COUNTY
P 0 BOX 6027 PINE BLUFF , AR 71611 71 - 0264612 501 ( C)3 12 , 822. /A N /A SUPPORT BGCA PROGRA
/ 12 86GC OF JOHNSON CITYASHINGTON COUNTY
P 0 BOX 5219 JOHNSON CITY , TN 37602 62 - 0810733 501 ( C)3 17,393 /A N/A UPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990) (2012)
JSA
ZOE1286 1 000 5OZONY 1965
a
V 12-6F 430966 PAGE 65
C7
SCHEDULE IGrants and Other Assistance to Organizations ,
OMB No 1545-0047(Form 990) ^®^^
Governments , and Individuals in the United StatesComptets K the osganiiation answered "Yes" to Form 990, Part 1V, tine 21 or 22. s • • 'bapartment o1 Me treasury
Internal Revenue Service ► Attach to Form 990.Name of the organization Employer identification numberBOYS & GIRLS CLUBS OF AMERICA 13-5562976
General information on Grants and Assistance •I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . . . . . ............... , , ..... . FRI Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organizationor government
(b) EIN (4) LRC sectionit app a
(d) Amount of rashgrant
(o) Amount o( non-cash assistance
(perMethod o f
°val uation
( otn(g ) Description d
non-cash assistance(A) Purpose of grant
or assistance
1 B^GC OF KENOSAA - - - - - - - - - - - - - - - - - - - -
P O BOX 1761 KENOSHA , WI 53141 - 1761 39-1732935 S011C ) 3 265 , 596. N/A N/A SUPPORT BGCA PROGRA)
_`21 BcGC OF )^NTUCKI__A
-P 0 BOX 4989 LOUISVILLE , KY 40204 61-0568789 5011C ) 3 189,234. N /A N/A SUPPORT BGCA PROGRAI
3 BcGC OF xERN COUNTY
P 0 BOX 5J BAXERSFIELD , CA 93385 95 -2462246 501(C)3 251,541. /A N/A SUPPORT BGCA PROGRA)
Q B.'C OF KING COUNTY-INC.£ 1 -- ._R___-'-------------------
603 STEWART ST SEATTLE , WA 98101-1313 91-0532600 501(C ) 3 245,462 . / A N/A SUPPORT BGCA PROGRA)
5 BiGC OF INT! INC
P 0 BOX 4362 KINSMAN , AZ 86402 20 - 3534536 501 ( C)3 16 , 863. /A N/A SUPPORT BGCA PROGRA)
61 BiGC OF KINGSVILLE
P O BOX 1181 KINGSVILLE , TX 78364 74-1499178 501(C)3 13,250. /A N/A SUPPORT BGCA PROGRAI
7 !t-C OF KOOTENAI COUNTY
P 0 BOX 3598 POST FALLS , ID 83877 84 - 1635505 5011C ) 3 21,967, N/A N/A SUPPORT BGCA PROGRAJ
$ Br;GC OF KOSCIUSKO/ATTALA COUNTY
P 0 BOX 187 KOSCIUSKO , MS 39090 31 - 1767021 5011C ) 3 36,000 . /A N/A SUPPORT BGCA PROGRAI
_C91 _B 6_G_C O_F_L_A_H_ABR_A_ _ _
1211 FAHRINGER WAY LA HABRA, CA 90631 95-1922180 501(C ) 3 15,392 . / A N/A SUPPORT BGCA PROGRAI
10 B•GC OF LA PLATA COUNTY
2750 MAIN AVE DURANGO , CO 81301 20 - 5112759 501 ( C)3 30,406. N/A N/A SUPPORT BGCA PROGRAI
11 !.(C OF lAGUNA BEACH
1085 LAGUNA CANYON RD 95-1678822 501(C ) 3 53,147 /A N/A SUPPORT BGCA PROGRA
1 Z BtGC OF LAGUNA tn,D E
190 PORT ROAD PORT ISABEL , TX 18578 07 - 4917160 501103 29,500 . / A N/A SUPPORT BGCA PROGRA
A r-lner wolai nurnoer or section oui(c)(3) ano government organizations listed in the line 1 table ... ... .......... . . .... ► _____________3 Enter total number of other organizations listed in the line I table ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I ( Form 990 ) ( 2012)
•
JSA
DE1288 1 000 50ZONY 1985 V 12-6F 430966 PAGE 66.A
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue Service
Name of the organization
Grants and Other Assistance to Organizations , ° 1W 121Governments , and Individuals in the United States ®1ZComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . Open to Puk
► Attach to Form 990. Ins pe cti o r
BOYS & GIRLS CLUBS OF AMERICA
Employer Identification number
13 -5562976
I Does the organization maintain records to substant iate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? . . . .... , . . .. . . . . . . . . . . . . .. . . . . . . . ........ E Yes F-1 No2 Describe i n Part IV the organ ization ' s procedures for monitoring the use of grant funds in the United States
jj^ Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000 . Part li can be duplicated if additi onal space is needed.
9QA
1 (a) Name and address of organization (b) EIN (e) iRC section ( d) Amount of cash (a) Amount of non. ( f) Method of valuation°pp'ffi'af•(b°°k F (g) Description of (h) Purpose of grant
or government it app ),eebie grant ^n assist c.ot ho^n non-cash assistance or assistance
1 BiGC OF LARE I SUn! COUNTIES
400 EXECUTIVE BLVD LEESBURG, FL 34748 59-1524504 501(C)3 23,664 . N/A N/A SUPPORT BGCA PROGRA)
-`2) B&GC OF LAXE COUNTY
724 S GENESSE WAUKEGAN, IL 60085 36-4266009 501{C ) 3 21,849 N / A N/A SUPPORT BGCA PROGRAI
-`3! B6GC OF-LAKE EUFAULA
P 0 BOX 1058 EUFAULA , AL 36072 26 - 4093561 501(C)3 49,921. /A N/A SUPPORT BGCA PROGRAI
4 B4GC OF LAKE TAHOE
P 0 BOX 17846 SOUTH LAKE TAHOE , CA 96151 68-0241891 501 ( C)3 31,000. /A N/A SUPPORT BGCA PROGRA)
5 B&GC OF LAKELAND_ I---------^-------------------
P 0 BOX 763 LAXELAND , FL 33802 59-0171815 501(C ) 3 39,068 . N/A N/A SUPPORT BGCA PROGRA)
-`s) B&GC OF-LANCASTER------------------------
P 0 BOX 104 LANCASTER , PA 17608 23-1352044 501(C ) 3 37,762. /A N/A SUPPORT BGCA PROGRA)
B[GC OF LANGIADE COUNTY
801 FIFTH AVENUE ANTIGO , n I 54409 39 - 1980025 501 ( C)3 22 , 500. /A N /A SUPPORT BGCA PROGRA)
B&GC OF LANSING
4315 PLEASANT GROVE ROAD LANSING , MI 48910 38 - 1788281 501 ( C)3 40 , 350. /A N/A SUPPORT BGCA PROGRAI
A) B&GC Qe LAREVO
P 0 BOX 1419 LAREDO , TX 78042 - 1419 74 - 1152598 501(C ) 3 73,492 . / A N/A SUPPORT BGCA PROGRAI
L10! BcGC OF LARIMER COUNTY
103 SMOKEY STREET FORT COLLINS , CO 80525 74 - 2425914 501(C)3 84,123. N/A N/A SUPPORT BGCA PROGRAI
t'I'I! B!GC OF LAS CRUCES
330 B LAS CRUCES AVE LAS CRUCES , ?M 88005 85-0167102 501(C)3 11,250 . / A N/A SUPPORT BGCA PROGRAI
I 12 BcGC OF I.A3 VEGAS __________________
(2850 SOUTH LINDELL RD LAS VEGAS , NV 89146 94 - 2965164 501(C ) 3 295,609. 1 /A N /A DPPOAT BGCA PROGS(AI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -
33 Enter total number of other organizations listed in the line 1 table ... . ....... .. .... . .... . . . .... . ...... . . . 11111,For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) ( 2012)
is
•
JSA
ze+2ee o00 50ZONY 1985 V 12-6F 430966 PAGE 67a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) c^0Governments, and Individuals in the United States _
Department of the Treasury Complete if the org anization answered "Yes" to Form 990, Part IV, line 21 or 22. • ' '
Internal Revenue Service ► Attach to Form 990. • ' •
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
JUM General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? ................................................. 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
jjEM Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated If additional space is needed.
1 (a) Name and address of organization (b) FIN (c)1RC section (d) Amount of cosh (a) Amount of non- (r Method Of valuation
(^k F ^p^^
(g) Description of (h) Purpose of grantor government H eppIKebte get men assistance o ' nOirush assistance or assistance
_01 HiGC OF I_AYRE_NC_E____ __
- ^P 0 BOX 748 LAWRENCE, KS 66044 23-7296824 501(C)3 83,814. N/A N/A SUPPORT BGCA PROGRAM
_ 2 _Bi_G_C_0_F_L_E E _C_O_N_TY_ INC ______________
8359 BEACON BLVD FORT MYERS. FL 33907 59-2013870 501(C)3 111,063. /A N/A SUPPORT BGCA PROGRA?
$ BGGC OF LEFLORE COUNTY --- -- -_
205 DEWEY AVE STE 6 POTEAU, OX 74953 64-0594883 5011C)3 45,000. /A N/A SUPPORT BGCA PROGRA?
4 B&GC OF LENAWEE_ -__-------------------------
327 ERIE ADRIAN, MI 49221 38-3558470 501(C)3 37,200. /A N/A SUPPORT BGCA PROGRAT
5 _BC_c_C_o_F_L_Ew _ rotr_-^________________
134 PARK STREET LEWISTOWN, MT 59457 80-0114397 501(C)3 14,300. /A N/A SUPPORT BGCA PROGRA!
g BiGC OF LINCOLN/LANCASTER COUNTY------------^-----------------P 0 BOX 22344 LINCOLN, NE 60542 20-3677226 501(C)3 35,976. /A N/A SUPPORT BGCA PROGRA)
_ 7 _BiG_C _OF _IVING S_TO__CO_U_NT_Y_____ ___ - _--
P 0 BOX 311 PONTIAC, IL 61764 37-0975574 501(C)3 11,249. /A N/A SUPPORT BGCA PROGRAI
_`81 BLGC of IDDI INC.
460 PASSAIC AVE. LODI, NJ 07644 22-1632037 501(C)3 80,083. /A N/A SUPPORT BGCA PROGRAI
_ 9 _Bi_G_C_0_F_L_ONG B EACH_..................
3635 LONG BEACH BLVD LONG BEACH, CA 90807 95-1643977 5011C)3 159,946. N/A N/A SUPPORT BGCA PROGRA)
1 01 BiGC OF IARAIN COUNTY
P 0 BOX 516 OBERLIN, OH 44074 34-1856214 501(C)3 120,819. /A N/A SUPPORT BGCA PROGRAI
11 BiGC OF LOS ANGELES RARBOR
1200 S'CABRILLO AVE 95-1661682 501(C)3 112,560. N/A N/A SUPPORT BGCA PROGRAI
1_2 _BiG_C_0_F_I_T S _FRE_SN _5___-. _-__-_-_____
100 WEST 3RD STREET LOS FRESNOS, TX 78566 74-2799966 501(C)3 24,774. /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .......................... ... ► _____------__3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
•
•
JSA:)2E12e81 Boo 50Z0NY 1985 V 12-6F 430966 PAGE 68a
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
internal Revenue Service ► Attach to Form 990.
2®12
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .. . .......................... ► -------------3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the instructions for Form 990. Schedule I (Form 990) (2012)
I Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
1 (a) Name and address of organization (b) E1N in) RC section (d) Amount of cash 0 (a) Amount of non- (1) Method of valuation(per FMV. app, (g) Description of (h) Purpose of grant
or government It applicable grant ®n assistance other non-cash assistance or assistance
-01
P 0 BOX 22B LOWER BRULE, So 57546 46-0463372 501(C)3 42,959. N/A NIA SUPPORT BGCA PROGRAI
_12! B&GC OF LUNBERTON/ROBESON COUNTY-- ------
P 0 BOX 2067 LUMBERTON, NC 28359 56-1943784 501(C)3 19,511 /A N/A SUPPORT BGCA PROGRAI
$ B&GC OF LYNN- ------------------------------
25 N COMMON STREET LYNN, MA 01902 04-2103924 501(C)3 15,415. /A N/A SUPPORT BGCA PROGRAI
L41 ± OF MAGIC VALLEY
999 FRONTIER RD TWIN FALLS, ID 83301 94-3176622 501(C)3 43,992. N/A N/A SUPPORT BGCA PROGRAI
$ BAGC OF MAGNOLIA-----------------------------P 0 BOX 611 MAGNOLIA, AR 71754-0811 71-0305932 50110)3 7,500. N/A N/A SUPPORT BGCA PROGRAI
s B&GC OF )MLIBU
30215 MORNING VIEW MALIBU, CA 90265 95-4774844 501(C)3 50,546. N/A N/A SUPPORT BGCA PROGRAI
_`7! BiGC-OF-MANATEE COUNTY---------------
5211 MANATEE AVE WEST BRADENTON, FL 34209 59-0675141 501(C)3 63,555. N/A N/A SUPPORT BGCA PROGRAI
B B&GC OF MMCHESTER
555 UNION STREET MANCHESTER, NH 03104 02-0226033 501(C)3 55,250. N/A N/A SUPPORT BGCA PROGRAI
`9) B&GC! OF MANHATTAN
P 0 BOX 1294 MANHATTAN, KS 66505-1294 23-7358134 501(C)3 74,309. N/A N/A SUPPORT BGCA PROGRAI
^1O! BiGC OF_?UW_T_ECA--- - ----------------
P 0 BOX 1061 MANTECA, CA 95336 94-2751177 501(C)3 22,302. N/A N/A SUPPORT BGCA PROGRAI
11 BtGC OF MN1IN i SOUTHERN SONONA COUNTIES _ _
203 MARIA DRIVE PETALUMA, CA 94954 94-1244390 501(C)3 94,845. /A N/A SUPPORT BGCA PROGRA
L121.ftljC_OLljflR!CLN COUNTY ---- ` ----___---
P 0 BOX 4109 OCALA, FL 34478 59-1172127 501(C)3 22,000. /A N/A SUPPORT BGCA PROGRAI
0
E
Z. JSA
M2E128e 1 000 5OZONY 1985 V 12-6F 430966 PAGE 69
SCHEDULE 1 Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' • -
Intemai Revenue Serwce ► Attach to Form 990. • •
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
V
GM General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance" . ... .... ...... ...... .. .... .. ....... .. I Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes' to Form 990,Part IV, line 21 , for any recipient that received more than $5 ,000. Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization ( b) EIN (c ) RC section (d) Amount of cash (e) Amount of non- (f) Method of valuation(book F appraisal.
(9) Description of (h) Purpose of grantor governmen( it applicable gran t Cash s,la,w,m __ot.
er)_
non-caah assistance or assistance
_`1! BLGC OF MARSHALL COUNTY
314 E JEFFERSON PLYMOUTH , IN 46563 35 - 1955489 501(C ) 3 11,065 . /A N/A SUPPORT OGCA PROGRAM
2 1 BiGC OF MARTIN COUNTY
11500 S E LAKES AVENUE HOBE SOUND , FL 33455 65 - 0253002 501(0)3 134 , 214. /A N/A SUPPORT BGCA PROGRAM
3 BiGC OF MASON VALLEY
P 0 BOX 534 YERINGTON , NV 89447 88 - 0407331 501(C ) 3 45,265. /A N/A SUPPORT BGCA PROGRAM
-L41 BiGC OF MASSILLON
730 DUNCAN STREET SM MASSILLON , OH 44617 34 - 0726102 SO1(C)3 20,500. IA N/A SUPPORT BGCA PROGRAM
A51BcGC OF MAUI --------------------
P 0 BOX 427 KUHULUI , HI 96733 99- 0272347 501 ( 0)3 532,916. /A N/A SUPPORT BGCA PROGRA?
BcGC OF MAURY COUNT? -----
210 WEST EIGHTH STREET COWMBIA , TN 38401 62 - 1611131 501 ( 0)3 36 , 806. N /A N/A SUPPORT BGCA PROGRA)
/ 7 1 Ba:GC OF MCALESTER
-P 0 BOX 1111 MCALESTER, OK 74502 73 -0708243 50l ( C)3 23 , 359. /A N/A SUPPORT BGCA PROGRA)
8 BLGC of MCALt.EN INC . _____________P 0 BOX 577 MCALLEN, TX 78505-0577 74-1553646 501(C ) 3 277,689 . /A N/A SUPPORT BGCA PROGRAI
9 BiGC OF MCGEHEE
P 0 BOX 495 MCGEHEE, AR 71654 71-0813343 SO1(C ) 3 25,000. N/A N/A SU PPORT BGCA PROGRA)
1Q BIGC OF MEMA D- - ---- - ---- - -----
P 0 BOX 1043 MENARD , TX 76859 26 - 3174725 501(C)3 17 , 000. /A N/A SUPPORT BGCA PROGRA)
L1_11 BtGC OF ME R I_DEN--------------------
15 LINCOLN STREET MERIDEN, CT 06451 - 3194 06-1013015 501(C ) 3 11,745. /A N/A SUPPORT BGCA PPOGRA1
12 BiGC OP l ETRO ATLANTA ------- - --
100 EDGEWOOD AVE NE ATLANTA , GA 30303 58 - 0566123 501 ( C)3 535 , 791. /A N /A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------
3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedu le I (Form 990 ) ( 2012)
0
0 JSA
zE+2e6 i o00 50Z0NY 1985 V 12-6F 430966 PAGE 70
"5
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)2012Governments, and Individuals in the United States
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV. line 21 or 22. • ' *71
Internal Revenue Service ► Attach to Form 990. • •
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selecltoa catteria used to aviasd the grants of asststarme'li ..... ......... . ......... ... .... . . .... . .. . . ... .. .. Yes El No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed. ,
5
V
1 (a) Name and address of organization ( b) EIN Ic) I RC sec mn ( d) Amount of cash(e^h
ount of non .(0 Method of valuation(book F MV. appr
of9 ) (h) Purpose of grantor government if epplceble grant other)
ash
assistancencondeash or assistance
1 BiGC OF METRO DENVER
2017 W 9TH AVE DENVER , CO 80204 84 - 0510404 501(C ) 3 182 . 484. N /A N/A SUPPORT BGCA PROGRAI
2 BiGC_
OF METRO PHOENIX INC._ -_ _..------------------------
2645 NORTH 24TH STREET 86-0107639 501(C ) 3 192 , 611. /A N /A SUPPORT BGCA PROGRA)
_132 B6GC OF METRO RICHHOND - - - - - - - - - - - - -- - -
5511 STAPLES MILL ROAD ST 301 54 - 0564901 501 ( C)3 500,474. /A N/A SUPPORT BGCA PROGRAI
4 BiGC OF ! '!e?AO MES?- - - - - - - - - - - - - - - -- - -
169 PLEASANT STREET MARLBORO , MA 01752 - 1101 04-2387225 501(C)3 30,915 . /A N/A SUPPORT BGCA PROGRAI
-`$1 ft, C OF,MET R_OPOLI 1A_N_BAL? IM_0_RE __ ` ____- _
11 WEST MT VERNON PLACE BALTIMORE , MD 21201 26 - 4371125 501 ( C)3 213,284. /A N /A SUPPORT BGCA PROGRAI
--------------------- --(j .!L1^C - !jF 'Lull
P 0 BOX 330219 MIAMI , FL 33233 - 0219 59-0879227 501(C)3 102 , 329. /A N/A SUPPORT BGCA PROGRAJ
BiGC OF MICHI!) C1?Y
301 E 8TH STREET MICHIGAN CITY , IN 46360 35 - 1992851 501 { C)3 20 , 117. /A N /A SUPPORT BGCA PROGRAI
BLGC OF MIDDLE GEORGIA REGION, INC.
141 ELEVENTH AVENUE EASTMAN, GA 31023 58 - 2585742 501(C)3 67 , 475. /A N/A SUPPORT BGCA PROGRAJ
9 BiGC OF MIDDLE TENNESSEE
P 0 BOX 110268 NASHVILLE, TN 37222 62 - 0540402 501 ( C)3 166 , 196. /A N/A SUPPORT BGCA PROGRAI
10 BiGC OF MIDDLESEX COUNTY
191 WASHINGTON STREET SOMERVILLE , MA 02143 23 - 7072768 501(C)3 23,415 . / A N/A SUPPORT 9CCA PROGRA0
1'I 1 BGGC OF MIDLAND- - - - - - - - - - - - - - - - - - - -
P 0 BOX 284 MIDLAND , TX 79702 75-1214505 501(0 ) 3 35,000. /A N/A SUPPORT BGCP PROGRAJ
I 12 BiGC OF MILFORDL-^--------------------------
IP 0 BOX 2294 MILFORD, CT 06460-1194 27-0786009 501(0)3 36,498 . /A N/A SUPPORT BGCA PROGRAJS
2 Enter total number of section 501(c)(3) and government organizations listed in the line I table , , , , , , , , ,, , , , , , , ,,, , ,,, , , , , , , ► -------------
3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990 ) (2012)
JSA
fkE12881000 50ZONY 1985
a
V 12-6F 430966 PAGE 71
•
SCHEDULE I Grants and Other Assistance to Organizations ,OMB No 1545-0047
(Form 990) 012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •' ' e •
internal Revenue Service ► Attach to Form 990. • •
Name of the organ ization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and q
the selection criteria used to award the grants or assistance's ... .... . .... ............... ..... .. ........... . .. F1x Yes No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization (b) EIN (c) I RC rectcn (d) Amount of cash (a) Amount of nor q Method of valuation( book
F(g) Description of (h) Purpose of grant
or government if appi to grant mh ass uriceIneri
non cmh assistance or assistance
BiGC OF MISSION
P O BOX 2257 MISSION , TX 78573-2257 75-6157015 501(C ) 3 17,035 . /A N/A SUPPORT BGCA PROGRAM
2 BiGC OF MISSISSIPPI BAND OF CHOCTAW INDIANS
P 0 BOX 6010 CHOCTAW , MS 39350 64 - 0345731 501(C)3 61,031. /A N / A SUPPORT BGCA PROGRAM
$ Bi(IC OF MISSISSIPPI Co. -------_
P 0 BOX 614 BLYTHEVILLE , AR 72316 31 -1737719 5011C)3 15,705. / A N/A SUPPORT BGCA PROGRA!
_L41 a i_GC _O_F_MI 5 _OU L_A_C_O_UN_T_Y____ ____ __
-617 S HIGGINS AVE MISSOULA, MT 59801 84-1414110 501(C)3 17,583 . /A N/A SUPPORT BGCA PROGRA?
6 BGGC OF MITCHELL COUNTY _____________
120 SOUTH HARNEY STREET CAMILLA , GA 31730 58 - 1976071 501 (0)3 33, 590. /A N/A SUPPORT BGCA PROGRA?
-`62 BiGC OF MONMOUTH COVNTY
1201 MUNROE AVE P 0 BOX 189 21 - 0694373 501 ( C)3 26 , 786. /A N/A SUPPORT BGCA PROGRA!
L71.2 t.Gc OF MONTEREY S! ly Y -- ---
P 0 BOX 97 SEASIDE , CA 93955 94 -1702753 501( C)3 148,699. /A N / A SUPPORT BGCA PROGRAf
I $ BiGC OF MONTGOMERY
P 0 BOX 234 MONTGOMERY , AL 36101 63- 0302108 501 ( C13 47,248 . / A N/A SUPPORT BGCA PROGRA)
9 BiGC OF MOORPAR3C INC. ____________ __
P 0 BOX 514 MOORPARX , CA 93020-0514 77-0112701 501(C) 3 31,937 . /A N/A SUPPORT BGCA PROGRAI
10 BiGC OF MORGAN COUNTY __ _ _________
217 E HIGH ST MOORESVILLE , IN 46158 36-4541410 501(C ) 3 26,000 . / A N/A SUPPORT BGCA PROGRAI
111 BLGC OF MORGAN COUNTY
P 0 BOX 1431 DECATUR , AL 35602 63 - 0389942 501 ( C)3 24 , 930 /A N/A SUPPORT BGCA PROGRA
12 + BiGC OF MORRISTOWN
P 0 BOX 1461 MORRISTOWN , TN 37816 62-0630667 501(0 ) 3 11,653 . / A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -
.33 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
JSA
Z2E12881000 5OZONY 1985 V 12-6F 430966 PAGE 72
a
• ^
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
X012
Name of the organuouon Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
on'srants ana Assista
A
I Does the organizat ion ma i ntain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criter i a used to award the grants or ass istance'? ... .. . .. .. .. ... . . . . . . . .... . . . . . . ... . . ..... . . ... .. 0 Yes q No2 Descri be in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Past IV, Itne 21 , for any recipient that tecerved more than $5,000 Part 11 can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) IRC secoon (d) Amount of cash (e) Amount of non- (n Method of veluahon(Gook . FMV. eppre".
) Descnptlon of (h ) Purpose of g rantor government i t eppticwe grant cash uwtanoe h non-cash assistance or asmstance
i1! BiGC OF HOULTRIE/COLQUITT CoVNTY
P 0 BOX 3982 MOULTRIE, GA 31776 26 - 3586811 501(C ) 3 32,818. N/A N/A UPPORT BGCA PROGRAI
2 BiGC OF NAl1PA
316 STAMPEDE DR NAMPA , ID 83687 82-0504332 SOl(C)3 29,808. /A N/A SUPPORT BGCA PROGRAJ
! 3 BiGC OF NAPA VALLEY ------ --------
1515 PUEBLO AVE NAPA, CA 94558 94 - 6033413 501(C ) 3 30,528 . /A N/A SUPPORT BGCA PROGRAI
4 BGGC OF NASH / EDGECOI E COUNTIES
P 0 BOX 1622 ROCKY MOUNT , NC 27802 56-0934910 501(C)3 94 , 778. N/A N/A SUPPORT BGCA PROGRAI
$ BLGC OF NATIONAL CITY
1430 D AVE NATIONAL CITY , CA 91950 33 - 0204241 501(C)3 12,359 . N/A N/A SUPPORT BGCA PROGRA
6 B4GC OF NAVAL BASE KI TSAP
124 5 DEWEY STREET BLDG 864 00-0000000 GOVT 100 , 000. N /A N/A SUPPORT BGCA PROGRAI
B1.GC OF NAVARRO COUNTY ( CORSICANA, TX)(7---------------------------P 0 BOx 2322 CORSICANA , TX 75151-2322 75-2230259 501(C)3 15 , 250. /A N /A SUPPORT BGCA PROGRAI
A81BiGC OF NESNOHA i WINSTON COUNTIES
29D BYRD AVENUE N PHILADELPHIA , MS 39350 26 -0785887 5D1 ( C)3 14 , 000. /A N/A SUPPORT BGCA PROGRAI
I9 B&GC OF NE! BRITAIN INC
150 WASHINGTON STREET 06 - 0660406 501 ( C)3 15 , 000. /A N /A SUPPORT BGCA PROGRA)
1_O _BC_G_C_OF_N_E7_ H_AV_EN -------------- - -
253-259 COLUMBUS AVENUE NEW HAVEN , CT 06519 06-0646935 S01(C ) 3 62,500 . N/A N/A SUPPORT BGCA PROGRAI
11 BLGC OF NEW ROCHELLE
79 7TH STREET NEW ROCHELLE , NY 10801 13 - 1943644 501(C ) 3 80,000. N/A N/A SUPPORT BGCA PROGRAI
Lt2j BLGC _!OF NEWljRx
155 WASHINGTON STREET SUITE 202 22 - 1515405 501 ( C)3 172,750. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . ............... . . . ► .............
3 Enter total number of other organizations listed in the line 1 table . . . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
2) JSA
2E1288 1.000 5OZONY 1985
J
V 12-6F 430966 PAGE 73
0
•
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)L,®12Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 .
Internal Revenue Service ► Attach to Form 990. ' ' •
Name of the organ ization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....... ...... .. ...... . . .. ... .=V
Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
ty
1 (a) Name and address of organization (b) EIN (c) IRC rowan (d) Amount of Cash (0) Amount Of not-(f) Ma:hod of reluetbn
b-" °(910esenp0on of (A) Purposed grant
or government it ikente grant wsh ass,» oo^ i non-rash assistance or assistance
01 B!GC OF NOBLESVILLE -----
1448 CONNER STREET NOBLESVILLE, IN 46060 35-1054426 501(C)3 12,017. /A N/A SUPPORT BGCA PROGRAM.
2 Bi GC C'F NOR7H AIABA1lA ---------- -
203 EAST SIDE SQUARE HUNTSVILLE, AL 35801 63-0360026 501(C)3 445,512. N/A N/A SUPPORT BGCA PROGRJU
3 BcGC OF NORTH CENTRAL FLORILVI ------- --
P 0 BOX 1474 PERRY, FL 32348 59-2973927 501(C)3 38,960. /A N/A SUPPORT BGCA PROGRAIt
4 BiGC OF NORTH CENTRAL GEORGIA
405 COMMUNITY COURT MONROE, GA 30655 27-1029072 501(C)3 68,545. /A N/A SUPPORT BGCA PROGRA!
5 BAGC OF NORTH CENTRAL LOUISIANA --------
300 MEMORIAL DRIVE RUSTON, IA 71270 72-1375839 501(C)3 31,750. /A N/A SUPPORT BGCA PROGRAF
6 BiGC OP NORTH CENTRAL PfASSACHUSETTS ------ -------------------------
365 LINDELL AVE LEOMINSTER, NA 01453 04-3576700 501(C)3 7,915. /A N/A SUPPORT BGCA PROGRAI
7` HiGC OF NORTH CENTARTN CAROLINA - - ^ -
P 0 BOX 5094 HENDERSON, NC 27536 56-2525793 501(C)3 18,000. /A N/A SUPPORT BGCA PROGRA)
-(82 BsGC OF NORTH-CENTRAL TEXAS ---^-------
303 ALAMO AVE LAKE DALLAS, TX 75065 75-2440493 501(0)3 13,275. /A N/A SUPPORT BGCA PROGRA)
J-91BcGC OF NORTH COUNT7----------------
P 0 BOX 476 FALLBROOK, CA 92028 95-2241614 501(0)3 20,052. N/A N/A SUPPORT BGCA PROGRA)
10B!GC OF NORTH GEORGIA -------------
1826 REFUGE ROAD JASPER, GA 30143 20-2957153 501(C)3 21,655. /A N/A SUPPORT BGCA PROGRAI
FL
0 BOX 1617 KINGS BEACH, CA 96143 31-1549603 501(C)3 12,500. /A N/A DPPORT BGCA PROGAA
12 HGGC OF NORTH t4I SSISSI PPI ----
LP 0 BOX 1098 TUPELO, MS 38802 64-0880602 SO1(C)3 44,477. /A N/A SUPPORT SGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------
3 Enter total number of other organizations listed in the line I table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990 ) ( 2012)
r ]
0
n JSA212EI288 1000 5OZONY 1985 V 12-6F 430966 PAGE 74
a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 201 ZGovernments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, line 21 or 22. • ' ' '
Internal Revenue Servne ► Attach to Form 990. • •
Name of the orpanu aLOn Flnployer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
N
A
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance'? ......... ........... . . . ........... Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
jj^ Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
I (a) Name and address o1 organization (b) EIN (c) me section (d) Amount at cash (e) Amount or non (9 Method of valuation( bock FMV appraisal. (g) Deseripbon of (h) Purpose of grant
or government If applicable grant cash assistance otner,
non-cash assistance or ass istance
1 BGGC OF NORTH SAN 14^TE0 COVNTY
201 W ORANGE AVE 94 - 1497000 501 ( C)3 59 , 010. /A N/A SUPPORT BGCA PROGRAJ
_ 11 2 ) B&G_C_0F_NORTHEAST _ALABAMA I NC______ _
-
_
P 0 BOX 22 GADSDEN , AL 35902 -0022 63-0336135 501(C ) 3 107 , 765. /A N /A SUPPORT BGCA PROGRA
3 BLGC OF NORTHEAST FLORIDA
1300 RIVER PLACE BLVD STE 310 59 - 6167630 501(C ) 3 206 , 917. N/ A N/A SUPPORT BGCA PROGRAI
B&GC OF NORTHEAST LOUISIANA- ( 4 )
-----------------------------P 0 BOX 1769 WEST MONROE , LA 71294 72-0550496 501(C ) 3 13,236 /A N/A SUPPORT BGCA PROGRAI
$ BLGC OF NORTHEAST MISSISSIPPI
P 0 BOX 642 CORINTH , MS 38835 64 - 0389412 501 ( C)3 24 , 184 /A N/A SUPPORT BGCA PROGRAI
6 BLGC _OF NORTHEAST_TEXAS___ _
v
_
P 0 BOX 1876 GREENVILLE, TX 75403 75-2174005 501(C ) 3 31,172. N/A N/A SUPPORT BGCA PROGRAI
-7B6GC_OF NORTAEASTERN _PENN S YLVANIA ------
609 ASH STREET SCRANTON , PA 18510 24-0796420 501(0 ) 3 44,682 . /A N/A SUPPORT BGCA PROGRAI
r $ B&GC OF NORTHERN ARIZONA-`---------------------------
1785 W HWY 89A 2D SEDONA, AZ 86336 86 - 0688398 501 ( C)3 59 , 736 /A N/A SUPPORT BGCA PROGRAI
B&GC OF NORTHERN CHAUTAUQUA COUNTY
323 CENTRAL AVENUE DUNKIRK , NY 14048 16 - 1532389 501(C ) 3 23,844 . /A N/A SUPPORT BGCA PROGRA)
L101 B&GC OF NORTHERN SHENANDOAH--------------------------
598 N KENT STREET WINCHESTER, VA 22601 54 - 1810019 501(0 ) 3 36,579 . /A N/A SUPPORT BGCA PROGRAI
Ll B6GC OF NORTHERN 1rESTCHESTER
351 E MAIN STREET 13 - 1739924 501(C ) 3 25,238 . /A N/A SUPPORT BGCA PROGRAJ
j2 _BC_G._0_F N_ORT_H_xEST _At.ABAlIA _ - --_---___-
[216 V IRVINE AVE FLORENCE, AL 35630 63-1044596 5011C ) 3 33.637. 1 / A N/R UPPORT BGCA PROCRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . . .. . . .. . ... . . .. ...... ... . . . . ► _____________3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form SSG ) (2012)
•
0
JSA
e12e81000 5OZONY 1985 V 12-6F 430966 PAGE 75a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)2012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, tine 21 or 22. • • ' '
Interna l Revenue Service ► Attach to Form 990. • ' •
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selecti on criteria used to award the grants or assistance? . . . . . . . . . . . . . . . . . . . .............................. . Yes q No2 Describe in Part IV the organization's procedures for monitar(ng the use of grant tu"ds Ut\Red States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated If additional space is needed.
1 (a) Name and address of organizat ion (b) ElN Ic IRC section ( d) Amount of cash (6)t
if) Method of vaiuewn
( F_'
Description (h) P urpose of grantor government if eoaxaeie grant cash a,,ais e __thw) nooncashaeaatance or assistance
B&GC or NORTHWEST COLORADO------------------------------P O BOX 1251 CRAIG , CO 81626 75-3124416 SDI(C ) 3 23,500 . /A N/A SUPPORT BGCA PROGRA?
B6GC OF NORTIn T GEORGIA IHC
P O BOX 2939 ROME, GA 30164 56-0632795 501(C)3 52 , 065. /A N / A SUPPORT BGCA PROGRAA
HLGC OF NORTHMEST INDIANA INC
839 BROADWAY THIRD FLOOR GARY , IN 46402 35 - 0941137 501(C)3 167,998. /A N/A SUPPORT BGCA PROGRA?
_`41 BGGC OF NORTHirE_S_T _lf1 9_9_I S S_I PP_I_---------
P 0 BOX B25 BATESVILLE , MS 38606 64-0896230 501(C ) 3 47,000. /A N/A SUPPORT BGCA PROGRA)
BLI-C OF NORTNVES7 NEN JERSEY
----------------------------153 GARSIDE AVENUE WAYNE , NJ 07470 22 - 2169444 501(C ) 3 27,156. /A N/A SUPPORT BGCA PROGRA!
s acGC OF NORTHxEST TETIESSEE
1020 DR MARTIN LUTHER KING DR 52 - 2441482 501 ( C)3 33 , 197. N/A N/A SUPPORT BGCA PROGRA)
7 9iGC OF NOAATA
300 S PINE STREET NOWATA , OK 74048 73 - 1569971 S01(C ) 3 29,875. /A N/A SUPPORT BGCA PROGRA)
g BL C of OAKLAND
P 0 BOX 23203 OARI.AND, CA 94623 94-1279794 501(C ) 3 90,7312 N/A N/A SUPPORT BGCA PROGRAI
_Bi_GC_0_F_O_CEA_NS I_DE _C_AL_I_PO_RN I A_ I N_C . _______ '
P 0 BOX 1601 OCEANSIDE , CA 92051-1601 95-1744905 501(C)3 107 , 362. /A N /A SUPPORT BGCA PROGRIU
0 BcGC OF ODESSA INC------------------------------600 E 13TH STREET ODESSA , TX 79761 75-0990952 501 ( C)3 34 , 967. /A N /A SUPPORT BGCA PROGRAI
Z1 BaGC OF OHAAY ONINGEH
P 0 BOX 1099 SAN JUAN PUEBLO , NM 87566 85 - 0228951 501(C)3 25,000. /A N/A SUPPORT BGCA PROGRAI
Lj2 BLGc OF OKLAHOMA COUNTY--------------
P 0 BOX 18701 OKLAHOMA CITY, OX 73154 73-1172202 501(C ) 3 79,844. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------3 Enter total number of other organizations listed in the line 1 table • IN,For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990 ) (2012)
•
0
M JSA
E12ee, 000 50ZONY 1985 V 12-6F 430966 PAGE 76
a
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the TreasuryComplete If the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' ehgibilrty for the grants or assistance, and
the selection criteria used to award the grants or assistance ? . . .. . ......... . .. .... . . . . ............ . . . .. . ...... L] Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990.Part IV, line 21 , for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
IMI
V
2012
Name of the organ ization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562916
1 (a) Name and address of organization ( b) EIN (c ) RC sema,(dl
Amount of cash (e) Amount of non- (0 Method of valuationBp y( book Ftt (g) DeseripUOn of (h) Purpose of grant
Or government it eppikanla grit cash ess,stancen
other non-cash assistance or assistance
1 B&GC OF OSHKOSH^ ------------------------------
P 0 BOX 411 OSHKOSH , VI 54903 39 - 6120658 501(C)3 23,250 . / A N/A SUPPORT BGCA PROGRAI
2 B6GC OF OTTARA COUNTY
P 0 BOX 656 MIAMI , OK 74355 73-1352753 501(C)3 75,000. N/A N/A SUPPORT BGCA PROGRAI
3 BLGC OF PALM BEACH COUNTY - -----------
800 NORTHPOINT PKWY STE 204 23 - 7060561 501 ( C)3 150 , 119. N /A N/A SUPPORT BGCA PROGRAI
r 4 B6GC OF PARK COUNTY , WYOMING
1130 SHERIDAN AVE SUITE 100 CODY , NY 82414 83-0320085 501(C ) 3 15,000. N/A N/A SUPPORT BGCA PROGRAI
$̀86GC OF PARKERSBURG---------------- ---------------1200 MARY STREET PARKERSBURG , WV 26101 55 - 0476226 501 ( C)3 34,696. N /A N/A SUPPORT BGCA PROGRA
6 B6GC OF PASADENA
3230 EAST DEL MAR BLVD PASADENA , CA 91107 95-1643305 501 ( C)3 86 , 184. N/A N/A SUPPORT BGCA PROGRAI
7 B6GC OF PATERSON AND PASSAIC, INC
264 21ST AVENUE PATERSON , NJ 07501-3506 22-1726665 501tC)3 89 , 250 /A N /A SUPPORT BGCA PROGRA
_C81 B&GC OF PAYTUCKET
ONE MOELLER PLACE PAWTUCKET , RI 02860 05 -0258924 501(C)3 45,000 . /A N/A SUPPORT BGCA PROGRAJ
9 B6GC 0F_PEKIH__________ ______ __
^l ` -1101 VEERMAN STREET PEKIN , IL 61554 37-0800532 501(C)3 15 , 000. /A N /A SUPPORT BGCA PROGRAI
t1O B6GC OF PENOBSCOT NATION-----------------------------12 VABANAKI WAY INDIAN ISLAND , 1€ 04469 26-0250671 501(C)3 155 , 489. /p N /A SUPPORT BGCA PROGRAI
11 86GC OF PERTH A2fBOY
149 KEARNY AVENUE THIRD FLOOR 56-2677208 501 ( C)3 61,500. /A N/A SUPPORT BGCA PROGRAJ
11 BLGC OF PHARA - - - - - - - - - - - - - - - - - - - - -
P 0 BOX 649 PHARR , TX 78577 75 - 2258513 501(C)3 68,000. /A N/A SUPPORT BGCA PROGRP
2 Enter total number of section 501(c)(3) and government organizations listed in the line I table ....... .... .... ► -------------
3 Enter total number of other organizations listed in the line 1 table ..................... . .. ......... ....... . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
d JSA
06e1288 1 000 50Z0NY 1985a
V 12-6F 430966 PAGE 77
•
SCHEDULE I OMB No ,545.0047
(Form 990 )Grants and Other Assistance to Organizations,
Governments , and Individuals in the United States 2012
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • ' ' • ' `
No- Attach to Form 990. • •Internal Revenue ServiceName of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance1 Does the osgantzatton mamtatn TetOTds to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ................................................. . Yes q No
2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
1h
V
1 (a) Name and address of organization ( b) EIN (a ) IRC,acuan (d) Amount of cash (el Amount anon- (0 Method or vmus^kn( -oK 'MV,
ofvalurat, (p) Description of (h) Purpose of grant
or government it apptraas grant rash esa,atm,ce __ non.cash assistance or assistance
t BLGC OF PHILADELPHIA
1518 WALNUT STREET SUITE 712 23-1966756 501(C)3 230 , 305. /A N /A SUPPORT BGCA PROGRAM
2 BiGC OF PHILLIPS COUNTY-
------ - ---- --- -- ._R__t -------
P 0 BOX 511 HELENA , AR 72342 06 - 1757016 501 ( C)3 52 , 500. /A N/A UPPORT BGCA PROGRAM
-(31 at GC OF_PIKE 4 SURROVNDING COUNTIES - -----------------
1318 N THREE NOTCH ST TROY , AL 36081 - 2832 27 - 3228308 5011C)3 55,200. N/A N/A SUPPORT BGCA PROGRAM
4 !!GC OF PIi7 COUNTY INC . -----------
P 0 BOX 20293 GREENVILLE , NC 27858-0293 56-0927694 501(C ) 3 54,076 . N/A N/A SUPPORT BGCA PROGRAM
-51 BiGC OF PLEASANTS COUNTY
---------------------------P 0 BOX 308 ST MARYS , WV 26170 55 - 0761328 501(C ) 3 21,500 . /A N/A SUPPORT BGCA PROGRA?
6 Bi S OF PLYMOUTH - - ---- - --------- --
9 RESNIK ROAD PLYMOUTH , MA 02360 04 - 2103926 501 ( C)3 96 , 665. N /A N/A SUPPORT BGCA PROGRA)
-B&GC OF POMONA VALLEY
- ------------------------------P 0 BOX 1149 POMONA , CA 91769 95-2557452 5D1 ( C)3 75,700. /A N/A SUPPORT BGCA PROGRA?
PO BLUFF-`g- - -- - - - -- - - - - - --- ---------- - --- -
P O BOX 55 POPLAR BLUFF , MO 63902 43 - 1831630 501 1 C)3 23 , 624. /A N/A SUPPORT BGCA PROGRA)
9 BiGC OF PORTAGE COUNTY ---- - --- -----------------------
P 0 BOX 171 STEVENS POINT , VI 54481 73 - 1630506 501(C)3 39 , 100. /A N/A SUPPORT BGCA PROGRA?
19B&GC OF PORTER COUNTY INC.
P 0 BOX 254 VALPARAISO , IN 46384 35-1262439 SO1(C)3 73,589 . / A N/A SUPPORT BGCA PROGRAI
Lj BiGC OF PORTLAND METRO AREA - ---------
7119 SE MILMAUXIE AVE PORTLAND , OR 97202 93 - 0474800 501(C ) 3 425,129. N /A N/A SUPPORT BGCA PROGRA
Lr1Z BLGC OF PRAIRIE CENTRAL
-----------------------------P 0 BOX 71 FAIRBURY , IL 61739 37 - 1336505 501(C ) 3 7,500 . /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ... .. . . ........ .... .. ...... . . ► -_------_-_--3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
JSA
2E 1288 1 000 5 0ZONY 1985 V 12-6F 430966 PAGE 78
•
SCHEDULE I OMB No 1545-0047
(Form 990)Grants and Other Assistance to Organizations, 012
Governments, and Individuals in the United States
Department of the TreasuryComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. Open to Public
Internal Revenue Service ► Attach to Form 990. Inspection
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
LEM General Information on Grants and Assistance •
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? , _ _ , , , , , , • • • . . . . . . . . .. . . .... ..... .. ... . . ... ..... . q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
(a) Name and address of organizationrg (b) EIN (c) R2C section (d) Amount of cash (e) Amount of non-kn(r) Mslnod of
f) FMyp^pluatraisio
(book (g) Description of (h) Purpose of grantor government If applicable great ash sssintsnce otn non-rash assistance or assistance
1 _Bf_G_C_O_F P_ROV_1 DE_N_CE__ ___ _ _____
90 IVES STREET PROVIDENCE, RI 02906-3627 05-0258929 501(C)3 167,624. /A N/A SUPPORT BGCA PROGRAI
2 B&GC OF PUEBLO COUNTY- -----------------------------
2601 SPRAGUE AVE PUEBLO, CO 81004 23-7307508 501(C)3 49,725 /A N/A SUPPORT BGCA PROGRAI
132 BiGC OF_MIL1T0 R1C0 INC------------------------
p 0 BOX 79526 CAROLINA, PR D0984-9526 66-0327504 501(0)3 140,702. N/A N/A SUPPORT BGCA PROGRAI
4 B&GC OF PULASRI- -----------------------------
p O BOX 369 PULASKI, TN 38478 62-1525606 501(C)3 45,212. /A N/A SUPPORT BGCA PROGRAI
-L5I B&GC OF-REDLANDS-----------------------
P O BOX 8416 REDLANDS, CA 92375 95-6187083 S01(C)3 112,230. /A N/A SUPPORT BGCA PROGRAI
6 BIGC OF ROBERTSON COUNTY
p 0 BOX 825 HEARN, TX 77859 32-0283851 501(C)3 14,350. /A N/A SUPPORT BGCA PROGRAI
j B&GC OF ROCHESTER
500 GENESEE STREET ROCHESTER, NY 14611 16-1001619 501(C)3 177,463 N/A N/A SUPPORT BGCA PROGRAI
$ B&GC OF ROCHESTER- ------------------------------
1026 E CENTER STREET ROCHESTER, !p7 55904 41-1945875 501(C)3 71,504. /A N/A SUPPORT BGCA PROGRA)
J-91.!! iGC OF ROCKFORD
p O BOX 1716 ROCKFORD, IL 61110 36-2167940 501(0)3 78,053. /A N/A SUPPORT BGCA PROGRA!LJ.P1
B+•'GC OF ROCKMALL COUNTY
901 E INTERUBRBAN STREET ROCKWALL, TX 75087 68-0588959 501(c)3 52,401. /A N/A SUPPORT BGCA PROGRAI
I11 BiGC OF ROSEBDD- - - - - - - - - - - - - - - - - - - - -
P 0 BOX 112 MISSION, SD 57555 46-0453641 50I(C)3 73,209. /A N/A SUPPORT BGCA PROGRAJ
12 BcGC OF ROSWELL- ------------------------------
201 S GARDEN AVENUE ROSWELL, NH 88201 85-0195358 501(C)3 33,000. /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► ___-----_____3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
JSA
:2El2ee 1 o00 5OZ0NY 1985
aV 12-6F 430966 PAGE 79
0
SCHEDULE I Grants and Other Assistance to Organizations,oµe No 1545-0047
(Form 990) c,^®^Governments, and Individuals in the United States _
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 .
► Attach to Form 990. •' •Internal Revenue Serwce
Name of the organ ization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . .. ..... .... . .... . El Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
1 (a) Name and address of organization l b) EIN (c ) atc section td) Amount of cash te) Amount of non-1f) Methoo of veluauon( book FMV appraisal , (g) Description of (h) Purpose of pram
or government if applicable grant cash enlafenu,
01harl
nonGah assistance or asstalance
1 BGGC OF ROUND VALLEY --- ----------
P 0 BOX 1606 EAGAR , AZ 05925-1606 25 - 5238993 501(C ) 3 12,500 . /A N/A SUPPORT BGCA PROGRA1
2 BaGC OF RUSK COUNTY --^ - _-_----_-_----------------710 ROBERTSON BLVD HENDERSON , TX 75652 75 -2730664 50111 ) 3 16,750 . /A N/A SUPPORT BGCA PROGRA!
BiGC OF RUTHEat COUNTY-------------------^----------P 0 BOX 3343 NURFREESBORO , TN 37133 62 - 1583332 502(C)3 - 39,614 N/A N/A SUPPORT BGCA PROGRA!
4 B6GC OF RUTLAND COUNTY -- - - --------- ( 4-------------------P 0 BOX 636 RUTLAND , VT 057D2 31 - 1653365 501(c ) 3 217 , 992. N/A N/A SUPPORT BGCA PROGRA)
_ 5 _ec_G_C_O_F_SAI N_T_C_H_AR_L_E9 _COUNT_Y_______ ___
-1400 OLIVE STREET ST CHARLES , MO 63301 43-0714369 501(C ) 3 10,273. /A N/A SUPPORT BGCA PROGRA!
_`g^ BcGC OF SAINT LOCIE COUNTY------------------------
607 N 7TH ST STE 1 FORT PIERCE, FL 34950 65 - 0505369 501([)3 56,805 . N/A N/A SUPPORT BGCA PROGRAT
7 86GC OF SALEM , MARION i POLK COUNTIES - - _ -
J1395 SU2OtER STR££T NE SAL44 , OR 99301 93 -D581410 502 ( C)3 74 , 117. /A N/A SUPPORT BGCA PROGRAJ
L81 UNTY
105 COX STREET BENTON , AR 72015 23 - 0411510 501([ ) 3 46,206 . N/A N/A SUPPORT BGCA PROGRA)
BiGC OF SAN ANGELO
P 0 BOX 107 SAN ANGELO , TX 76902 75-1216481 501(C ) 3 74,500 . N/A N/A SUPPORT BGCA PROGRA)
1O BLCC OF SANANTONIO -----------
600 SW 19TH STREET SAN ANTONIO , TX 76207 74 - 1109637 501 ( [)3 713 , 676. /A N/A SUPPORT BGCA PROGRA)
`lj BaGC OF SAN BENIT0- - - - - - - - - - - - - - - - - -
P 0 BOX 443 SAN BENITO , TX 78586 74-1883913 501(C ) 3 11,250 . / A N/A SUPPORT BGCA PROGRA
12 BiGC--OF SAN DIEGUITO
-----111 •^- -----------------$33 1( tRs SANTA FE DRIVE 95-2470435 501(C)3 40 , 289 /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ...... . .. . . ... .......... .. ... 10- __-_____----_3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
0
JSA
:32E128e 1000 5OZONY 1985 V 12-6F 430966 PAGE 80
"5
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue Service
Name of the organization
Grants and Other Assistance to Organizations , "m° " ""'-"'Governments , and Individuals in the United States ©12Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . Open to '
► Attach to Form 990. Inspectio i
BOYS & GIRLS CLUBS OF AMERICA
Employer identification number
13-5562976
all I nformation on Grants and A1 Does the organtizatisn maintain records to substantiate the amount of the grants or assistance, the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . .. .. ...... . ...... . ... .. .. .. ... .. . . . .... . . . . .. . .. Q Yes q No2 Describe in Part IV the organization 's procedures for monitoring the use of grant funds in the United States.
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
1 (a) Name and address of organization ( b) ElN (c ) INC section (d) Amount of cash (e) Amount or non.( r) Method of V8NaBon(pa, fMV eppraam (9) Description of (h) Purpose of grant
or overnmentg it applicable grant ^h ana}anos Ot nent9sh assistance or assistance
-^1^ BaGC OF _FIE VALLEY- - ---- - --_-
11251 GLENOAKS BLVD PACOIMA , CA 91331 95 - 2468440 501(C)3 70,519 . N/A N/A SUPPORT BGCA PROGRAI
J 2 1 B&GC OF SAN FRANCISCO ------- - ----- --
55 hA THORNE STREET SUITE 600 94 - 1156608 501(C)3 416 , 153. N/A N/A SUPPORT BOCA PROGRA)
3 B&GC OF SAN GABRIEL VALLEY
P 0 BOX 4703 EL MONTE , CA 91734 95-2307624 501(C ) 3 34,346 . /A N/A SUPPORT BOCA PROGRA)
4 9&GC OF SAN GORGONIO PASS
P 0 BOX 655 BEAUMONT, CA 92223 20 - 3812932 502(C ) 3 98,300. /A N/A SUPPORT BGCA PROGRA)
5 Bccc of sAx etgRCOs------------------------------I POSITIVE PLACE SAN MARCOS , CA 92069 95-3330218 501(C ) 3 58,500 . /A N/A SUPPORT BGCA PROGRAI
6 1 B&GC OF SANFORD / LEE COUNTY
P 0 BOX 2027 SANFORD , NC 27331 56 - 1923703 501 ( C)3 193,413. /A N/A SUPPORT BGCA PROGRAI
7 B&GC OF SANTA ANA
1615 E 17TH ST STE 150 SANTA ANA, CA 92705 95-1893417 501(C ) 3 67,407 . N/A N/A SUPPORT BGCA PROGRA)
-^$1 BLGC OF SANTA BARBARA------------------------
632 E CANON PERDI DO ST 95-1641425 SO1(C)3 22,365 . N/A N/A SUPPORT BGCA PROGRAI
_`9) B&GC OF SANTA CLARA VALLEY
806 RAILROAD AVENUE SANTA PAULA, CA 93060 95-2497853 501(C ) 3 41,563 . N/A N/A SUPPORT BGCA PROGRA)
L1 Q! BLGC OF SANTA CRUZ---------------------------
P 0 BOX 873 SANTA CRUZ , CA 95061 94 - 6129075 501 ( C)3 21,746 . /A N/A SUPPORT BGCA-PROGRA!
/ 11 BiGC OF SANTA MARIA VALLEYL_ -__-•------__---'-------------
901 NORTH RAILROAD AVENUE 92 -2468116 5D1 ( C)3 19 , 685. /A N/A SUPPORT BOCA PROGRA
12 _B i_G_C_OF_5_ANTAMONICA _ _
- 1238 LINCOLN BLVD SANTA MONICA CA 90401 95 - 1890706 501 ( C)3 182 , 075. /A N/A [S UPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . . . . . .. . . ... . . ........ ... . .. ► -------------3 Enter total number of other organizations listed in the line 1 tableFor Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I ( Form 990) (2012)
0
JSA
2)2012e81000 50ZONY 1985 V 12-6F 430966 PAGE 81
a
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue service ► Attach to Form 990.
2012
Name of the organization Employer Identlflcatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
U-M General Information on Grants and Assistance1 Does the organization maintain seconds to substanl)ate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . ....... . . . . . . .................................. Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
1h
t]
1 (a) Name and address of organization (b) EIN (t( INC secUOn (d) Amount of cash (e) Amount or non-( f) Method or ymua6on( per Ftry ^^yy (g) Description of (h) Purpose Cl grant
or government H ownwe G^ ®sn auJe nce dirt mn^eh assistance or assistance
1 BsGC of SARASOTA COUNTY
1226 N TAMIANI TRAIL SARASOTA , FL 34236 59 - 6211876 501 (C)3 210 ,561 /A N /A SUPPORT BGCA PROGRAM.
2 BaGC OF SCHENECTADY --- -
P 0 BOX 466 SCHENECTADY , NY 12301 14 - 1364595 501 ( C)3 69 , 750. /A N / A SUPPORT BGCA PROGRAM
_ 3 _BtG_C OF_5_CORRY _COU_N_TY TEXAS__I NC --_ - _--
P 0 BOX 127 SNYDER, TX 79549 75-0952235 501(C)3 15,500 . /A N/A SUPPORT BGCA PROGRAM
4 BiGC OF SEQUOYAA COUNTY i
111 N ELM SALLISAW , OK 74955 73 - 1128670 501(C)3 127, 500. /A N /A SUPPORT BGCA PROGRAM
A51BtIL OF SHEBOYGAN COIR4TY --------`
319 CEDAR ST SHEBOYGAN FALLS, WI 53085- 1561 39 - 1246782 501 ( c)3 16 , 000 /A N / A SUPPORT BGCA PROGRAR
_l61 BGGC OF SIDNEY
21 LIBERTY STREET SIDNEY , NY 13B38 22 - 3080023 501 ( C)3 22,498. N /A N/A SUPPORT BGCA PROGRAR
7 BcGC OF SIERRA BLANCA
- - - - - - - - - -- -134 REESE DRIVE RUIDOSO , NM 88345-6016 27-0586442 501(C)3 20,000. /A N/A SUPPORT RGCA PROGRA)
A8j BLGC OF SIERRA COUNTY
P 0 BOX 3262 95-0469246 501(C ) 3 18,581. /A N/A SUPPORT BGCA PROGRAI
9 BLGC OF SIERRA VISTA
P 0 BOX 688 SIERRA VISTA , AZ 85635 86-0801728 501(C)3 20 , 809. /A N/A SUPPORT BGCA PROGRAI
091BtGc OF SILICON VALLEY --------- - ----
518 VALLEY WAY MILPATAS , CA 95035 94 - 1294898 501 ( C)3 203 , 016. /A N/A SUPPORT BGCA PROGRAI
11 BcGC OF SIMI VALLEY ----------------
2850 LEMON DR SIMI VALLEY , CA 93063 95 -2811018 501 (C)3 43,759 . /A N/A UPPORT BGCA PROGRAI
12 BL_GC_OF_5_NOHOMI_SH_COUNTY---------- - ---
4322 RUCKE R EVERETT , WA 98203 91-0549511 501(C ) 3 292,110. /A N/A UPPOAT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . .... ... . ... ........ . . .. ..... ► ------------_3 Enter total number of other organizations listed in the line 1 table • ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I ( Form 990 ) 12012)
0
0
JSA
d2Esq
728a 1 00050Z0NY 1985 V 12-6F 430966 PAGE 82
a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)C5
• ^
Governments, and Individuals in the United StatesComplete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •' • `Department of the Treasury
d12
Internal Revenue Samoa le. Attach to Form 990.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-556 2976
General Information on (
g
A
A floes the organization maintain records to substantiate the amount of the grants or assistance , the grantees' ellgibilrty for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . ..... . ....... .... ........ . ... . . . .. .... . . ....... 0 Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that rece ived more than $5,000 . Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (e ) RC section (d) Amount of cash (s} Amount of non-(1) Method of valumpn(W* FMV.
apPia'sal(g) Description of IN Purpose of grant
or government d apps Ie grant coh assistzince Orn non-cash assistance or assistance
1 BtRc OF SOMERSET COUNTY
P O BOX 752 SOMERSET , PA 15501 20 -0685300 501 ( C)3 20 , 476. /A N/A SUPPORT BGCA PROGRAI
C21 BiGC OF SONOl4^ VALLEY_•---------------------------P 0 BOX 218 EL VERANO , CA 95433 94 - 1579901 501 ( C)3 37,500 . / A N/A SUPPORT BGCA PROGRAI
_L31 HiGC OF SOUHEGAN VALLEY
P 0 BOX 916 MILFORD , NH 03055 02 -0450773 501 ( C)3 25 . 640. N /A N/A SUPPORT BGCA PROGRAI
-(4) B&GC OF-SOUTH ALABAMA ---------------
1102 GOVERNMENT ST MOBILE , AL 36604 63 - 0414826 501(C)3 32,068 . /A N/A SUPPORT BGCA PROGRAI
$ HtGC OF SOUTH CENTRAL ALpHAHA
456 SOUTH COURT STREET MONTGOMERY , AL 36104 63-0196124 501(C ) 3 29,211 /A N/A SUPPORT BGCA PROGRAI
I s BLGC OF SOUTH CENTRAL KAlISAS
2400 N OPPORTUNITY DRIVE WICHITA . KS 67219 48-1071303 501(C ) 3 54,241 . / A N/A SUPPORT BGCA PROGRAI
7 BcGC OF 500TH CENTRAI, TEXAS --- _
400 UHLAND ROAD SAN MARCOS , TX 78666 74 -2729963 501 ( C)3 36 , 905 /A N/A SUPPORT BGCA PROGRAI
- -COUNTYB&GC OF SOUTH-----_`^-----------------------
P 0 BOX 520 IMPERIAL BEACH , CA 91933 95 - 3667707 SO1LC ) 3 201 , 047 N/A N/A SUPPORT BGCA PROGRAI
BirC OF SOUTH LOGAN COUNTY
P O BOX 545 BOONEVILLE, AR 72927 71-0848678 501(C ) 3 23,750 /A N/A SUPPORT BGCA PROGRA!
^^ HGGC OF SOUTH OAKi.AND COUNTY
1545 EAST LINCOLN AVENUE 38-1579180 501(C)3 182,173 . /A N/A SUPPORT BGCA PROGRAI
W BcGC OF SOUTft PARX
P 0 BOX 2167 FAIRPLAY , CO 80444 68 - 0538363 501IC ) 3 11,000 . /A N/A SUPPORT BGCA PROGRA
U IL
1501 PACIFIC AVENUE STE 301 91-0759832 501(C ) 3 559,549. /A N/A SUPPORT BGCA PROGPJ
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . ...... . . ..... .. ........... .. ► __-_--__-___-
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990- Schedule I (Form 990 ) ( 2012)
-0 JSA
E128e 1000 5OZONY 1985
a
V 12-6F 430966 PAGE 83
•
•
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 15454047
(Form 990) 012Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, line 21 or 22 . • • '
Internal Revenue Service ► Attach to Form 990. • ' •
Name of the organization Employer IdonUflcalJon number
BOYS & GIRLS C LUBS OF AMERICA 13-5562976
terat
I Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? .... . ............................................ [] Yes q No
2 Describe in Part IV the organization' s procedures for monitoring the use of grant funds in the United States
jiMM Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5 , 000. Part it can be duplicated if additional space is needed
(a) Name and address of1 organization (b) EIN (c) RC eecUOn ( d) amount of cash to) Amount of non.(1) Method of Valuation(book . FMV appraisal (g) Description d (h) Purposed grant
or government If applicable grant cash asaakmce 0111 6TI non-coah assistance or assistance
1 BtGC OF SOUTH SAN LUIS OHISPO COUNTY
P 0 BOX 1005 OCEANO. CA 93475 77 - 0390117 501 ( C)3 43 , 500. /A N/A SUPPORT BGCA PROGRAF
- - - - - - - - - - - -- -2 !iRC OF SOVTH VALLEY, THE
P 0 BOX 57071 MURRAY , UT 84157 87-0304654 501(0 ) 3 104 , 389. N /A H/A SUPPORT BGCA PROGRAM
BiGC OF SOUTHCENTRAL ALASKA
2300 WEST 36TH AVE ANCHORAGE , AK 99517 92 - 0036082 501(C ) 3 1,263,689. N/A N/A SUPPORT BGCA PROGRA?
4 BiGC OF SOUTHEAST ALAHA?0\, INC
P 0 BOX 219 OZARK , AL 36361 58 -2010059 501 ( C}3 69 , 890. /A N/A SUPPORT BGCA PAOGRA?
-^$^ BiGC OF SOOTHEAST GEORGIA
P 0 BOX 1193 BRUNSWICK , GA 31521 58 - 0973039 501 ( C)3 112 , 912. /A N /A SUPPORT BGCA PROGRA)
`61 t.GC OF SOUTHEAST LOUISIANA
650 POYDRAS STREET SUITE 2225 72-0648695 501(C ) 3 96,851 . /A N/A SUPPORT BGCA PROGRA)
] BLGC OF SOUTHEAST VIRGINIA
3415 AZALEA GARDEN RD NORFOLK , VA 23513 54 - 0515764 501(C ) 3 46,403 N/A N/A SUPPORT BGCA PROGRA)
8 1 t.Gc OF 60UTHEASTERN CONNECTICUT
30 CENTRAL AVE GROTON , CT 06340 06 - 1509637 501(C)3 18.465. /A N/A SUPPORT RGCA PROGRA)
BiGC OF SOUTHEASTERN MICHIGAN
26777 HALSTEAD ROAD SUITE 100 38 -1387123 501 ( C)3 327 , 551. /A N /A SUPPORT BGCA PROGRA)
LIP! aiGC OF SOUTHERN CAROLINA--------------------------
1750 JACKSON ST BARNWELL , SC 29812-1569 90-0422160 501(C)3 44,154. /A N/A SUPPORT BGCA PROGRAI
^11I tlGc OF SOUTHERN MAINE-------------------------
P 0 BOX 7830 PORTLAND, ME 04112 01-0211543 5011C)3 116,132. /A N/A SUPPORT BGCA PROGRA
12 BiGC OF SOUTHERN MARYLAND------------------------------P 0 BOX 413 LUSBY , MD 20714 - 0413 52 - 2145392 501 ( C)3 66 , 951. N / A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table . . . . . . .. . .......... . ......... ► _-______-----
3 Enter total number of other organizations listed in the line 1 table • ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
n
p JSA PAGE 84n2E1288 1,000 50ZONY 1985 V 12-6F 430966
A
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue service
Name of the organization
Grants and Other Assistance to Organizations, OMB No 1545.0
Governments, and Individuals in the United States 2©12Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. Ope n 4
► Attach to Form 990. Ins pe ctioi
BOYS 6 GIRLS CLUBS OF AMERICAEmployer Identification number
13-5562976on grants a
1 Does the organ ization mainta i n records to substantiate the amount of the grants or assistance, the grantees ' eligibility for the grants or assistance, and ^the selection criteria used to award the grants or assistance? . . . . . . . . . . . .. .. .. . , . , , , , . . . L:J Yes 13 No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV , line 21 , for any recip ient that received more than $5,000. Part li can be duplicated if additional space is needed.
1 (a) Name and address of organization (b) EIN (c) RC section (d) Amount a cash (e) Amount of no. M Method of valuationF
bDescription of grantsose of
(h^or government it applicable grant cash assistance ( o* n^sm' non-cash assistance
ceof
_(12 84GC OF SOOT165 RENSSELAER COl)NTY
544 BROADWAY RENSSELAER, NY 12144 14-1471475 501(C)3 26,553. /A N/A SUPPORT BGCA PROGRA
21 BLGc OF SOOTHWEST AIA_8_AN_A _
^P O BOX 158 THOMASVILLE, AL 36784 72-1363534 501(0)3 22,186. N/A N/A SUPPORT BGCA PROGRAI3 B&GC OF SOUTHWEST COUNTY
P 0 BOX 892349 TEMECULA, CA 92589-2349 33-0475756 501(0)3 247,972. /A N/A SUPPORT BGCA PROGRAI`4) asGC OF SOUT}nJEST NISSI SSIPPI
P O BOX 7 304 XCCO)B, MS 39649 64-0806571 501(C)3 103,154. N/A N/A SUPPORT BGCA PROGRAI-`$1 BLGC OF-SOUTHWEST MISSOURI--___
P 0 BOX 819 JOPLIN, MO 64602 44-0627566 501(C)3 77,750 N/A N/A SUPPORT BGCA PROGRAIBaGC-OF-SOUT_HWE_8_T_MON_TANA__ __ ----_
600 BRIDGER DRIVE BOZEMAN, MT 59715 81-6013668 501(C)3 21,913. N/A N/A SUPPORT BGCA PROGRAI
71 B&GC OF SOUTHWEST VIRGINIA
1714 9TH STREET SE ROANOKE, VA 24013 54-1867366 501(C)3 60,041. /A N/A SUPPORT BGCA PROGRAI
_( 8) BLGC_0F 5OUTHWEST WASHINGTON __
409 NE ANDERSON ROAD VANCOUVER, WA 98665 91-1978646 501(C)3 32,046 N/A N/A SUPPORT BGCA PROGRA!
9 B&GC OF SOUTHWESTERN OREGON
P 0 BOX 1082 COOS BAY, OR 97420 93-0816161 501(0)3 10,840. /A N/A SUPPORT BGCA PROGRA?t0 BcGC OF SPARTA
1000 E MONTGOMERY SPARTA, NI 54656 39-1798177 501(0)3 35,358. N/A N/A SUPPORT BGCA PROGRA!
1 `BiGC OF SPOKANE COUNTY - - - - - - - - - - - -
- - - -544 EAST PROVIDENCE SPOKANE, WA 99207 91-1963357 501(C)3 55,600. /A N/A UPPORT BGCA PROGRA)
1 B!GC OF SPRINGFIELD
1410 NORTH FREMONT SPRINGFIELD, MO 65802 44-0513659 501(C)3 40,950. N/A N/A SU PPORT BGCA PROGRA!z Inter total number of section 501(c)(3) and government organizations listed in the line 1 table . . . . ........ . . ►3 Enter total number of other organizations listed in the line 1 tableFor Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
0
.ISA
a2E1288 1 000 5OZONY 1985 V 12-6F 430966 PAGE 85a
SCHEDULE I Grants and Other Assistance to Organizations,0MB No 1545-0047
(Form990)©12Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • - '
Internal Revenue service ► Attach to Form 990. ' ' •
Name of the organization Employer Identificati on number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criter ia used to award the grants or assistance? ... ...... .. .............. ...... . ....... ... . .. .. .. 0 Yea q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
Li
b
1 (a) Name and address of organization (b) EIN ( o) utC section ( d) amount at =h (e) Amount of non-(1 Method of valuationbook. ralsal,
f(g) Description Of (h) Purpose of grant
or government if appIka to grail cash euwa+ce o r) non•canh assistance or assistance
1 BiGC OF ST HELENA INC ---------------
1420 TAINTER STREET ST HELENA , CA 94574 68-0226714 501(C ) 3 30,000 /A N/A SUPPORT BGCA PROGRAM
/ 2!--BiGC OF STANFORD
--` -------------------------347 STILLWATER AVENUE STAMFORD , CT 06902 06 - 0646911 501(C ) 3 75,250 /A N/A SUPPORT BGCA PROGRAM
3 BiGC OF STAN 2N - - - - - - - - - - - - - - - - - - - -11050 CEDAR STREET STANTON , CA 90680 95 - 2913402 5011C)3 24,820 /A N/A SUPPORT BGCA PROGRAM
4 _8c GC_OF_S_TOC_KTON -- - ----- - ---------
P 0 BOX 5483 STOCKTON , CA 95205 94 - 1567094 501(0)3 71,101 /A N/A SUPPORT BGCA PROGRAI
5 BLGC OF SUFFOLK COUNTY. INC.
P 0 BOX 593 STONY BROOK , NY 11790 11 - 2437849 501 ( C)3 16 , 989. IA N/A SUPPORT BGCA PROGRA?
B 86GC OF SYRACUSE ------------------
2100 EAST FAYETTE STREET SYRACUSE , NY 13224 15-0532240 5011C)3 80.987 . / A N/A SUPPORT BGCA PROGRA!
7 BLGC OF TABULA ROSA----------------------------11939 NW STATE ROAD 20 BRISTOL, FL 32321 20 - 5421558 5011C ) 3 26,283 /A N/A SUPPORT BGCA PROGRA)
_`81 Bice OF TAHLEQUAN _ OK.-- - ------------
SEQUOYAH UNIT 649 PENDELTON STREET 73 - 1505432 501 ( C)3 336 , 000. /A N/A SUPPORT BGCA PROGRA)
9 BLIC of TAMPA BAY --------- - -------
1307 NORTH MACDILL AVE TAMPA, FL 33607 59 - 0624368 501(C)3 247 , 525. /A N/A SUPPORT BGCA PROGRA)
0.91 Bt. C OF TAUNTON---------------------------
31 COURT STREET TAUNTON , MA 02780 04 - 2133246 5011013 18,415 . /A N/A SUPPORT BGCA PROGRAI
11 BtGc OF THE ALTAC LA AREA
310 SOUTH 11TH ST JESUP, GA 31545 - 0720 21-7041873 501(C ) 3 78,529 . /A N/A SUPPORT BGCA PROGRAJ
12 BLGC OF THE ARKANSAS RIVER VALLEY
P 0 BOX 1477 RUSSELLVILLE , AR 72811 71 - 0601999 503 ( 0)3 36,787 /A N /A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .. . . ..... . ................... ► _------------3 Enter total number of other organizations listed in the line 1 table .... ...... .. ...... ........ ... ..... . . . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) 12012)
: JSA
02E1288 1 000 50ZONY 1985
a
V 12-6F 430966 PAGE 86
•
SCHEDULE I Grants and Other Assistance to Organizations, OMB No 1545-0047
(Form 990) ^01tGovernments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •internal Revenue service ► Attach to Form 990.Name of the organization
Employer identification numberBOYS & GIRLS CLUBS OF AMERICA 13-5562976
%aenerai inrormaaon on grants an(I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? , , , , , , , , , , , , ,, , ,, , ,, , , , , , , , , Yes q No2 Describe in Part IV the organ ization's procedures for monitoring the use of grant funds in the United States.
ff^ Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes' to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
1 (a) Name and address of organizationor overnment
(b) EIN (c) (RC seam of cash( d)
Ar"g^an
(e) Amount w non M Method of vduauon( Fes, appratse (g)g If ie t cash assista nce.
non-cash assistance orr assistance
HiGC OF THE IN AREA------------------------------5407 N INTERSTATE 35 AUSTIN , TX 78723 74 - 6087356 501(C ) 3 195 , 122. /A N/A SUPPORT BGCA PROGRAI
2 HLGC OF THE EAR'S PAS
R R I-BOX 612 BOX ELDER , MT 59521 81-0473537 501(C ) 3 70,000 . N/A N/A SUPPORT BGCA PROGRAI
3 SiGC OF 7'HE BELLPORT AREA
471 ATLANTIC AVE. BELLPORT , NY 11713 23 -7376060 501 ( C)3 31 , 000. /A N/A SUPPORT BGCA PROGRA!4 BiGC OF THE BENI DJI AREA
1600 MINNESOTA AVE NW BEMIDJI, MN 56601 81-0599601 501(C)3 23,463. /A N/A SUPPORT BGCA PROGRAIB&GC OF THE HIG BEND
306 IAURA LEE AVENUE TALLAHASSEE , FL 32301 59 - 3076558 501(C)3 168,403. /A N/A SUPPORT BGCA PAOGAAI
_(61.! tGC IF THE HIG 15Li1ND
100 KAMAKAHONU STREET HILO , HI 96720 81 - 0575345 5D1(C)3 521.622 N/A N/A SUPPORT BGCA PROGRAI] BtGC OF THE HIG PINES
- --- -------------------------P 0 BOX 2041 MARSHALL , TX 75671 75-2318241 501(C ) 3 105,474. N /A N/A SUPPORT BGCA PROGRAI
_ $ _B iG_C _!IF T_HE _B_LAC_K_H I L_L_S_---------
P 0 BOX 677 HILL CITY , 5D 57745 46-0332124 5D1(C ) 3 162 , 227. N /A N/A SUPPORT BGCA PROGRA!
-9 B&GC
-OF-THE BLUE- RIDGE ----=---------
6 EAST MAIN STREET STE A 26 - 3166453 501(C)3 60,927 . /A N/A SUPPORT BGCA PROGRIUL101 84GC OP THE CAPITAL AREA
5407 NORTH INTERSTATE 35 SUITE 400 74-6087356 501(C ) 3 30.336 /A N/A SUPPORT BGCA PROGRA?
11 BiGC OF 7NE CAPITAL CITY
727 E ELM STREET JEFFERSON CITY , MO 65101 43-1733063 501(C ) 3 25,963 . /A N/A SUPPORT BGCA PROGRA?
12 HiGC OF THE CASA GRANDE VALLEY
P 0 BOX 10291 CASA GRANDE , AZ 85230 86 - 0864429 501(C } 3 63,995 N/A N/A SUPPORT BGCA PROGRAT2 Enter tota l number of section 501(c)(3) and government organizations listed in the line 1 table ..... , ►3 Enter total number of other organizations l i sted in the line 1 tableFor Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)JSA
E1288 1000 5OZONY 1985 V 12-6F 430966 PAGE 87
C:
•
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990. •
Name of the orpenisotion 7Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
FITM General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ') .. .. . . . . ..... .... ... . ..... . ..................... X Yes No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
(a) Name and address of organization h EIN() (c ) iRC sect ion (d) Amount at cash ( e) Amount of non,( r1 Method of vau,auon
preisd(Do*F
(g) Description of (h) Purpose of grantor government it eppumWe grant cash sssntance a non-Cash assistance or assistance
1 BiGC OF THE CHATTAHOOCHEE VALLEY
1700 BUENA VISTA ROAD COLUMBUS , GA 31906 58-1174393 5011C)3 70,298 . /A N/A SUPPORT BGCA PROGRAM
2 BcGC of THE COASTAL EMPIRE -----_----
510 E CHARLTON STREET SAVANNAH , GA 31401 58 - 0622969 501(C)3 86,403. /A N/A SUPPORT aOCA PROGRAM
$ Bt GC OF THE COASTSIDE ---------- -
P O BOX 545 HALF MOON BAY , CA 94019 94 - 3193725 501(C)3 25,833. N/A N/A SUPPORT BGCA PROGRA),
! Q BiGC ty THE COLORADO-RIVER
---- -
P 0 BOX 20688 BULLHEAD CITY . AZ 86439 86-0573993 501(C)3 89,930. /A N / A SUPPORT BGCA PROGRA?
$ BtCC OF THE COLUlOlIA AREA ---- - ---
1002 FAY STREET COLUMBIA , MO 65203 43-7662116 501(C ) 3 38,760 . /A N/A SUPPORT BGCA PROGRA!
L61 2!UMID A HASIN ----
P 0 BOX 591 MOSES LAKE , WA 98837 91 - 1634789 501(C)3 19 , 762. /A N/A SUPPORT BGCA PROGRAI
7j---BiGC OF THE CUMBERLAND PLATEAU_L ---------------------------17025 ALBERTA STREET ONEIDA , TN 37841 20-5767918 501 ( C)3 22 , 482. N /A N/A SUPPORT BGCA PROGRA!
_`8j BiGC Or THE DANVILLE AREA---------------------
123 FOSTER STREET DANVILLE , VA 24541 54-1880308 501(C ) 3 30.835 . / A N/A SUPPORT BGCA PROGRA)
9 86GC OF THE DIABLO VALLEY
1301 ALHAI4BRA AVENUE MARTINEZ , CA 94553 94-1333618 501 ( C)3 52,378. /A N /A SUPPORT BGCA PROGRAI
1101 BcGC OF THE EAST VALLEY--------------------------
1405 E GUADALUPE RD STE 4 TEl4PE , AZ 85283 86 -0550646 501 ( C)3 238 , 041. /A N/A SUPPORT BGCA PROGAA)
11 Hi GC OF THE EASTERN PANHANDLE __- - ---_
P 0 BOX 1184 MARTINSBURG , WV 25402 20 - 2257657 501(0 ) 3 60,539 . /A N/A SUPPORT BGCA PROGRAI
12 _B f_G_C_Or_T_HE EtdE_AAI. D_C_OAST -----__--^__
923 DENTON BLVD NW 59 - 1267050 501(C)3 63 , 105. N/A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line I table - - - - - - - - - - - - -
33 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
11 JSA
:12E12881000 SOZONY 1985c3
V 12-6F 430966 PAGE 88
0
•
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV , line 21 or 22.
Internal Revenue Seneca ► Attach to Form 990.
2012
Name of the organ ization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees ' eligibility for the grants or assistance, andthe selection criteria used to award the grants or assistance? . . . .... . .. ..... .. . .. ... . ... . ............ ... ...... . Yea q No
2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recip i ent that received more than $5 , 000. Part li can be duplicated if add itional space is needed
1 (a) Name and address of organization ( b) EIN (e) iRC section (d) Amount of cash a) Amount of non. ( W Method e} valuationpos(9) Description of (h) Pur e of grant
or government H applicable grant cash msatence an non-cash assistance or assistance
1 Br,GC OF THE FLATHEAD RESERVATION AND LAKE C
P 0 BOX 334 RONAN , MT 59864 91-0515029 501(C)3 50,500 . /A N/A SUPPORT BGCA PROGRN
-f21+ BLGC Of THE FOOTHILLS------------------------------600 S SHAMROCK AVE MONROVIA , CA 91016 95-4453545 501(C ) 3 104 , 630 /A N/A SUPPORT BGCA PROGRAI
$ BLGC OF THE FORT PECK RESERVATION ---` _ -
502 MAIN STREET WOLF POINT , MT 59201 61-0479451 501 ( C)3 30 , 317 N / A N/A SUPPORT BGCA PROGRAI
4 BtGC OF THE GRAND RIVER AREA ----- ---
P 0 BOX 229 MCLAUGHLIN , SD 57642 46-0376995 501(C)3 48,069 /A N/A SUPPORT BGCA PROGRA)
$ Hi GC--OF THE GRAND STRAND ------------ -
- --- ---RT_L --1404 CARVER STREET MYRTLE BEACH , SC 29577 57-3051611 5011C ) 3 28,647 N/A N/A SUPPORT BGCA PROGRPJ
-( 61 9&GC OF THE GREATER CHIPPEWA VALLEY
201 E LAKE STREET EAU CLAIRE , WI 54701 39-2032491 50l(C ) 3 51,230. /A N/A SUPPORT BGCA PROGRAJ
] HcGC OF THE GREATER COOK COUNTY AREA------------------------------P 0 BOX 893 ADEL, GA 31620 75 - 3214885 5D1 ( C)3 20 , 905. /A N/A SUPPORT BGCA PROGRAI
$ HLIC OF THE GREATER SANTIAM
305 S STH STREET LEBANON , OR 97355 52 - 1043668 501 ( C)3 31,700 /A N /A SUPPORT BGCA PROGRAI
_ J _8i_GC_0_F_TH E _G_UL_F_ CO_AS_T_______________
11975-B SEAWAY ROAD GULFPORT , MS 39503 64 - D539145 501 ( 0)3 65,704 . / A N/A SUPPORT BGCA PROGRAI
1101 B&GC OF THE HARBOR AREA
2131 TUSTIN AVENUE COSTA MESA , CA 92627 95-1809563 501(C ) 3 50,499 . /A N/A SUPPORT BGCA PROGRAI
11 BtGC OF THE HI-DESERT IHC
P 0 BOX 402 YUCCA VALLEY, CA 92286- 0402 95-3766860 501 ( C)3 36 , 444. /A N /A SUPPORT BGCA PROGRAI
12 .26GC0FTH E HIGHLAND LAKES-- -- ----- - --
P 0 BOX 190 MARBLE FALLS , TX 78654 74-2907284 501(C)3 15,000 . /A N/A SUPPORT BGCA PROGRAJ
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , , . , - - - - - - - - - - - - -
-33 Enter total number of other organizations listed in the line I table ............................................. ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedu le I (Form 990 ) ( 2012)
•
Z ISA0261268 1.000 50Z0NY 1985 V 12-6F 430966 PAGE 89
a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545.0047
(Form 990)2012Governments; and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, tine 21 or 22. '
Internal Revenue Service ► Attach to Form 990. ' ' •
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? .... . ... .......... . ........ . ... ..... ..... . ... . ... Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
(a) Name and address of organization (b) EIN (c ) Ac section (d) Amount of cash ( e) Amount of non-(r1 Method of valuation(book F epprasal (9) Description of (h) Purpose of grant
or government if apppka6te grant ,t, assistancee non-cash assistance or assistance
1 Bc GC OF THE HI-LINE ------_
500 1ST AVENUE HAVRE , MT 59501 81-0409011 501(C ) 3 6,OD0. / A N/A SUPPORT BGCA PROGRAP
.121BiGC OF TNB KENAI PENINSULA - ----
705 FRONTAGE RD SUITE B KENAI , AK 99611 94-3067142 501(C ) 3 99,333. N/A N/A SUPPORT BGCA PROGRW
3 BLGC OF THE KEYS AREA - - - - - - - - - - - - - - - -2400 UNITED STREET KEY WEST , FL 33040 65 - 0678071 501(C)3 23,500 . / A N/A SUPPORT BGCA PROGRAF
4 BiGC OF THE LAC COURTS OREILLES OJIBWE BAND
13394 WEST TREPANIA ROAD HAYWARD . WI 54843 39-1832703 501(0 ) 3 31,137. /A N/A SUPPORT BGCA PROGRAI
$ BtGC OF THE LAKE FIARTIN AREA ------_---
P 0 BOX 1016 ALEXANDER CITY , AL 35011 63-1044271 501(C)3 47 , 000. N /A H/A SUPPORT BGCA PROGRAI
6 1 BLGC OF THE LAKE3 REGION -------------
P 0 BOX 1536 LACONIA , NH 03247 20 - 1652382 501(C ) 3 30,500 . / A N/A SU PPORT BGCA PROGRA)
7 BLGC OF THE LEECH LAKE AREA ---- _ ------- -----------------
P 0 BOX 817 CASS LAKE , MN 56633 41-1929446 501(C ) 3 150 , 348 /A N/A SUPPORT BGCA PROGRAI
-le^ B&GG OP THE _LEW I_S _C_LA_RK V_ALL_EY _ -------
1021 BURRELL AVE LEWISTON, ID 83501. 82-6001432 501(C ) 3 99,774 . N/A N/A SUPPORT BGCA PROGRAI
_`9! BGGC OF THE _LONG_BE_AC_H PE_N I N_SU_LA ------ _
P 0 BOX 1172 LONG BEACH , WA 98631 20 - 3505444 501(C ) 3 17,222. /A N/A SUPPORT BGCA PROGRAI
10 BLGC OF THE LOWCOUNTRY
17-B HARSHELLEN DRIVE BEAUFORT , SC 29902 57 - 0811876 501 ( C)3 60 , 158. N/A N/A SUPPORT BGCA PROGRAI
1_1 _2t.C 0_F_T_HE _LOtr_ER_N_AU_G_AT_U_CK__VAL_LEY_-__---
P 0 BOX 209 SHELTON , CT 06484 06-0653185 501(C ) 3 73,487. /A N/A SUPPORT BGCA PROGRA
21 BI-C--OF THE LUMBEE TRIBE
-__---------------------P 0 BOX 2709 PEMBROKE , NC 28372 84 - 1704531 501(C ) 3 106 , 000. /A N / A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , , ....... . .. . ► -------------
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) 12012)
M JSA2EI2e8100050ZONY 1985a
V 12-6F 430966
r1^,
a
PAGE 90
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue service
Name of the organization
Grants and Other Assistance to Organizations , OMB No 1545.01
Governments , and Individuals in the United States 2012Complete If the organization answered " Yes" to Form 990, Part IV, line 21 or 22 . Open to .
► Attach to Form 990. Inspe ctior
BOYS & GIRLS CLUBS OF AMERI CAlployer identification number
13-5562976nerai
V
andI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance' . ... .. . ..... . . .... . . . ... . .. Q Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
jj= Grants and Other Assistance to Governments and Organizations In the United States. Complete if the organization answered "Yes" to Form 990,Part IV , line 21 , for any recipient that received more than $5 , 000 Part II can be duplicated if additional space is needed.
I (a) Name and address of organizationor government
( b) EIN (c ) RC section (d) Amount of cash(a)
Amount of non-(F) Method of valuationIrk roV spvrwal
(g) Descrip tion of th) Purpose of grantif applk,ACle grant
cashassistance ,
other) non-cashashash assistance or assistance
1!BcGC OF THE MIDLANDS
_l__„--------------------------BEN ARNOLD UNIT 2016 SUMTER STREET 57-0399608 501(C)3 587,502 . / A N/A SUPPORT BGCA PROGRAI
_( 21 BiGC OF THE MIDLANDS INC
2610 HAMILTON STREET OMAHA , NE 68131 47 - 0467350 501(C ) 3 195,346. N/A N/A SUPPORT BGCA PROGRAI3 BLGC OF THE NISSISSI PPI DELTA
P 0 BOX 1617 YAZOO CITY , 01$ 39194 45-0469376 501(C ) 3 323 , 000. N/A N/A SUPPORT BGCA PROGRAI
4 Bi4C THE HISSISSIPPI VALLEY---_
!!f_-----------------------
338 6TH STREET MOLINE , IL 61265 36 - 3838421 501(C)3 34,900. /A N/A SUPPORT BGCA PROGRAI
$ Ba;GC OF THE MISSOURI RIVER AREA
104 SHERIDAN AVENUE WAGNER , SD 5738D 46-0445099 50110 ) 3 54,895 . N/A N/A SUPPORT BGCA PROGRAI
6 BLGC OF THE MOHANK VALLEY------------------------------755 LANSING ST UTICA , NY 13501 15 - 0532057 50110 ) 3 45,000. /A N/A SUPPORT BGCA PROGRAI
7 BLGC OF THE HONROE AREA
110 LOCUST STREET MADISONVILLE , TN 37354 62-1634566 50110 ) 3 30,766. /A N/A SUPPORT BGCA PROGRA)-FiB^ BiGC OF THE NORTH VALLEY
601 WALL STREET CHICO, CA 95926 68 - 0294846 501(C ) 3 45,590. N/A N/A SUPPORT BGCA PROGRA!
-9 BiGC OF THE NORTHERN NECK-----------------------------P 0 BOX 564 KILMARNOCK , VA 22482 20 - 4887254 5011C)3 28,443 . /A N/A SUPPORT BGCA PROGRA!
'IOj-BLGC OF THE NORTHLAND
--------------------------P 0 BOX 16435 DULUTH , !1N 55816 41-0969947 501(C)3 97,833. /A N/A SUPPORT BGCA PROGRA)
`7 1! Bi GC_O_F_THE _NORT_HTO_nN_5_ O_F_ WN_Y_ _ _ _ _ _ _
-54 RIVERDALE AVENUE BUFFALO , NY 14207 16 - 0755733 501(0 ) 3 105,301. N /A N/A SUPPORT BGCA PROGRAIj B6GC OF THE OLYMPIC PENINSULA
P 0 BOX 4167 SEQUIN , WA 98382 91 - 1376766 501(C)3 23,529 . /A N/A SUPPORT BGCA PROGRAI
z Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ... ....................... .3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)JSA
p2E126e+000 50Z0NY 1985
C3
V 12-6F 430966 PAGE 91
•
0
SCHEDULE[ Grants and Other Assistance to Organizations,OMB No 15145-0047
(Form 990) ^0^^Governments, and Individuals in the United States
Department of the Treasury Complete If the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •
Internal Revenue Service ► Attach to Form 990. • •
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13 -556 2 976
Grants and Assistance
lb
A
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and q
the selection criteria used to award the grants or assistance? , , , , , , , , , . , X Yes No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
1 (a) Name and address of organ ization (b) EIN (c) INC seauon ( d) Amount of rah (e) Amount of non-( f) Method of velumon
( F _Prajsai-
(9) OescnpUOn of th) Purpose of grantor government If oppliews grant ®h ass(5lanoe o non-cash easntance or assistance
BLgC OF THE PEE DEE AAFA INC--------------------------
310 w ROUGHFORK STREET FLORENCE, SC 29506 57 - 6026677 501(0 ) 3 141,662. /A N/A SUPPORT BGCA PROGRAM.
2 P OF THE PENINSULA
401 PIERCE ROAD MENLO PARK , CA 94026 95-1552131 501(C )3 111,217. /A N/A SUPPORT BGCA PROGRA),
3 BiGC OF THE PIS HON7 ------------ - --
1415 SHELTON AVE STATESVILLE, NC 28677 20 - 3237215 501 ( C)9 50 , 028. N/A N/A SUPPORT BGCA PROGRAP
BLGC OF THE PINES PEAR REGION-- - _------_(41--------------------1445 S. CHELTON ROAD 84 - 0416503 501 ( C)3 645 ,557 /A N/A SUPPORT BGCA PROGRA)
-`§1 BLGC OF THE POARCH BAND OF CREEK INDIANS
5811 JACK SPRINGS RD ATMORE, AL 36502 - 5025 00 - 0000000 GOVT 47,720. /A N/A SUPPORT BGCA PROGRA!
$ BiGC OP THE PRAIRIE BAND POTA^ATOt7I NATION
15424 K ROAD MAYETTA, KS 66509 90 - 0036315 501 (C)3 25, 000. /A N/A SUPPORT BGCA PROGRA)
_C71 BiGC OF THE RED RIVER VALLEY-------------------
2500 18TH STREET S FARGO , ND 58103 4S-0316132 501(C ) 3 136 , 479. /A N/A SUPPORT BGCA PROGRA)
$ BGGC OF THE RED RIVER VALLEY ----------
1530 1ST STREET NE PARIS , TX 75160 - 6360 75 - 0800621 501 (C)3 107, 864. N/A N / A SUPPORT 8GCA _ PROGRAJ
9 B6GC OF THE REDWOODS ----------
3117 PROSPECT AVE EUREKA , CA 95503 94 - 2184464 501(C ) 3 80,500. /A N/A SUPPORT BGCA PROGRA!
LL01 OF THE ROGUE VALLEY
203- SE 9TH STREET GRANTS PASS , OR 97526 93 - 0589108 501 ( C)3 20 ,792. /A N/A SUPPORT BGCA PROGRAI
L11j BiGC OF 7HE SANDHILLS
160 MEMORIAL PARK COURT 91-1877405 501(C)3 23,343 . /A N/A DPPORT BGCA PROGRAI
12 HiGC OF THE SIOl1X EMPIRE
L824 E 14 STREET SIOUX FALLS , SD 57104 46-0399482 501(C)3 28,969 . /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ......... ........ ........... . ► -------------
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
ZI JSA
2E12BetOoo SOZONY 1985 V 12-6F 430966 PAGE 92
•
•
SCHEDULE I Grants and Other Assistance to Organizations ,OMB No 1545-0047
A(Form 990 ) ^O 12Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •Internal Revenue Service ► Attach to Form 996. N.=^
- Name of the organizationEmployer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976General Information on Grants and Assistance
I Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, andthe selection criteria used to award the grants or assistance? , , , , , , , , , , , , , , ,, , , ,, , , ..... , , L1 Yes q No2 Descr i be in Part IV the organizat ion's procedures for monitori ng the use of grant funds in the United States
J^M Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
V
1h
V
1 (a) Name and address of organizationor government
(b) E(N (o ) 82C Section (d) Amount of rash oun t_-(0)( f) Method of valuation(per F ^pt^ (g) Description of (h) purpose grantn mpicaMe grant
_of non-cash assistanceassistance
nor assistance
BLGC OF THE SMOKY MOUNTAINS--------------------------------
209 MCI4AHAN AVENUE SEVIERVILLE, TN 37862 62 - 1500789 501(C ) 3 137 . 068. /A N /A SUPPORT BGCA PROGRAI2 HiGC OF THE SOUTH BAY
1220 WEST 256TH STREET 33-0450797 501(0 ) 3 112,555. /A N/A SUPPORT BGCA PROGRAI3 BLGC OF THE SOUTH COAST AREA
P 0 BOX 3042 SAN CLEI4ENTE, CA 92674 95-6111998 501(C ) 3 132 , 902. /A N/A SUPPORT BGCA PROGRAI4 HLGC OF THE SOUTHERN UTE INDIAN TRIBE
P 0 BOX 737 IGNACIO , CO 81137 84 - 0404384 501(C)3 7 , 894 /A N /A SUPPORT BGCA PROGRAJ$ B&GC OF THE SPIRIT LAKE NATION
P 0 BOX 548 FORT TOTTEN, NO 58335 87 - 0713806 501(0 ) 3 44,560. /A N/A SUPPORT BGCA PROGRAU6 BLGC OF THE SUNCOAST INC.
2300 TALL PINES DRIVE STE 150 59 - 1566799 501(C ) 3 237,288. N /A N/A SUPPORT BGCA PROGRAIBr,GC OF THE TENNESSEE VALLEY
220 CARRICK ST SUITE 318 62-0475743 501(0)3 240,279. /A N/A SUPPORT BGCA PROGRAIB HLGC OF THE TEXAS HILL COIIHTRY
208 EAST PARK STREET 74-2758055 501(C)3 11,384. /A N/A SUPPORT BGCA PROGRAI91-!L(C OF THE THREE AFFILIATED TRIBES
- ----------------------------P 0 BOX 169 NEW TOWN, ND 58763 91 - 2184912 501 ( C)3 244 , 718. /A N/A SUPPORT BGCA PROGRA!
10 BiGC OF THE TIMBER RIDGE
763 LYONS HILL HOMER, LA 71040 72-1401675 501(C ) 3 28,000 . /A N/A SUPPORT BGCA PROGRA?'I^ BLGC OF THE TWIN CITIES
6500 NICOLLET AVE. MINNEAPOLIS, MN 55423 36-3433837 5D1(C ) 3 214 , 399. /A N/A SUPPORT BGCA PROGRAIBiGC OF THE UMPGLU VALLEY
1144 NE CEDAR ROSEBURG , OR 97470 91 - 1788798 501 ( 0)3 28 , 276. /A N/A SUPPORT BGCA PROGRAI
A =IIiCI IVt121 Iu,n,uet of seouon oultC)(s) ana government organizations listed in the line 1 table .. ► _________3 Enter total number of other org anizations listed in the line I table ....... .. . . . . . . . . .
.
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)d JSA
2E1288 1 000 50ZONY 1985A
V 12-6F 430966 PAGE 93
•
•
SCHEDULE[ Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
on Grants and Assistance
n
V
X012
Name of the organization Employer Identflcatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the setectton crttOrt used to award the grams or asstistance& • . . . .... . ..... ...... .... . . .. ....... .... ...... . Yes 0 No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
LZM Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
I (a) Name and address of organization (b) EIN Ic) atc sermon (d) anount of cash •(e) Amount of nonm Method of vetuauon(book FMV appraisal
(g) Description of -(h) Purpose of grantor government It applicable
grantcash MSISIence et non-cash assistance or assistance
1 pt C OF THE UPSTATE
P 0 80X 2794 SPARTANBURG, SC 29304 57-0862226 5011C)3 114,828 N/A N/A SUPPORT BGCA PROGRAI',
2 B6GC OF THE- ------ - - -------------
17537 MONTEZUMA STREET ADELANTO. CA 92301 51-0501395 5011C)3 17,000. /A N/A SUPPORT BGCA PROGRAF
BiGC Or THE VIRGIN ISL nS -_----__---
P 0 BOX 128 CHRISTIANSTED 66-0259901 501(C)3 22,700. /A N/A SUPPORT BGCA PROGRAT
4 BiGC OF SHE VIRGINIA PENINSULA --------
11825 ROCK LANDING DR 54-0538202 501(C)3 323,450. /A N/A SUPPORT BOCA PROGRA?
B tGC OF THE YAUSAU AREA, INC.
P 0 BOX 2386 WAUSAU, WI 54402-2306 39-1850386 501(C)3 92,648. /A N/A SUPPORT BGCA PROGRA!
-lsl BiGC--OF THE WESTERN RESERVE-------------------------
889 JONATHAN AVE AKRON, OH 44306 34-1351557 501fC)3 35,500. /A N/A SUPPORT BGCA PROGRA)
7 cGC-O-F-THE-WHITE EARi11 RESERVATION- ----- --------------------
P 0 BOX 186 NAYTAHWAUSH, MN 56566 41-2050817 501(C)3 150,000. /A N/A SUPPORT BGCA PROGRAI
_`J BGGC OF THE-wIREG5---.----RA---............... .
457 S ALICE STREET DOTHAN, AL 36301 63-0422560 501(C)3 44,117. /A N/A SUPPORT BGCA PROGRAI
_`9! BLGC_OF_T_HE M I S_C_ON_S I N__RAP_I D_S_AR_E_A__ ____
P 0 BOX 1175 WISCONSIN RAPIDS, WI 54495 39-1745942 501(C)3 28,061. /A N/A SUPPORT BGCA PROGRA!
1 Bf GC OF THREE DISTRICTS YOUTH SERVICES
P 0 BOX 518 FT THOMPSON, SD 57339 46-0463097 501(0)3 6,600. /A N/A SUPPORT BGCA PROGRA)
L11j BiGC OF THURSTON COUNTY------------- -
3003 SUNSET WAY SE TUMWATER, WA 98501 91-2124629 501(C)3 130,213. N/A N/A SUPPORT BGCA PROGRAI
12 BcGC OF TIPTON COUNTY INC. ,
341 W JEFFERSON STREET /A TIPTON, IN 46072 35-1871264 501(0)3 17,127. /A N/A SUPPORT BGCA PROGRN
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table IEnter total number of other organizations listed in the line 1 table • ►
For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule 1(Form 990) (2012)
JSAE1288 1 000 50ZONY 1985 V 12-6F 430966 PAGE 94
•
r
SCHEDULE 1 Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 201 !tGovernments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' • •
Internal Revenue Sennee ► Attach to Form 990. . •
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
0Q
L General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees ' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance' ........... .. .. .. ... ... .. . ........ .. . . ....... .... 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
lj^ Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
1 (a) Name and address of organization IN EIN (C) IRC section (d1 Amount of cash ) Amount of non.le(r) Method of valuation(booK Fqy appmsN (g ) Descrip0on of (h) Purpose of grant
or government if epplceble grant cash assistance.
otn non-cash assistance or assistance-
11 BiGC OF TOCCOA-STEPHENS COUNTY
0 BOX 921 TOCCOA, GA 30577 58-2009029 5011Ci3 19,000. /A N/A SUPPORT BGCA PROGRA)
2 BiGC OF TOLEDO -- - ----- -- ---
2250 N DETROIT AVENUE TOLEDO, OH 43606 34-4427933 501(C)3 94,935. /A N/A SUPPORT BGCA PROGRA)
_(3j BLGC of TOONBS COUNTY
P 0 BOX 324 VIDALIA, GA 30475 58-2141084 501(C)3 70,924. N/A N/A SUPPORT BGCA PROGRAI
4 BcGC OF TOPEXA
2150 WESTPORT DRIVE SUITE 204 4B-0636732 501(C)3 47,500. /A N/A SUPPORT BGCA PROGRAS
_ 5 _Bi_G_C _O_F_7_RAC_Y ----------- - --------
753 W LOWELL AVE TRACY, CA 95376 68-0028682 501(C)3 62,401 N/A N/A SUPPORT BGCA PROGRAI
6 BiGC OF TRANSYLVANIA C VNTY
P 0 BOX 1360 BREVARD, NC 28712 56-2142829 501(C)3 24,929. IA N/A SUPPORT BGCA PROGRAI
`71 BiGC OF TRENTO!.LPI RCER COUNTY
212 CENTRE STREET TRENTON, NJ 08611-2217 21-0634556 501(C)3 197,955. IA N/A SUPPORT BGCA PROGRA)
BiGC OF TROY
3670 JOHN R RD TROY, NI 48083 23-7390931 501(C)3 17,225. /A N/A SUPPORT BGCA PROGRA)
BLGC OF-TRUCKEE MEADOWS-------- - -----
2680 E 9TH STREET RENO, NV 89512-3231 88-0142068 501(0)3 300,452. /A N/A SUPPORT BGCA PROGRA!
W01 B OF-7c TN
P 0 BOX 40217 TUCSON, AZ 85717 86-0172257 501(C13 207,730. /A N/A SUPPORT BGCA PROGRAI
U B! C OF TULARE COUNTY
215 Y TUTARE AVE VISALIA, CA 93277 77-0469369 501(C)3 130,273. /A N/A SUPPORT BGCA PROGRAI
LL2j.P&GC_0F_TUSTIN
580 WEST 6TH STREET TUSTIN, CA 92780 95-2482220 501(C)3 50,678. N/A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► _-___--_-_-_-3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
JSA
3E1288to00 50Z0NY 1985 V 12-6F 430966 PAGE 95
10.1
SCHEDULE IGrants and Other Assistance to Organizations , OMB N. 1515.00.7
Governments, and Individuals in the United States 2012Department of the Treasury Complete If the organization answered "Yes" to Form 990, Part IV, line 21 or 22.Internal Revenue Service ► Attach to Form 990.Name of the organization
IEmployer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976Kit-iM taenerai information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants orassistance..... , ..... 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
(a) Name and address of organizationor government
(b) EIN (c) IRC sectionif applicable
d Amount of cashgrant
tel Amount of non-cash assistance
(r) Method of valuationFMV(bookoth Cp l
Descri p tion Wno-cash assistance (
h) Purpose of g rantor assistance
-`71 BcGC of DxIAR---------------------------
P O BOX 677 UKIAN, CA 95482 68-0340783 501(c ) 3 31, 199 . N/A N/A SUPPORT BGCA PROGRAI
2 BiGC OF UNION COUNTY
1050 JEANETTE AVENUE UNION, NJ 07083 22 - 1641962 501 ( C)3 323,785. /A N / A SU PPORT BGCA PROGRABLGC OF UTAH COON
-TY
-------------- ----------------1837 SOUTH EAST BAY BLVD STE 202 87-0293260 501 ( 0)3 28 , 753. /A N/A SUPPORT BGCA PROGRAI
`4 BAGC OF VALDOSTA------------------------------P O BOX 682 VALDOSTA , GA 31603 23 - 7067775 501 ( C)3 103,949. /A N/A SUPPORT BGCA PROGRAIBAGC OF VALENCIA COUNTY------------------------------620 M REINKEN AVE BELEN , NM 87002 85- 0389467 501 ( C13 20 , 000 /A N / A SUPPORT BGCA PROGRAI
I8 BiGC OP VAN BUREN
P 0 BOX 443 VAN BUREN , AR 72956 71-0327975 501 ( C)3 42,500. N /A N/A SUPPORT BGCA PROGRA)BcGC OF VENICE- -------------------------
2232 LINCOLN BLVD VENICE , CA 90291 95 - 6209203 501 ( C)3 206 , 036. N/A N/A SUPPORT BGCA PROGRAIBiGC OF2TE!_1 AA_
6059 KING DRIVE SUITE A VENTURA, CA 93003 95 -2248919 501 ( C)3 7 7,418 . / A N/A SUPPORT BGCA PROGRAI
BLIC OF VEnp-N
P 0 BOX 1785 VERNON , TX 76385 75-1052556 501(C)3 17 , 500. /A N/A SUPPORT BGCA PROGRAI
L- C--OF ICTORIA
---INC.^Q
-!L------------------------
202 HOPKINS VICTORIA , TX 77901 74-6104461 503(C ) 3 16,627. / A N/A SUPPORT BGCA PROGRAI
11 BcGC OF vINELAND / BROADEN YOUR SUCCESS
1370 SOUTH MAIN ROAD STE 1106 22-3604451 S01(C ) 3 91,955 . / A N/A SUPPORT BGCA PROGRAILl2 !tGC OF I
-ISTA
- -----------------------------410 W CALIFORNIA AVE VISTA , CA 92083 95 -2266749 501(C)3 93,702 /A N/A SUPPORT BGCA PROGRAI
-1-1 .Via. IIUIIIuvr UI secuun outtc)(o) ana government organizations listed in the line 1 table .... .. . .. ... .... ...... ► _____________3 Enter total number of other organizations listed in the line 1 table .For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
. '
•
ISA
:12E1288 t 000 50ZONY 1985 V 12-6F 430966 PAGE 96a
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990 , Part IV, tine 21 or 22.
Internal Revenue service ► Attach to Form 990.
2012
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
I Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . ... . . .. ..... ....... .. . . .... . . . ... . . . . . . .. . .. . ... Q Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
A
(a) Name and address of organization (b) EIN (c ) IRC section ( d) Amount of cash ' (6) Amount of non-(t) Metnod of valuation(b F=. 8ppmyy of(g) Description (h) Purpose of grant
or government if applicable grant evils ass istance oth non-cash assistance or assistance
1 B6GC OF VOLUSIA/ FLAGLER COUNTIES-----------------------------101 N WOODLAND BLVD STE 400 59-3156162 501(C ) 3 12,907. / A N/A SUPPORT BGCA PROGRAI
2 BLGC OF WALKER COUNTY ( HUNTSVILE , TX)- - - -
P 0 BOX 8600 HUNTSVILLE , TX 77340 03 - 0476151 501 ( C)3 5,824. /A N/A SUPPORT BGCA PROGRAI
3 B&GC OF WARWICK - ------ ----------
P 0 BOX 8938 WARWICK , RI 02888 05-6019193 501 ( C)3 24.603. /A N/A SUPPORT BGCA PROGRAI
-`4! B&0C OF YASHINGTON CO
P 0 BOX 1415 GREENVILLE , NS 38702-1415 64 - 0592494 501(C ) 3 25,6D9 . / A N/A SUPPORT BGCA PROGRAI
$ BiGC OF WASHINGTON CO INC
925 N SILVERBROOK DRIVE WEST BEND , WI 53095 39 - 1773689 501 ( C)3 41 , 950. /A N/A SUPPORT BGCA PROGRAI
BcGC OF WASHINGTON COUNTY ---- - -------
805 PENNSYLVANIA AVE HAGERSTOWN , MD 21742 23 - 7252343 5D1(C ) 3 55,844. /A N/A SUPPORT BGCA PROGRAI
7 BLGC OF YATERTONrI INC- -----------------------------
P 0 BOX 833 WATERTOWN , SD 57201 - 0833 46 -0311845 501(C)3 98 , 873. /A N / A SUPPORT BGCA PROGRAI
LaiBLIC Or MAYNE COUNTY
P 0 BOX 774 GOLDSBORO, NC 27533 56-0706013 S01 ( C)3 82 , 339. /A N/A SUPPORT BGCA PROGRA)
-L9! B&GC OF NAYNE COUNTY , INDIANA ---- - ---
1717 S L STREET RICHMOND , IN 47374 35-1065715 501(0 ) 3 58,727 /A N/A SUPPORT BGCA PROGRAI
10 BiGC OF WEHSTER- DUDLEY
55 OXFORD AVE DUDLEY , MA 01571 - 3201 04-2238069 501(C)3 5,415. N/A N/A SUPPORT BGCA PROGRAI
11 1 HLGC-
. _!E-
OF LCOUNTY------------------------2400 WEST 4TH STREET GREELEY , CO 80631-2637 84-0529902 501(C ) 3 56,738 . /A N/A SUPPORT BGCA PROGRAI
L1 21 HcGC OF MES7 ALABAMA---------------------------
LP 0 BOX 40221 TUSCALOOSA , AL 35404 63-0452285 501(C)3 51,231. /A N/A PPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table , . _ . ,
3 Enter total number of other orpanlzatlons listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
•
40
JSAV2E1288 I 000 50ZONY 1985 V 12-6F 430966 PAGE 97
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Deportment of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
2012
Name of the organ ization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13 -5562976
on Grants andI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? .................. . .............................. I Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (c) RC section{d)
Amount of Cash non.
s(emsn
(Q Method m valuation
F M tasn0ssDescription
^
em(h) Purpose Bor overnment d applicable grant Messlrt w non
ancor
`1! !!!IC OF WEST CENTRAL MISSOURI
P 0 BOX 805 SEDALIA, MO 65302 43-6051103 501(C)3 33,048. /A N/A SUPPORT BGCA PROGRAM
_`21BiGC OF WEST CENTRAL. WISCONSIN
P 0 BOX 765 TONAL 81 54660 39-1962065 501(C)3 62,075. N/A N/A SUPPORT BGCA PROGRAM
- ( 3 ) NTY - - - -
4000 ST PAUL AVE BELLWOOD, IL 60104 36-2374421 501(C)3 24,950. N/A N/A SUPPORT BGCA PROGRAM
WEST GEORGIA ---- --- ------ -L41 !
P 0 BOX 1328 LAGRANGE, GA 30241-1328 58-1998988 501(C)3 53,270. /A N/A SUPPORT BGCA PROGRAM
`5) B&GC OF WESTERN 13EN_TO_N C_O_UN_T_Y_------_--
627 WEST HARVARD SILOAM SPRINGS, AR 72761 62-1666732 501(C)3 18,000. N/A N/A SUPPORT BGCA PROGRA!
BSGC OF WE-- - --- ----------- -
ONE CLUBHOUSE RD ENDICOTT, NY 13760 16-1446907 501(C)3 29,500. N/A N/A SUPPORT BGCA PROGRAT
C71 84GC OF WESTERN LANE COUNTY ----`-------------------------P 0 BOX 739 FLORENCE, OR 97439 93-1236854 501(0)3 7,500. /A N/A SUPPORT BGCA PROGRA?
181 BLGC OF_WESTERH NEV_AD_)__-_-- . __---___
673 5. STEWART STREET CARSON CITY, NV 89701 88-0269139 501(C)3 64,329. /A N/A SUPPORT BGCA PROGRA?
_`91 B61jC OF WESTERN PENNSYLVANIA
5432 BUTLER STREET PITTSBURGH, PA 15201 25-1206970 501(C)3 120,605. N/A N/A SUPPORT BGCA PROGRA)
(101 8 LGC OF WESTERN TREASURE VALLEY __--`---
1178 SW 4TH STREET STE 2 ONTARIO, OR 97914 20-8035378 501(0)3 31,667. /A N/A SUPPORT BGCA PROGRN
BiGC OF WESTMINSTER- ------------------
14400 CHESTNUT AVE WESTMINSTER, CA 92683 95-2919799 501(C)3 50,919. /A N/A SUPPORT BGCA PROGRAI
21 BiGC OF WESTMINSTER
25 UNION STREET WESTMINSTER, MD 21157-4507 27-4271460 501(C)3 20,200. /A N/A SUPPORT BGCA PROGRAI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............. . ... .... ....... . ' ____-__-_--__3 Enter total number of other organizations listed in the line 1 table • ►
1) For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990 ) 12012)
zi SSA
V2E1288 1 000 5OZONY 1985 V 12-6F 430966 PAGE 98
•
•
SCHEDULE IGrants and Other Assistance to Organizations, OMB No 1545.0047
(Form 990)2012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • • .Internal Revenue Service Iii. Attach to Form 990. • . ,Name of the organizat ion
I
Employer Identification numberBOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, andthe selection criteri a used to award the grants or assistance . ... . . ... . ........ . 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
jj^ Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
(a) Name and address of organizationor overnment9
( b) EIN C ) RC section( (d) Amount of cam (0) Amount of non.Method of valuation
( booK Fes apprmo (g) Description of (f,) Purpose of grant,fapprinDre grant cash assistance
, .other) non-cash assistance or assistance
BGGC OF WBATCOM COUNTY
1715 KENTUCKY STREET BELLINGHAM , WA 98229 91 - 0836427 501(C)3 137,596. /A N/A SUPPORT BGCA PROGAA2 Br GC OF WHITE RIVER VALLEY
- -----------------------------P 0 BOX 237 19 SOUTH PLEASANT ST 03 - 0360994 501(C)3 120 , 131. /A N/A SUPPORT BGCA PROGRAI
3 B&GC OF WHITTIER
7905 S GREENLEAF AVE WHITTIER , CA 90602 95 - 6151763 501(C ) 3 146 , 196. N /A N/A SUPPORT BGCA PROGRA4 BGGC OF WICHITA FALLS
1318 6TH STREET WICHITA FALLS , TX 76301 75-0883102 501(C)3 24,360. /A N/A SUPPORT BGCA PROGRAJB&GC OF WILSON
532 BIRCH STREET WILSON , OK 73463 73 - 1557583 501(C ) 3 75,000 / A N/A SUPPORT BGCA PROGRA1$1 B&GC OF WOBURN INC.
- ------------------
I CHARLES GARDNER LANE 04-2301953 501(C)3 24,042. /A N/A SUPPORT BGCA PROGRAJ7 B&GC OF WOONSOCKET
P 0 BOX 579 WOONSOCKET , RI 02895 06 - 1663293 501 ( C)3 15,000. N/A N/A SUPPORT BGCA PROGRAI$ B&GC OF WORCESTER------------------------------65 TAINTER ST WORCESTER , NA 01610 - 2520 04 - 2105851 5D1(C)3 83,556. /A N/A SUPPORT BGCA PROGRAI
9^t BiGC OF YELLOWSTONE COUNTY INC.-------------------------------505 ORCHARD LANE BILLINGS , hit 59101-5027 81 - 0308003 S01 ( C)3 10,500. /A N/A SUPPORT BGCA PROGRA)
10 BiGC OF YORK COUNTY
P 0 BOX 226 ROCK HILL, SC 29731 57 - 0951118 501 ( C)3 24,012. N /A N/A SUPPORT BGCA PROGRAI11 B&GC OF YOUNGSTOWN, THE
2105 OAK HILL AVENUE YOUNGSTOWN , ON 44507 34-1039928 501(C)3 6 568, . /A N/A SUPPORT BGCA PROGRAI12 BiGC OF ZIONSVILLE - - - - - - - - - - - - - - - - -
1575 MULBERRY ST ZIONSVILLE , IN 46077 35-1750659 501 ( C)3 33,539. /A N /A SUPPORT BGCA PROGRAIL LI,101 .uia, „u ,,,uo, w section ou i tcjit,3) ana government organizations listed in the line 1 table ......... ► _ _ _ _
1111,3 Enter total number of other org anizations listed in the line 1 table ..... ..... . .. . .. . . . . ........... . -For Paperwork Reduction Act Notice , see the Instructions for Form 990. Sche dule I (Form 990) (2012)
a 1SA261266 1 000 50ZONY 1985 V 12-6F 430966 PAGE 99
r:
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990)20 12Governments , and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV , line 21 or 22. • • ' •
Internal Revenue Service ► Attach to Form 990. • ' •
Name of the organ iz ation Employer identificat i on number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General information on Grants and AssistanceI Does the organ ization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? ........... .. ............ ... .......... ..... ...... 0 Yes q No2 Describe in Part IV the organization' s procedures for monitoring the use of grant funds in the United States
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organ ization answered "Yes" to Form 990,Part IV, line 21, for any recipient that rece ived more than $5,000 Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization ()( b ) (c) Bic seam (d) Amount 01 rash (a) Amount of non(f) Method at VBlualion
,, app,m^ ,( book F (9) Descnption of (h) Purpose of grantor government it apphceble grant c has ± ath non-cash essufance or assistance
_112 BEALE AIR PORCE BASE M H CENTER
15160 GAVIN KANDREY DRIVE 00-0000000 GOVT 7,750. /A N/A SUPPORT BGCA PROGRA!
_C21 CK CANYON BAGC
P 0 BOX 1907 MONTROSE , CO 61402 84-1508048 501 (C)3 32, 320. /A N/A SUPPORT BGCA PROGRA?
$ ROLLING AIR FORCE BASE YOTITH CENTER -----
150 ARNOLD AVE ROLLING AFB, DC 20332 00-0000000 GOVT 12,500 . N/A N/A SUPPORT BGCA PROGRA!
_(41 BOYS i GIRLS CLUBS --------_--------------------701 N RALEIGH BLVD RALEIGH , NC 27610 56-0863051 501 ( C)3 111 , 270. N /A • N/A SU PPORT BGCA PROGRA!
-151 BOYS CLUB O F_ OAK_ R_I_DG_E------ ---------
P 0 BOX 4021 OAK RIDGE , TN 37831 62-0589052 5D1(C ) 3 52,728 . N/A N/A SUPPORT BGCA PROGRA?
BOYS CLUB OF STONEHAM -------- ^'-----------------------P 0 BOX 80064 STONEHAM , MA 02180 23 -7025777 501 ( C)3 14 , 165. N /A N/A SUPPORT BGCA PROGRA!
BOYS CLUBS i GIRLS CLUBS OF NEWPORT CO
95 CHURCH STREET NEWPORT, RI 02840 05-0281572 501(C ) 3 35,600 N/A N/A SUPPORT BGCA PROGRAI
-`8! BRIGADE BcEc
2759 VANCE STREET WILMINGTON, NC 28412 56 - 0529939 501 ( C)3 157 , 358. /A N/A SUPPORT BGCA PROGRAI
-( 9 ) BRIST_0L _B±GCAS_SOC_IATI ON___ _________
105 LAUREL STREET BRISTOL , CT 06010 06 - 0646556 501 ( C)3 92 , 478. /A N/A SUPPORT BGCA PROGRAJ
(101 BOCIQ.EY A_I R AI_ONAL EASE. YOUTH _CN_T_R
17851 E BRECKENRIDGE AVE AURORA , CO 80011 00 - 0000000 GOVT 9 , 904. /A N/ASUPPORT BGCA PROGRAI
OilBURKBtIRNETT BioC
P 0 BOX 2 BURKBURNETT , TX 76354 75-1478734 501(C ) 3 9,200 . /A N/A SUPPORT BGCA PROGRAI
0121 CARING PEOPLE ALLIANCE -
1819 JFK BLVD SUITE 220 23-1352104 501(C ) 3 86,148. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations fisted in the line 1 table . ... . .... . . . . . ............... ► -------------3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I ( Form 990) (2012)
40
Z) JSA
P2E12ee t DDD 50Z0NY 1985 V 12-6F 430966 PAGE 100
SCHEDULE I Grants and Other Assistance to Organizations , L OMB No 1545-0047
(Form 990)2012Governments, and Individuals in the United States
Department of the TreasuryComplete If the organization answered "Yes" to Form 990, Part IV , line 21 or 22 . • • ' •
• . •
Internal Revenue Seance ► Attach to Form 990.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance ? , , , , , , , , , , , , , ,, , , , , , , ,, , , , , , , ,, , , , , , , ,, , , , , , , , , , , Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
jj= Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
9
A
1 (a) Name and address of organization (b) EIN (C ) RC section (d) Amount Cl cash non-(B^ e
to Meu+oo of raiua"appraisal.(book
F • iptionof
o ) cr(h) Pu rpose of g rant
or government if applicable grant n a^lytance o r) n .cass assistanceno
1 CHALLENGERS BLGC
P 0 BOX 37189 LOS ANGELES , CA 90037 95 -2637167 5011C ) 3 128 , 160 N/A N/A SUPPORT BGCA PROGRAI
-12) CHEROKEE YOUTH CENTER
P 0 BOX 455 CHEROKEE, NC 29719 56 - 2053463 50110)3 77,723 . N/A N/A SUPPORT BGCA PROGRAI
11 3 1 CHICKASAW NATION BLGC
217 E MAIN ST DAVIS , OK 73030 73 - 1547929 501 ( C)3 50,000. /A N/A SUPPORT BGCA PROGRAI
4 CHICOPEE BAGC
500 MEADOW STREET CHICOPEE , NA 01013 04 -2366805 501 (C)3 12, 915. /A N /A SUPPORT BGCA PROGRAI
_ S CHILDREN'S-AID SOCIETY------ - --- -----
105 EAST 22ND STREET ROOM 908 13 - 5562191 501 ( C)3 233,627. N/A N/A SUPPORT BGCA PROGRA)
I6 CITRUS CENTER BLGC
P 0 BOX 2666 WINTER HAVEN , FL 338B3 59-0776417 50140)3 9,482. N/A N/A SUPPORT BGCA PROGRAI
(7) CLIFF RAGAN 86GC-----------------------
3415 BUCKLAND SQUARE OWENSBORO , KY 42301 61 - 0663746 501(0 ) 3 17,672 . / A N/A SUPPORT BGCA PROGRAI
CLINTON COUNTY B ± GC__ _____________
1100 W GREEN STREET FRANKFORT , IN 46041 35-1172553 501(C ) 3 16,962. /A N/A SUPPORT BGCA PROGRAI
AS) COMMUNITY Bccc----------------------------
P 0 BOX 1612 WILMINGTON, NC 28402 56-0636247 5011C ) 3 35,368 . / A N/A SUPPORT BGCA PROGRAI
10CONCORD BiGC
55 BRADLEY STREET CONCORD , NH 03301 02 - 0259874 501(C ) 3 74,355 /A N/A SUPPORT SGCA PROGRAJ
11 _CO_H_TN_EN_T_ALS__OF_ OMEGA BLGCI -- - ,-_---___
1 POSITIVE PLACE VALLEJO , CA 94589 23 - 7129424 5011C )3 17,500 N/A N/A SUPPORT BGCA PROGR]
12 _D . AR_!tRC _ __ _____ _---
1423 SEVENTH STREET MENOMINEE, MI 49858 38-1392687 501 ( C)3 15 . 525. /A N /A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line I table ............................. ► _____________3 Enter total number of other organizations listed in the line 1 table ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
P JEA%Etzae 1000 50ZONY 1985 V 12-6F 430966 PAGE 101a
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue service
Name of the organization
BOYS & GIRLS CLUBS OF AMERICA
Employer Identification number
1 3-5562976
on Grants and Assista
i)
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . . . . . . . .. . . . . . . . .. . ..... . .. . . . . . ....... ... .. .... E1 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line-21 , for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
(a) Name and address of organization (b) EIN (C) IRC seuia, (d) Amount of cash (s) Amount at non-(f) Method of ^„mw,(per FWV. appraisal, (g) Description or (h) Purpose of grant
or government 11 applicable grant cash aosetgnce oth er) non-cash assistance or assistance
DEPEW_.EJ CASTER t(GC----------------------
5440 BROADWAY STREET LANCASTER, NY 14086 16-1313581 501(C)3 8,000. /A N/A SUPPORT BGCA PROGRAM
_`21 DON MOYER BcGc--------------
--------P 0 BOX 1396 CHAMPAIGN, IL 61824 37-0906638 50I(C)3 36,592. /A N/A SUPPORT BGCA PROGRAF
_`31 DONALD N. REYNOLDS BiCC---------------------------
560 N RUPPLE ROAD 71-0254287 501(C)3 52,680. N/A N/A SUPPORT BGCA PROGRAI
_`41 EAST LOS ANGELE6 BiGC
324 N MCDONNELL AVE 95-1865996 501(C)3 333,850. /A N/A SUPPORT BGCA PROGRA?
-`S1 EAST VALLEY BiGC
P 0 BOX 248 BALDWIN PARK, CA 91706 95-2935952 501(C)3 57,006. /A N/A SUPPORT BGCA PROGRA!
-`s2 EL DOAApO COUNTY WESTEAH SLOPE BiGC-------------------------
P 0 BOX 2535 PLACERVILLE, CA 95667 91-1774039 501(C)3 60,333. /A N/A SUPPORT BGCA PROGRAT
7 ELXO 8 C
P 0 BOX 2114 ELKO, NV 89803 86-0859401 501(C)3 15,511 N/A N/A SUPPORT BGCA PROGRA3
_ 8 _FA_LCO_H_TA_A I L_ YOOTH _CE_N_TE_R ------- -- --_
10 SVSSVYY 5132 CATHEDRAL DR 00-0000000 GOVT 6,033. /A N/A SUPPORT BGCA PROGRAI
9 ELUILY CENTER BOYS CLUB
100 ACORN ST SPRINGFIELD, MA 01109 04-2105940 501(C)3 47,915. /A N/A SUPPORT BGCA PROGRAI
1Q FOR7 DETRICR YOUTH SERVICES SKY DOME- - - - -
COMMANDER-US ARMY 00-0000000 GOVT 8,500 N/A N/A SUPPORT BGCA PROGRAI
11 FORT GORDON YOUTH SERVICES CENTER - - - -
FORT GORDON YOUTH SERVICES 00-0000000 GOVT 8,965. /A N/A SUPPORT BGCA PROGRAI
121-FO------RTHOOD CHILD i YOUTH SERVICES
----------BLDG 121 RIVERS BLDG PORT HOOD, TX 76544 00-0000000 GOVT 9,300. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .......... .... . ...... ... . . . .. ► - _ _ _ _ _ _ _ _-_ _ -
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990 . Schedule I (Form 990 ) ( 2012)
Grants and Other Assistance to Organizations,OMB No 1545-0047
Governments, and Individuals in the United States 2012Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. Open t o Public
► Attach to Form 990. Ins pecti o n
1
•
•
JSA
^2ei290 1 000 50Z0NY 1985 V 12-6F 430966 PAGE 102
SCHEDULE I Grants and Other Assistance to Organizations,OMI3 No 1545-0047
(Form 990) 201.Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . • • ' ••Internal Revenue Service ► Attach to Form 990. 111,-71 0 1 11
Name of the orpen¢eLOn Employer Idontlfcatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information onI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance) . . .. .... ... ............... . . .. . .. . ... . . .... . . .... Yes q No2 Describe in Part IV the organization ' s procedures for monitoring the use of grant funds in the United States
jjQM Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21 , for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
(a) Name and address of organization (b) SIN IQ INC section (d) Amount of cash(a) Amount of "e"
if) M ethod or valuation(book Ftrv eppn (g) Description of (h) Purpose of grant
or overnment9 appiceuleH rantgrant cash assistance t, non-cash assistance or assistance
FORT MACARTHUR YOUTH CENTER ----------_------------_- ------_2430 VELA WAY EL SEGUNDO , CA 90245-4659 00-0000000 GOVT 18 , 044. /A N/A SUPPORT BGCA PROGRAI
2 FORT tX E YOUTH SERVICES- -----------------------------
BLDG 4216 ROBERTS AVE FT MADE , HD 20755 00-0000000 GOVT 9,001. /A N/A SUPPORT BGCA PROGRAI
31 FORT RI LEY YO[TfN CENTER
JFORT RILEY KS YOUTH SERVICE CTR 00 - 0000000 GOVT 8,242. /A N /A SUPPORT BGCA PROGRAI
4 FORT SMITH BLGC------------------------------4905 NORTH 0 ST FORT SMITH , AR 72904 71 - 0270690 501(C ) 3 124 , 574. /A N /A SUPPORT BGCA PROGRA
GEORGE WERDEN BUCK SOY. CLUB
P 0 BOX 683 JOLIET , IL 60434 36-2270044 501(C ) 3 19,700 . /A N/A SUPPORT BGCA PROGRAJ
_(61GLEN C_OV_E_ B t_GC _A_T L I N_C_OL_N_ HO_
113 GLEN COVE AVE GLEN COVE NY 11542 11-1673938 501(C ) 3 31,000 . /A N/A SUPPORT BGCA PROGRA!
_`71 GLENN E. HINES MEMORIAL BiGC OF NEWBURGN
285 LIBERTY STREET NEWBURGH , NY 12550 14 - 1506144 501(C ) 3 19,199 . /A N/A SUPPORT BGCA PROGRAI
-`81 GREAT LAKES , IL NAVY YOUTH PROGRAt4S
260 IE PAUL JONES STREET 00-0000000 GOVT 8 , 583. /A N /A SUPPORT BGCA PROGRAI
-L91 GRENV_ILL_E_ BAXER__Bi_G_C _____ __________
P 0 BOX 344 LOCUST VALLEY, NY 11560 11-1660955 501(C ) 3 17,700 . /A N/A SUPPORT BGCA PROGRAI
L1Qj HARFORD COUNTY BIGC
100 E BELAIR AVENUE ABERDEEN , MD 21001 52 - 1701612 501 ( C)3 215 , 130. /A N /A SUPPORT BGCA PROGRAI
^11! HARLAN COUNTY BLOC, INC.-----------------------------
1 POSITIVE PLACE HARLAN, KY 40831 31-1793599 501(C ) 3 26,614 . / A N/A SUPPORT BGCA PROGRAI
12 HAWK-HOUSTON a&GC OF DOTHAN
P 0 BOX 891 DOTHAN , AL 36302 63-0517947 501 1 C>3 30,959 /A N/A UPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the fine 1 table ............................. ► -------------.3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) (2012)
•
a
D. JSA
:PE12ee 1 ODD 50ZONY 1985 V 12-6F 430966 PAGE 103
C
SCHEDULEI(Form 990)
Department of the Treasury
Internal Revenue Service
Name of the organization
BOYS & GIRLS CLUBS OF AMERICA
Employer Identification number
13-5562976
10M General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . ....... .......... 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
I (a) Name and address of organization (b) EIN (c) INC serum (d) Amount of cash (e) Amount of non.(1) Method of vmuatpn(book. FMV appraisal. {g) Description of (h) Purpose of grant
• or government it applicable grant cash assistance om non-cash assistance or assistance
_C11 HELP COMMITTEE AND B6GC OF THE HI-LINE--------!2
0 BOX 68 HAVRE, MT 59501 81-0408011 501(C)3 80,000. /A N/A SUPPORT BGCA PROGRAM
`21 NENPSTEAD BLGC----------------------
40 WASHINGTON STREET HEMPSTEAD, NY 11550 11-3391667 501(C)3 36,505. /A N/A SUPPORT BGCA PROGRAM.
3 HERBERT HDOVER BiGC OF ST LOUIS TNC.
2901 N GRAND BLVD ST LOUIS, MO 63107 43-6061693 501(C)3 229,668. N/A N/A SUPPORT BGCA PROGAAF
4 HICKSVILLE YOUTH COUNCIL'S T1!
79 WEST OLD COUNTRY RD. 11-2287963 501(C)3 12,500. /A N/A SUPPORT BGCA PROGRA?
5 HURLBURT YOUTH PROGRAMS---------- - ---
117 MCMILLAN ST HURLBURT FIELD, FL 32544 00-0000000 GOVT 17,386. /A N/A SUPPORT BGCA PROGW
`61 JIM LARSEN BiGC OF WOR COUNTY
P 0 BOX 579 STURGEON BAY, WI 54235 39-2038359 50110)3 13,857. /A N/A SUPPORT BGCA PROGRA!
7 JOHN AVERY B6GC
P 0 BOX 446 DURHAM, NC 27702 56-6001906 501(0)3 25,576 /A N/A SUPPORT BGCA PROGRA!
_L81 KAISERS LAUTERN CHILD i YODTH SERVICES----------------------------USAG KAISERSLAUTERN YP APO, AE 09227 00-0000000 GOVT 5,500 N/A N/A SUPPORT BGCA PROGRA)
9 KINGSTON BL GC
P 0 BOX 2271 KINGSTON, NY 12401 14-1374487 501(0)3 19,500. /A N/A SUPPORT BGCA PROGRAI
19KIPS BAY BiGC
1930 RANDALL AVENUE BRONX, NY 10473 13-1623850 501(0)3 213,896. /A N/A SUPPORT BGCA PROGRAI
1111 LALlESA BiGC
P 0 BOX 626 LA9D SA, TX 79331 75-1076737 501(C)3 15,250. /A N/A SUPPORT BGCA PROGRAI
12 LANSINGBURGH BtL
501 4TH AVENUE TROY, NY 12182-2703 11-1338445 501(C)3 10,000. /A N/A SUPPORT BGCA PROGRIU
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ . ► -----_-------3 Enter total number of other orcianizatlons listed in the line 1 table • ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 . Schedule I (Form 990 ) ( 2012)
n JSAE1288 1 o00 50ZONY 1985 V 12-6F 430966
Grants and Other Assistance to Organizations , "'"° ." ""'Governments, and Individuals in the United States 2012Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. •
► Attach to Form 990.1 Inspection
•
PAGE 104
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22.
Internal Revenue Service ► Attach to Form 990.
2012
Name of the agan¢etron Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . ......... ..................................... . Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed
V
1 (a) Name and address of organization ( b) EIN (c) SRC section (d) Amount of cash
i(emsna ma(f) Method at ralualan
1DO01` F^Desc ription of
o asotc
( h) oruaor government If applicable grant u, r , ,thli n n - he
s
1 LAWRENCE BcGC-------------------------------136 WATER ST LAWRENCE , MA 01841 04-2104377 501(C ) 3 56,665 . /A N/A SUPPORT BGCA PROGAAI
LEBANON AREA BiGC_`21
P 0 BOX 362 LEBANON , IN 46052 35 - 6041946 501 (C)3 12 ,194. /A N/A SUPPORT BGCA PROGRAI
_(3I LIDE ^7HITE H_E_MO_RIA_L_B_6GC------ - -------
1551 NSH NORTHGATE RD MADISON , IN 47250 35 - 1143819 501 ( C)3 21 , 342 IA N /A SUPPORT BGCA PROGRAI
4 LIlMESTONE GIRLS CLUH
2009 19TH STREET BEDFORD , IN 47421 35 - 1278841 501(C ) 3 14,647 , N/A N/A SUPPORT BGCA PROGRAI
_t51 LOS ANGELES BiGC---------------------------
2635 PASADENA AVE LOS ANGELES , CA 90031 23 - 7304197 501 ( 0)3 75,325. N/A N/A SUPPORT BGCA PROGRAI
s LUBBOCK B&GC
P 0 BOX 94163 LUBBOCK, TX 79493 75 - 1D37228 501(C ) 3 62,578. /A N/A SUPPORT BGCA PROGRAJ
7 LYN TREECE BLGC OF TIPPECANOE COUNTY
1529 N 10TH ST LAFAYETTE , IN 47904 35-1262269 501(C)3 43,817 . N/A N/A SUPPORT BGCA PROGRAI
-`8) MADISON SQUARE B C GC___________ _____
350 5TH AVENUE STE 912 NEW YORK , NY 10118 13-5596792 501(C)3 311,167 N /A N/A SUPPORT BGCA PROGRAJ
_92 MARINE COR PS RASE HAWAI I _ ___________
P 0 BOX 63073 KANEOHE BAY , HI 96863 00- 0000000 GOVT 15,967 . /A N/A SUPPORT BGCA PROGRAJ
-U01 !lARION Y OUTH DEVEL__COUNCIL/ _B 4 GC-O_F_MARION
-P 0 BOX 207 MARION , OH 43301 31 - 1423275 501(C )3 39,000. N/A N/A SUPPORT BGCA PROGRAI
1 MARTHA ' S VINEYARD BO7S CLUB .. . .........
0 BOX 654 EDGARTOWN , MA 02539 04-2104167 501(C)3 25 , 415. N/A N/A SUPPORT BGCA PROGRA
L12Jt'mL SIBI ( BAD RIVER) B1GC_ -
- - - - - - - - - - - - - - - i IP 0 BOX 233 ODANAH , WI 54861 30 - 0028025 501 ( C)3 26 , 115. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -
33 Enter total number of other organizations listed in the line 1 table ..... ....... ... . . ......... ...... .... ... ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
•
-5 JSA
e+2ee 1 ooD 5OZONY 1985 V 12-61? 430966 PAGE 105
at
SCHEDULE I 0MB No 1545.0047
(Form 990)Grants and Other Assistance to Organizations, BN012
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • ' ' •
Internal Revenue service ► Attach to Form 990. ' ' •
Name of the organ ization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? , , , . , , , . . . . . . . . . . . . . . . ..................... 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
I (a) Name and address of or anization() g (b) EIN (c) RC seet,on (d) amount of ^h (e) Amount of non-(f) Method of vaiuaum( book.
F(g) Description of (h) Purpose of yront
or government If apptrtme grant cash assistance non-cash assistance or assistance
1 MAVERICK BiGC-- - - - --- - ----------
1923 S LINCOLN STREET AMARILLO, TX 79109 75-0808760 501 ( C)3 31,063. /A N / A SUPPORT BGCA PROGRA?
r 2 MCCONNELL AIR FORCE BASE YOUTH CENTER - --
22 SVS / SVYY 53427 LINCOLN ST 00-0000000 GOVT 5 , 694. /A N/A SUPPORT BGCA PROGRA!
-^31-M--CCURTAIN CO BiGC OF THE CHOCTAW NATION------------------------
P 0 BOX 490 BROKEN BOW, OK 74728 73-1506395 501(C ) 3 501000 . N/A N/A SUPPORT BGCA PROGRAP
4 MID-PENINSULA B&GC -------- - --------
200 N QUEBEC ST SAN MATEO , CA 94401 94 - 1431583 501 ( C)3 28 , 481. /A N/A SUPPORT BGCA PROGRA?
_( MINOT AIR FORCE BASE YOUTH ACTIVITIES CENTS- ----------------------
300 SU)DiITT DRIVE MINOT AFB , ND 58705 00 - 0000000 501 ( C)3 70 , 000. /A N/A SUPPORT BGCA PROGRAT
-ls! MNM ttGC OF THOMAS COUNTY
P 0 BOX 3026 THOMASVILLE , GA 31799 58 - 2426833 501 ( C)3 24 , 125. /A N/A SUPPORT BGCA PROGRA!
7 HONTEREY CA NAVY TECH tEEH i YOUTH CNTR
I UNIVERSITY CIRCLE ; BLDG . 220 00-0000000 GOVT 19.582. /A N/A SUPPORT BGCA PROGRA)
_`8! MOODY YOUTH CENTER
5251 BERGER STREET STE 1 00-0000000 GOVT 9,968. /A N/A SUPPORT BGCA PROGRAI
-`91 MOUNTAIN _CO_M_M_UN_I_TI_ES _B_iGC_ ___________
P 0 BOX 2228 CRESTLINE , CA 92325 33 - 0653707 501(C)3 31 , 000. /A N/A SUPPORT BGCA PROGRAI
10 MOUNTAINEER BLGC ---- - --_
300 COURT STREET MORGANTOWN , WV 26505 31-1567027 5D1(C)3 49,305. /A N/A SUPPORT BGCA PROGRAI
011 MUNCIE npsc
1710 S MADISON ST MUNCIE , IN 47302 35 - 0869060 5011C ) 3 33,504 . / A N/A SUPPORT BGCA PROGRPJ
12 NAPLES ITALY NAVY YOUTH CENTER _
PSC 617 BOX 9 FPO , AE 09622 - 0009 00-0000000 GOVT 16,750 /A N/A SUPPORT BGCA PROGP.AI
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -
33 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
•
•
21 asp
&E1268, 000 5OZONY 1985 V 12-61F 430966 PAGE 106a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 2012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' •
Internal Revenue Serece ► Attach to Form 990. • •
Name of the organizationiEmployer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
V
General Information on Grants and AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . . . . . . . . . .. . .. .. . . . . . . . . . .. ... .... ...... . ..... . . FE Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part tv, line 21, 10r any recipient that received more than $5,000 Part 11 can be duplicated if additional space is needed.
(a) Name and address of organization (b ) EIN (c RC ssalan (d ) Amount of cash (a ) Amount of nor fri M:.tlFmapp ma,^uatu1
(cook ' Cq T Description of (h) Purpose of grantor government d appbcaDls grant rasa ma,xs,ce
otn non-cash assistance or assistance
-01 NAVAL AIR FACILITY EL CENTRO YOUTH CENTER
BLDG 318 CODE 60 EL CENTRO , CA 92243 00 - 0000000 GOVT 12,688 . /A N/A SUPPORT BGCA PROGRAI
2 NAVY M11R NID ATLANTIC BiGC
1559 SCOTT CENTER ANNEX 00-0000000 GOVT 11,896 /A N/A SUPPORT BGCA PROGRA1
- 3̀1 NORTH PENN VALLEY BaGC
P O BOX 103 LANSDALE , PA 19446 23 - 7164617 501(0 ) 3 6,500. N/A N/A SUPPORT BGCA PROGRAI
4 NORTH SLO COUNTY BiGC
P 0 BOX 3037 PASO ROBLES, CA 93447 77-0272094 501 ( 0)3 26 , 876. /A N/A SUPPORT BGCA PROGRAI
$ OGDENSUAG BOYS GLOB - - - - - - - - - - - - - - - - -
610 PATTERSON ST OGDENSBURG , NY 13669 16-0874412 501(C ) 3 20,000. /A N/A SUPPORT BGCA PROGRAI
I 6 OLIVET BiGC OF READING i BERKS COUNTY - - - -
1161 PERSHING BLVD READING , PA 19611 23 - 1365380 501 ( 0)3 142 , 000. /A N/A SUPPORT BGCA PROGRAI
_671 ORANGEBURG AREA _BO_Y S _CLUB ------------_
P 0 BOX 2783 ORANGEBURG SC 29116 57 - 0834510 501 ( 0)3 47 , 927. /A N/A SUPPORT BGCA PROGRAI
AS) OSCAR CROSS B&GC OF PADUCAH, INC.
P 0 BOX 203 PADUCAH , NY 42002 61 - 1001392 501)C ) 3 30,163. /A N/A SUPPORT BGCA PROGRAJ
-(9)OTEROCOUNTY BCGC ___ _ _____ _____
-
_
P 0 BOX 1731 ALAMOGORDO NM 88311 85-0201122 501(C ) 3 26,015. /A N/A SUPPORT BGCA PROGRN
j0 _PAU_L BEM_I_E_B_& GC--------------------
P 0 BOX 8603 HOT SPRINGS VILLAGE , AR 71910 71 - 0698711 501(C ) 3 18,750 . /A N/A SUPPORT BGCA PROGRAI
11 PUEBLO OF POJOAODE BaGC
101 A LIGHTNING LOOP SANTA FE, NM 87506 85-0219423 501(C ) 3 64,500.' N/A N/A SUPPORT BGCA PROGRA
tt2j RAHSTEIN YOUTH PROGRAMS_------------------------------
UNIT 3240 BOX 535 APO, AE 09094 - 0536 00-0000000 GOVT 8,000 . /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table - - - - - - - - - - - - -
33 Enter total number of other organizations listed in the line I table .. . . . ...... . . . . .. ... . . . . . . ... . . ... .. . . . . . . . .. ►For Paperwork Reduction Act Notice, see the Instructions for Form 990 . Schedule I (Form 990) (2012)
0 JSAA51288 t 000 50ZONY 1985J
V 12-6F 430966 PAGE 107
r1
•
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545.0047
(Form 990)^^12Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • '
Internal Revenue Servtce ► Attach to Form 990.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
General information on Grants and Assistance
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and1-771
the selection criteria used to award the grants or assistanca? . .... ...... .. ...... . ... .... ...... ......... ....... . Yes LJ No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations In the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
A
1 (a) Name and address of organization (b) EIN (c) SRC moon (d) Amount of cash() (a) Amount of non-(f) Method o f vWust n(off P
pro"(g) Description of (h) Purpose of prnnt
or overnment9iteppt a grant csh assmanm
oi
of h6T non-cash assistance or assistance
-l1! RANDOLPH AIA FORCE BASE YOiTfH CENTER-------- ----------- ----
12 SPTG/SVY 415 B ST EAST 00-0000000 GOVT 21,739. N/A N/A SUPPORT BGCA PROGRAh
_`21 RED LAKE NATION BLCC--------------------------
P 0 BOX 1124 RED LAKE, MN 56671 41-1935631 SO1(C)3 41,139. /A N/A SUPPORT BGCA PROGRAI
3 RIDGEFIELD BiGC
41 GOVERNOR ST RIDGEFIELD, CT 06877 06-0653182 501(C)3 8,500. N/A N/A SUPPORT BGCA PROGRAM
41 RIO HON DO BiGC
7104 PERRY ROAD BELL GARDENS, CA 90201 95-2143326 501(C)3 78,148. /A N/A UPPORT BGCA PROGRA(•
J-51 SALEH EGC--INC-------------------------3 GERE?(ONTY DRIVE SALEM, NH 03079-3314 02-6017326 501(C)3 27,500. IA N/A SUPPORT BGCA PROGRAS
ALESIAN _P1 (!C INC_C61----------------------------150 BYRON ST EAST BOSTON, MA 02128 04-2558218 501(C)3 14,509. N/A N/A SUPPORT BGCA PROGRA)
/7 SALESIAN BiGC OF LOS ANGELES
3218 WABASH AVE LOS ANGELES, CA 90063-2722 95-2430743 501(C)3 37,670. /A N/A SUPPORT BGCA PROGRA)
8 SALVATION ARMY BiGC OF BALTIMORE ----__A ----------------------- -
814 LIGHT ST BALTIMORE, ND 21230 52-0591457 501(C)3 23,634. /A N/A SUPPORT BGCA PROGRPJ
09 SALVATION ARMY BiGC OE BUNCOMBE COUNTY
750 HAYWOOD ROAD ASHEVILLE, NC 28806 58-0660607 501(C)3 28.832. N/A N/A SUPPORT BGCA PROGRAt
I1O SALVATION AR}SY BiGC OF CONNAY/HOARY CO
1302 4TH AVE CONWAY, SC 29526 58-0660607 501(C)3 10,302. /A N/A SUPPORT BGCA PROGRA)
ORSALVATION ARMY BiGC OE DAVI DSOH COUNTY
10 PINE STREET THOMASVILLE, NC 27360-0502 56-0543227 501(C)3 40,433. N/A N/A SUPPORT BGCA PROGRAI
12 SALVATION AHD(Y BiGC OF DURH127
810 ALSTON DURHAM, NC 27702 58-0660607 501(C)3 26,932. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .. ... .... ... . . .... . . . . ....... ► ---___--_----3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I ( Form 990 ) ( 2012)
•
JSA
^2E1288, 000 50ZONY 1985 V 12-6F 430966 PAGE 108
A
SCHEDULE IGrants and Other Assistance to Organizations, OMB No 1545-0047
(Form 990)^^ 12Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV , line 21 or 22. • r • 'Intemal Revenue Seance ► Attach to Form 990. . •Name of the organization
Employer Identification numberBOYS & GIRLS CLUBS OF AMERICA 13-5562976
M7M caelterat tntormattoa on Grants attd AssistanceI Does the organization maintain records to substantiate the amount of the grants or assistance , the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the Unted States
JjCW Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
n
A
(a) Name and address of organization ( b) EIN (c) IRC se (d) Amount of cash (e) Amount of non- if)Fo ^P^^ (g) Description of (h) Purpose of grantor government if appleable grant cash assutence ( p^h non-cash asalatance or assistance
_`1! SALVATION ARMY BcGC OF GREATER ATLANTA----------------------------
1190 H DRUID HILLS DRIVE ATLANTA , GA 30329 56-0660607 502 ( C)3 23,389. N/A N/A SUPPORT BGCA PROGRAI2 SALVATION ARMY B&GC OF GREATER CHARLOTTE
P 0 BOX 31128 CHARLOTTE , NC 28231 - 1128 58 - 0660607 501(C)3 96,917 . / A N/A SUPPORT BGCA PROGRAI`32 SALVATION ARMY BLGC OF GREATER OKLAHOMA
5101 N. PENN OKLAHOMA CITY, OK 73112 58-0660607 501(C )3 77,377. /A N/A SUPPORT BGCA PROGRAI
4 1 SALVATION ARNY SLGC OF GREENSBORO
P O BOX 5310 GREENSBORO , NC 27435 58-0660607 50 ]( C)3 20,667. /A N/A SUPPORT BGCA PROGRAI(5) SALVATION ARMY B&GC OF GREENVILLE
P _ O BOX 1237 GREENVILLE , SC 29602 50-0660607 501 ( C)3 8,359 . N/A N/A SUPPORT BGCA PROGRAI
-`6) SALVATION ARMY B&GC OF HICKORY
P 0 BOX 1167 HICKORY , NC 28603 13 - 5562351 501 (C)3 25, 681. N/A N/A SUPPORT BGCA PROGRA)
( 7 ) SALVATION ARMY B&GC OF METRO TULSA
1400 WEST WASHINGTON BROKEN ARROW , OK 74012 58 -0660607 501 ( C)3 38,998. /A N/A SUPPORT BGCA PROGRAI-1$1 SALVATION ARMY B [ GC OF METRO HOUSTON
2600 ALDINE WESTFIELD RD HOUSTON , TX 77093 58-0660607 501 ( C)3 48 , 241. N /A N/A SUPPORT BGCA IROGPR1
9 SALVATION ARMY BcGC OF RICHMOND
3701 R STREET RICHMOND, VA 23223 58-0660607 501(C)3 16,960. /A N/A SUPPORT BGCA PROGRAO`1 Q! BALVATI ON ARMY L,G OF SAN ANTONIO
521 Y ELMIRA SAN ANTONIO , TX 78212 75-0600678 501(C ) 3 18,001 . /A N/A SUPPORT BGCA PROGRA!
L112 SALVATION ARMY BiGC OF SHREVEPI T----------------------
P 0 BOX 1158 SHREVEPORT , LA 71163 58 - 0660607 501 ( C)3 29 , 634. /A N/A SUPPORT BGCA PROGRID12 SALVATION ARMY BLGC OF SU?I
-----------P 0 BOX 2229 SUMTER, SC 29151 58-0660607 501(C}3 24,000. N/A N/A SUPPORT BGCA PROGRAI'
< <u,«, «L01 Iluliwcl v1 section auttc)ts) ana government organizations listed in the line 1 table ► ---..... .. . .. ---------3 Enter total number of other organizatio ns listed in the line 1 tableFor Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule I (Form 990) (2012)
•
0
JSA2E12881000 SOZONY 1985 V 12-6F 430966 PAGE 109a
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) ^Governments, and Individuals in the United States
Deportment of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 .
Internal Revenue Service ► Attach to Form 990.
Name of the organaation Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
x7
LEM General Information on Grants and Assistance1 Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? . . . . .. ............ .... ......... . ........... .. .... 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000 Part II can be duplicated if additional space is needed.
1 (a) Name and address of organization ( b) ElN (C ) C •^on (d) Amount of cash1 (9) amoun[ of nor,m method or value
( book FWV appre„y. (g) Deaenpuon of (h) Purpose of grantor government
itapplicable grant ryh wsutents ottw) non^ash assurance
oror assistanceassistance
_ L11 SALVATION AR17Y BiGC OF WINSTON-SALEM
P 0 BOX 1205 WINSTON SALEM , NC 27102 58 -0660607 501 ( C)3 29 , 305. /A N/A SUPPORT BGCA PROGRAM
_(21 SALVATION ARMY BOYS AND 1RLS CLUB
P 0 BOX 829 YUMA , AZ 85364 94-1156347 501(C) 3 11,494 . /A N/A SUPPORT BGCA PROGRAZ
3 _La vA_T_I O_N ! A, t W I LSOH__BO_)_S_CLUB_ - - - -----
P 0 BOX 96 WILSON, NC 27893 58-0660607 501 ( C)3 15,801. /A N/A SUPPORT BGCA PROGRAF
SALVATION ARMY /NANCY YIOORE -THORISOND BIGC-L41
P 0 BOX 439 AIKEN , SC 29802 58-0660607 501(C )3 22,124 . /A N/A SUPPORT BGCA PROGRA!
r 5 SAN DIECO CA NAVY YOOTH PROGRAMS
NAVAL STATION 4867 SANTO RD. 00 - 0000000 GOVT 6,195. N/A N/A SUPPORT BGCA PROGRA!
G SAN YMI!RO BcGC
P 0 BOX 234 SAN LEANDRO , CA 94577 94- 6003779 501 ( C)3 83 , 601 /A N/A SUPPORT BGCA PROGRA)
_`71 SANTA CLARITA VALLEY B&E(
24909 NEW HALL AVE NEWHALL, CA 91321 95 - 2572622 501(C )3 198 , 265. N /A N/A SUPPORT BGCA PROGRAI
_`8! SANTA FE BaGC
P 0 BOX 2403 SANTA FE , NM 87504 - 2403 B5 - 0102948 501 ( C)3 64 , 306. /A N/A SUPPORT BGCA PROGRAI
-`9! SARA__H E INZ H_OU_S_E
ONE HEINZ STREET PITTSBURGH , PA 15212 25-0965390 501(C)3 96,234 . N/A N/A UPPORT BGCA PROGRAI
1O SCOTT COUNTY BiCC
P 0 BOX 1013 WALDRON , AR 72958 71 - 0830848 501 (C)3 7,500. /A N/A SUPPORT BGCA PROGRAI
1111 SOUTH ODEENS BiGC-------------------------
110-04 ATLANTIC AVENUE 11-1966067 501(C ) 3 138,281. N /A N/A SUPPORT BGCA PROGRA
1121 5011TH SEBASTIAN COUNTY BlGC-------------------------
P 0 BOX 219 GREENWOOD , AR 72936 71 - 0430937 501 ( C)3 18 , 750 /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501( c)(3) and government organ izations l i sted in the line 1 table ............................. ► -------------3 Enter total number of other organizations listed i n the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedulo I (Form 990 ) ( 2012)
0 JSA
D2E1288 1 000 5OZONY 1985
a
V 12-6F 430966 PAGE 110
r1
•
SCHEDULE I OM13 No 1645-0047
(Form 990)Grants and Other Assistance to Organizations, X012
Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22. • • ' • •
Internal Revenue Service ► Attach to Form 990. • •
Name of the orgamzatron Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
GeneralI Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? Q Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated If additional space is needed
I (a) Name and address of organization (b) EIN (c) IRC seams (d) Amount of cash (eI Amount of non-M Method o f Valuation(per FMV. ap^
(g) Description of (h) Purpose of grantor government If appl icable grant cash aaaiafence otherl non-cash assistance or assistance
SOUTHSIDE BLGC
P 0 BOX 4562 NORFOLK, VA 23523 54-0839152 501(C)3 92,961. /A N/A SUPPORT BGCA PROGRAI
-(21 SPRINGFIELD --------------------
481 CAREW STREET SPRINGFIELD, MA 01104 04-1858620 501(C)3 15,415. N/A N/A SUPPORT BGCA PROGRAI
_L31 STATELI NE BiGC - - - - - - - - - - - - - - - - - - - - -1951 MOORE ST BELOIT, WI 53511 39-0974673 501(C)3 7,500. /A N/A SUPPORT BGCA PROGRAI
4 STELLA SNITH BiGC OF VALVERN
1840 W MOLINE MALVERN, AR 72104 71-0785912 501(C)3 11,541 /A N/A SUPPORT BGCA PROGRAI
.151 SUANNE BIG CROW BiGC--------------------------
P 0 BOX 5079 PINE RIDGE, SD 57770 46-0423326 501(C)3 45,000. N/A N/A SUPPORT BGCA PROGRAI
-`61 TERRE HAUTE B1.GC
220 NORTH 3RD ST TERRE HAUTE, IN 47807 35- 0868182 501(C)3 7,426 N/A N/A SUPPORT BGCA PROGRAI
THE EDUCATIONAL ALLIANCE BiGC----------
197 EAST BROADWAY NEW YORK, NY 1D002 13-5562210 501(c)3 89,500 /A N/A SUPPORT BGCA PROGRAI
THE-SALVAT I ON
-ARMY BiGC OF TEXAS
P 0 BOX 2608 DALLAS, TX 75235-2608 58-0660607 501(C)3 69,219. /A N/A SUPPORT BGCA PROGRAI
-( q ) TH0NASCHEN MEN0RIAL_BOYSCLU B ----------
803 BEDFORD STREET FALL RIVER, MA 02721 04-2103923 501(C)3 16,415. /A N/A SUPPORT BGCA PROGRAI
Q 111M COUNTY BOYS GLOB(1 1201 ERIE STREET OWEGO, NY 13827 15-0610883 501(C)3 7,635. /A N/A SUPPORT BGCA PROGRA)
01 TOH BROWNING BiGC
P 0 BOX 206 MAYSVILLE, KY 41056-0206 60-0474747 501(C)3 5,711. /A N/A SUPPORT BGCA PROGRA
L121 TOWN OF MALLKII.L BiGC---------------------------
P 0 BOX 14 60 CREAMERY ROAD 13-3741014 501(C)3 48,750. /A N/A SUPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table _ ...... ................... ► ______---____
3 Enter total number of other organizations listed in the line 1 table . ►For Paperwork Reduction Act Notice , see the Instructions for Form 990 , Schedule I (Form 990) (2012)
JSA
neE1288 1 000 50ZONY 1985
d
V 12-6F 430966 PAGE 111
•
SCHEDULE I Grants and Other Assistance to Organizations,(Form 990)Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990. Part N , line 21 or 22.
Internal Revenue SerAce ► Attach to Form 990.
2012
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Gene
0
V
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , ,,,,,,,, ,,,,,,,, 0 Yes q No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Past 1V, tine 21, for any Tec)p)ent that received more than $5,000. Part 11 can be duplicated if additional space is needed.
1 (a) Name and address of organization1 EINl b ) (C ) me swim( (d) Amount of ^h (0) Amount of non.(f) method of valusua,(book . FMV, appriesit, (g) Description of (h) Purpose of grant
or government If appl icable greet MIN eminence om non-cash assistance or assistance
1 rRAVls YOUTH CENTER ----------------
510 AIRLIFT DRIVE BLDG 3808 00-0000000 GOVT 6,733. /A N/A SUPPORT BGCA PROGRAM
2 TROY Booc ---- - --
1700 7TH AVENUE TROY, NY 12180-3411 14-1338574 501(C)3 24,363. /A N/A SUPPORT BGCA PROGRAM
-`31 UNION LEAGUE BtGC
65 W JACKSON BLVD, 2ND FL CHICAGO, IL 60604 36-2167939 5031C)3 336,189. N/A N/A SUPPORT BGCA PROGRAM
J41 UNITED BcGC OF SANTA 13ARHARA COUNTY - - - -
P 0 BOX 1485 SANTA BARBARA, CA 93102 23-7087814 501(C)3 42,335 /A N/A SUPPORT BGCA PROGRA!
-151 USAG FORT JACKSON YOUTH 6ERVIS---------------------------
3392 MAGRUDER AVENUE 00-0000000 GOVT 11,263. /A N/A SUPPORT BGCA PROGRA!
s YACAVILLE NEIGHBORHOOD 4GC ------------ -------------------
1625 ALAMO DR VACAVILLE, CA 95687 13-4223488 501(C)3 9,856. N/A N/A SUPPORT BGCA PROGRAI
7 VARICTY BGGC------------------------------2530 CINCINNATI ST LOS ANGELES, CA 90033 95-1919219 501(C)3 58,461. /A N/A SUPPORT BGCA PROGRA)
VARIETY B4CC OF QUEENS _
21-12 30TH ROAD LONG ISLAND CITY, NY 11102 11-6014770 501(C)3 . 72,500. N/A N/A SUPPORT BGCA PROGRAI
-`91>iAKI?fA_N !lEHO_R I A_L_A_S_50_C_IA_T_I ON___________
P 0 BOX 118 SOUTHPORT, CT 06890 06-0662198 501(C)3 53,900. /A N/A SUPPORT BGCA PROGRAI
0-01NALTHA- BiGC INC.
20 EXCHANGE ST WALTHAM, MA 02451-4498 04-2103927 501(C)3 5,560. /A N/A SUPPORT BGCA PROGRAI
RA6HINGnbl CO YOUTH SERVICE BUREAU AND tiGC
P 0 BOX 627 )4ONTPELIER, VT 05601 03-026216'2 501(C)3 92,058. /A N/A SUPPORT BGCA PROGRAI
12 MATERVILLE AREA etGC ---------------
126 NORTH STREET WATERVILLE, ME 04901 01-0344605 501(C)3 131,437. /A N/A UPPORT BGCA PROGRA
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table .... ..... ..... ...... ......... ► -________----3 Enter total number of other organizations listed in the line 1 table • ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990) (2012)
.15.4
22E12ee 1 000 50ZONY 1985
a
V 12-6F 430966 PAGE 112
•
•
SCHEDULE I Grants and Other Assistance to Organizations,OMB No 1545-0047
(Form 990) 2012Governments, and Individuals in the United States
Department of the Treasury Complete if the organization answered "Yes" to Form 990, Part IV, line 21 or 22 . Open to Public
Internal Revenue Seance ► Attach to Form 990. Ins pecti o n
Name of the organizationIEmployer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
3eneral Information on t
I Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and q
the selection criteria used to award the grants or assistance? , ^ ] Yes No2 Describe in Part IV the organization's procedures for monitoring the use of grant funds lathe Un .ed States
Grants and Other Assistance to Governments and Organizations in the United States . Complete if the organization answered "Yes" to Form 990,Part IV, Iine 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed
V
I (a) Name and address of organization ( b) EIN (c ) IRC "cum (d) Amount of cash (a) Amount of non- ( f) Method of valuaa( book, FMV anrwm (g ) Description of (h) Purposed grant
or government if applkable grant cash assistance,
oth non-cash assistance or assistance
1 WATTS _/ 1rI LL_OirB_R00_K_ B_i_GC _ _ _ ___
1339 E 120TH STREET LOS ANGELES , CA 90059 95 - 1945829 501 ( C)3 99 , 992. /A N/A SUPPORT BGCA PROGRAI
2 frELLS 521LPTNITY BGGC
1410 S WAYNE ST BLUFFTON , IN 46714 31-1253620 501(C ) 3 19,483 . / A N/A SUPPORT BGCA PROGRAI
L31 ! 2!9!105 ALLSTON ST BOSTON , MA 02134 04-2105825 501(C)3 36,415. /A N/A SUPPORT BGCA PROGRAI
4 WEST SAN GABRIEL VALLEY BLGC
328 S RANONA AVE MONTEREY PARR, CA 91754 95-2782501 501(C ) 3 52,285. N/A N/A SUPPORT BGCA PROGRAI
!SST VALLEYP±
7245 RENNET AVENUE CANOGA PARK , CA 91303 95 - 4419365 SO1 ( C)3 154 , 196. /A N/A SUPPORT BGCA PROGRAI
NINIFRED CRAWF'ORD DIBERT BiGC OF JAMESTOWN- ------------------------------
62 ALLEN STREET JAMESTOWN , NY 14701 - 6644 16-0743055 301(C)3 5,500 N /A N/A SUPPORT BGCA PROGRAI
WOODLAND BcGC
P 0 BOX 261 NEOPIT , NI 54150 39 - 1423945 501 ( C)3 24 , 738. N/A N/A SUPPORT BGCA PROGRAI
YOKOSUKA JAPAN NAVY YOUTH CENTER- ------------------------------
PSC 473 BOX 60 FPO , AP 96349 - 1105 00-0000000 GOVT 10,654. N/A N/A SUPPORT BGCA PROGAAI
-C91------------------------------
i102------------------------------
(111------------------------------
U21------------------------------
2 Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ............................. ► -------------3 Enter total number of other organizations listed in the line 1 table ... ... . . .. . .......... ... .. ..... .......... .... ►For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule I (Form 990 ) ( 2012)
n- JSA
501288 1 000 5OZONY 1985 V 12-6F 430966 PAGE 113
i
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule I (Form 990 ) ( 2012) Pape 2
jj= Grants and Other Assistance to Individuals In the United States . Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duDllcated if additional space is needed
(a) Type of grant or assistance (b) Number ofrecipients
(c) Amount ofcash grant
( d) Amount ofrmcSSh assistance
(e) Method of va uabon ( book ,FMV, epprasal, othy
( f) Descnptlon of non-cash assistance
SCHOLARSHIPS 6. 52,355 FMV N/A
2
3
4
5
6
7
V Supplemental Information . Complete this part to provide the information required in Part 1, line 2, Part iii, column (D), ana any otner aaattlonai
information
ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE US
SCHEDULE I, PART I, QUESTION 2
BOYS & GIRLS CLUBS OF AMERICA ("BGCA") STRIVES TO PROVIDE ONGOING AND
EFFECTIVE TECHNICAL ASSISTANCE, INFORMATION, SYSTEMS AND MONITORING SO AS
TO HELP ENSURE THAT BGCA AND LOCAL CLUBS RECEIVING PASS-THROUGH GRANTS
FROM BGCA MAKE FULL AND COMPLIANT USE OF ALL FUNDS ENTRUSTED TO BGCA -
FEDERAL AND NON-FEDERAL.
FOR THE LIFE OF THE GRANT, CONTRACT, ETC., THE FINANCIAL/LEGAL SERVICES,
SERVICES TO CLUBS AND FEDERAL GRANTS DEPARTMENTS PROVIDE COMPLIANCE AND
Schodule I (Form 990) (2012)
U
,SA
Dee t so4 2 000PAGE 114J 50ZONY 1985 V 12-6F 430966
C7
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule I ( Form 990 ) (2012) page 2
Grants and Other Assistance to Individuals in the United States . Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duplicated if additional space is needed
(a) Type of grant or assistance•
( b) Number ofrecipients
(c) Amount of
cash grant
(d) Amount or
non-cash assistance
(0) Method or va uawn (book
FMV. apprrsd other)
( f) Description of non-cash assistance
Z
3
4
5
6
7
gi^ Supplemental Information . Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additionalinformation.
FISCAL MANAGEMENT RELATED GUIDANCE AND OVERSIGHT. THE PROGRAM SPONSORING
DEPARTMENT IS ALSO INVOLVED IN THESE AREAS, AND IS PRIMARILY RESPONSIBLE
FOR THE PROGRAMMATIC ACTIVITIES AND OUTCOMES.
THROUGHOUT THE PROCESS, INFORMATION AND EDUCATION IS PROVIDED TO CLUB
REPRESENTATIVES THROUGH, FOR EXAMPLE, THE FUNDING ANNOUNCEMENT PACKET;
GRANT ADMINISTRATION TRAININGS; ONLINE VIA WWW.BGCA.NET; LETTERS OF
AGREEMENT; AND ESPECIALLY VIA BGCA STAFF IN FEDERAL GRANTS, FINANCIAL
SERVICES, SERVICES TO CLUBS AND GOVERNMENT RELATIONS.
P-A
C]
P
1hSchedule I (Form 990 ) (2012)
13
e^ JSA
ec2 E 1504 2 000
a 5OZONY 1985 V 12-6F 430966 PAGE 115
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule I (Form 990 ) ( 2012) Page 2
Grants and Other Assistance to Individuals in the United States . Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duDlrcated if additional space is needed.
(a) Type of grant or assistance (b) Number ofrecipients
(c) Amount of
cash grant
(d) Amount of
rash ssseterua
(e) Method of vetustlon (book.
FMV, eppteuel, M er)
(f) Description of non-cash assistance
2
3
4
5
6
7
JjQJIk`/ Supplemental Information . Complete this part to provide the intormation required in Fart I , nine z, Part iii, column (o), ano any otner aaaruonat
information.
BGCA STAFF CONTINUALLY MONITOR THE FINANCIAL AND PROGRAMMATIC PERFORMANCE
OF SUB-RECIPIENTS THROUGH CLUB FINANCIAL REPORTS, CLUB PROGRAM REPORTS,
DIRECT COMMUNICATIONS WITH CLUBS, SITE VISITS, ETC.
WHEN GRANTS ARE AWARDED TO CLUBS ON A REIMBURSEMENT BASIS (I.E. FEDERAL
GRANTS), REQUESTS FOR EXPENDITURES ARE THOROUGHLY REVIEWED FOR ACCURACY,
ALLOWABILITY AND APPROPRIATENESS PER AGREED UPON BUDGETS AND PROGRAM
DELIVERABLES THAT ARE IN ALIGNMENT WITH THE DONOR OR GRANTOR'S INTENT AND
REQUIREMENTS.
•
V Schedule I (Form 990) (2012)
!S4
'E15042 O00
5OZONY 1985 V 12-6F 430966 PAGE 116
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule I (Form 990) (2012) Page 2
Grants and Other Assistance to Individuals in the United States . Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duplicated if additional space is needed
(a) Type of grant or assistance (b) Number ofrecipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuahm (body
FMV appraisal, other)
(f) Description of non-cash assistance
1
2
3
4
5
6
7
1:M-E Supplemental Information . Complete this part to provide the information required in Part I , line 1, Part in, column ( b), and any other additionalinformation
PERIODICALLY BGCA RECEIVES DETAILED FINANCIAL AND PROGRAMMATIC REPORTS
FROM THE SUB-RECIPIENTS (I.E. CLUBS RECEIVING PASS-THROUGH FUNDS FROM
BGCA, TO DOCUMENT THEIR USE OF THE FUNDS FOR THE SPECIFIC PURPOSE FOR
WHICH THEY ARE GRANTED). THESE REPORTS ALSO INCLUDE SUB-RECIPIENT CLUB
FINANCIAL STATEMENT AUDIT REPORTS AND IF APPLICABLE, AUDIT REPORTS IN
ACCORDANCE WITH OMB CIRCULAR A-133 FOR THE USE OF FEDERAL FUNDS.
G
LIKEWISE, FINANCIAL AND PROGRAMMATIC REPORTS ARE ALSO ISSUED BY BGCA TO
THE APPROPRIATE FUNDING SOURCES - FEDERAL AGENCIES OR PRIVATE SECTOR
DONORS - DETAILING THE USE OF GRANT/DONATED FUNDS AND PROGRAMMATIC
ACHIEVEMENTS/OUTCOMES.
1hSchedule I (Form 990 ) (2012)
JSA
301504 2 000
50ZONY 1985 V 12-6F 430966 PAGE 117
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule I (Form 990 ) (2012) Pape 2
Grants and Other Assistance to Individuals in the United States . Complete if the organization answered "Yes" on Form 990, Part IV, line 22.Part III can be duDlicated if additional saace is needed.
(a) Type of grant or assistance (b) Number ofrecipients
(c) Amount ofcash grant
(d) Amount ofroxash e3s scan a
( 0) Method of valuation (DodgyFMV, apprasm , other?
(f) Description of non-cash assistance
2
3
4
5
6
7
giNIu 5uppiemental information . Complete this part to provide the information require( in Fart I, line Z, fast iii, column (D), ana any otner aaai ionaiinformation.
BGCA ALSO CONDUCTS NUMEROUS ONSITE VISITS OF LOCAL-CLUB ORGANIZATIONS AND
THEIR GRANT AND FISCAL MANAGEMENT PROCEDURES, AGAIN TO ENSURE THAT THE
CLUBS ARE COMPLIANT WITH THE TERMS OF THE GRANTS AWARDED TO THEM BY BGCA
AND ARE USING THE GRANT FUNDS APPROPRIATELY FOR THE DELIVERABLES OF THE
GRANTS. MAJORITY OF THESE SITE VISITS ARE CONDUCTED BY INDEPENDENT CPA
FIRMS ON BEHALF OF BGCA.
•
is
BGCA HAS CONTRACTED WITH SCHOLARSHIP AMERICA, A SCHOLARSHIP MANAGEMENT
SERVICE, TO ADMINISTER SCHOLARSHIPS TO ELIGIBLE CLUBS KIDS.
Schedule I (Form 990) (2012)
JSA
AEl5042000
50ZONY 1985 V 12-6F 430966 PAGE 118
9 0SCHEDULE J Compensation Information OMB No 1545-0047
(Form 990) For certain Officers , Directors , Trustees , Key Employees , and Highest ^O7J 2
Compensated Employees► Complete If the organization answered 'Yes" to Form 990,
Department of the TreasuryPart IV, line 23 . • 0- •
Internal Revenue se.vloe ► Attach to Form 990 . ► See separate Instructions.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
rNIF Questions Regarding Com pensationYes No
1 a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form990, Part VII, Section A, line la Complete Part Ili to provide any relevant information regarding these items
First-class or charter travel Housing allowance or residence for personal useTravel for companions Payments for business use of personal residenceTax indemnification and gross-up payments Health or social club dues or initiation feesDiscretionary spending account Personal services (e g, maid, chauffeur, chef)
b If any of the boxes on line la are checked, did the organization follow a written policy regarding paymentor reimbursement or provision of all of the expenses described above? If "No," complete Part III toexplain ............... .......... .................. .. 11
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers, _directors, trustees, and the CEO/Executive Director, regarding the items checked in line la? .. ... ..... 2
3
4
a
b
c
5
a
b
6
a
b
7
8
9
Indicate which, if any, of the following the filing organization used to establish the compensation of theorganization's CEO/Executive Director Check all that apply Do not check any boxes for methods used by arelated organization to establish compensation of the CEO/Executive Director, but explain in Part 111.
R
X Compensation committee Written employment contract
X Independent compensation consultant X Compensation survey or study
X Form 990 of other organizations X Approval by the board or compensation committee
During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filingorganization or a related organization
Receive a severance payment or change-of-control payment? , , , .. ......................Participate in, or receive payment from, a supplemental nonqualified retirement plan? , , ,
Participate in, or receive payment from, an equity-based compensation arrangement?, , , , , , , , , , , , , , ,
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III
Only section 501(c )( 3) and 501 ( c)(4) organizations must complete lines 5-9.
For persons listed in Form 990, Part VII, Section A, line 1 a, did the organization pay or accrue any
compensation contingent on the revenues of
The organization? ........ .......... ....... ........... .. ............ .Any related organization? . . .. . .. .. .... . . ... .. . ... . ... . . .. . . ..... .. . ... . .If "Yes" to line 5a or 5b, describe in Part III
For persons listed in Form 990, Part VII, Section A, line la, did the organization pay or accrue any
compensation contingent on the net earnings of
The organization? . . . . .. . . . .... .... . .... .. . ... . ... . ... . . ..... ... ... . .Any related organization? . . . . . . . .. ... .. . . ..... . . . ... . . . . . . . .... ....... . .If "Yes" to line 6a or 6b, describe in Part III
For persons listed in Form 990, Part VII, Section A, line la, did the organization provide any non-fixed
payments not described in lines 5 and 6') If "Yes," describe in Part Ill . .... . .. . ... . .
Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subjectto the initial contract exception described in Regulations section 53 4958-4(a)(3)? If "Yes," describe
in Part III ........................................................
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described inRegulations section 53.4958-6(c)? .. ...................... .
For Paperwork Reduction Act Notice, see the instructions for Form 990.
4a X
4b X
4c X
5a X
5b X
6a XSb X
7 X
it X
1 9 1Schedule J (Form 990) 2012
JSA
2E1290 1 00050ZONY 1985 V 12-6F 430966 n BRls tl Lb
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule J (Form 990) 2012 page 2
Officers, Directors Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is neededFor each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (I) and from related organizations, described in theinstructions, on row (ii) Do not list any individuals that are not listed on Form 990, Part VII.Note . The sum of columns (8)(I)-(Iii) for each listed Individual must equal the total amount of Form 990, Part V11, Section A, line 1a, applicable column (D) and (E) amounts for thatindividual
(B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and (0) Nontaxable (E) Total of columns (F) Compensation
(A) Name and Title (1) aase q1) Bonus & incentive fit;) Other other deterred benefits (Bx+)-(0) reported as deterred m
compensation compensation reportable compensation poor Form 990
compensation
CLARK, JAMES L (() 413,115. 100,000. 144,905 100,000 28,398. 786,418 01 PRESIDENT AND CEO ----------- ------------- ------------- - - - - - - - - - - - O
FIELDEN, NELL (() 168,164. 14,000. 18,123. 15,248. 22,830. 238,365 02 SR VP , HUMAN RESOURCES
l
- ------ ------------ ------------ ------------- ------------- ------------- ------------O
MCCARTNEY, KEVIN (() 209,382. 21,000. 951. 17,066. 21,423. 269,822. 0S SR VP , GOVERNMENT RELATIONS -- - - - - - - - - - - - - - - - - - - - - - - - - - - -------------O
MCELROY, EVAN (q 194,231. 14,000. 2,706. 16,564. 30,097. 257,598. 04 SR VP 1 oarr i COMMUNICATIONS I) ------------- ------------- ------------- -------------
MEHTA, ANAND tq 248,379 40,000 19,772. 19,600. 26,845. 354,596. 05 ASSISTANT TREASURER ---------- ------------ ------------ ------------- ------------- ------------- -------------
O
MISHRELL, WILLIAM E. (q 181,381. 13,000. 7,731. 14,969. 26,218 243,299. 06 SVP, PLANNING i MEASUREMENT
1--- ----- ------------ ------------ ------------- ------------- ------------- ------------ 0
MORAIN, KRISTINE (5) 167,493 7,000 3,140. 13,436. 26,669. 217,738. 0T ASSISTANT SECRETARY () ----- ------------ ------------ ------------- ------------- ------------- -------------O
ORR, LORRAINE E (I) 213,157 13,000 5,791 14,753 8,908, 255,609. 0B SA VP , CLUB SERVICES
li- ----- ------------ ------------ ------------- ------------- - ---
---------- -------------
O
PICKENS, JUDITH t^ - 174,327. 12,000. 19,649. 16,092 26,017 248,085 09 SVP, PROD i YOUTH DEV SERVICES I(
--- ----- ------ ------ ------ ----- -O
RANDOLPH, LYDIA (() 209,888. 10,000. 350 14,382. 10,433 245,053 010 VP , RESOURCE DEVELOPMENT -- ---- ------------ ------------ ------------- ------------- ------------- ------------0
SPILLETT, ROXANNE (I) 333,932. 123,500. 52,357. 19,600 15,3B6 544_775 011
rMR PILES EMERITUS, SR EXEC VP II
---- ----- ------ ------ ------ ----- --------
----O
(I) ---- - -- ----- ------------ - - ------------ - ------------- - ------------- ------------- -------------12
13
(I)(10
14())11110
------------ ---------- ----------- ----------- ----------- ----------- ------------
(() ------------ -------------- -------------- ------------------------ ----------- ------------
18(liII
------------ ------------ ------------ ----------- - ------------ - ------------ - -------------
•
0
Schedule J (Form 990) 2012
JSA2E1291 1 000
5OZONY 1985 V 12-6F 430966 PAGE 120
BOYS & GIRLS CLUBS OF AMERICA 13 -5562976
Schedule J (Form 990 ) 2012 Page 3
Supplemental InformationComplete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part IIAlso complete this part for any additional information
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN
SCHEDULE J, PART I, QUESTION 4B •
IN 2011 THE BOARD OF GOVERNORS APPROVED A SUPPLEMENTAL EXECUTIVE
RETIREMENT PLAN FOR THE BENEFIT OF A MEMBER OF SENIOR MANAGEMENT WHEREBY
A RETIREMENT BENEFIT WILL BE EARNED RATABLY BY THE EXECUTIVE DURING THE
SERVICE TERM AS DEFINED IN THE PLAN AGREEMENT. THE VESTED AMOUNT WILL BE
PAID TO THE EXECUTIVE UPON RETIRMENT, DIABILITY, OR TERMINATION WITHOUT
CAUSE AS DEFINED IN THE PLAN AGREEMENT.
INCENTIVE COMPENSATION
SCHEDULE J, PART I, QUESTION 5A
BGCA HAS A PAY AT-RISK PROGRAM THAT HOLDS BACK A PORTION OF THE PERSON'S
PAY OPPORTUNITY UNTIL MULTIPLE, STRETCH PERFORMANCE CRITERIA ARE MET.
NONE OF THE PAY AT RISK WILL BE EARNED BY ANY ONE PERSON UNTIL A
PRE-ESTABLISHED LEVEL OF FINANCIAL PERFORMANCE IS ATTAINED, ENSURING THAT •
WE HAVE THE FINANCIAL RESOURCES TO MEET THE OBJECTIVES OF OUR MISSION,
FIRST AND FOREMOST. BGCA MET THE FINANCIAL PERFORMANCE CRITERIA FOR THE
2011 CALENDAR YEAR AND PERSONS LISTED IN SECTION VII, PART A, RECEIVED A
PORTION OF THIS PAY AT RISK IN 2012. THE PAYMENT WAS BASED ON MULTIPLE
Schedule J (Form 990) 2012
JSA:) E 1&D5 1 000
50ZONY 1985 V 12-6F 430966 PAGE 121
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule J ( Form 990) 2012 Page 3
Supplemental InformationComplete this part to provide the information , explanation , or descriptions required for Part I, lines 1a , 1b, 3, 4a, 4b, 4c , 5a, 5b, 6a, 6b, 7, and 8 , and for Part II.Also complete this part for any additional information
FACTORS IN ADDITION TO REVENUE, INCLUDING.ORGANIZATIONAL AND INDIVIDUAL
PERFORMANCE GOALS THAT WERE PRE-ESTABLISHED AND BOARD-APPROVED AT THE •
BEGINNING OF THE YEAR.
is
Schedule J (Form 990) 2012
JSA
%E1505 1 000
A 50ZONY 1985 V 12-6F 430966 PAGE 122
DEVELOPMENT AUTHORITY OF FULTON COUNTY
SCHEDULE K Supplemental Information on Tax-Exempt Bonds OMB No 1545-00
A(Form 990) 20 1L► Complete if the organization answered "Yes" to Form 990 , Part IV , line 24a. Provide descriptions,
explanations , and any additional Information in Part VI.Depanment or tiro Treasuryintsmal ReAnuese e ► Attach to Form 990. ► See separate instructions.
Name of the organization Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP 9 (d) Date issued ( e) Issue price ( f) Description of purpose (8) Deft-ad(h)behalf
Onof
issuer
fi( I
acded
nenang
Yes NO Yes No Yes No
A DEVELOPMENT AUTHORITY OF FULTON COt7NTY 50-1506878 359900RJO 09/27/2005 15,000,000. ADDITION AND DEVELOPMENT X
B
C
D
Proceeds
A B C D
1 Amount of bonds retired ...................................2 Amount of bonds legally defeased . . .. . . . .. . . . .. . . .. ...... . ... . .
3 Total proceeds of issue , 15,000,000.
4 Gross proceeds in reserve funds .
5 Capitalized interest from proceeds ,
6 Proceeds in refunding escrows.
7 Issuance costs from proceeds 182,432.
8 Credit enhancement from proceeds ,
9 Working capital expenditures from proceeds
10 Capital expenditures from proceeds . 14,817,568.
11 Other spent proceeds
12 Other unspent proceeds
13 Year of substantial completion , . . . . . . . . . . . . . . . . . . . . . . . . 2005
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding Issue' .. X
16 Were the bonds issued as part of an advance refunding issue'7. X
16 Has the final allocation of proceeds been made X
17 Does the organization maintain ad eq uate books and records to support the final allocation of proceeds? . X
Privates Rrrcinacc Lime
A B C D
I Was the organization a partner in a partnership, or a member of an LLC , Yes No Yes No Yes No Yes No
which owned property financed by tax-exempt bonds? X
2 Are there an y lease arrangements that may result in private business use of bond-financed properlp XA
For Paperwork Reduction Act Notice , see the Instructions for Form 990.
JSA
2EI2951JZONY 1985 V 12-6F 430966V
Schedule K (Form 990) 2012
PAGE 123
S
.I
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule K (Form 990) 2012
Private Business Use Continued DEVELOPMENT AUTHORITY OF FUL
A e
3a Are there any management or service contracts that may result in private business Yes No you No
use of bond - financed p roperty? . , , , X
b If "Yes" to line 3a. does the organization routinely engage bond counsel or other outside counselto review any management or servi ce contracts relating to the financed property? ,
c Are there any research agreements that may result in private business use of bond-
financed property? X
d If 'Yes " to line 3c , does the organization routinely engage bond counsel or other
outside counsel to review any research agreements relating to the financed property?. ,
4 Enter the percentage of financed property used in a private business use by entitiesother than a section 501 (c) (3) org anization or a state or local g overnment , ► 5. 0000 %
S Enter the percentage of financed property used in a private business use as aresult of unrelated trade or business activity carried on by your organization,another section 501 ( c)( 3 ) org anization , or a state or local government . ► %
6 Total of lines 4 and 5 . 5. 0000 %
7 Does the bond issue meet the p rivate security or payment test? , ,
ea Has there been a sale or disposition of any of the bond -financed property to a nongovern-mental person other than a 501 ( c )( 3 ) or ganization since the bonds were Issued).. X
b If "Yes" to line 8a , enter the percentage of bond -financed property sold or disposed...............................................of ON
c If "Yes" to line 8a , was any remedial action taken pursuant to Regulations sections1 141-12 and 1 145-2?. ...................................
9 Has the organization established written procedures to ensure that all nonquallfiedbonds of the issue are remedlated in accordance with the requirements underRegulations sections 1.141 - 12 and 1 145-2 ? . . . . .. ... .. .... . ..... .. X
Orhitrarm
2E129610005OZONY 1985 V 12-6F 430966
5cheaule R (rorrn u) [ulA
PAGE 124
Page 2
C D
No Yes No
•
A B C 0
Yes No Yes No Yes No Yes No
I Has the issuer filed Form 8038-T? , X2 If "No" to line 1 , did the followinga pply?a Rebate not due t?,
b Exception to rebate?.
c No rebate dues ....................................
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate
com p utation was performed
3 Is the bond issue a variable rate Issue? x
4a Has the organization or the governmental issuer entered into a qualified hedge with
respect to the bond Issue? . ................................. x
b Name of provider . ......................................
Term of hedge. ........................................cd Was the hedg e su nnte rated Xe Was the hedge terminated?. X
JSA
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule K (Form 990 ) 2012 Page 3
MUM Arbitrage (Continued)A B C D
Yes No Yes No Yes No Yes No
5a Were g ross p roceeds invested Ina g uaranteed investment contract (GIC)? . X
b Name of p rovider . ......................:...............
c Term of GIC . ........................................
d Was the reg ulato ry safe harbor for establishing the fair market value of the GIC satisfied? . .
6 Were any gross proceeds Invested beyond an available tem pora ry nod .... X
7 Has the organization established written procedures to monitor the
req uirements of section 1487 ................................
ff3.7= Procedures To Undertake Corrective Action
A B C 0
Has the organization established written procedures to ensure that violations of federal Yes No Yes No Yes No Yes No
tax requirements are timely identified and corrected through the voluntary closing
agreement program if self-remediation is not available under applicable regulations? X
ORM Supplemental Information . Complete this part to provide additional information for responses to questions on Schedule K (see instructions)
2SAE 1328 1 000
Schedule K (Form 990) 2012
as 50ZONY 1985 V 12-6F 430966 PAGE 125
.I
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule K ( Form 990) 2012 Pope 4
Supplemental Information . Complete this part to provide additional information for responses to questions on Schedule K (see instructions) (Continued)
•
V
na JSA Schedule K (Form 990) 2012
2E15111c 9W20NY 1985 V 12-6F 430966 PAGE 126
• •
SCHEDULE M OMB No 1545-0047
(Form 990) Noncash Contributions0- Complete if the organizations answered "Yes" on Form
Department of the Treasury990, Part IV , lines 29 or 30 .
6iimInternal Revenue Sennce ' Attach to Form 990.
Name of the organization Employer IdentNtcatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
T es of Prope rty(c) (d )
Check of Number of contributions or Noncesh contributionMethod of determining
applicable items contributed Formam990
990,.Part Vlll,reported
linean
1g noncash contribution amounts
I Art - Works of art .. ...... .2 Art - Historical treasures . ... .
3 Art - Fractional interests . .. . .
4 Books and publications .... .
5 Clothing and household
goods .. ...... ...... .
6 Cars and other vehicles . ... .
7 Boats and planes... .. ... .
8 Intellectual property . .. ... .
9 Securities - Publicly traded ... X 18. 2, 901, 320. FMV
10 Securities - Closely held stock .. .
11 Securities - Partnership, LLC,
or trust interests . .... ... .
12 Securities - Miscellaneous ... .
13 Qualified conservation
contribution - Historic
structures ........... .
14 Qualified conservation -
contribution - Other .. .... .
15 Real estate - Residential .... .
16 Real estate - Commercial ... .
17 Real estate - Other ... ..... .
18 Collectibles. ... . .. . ... .
19 Food inventory . . . .. . ... .
20 Drugs and medical supplies .. .
21 Taxidermy . . .. . . . . ... .
22 Historical artifacts . ... ... .
23 Scientific specimens ...... .
24 Archeological artifacts. . ... .
25 Other _______ )
26 Other lli-(
27 Other
28 Other
29 Number of Forms 8283 received by the organization during the tax year for contributions for
which the organization completed Form 8283, Part IV, Donee Acknowledgement ... .. . . . 29
You No
30a During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that
it must hold for at least three years from the date of the initial contribution, and which is not required to be
used for exempt purposes for the entire holding period? . 30a X........................... . .
b If "Yes," describe the arrangement in Part II
31 Does the organization have a gift acceptance policy that requires the review of any non-standard
contributions' ..... . . .. ..... . .... ........... . . ..... . ..... .. . . . . . .. . . 31 X32 a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ... .. . . .. . . .. ... .. . ... .. ..... .. ... . .. .... .. . . .. . .. .... 32a X
b If "Yes," describe in Part II
33 If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part 11.
For Paperwork Reduction Act Notice , see the Instructions for Form 990. Schedule M (Form 990) (2012)
!Sri2E 1298 1 000
50ZONY 1985 V 12-6F 430966 n RNX 4 yq
• BOYS & GIRLS CLUBS OF AMERICA • 13-5562976
Schedule M ( Form 990 ) (2012) Pepe 2
Supplemental information . Complete this part to provide the information required by Part I, lines 30b, 32b,and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, thenumber of items received, or a combination of both. Also complete this part for any additional information.
USE OF THIRD PARTIES
FORM 990, SCHEDULE M, PART I, LINE 32A
BOYS & GIRLS CLUBS OF AMERICA USES THE SERVICES OF AUCTIONEERS AT
FUNDRAISING EVENTS.
JSA Schedule M (Forth 990 ) (2012)
2E1508 2 0005OZONY 1985 V 12-6F 430966 n PAGE 1T2 51 q
• •SCHEDULE 0 Supplemental Information to Form 990 or 990-EZ(Form 990 or 990-EZ)
Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.0epanmom of the Treasury
Lntemal Revenue semce to Form 990 or 990-EZ.
OMB No 1545-004 7
2012
Name of the organ iz ation Employer Identification number
BOYS & GIRLS CLUBS Of AMERICA 13-5562976
PROGRAM SERVICES ACCOMPLISHMENTS
FORM 990, PART III, LINE 4
LINE 4A
THROUGH THE PROVISION OF $48.3 MILLION NATIONAL MENTORING PROGRAMS
FUNDING OJP/OJJDP PARTNERED WITH BGCA TO STRENGTHEN, EXPAND AND ENHANCE
MENTORING PROGRAMS AND EXPERIENCES FOR APPROXIMATELY 50,000 CLUB MEMBERS
IN FIVE SPECIFIC GOAL AREAS:
" SUPPORT FOR MENTORING IN UNDERSERVED COMMUNITIES;
" MENTORING THROUGH TARGETED OUTREACH;
SUPPORT FOR MINORITY MALE MENTOR RECRUITMENT;
of MENTORING MILITARY YOUTH OFF INSTALLATION; AND
" MENTORING MILITARY YOUTH ON INSTALLATION.
GOAL 1: POSITIVELY IMPACT THE LIVES OF CURRENT AND NEW CLUB MEMBERS
THROUGH THE STRENGTHENING, ENHANCEMENT AND EXPANSION OF OUR MENTORING
PROGRAMS FOR AT-RISK YOUTH RESIDING IN DISTRESSED AREAS
GOAL 2: PROVIDE SUPPORT, TRAINING AND TECHNICAL ASSISTANCE TO CLUBS
IMPLEMENTING TARGETED OUTREACH MENTORING INITIATIVES (GANG PREVENTION,
GANG INTERVENTION, DELINQUENCY PREVENTION, AND DELINQUENCY INTERVENTION)
WITH AN EMPHASIS UPON STRENGTHENING, ENHANCING AND EXPANDING MENTORING
PROGRAMS FOR HIGH-RISK YOUTH
GOAL 3: PROVIDE SUPPORT, TRAINING, TECHNICAL ASSISTANCE AND RESOURCES TO
ALL CLUBS TO EFFECTIVELY ASSESS AND ADDRESS THE MINORITY MALE MENTOR
For Privacy Act and Paperwork Reduction Act Notice , see the Instructions for Form 990 or 990 -EZ. Schedule 0 (Form 990 or 990-EZ) (2012)JSA
2 E 1227 1 000
50ZONY 1985 V 12-6F 430966 TTPAGF, 1 &ap •p
• • •Schedule O (Form 990 or 990-EZ) 2012 Pape 2
Name of the organ iz ation Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
RECRUITMENT NEEDS OF CLUB MEMBERS
GOAL 4: POSITIVELY IMPACT THE LIVES OF CURRENT AND NEW MILITARY-CONNECTED
CLUB MEMBERS THROUGH THE STRENGTHENING, ENHANCEMENT AND EXPANSION.OF OUR
MENTORING PROGRAMS FOR MILITARY YOUTH RESIDING OFF MILITARY
INSTALLATIONS
GOAL 5: POSITIVELY IMPACT THE LIVES OF CURRENT AND NEW MILITARY-CONNECTED
CLUB MEMBERS THROUGH THE STRENGTHENING, ENHANCEMENT AND EXPANSION OF OUR
MENTORING PROGRAMS FOR MILITARY YOUTH RESIDING ON MILITARY INSTALLATIONS
BGCA CONTINUES TO DEVELOP AND IMPLEMENT SYSTEMS, PROCESSES, TOOLS AND
RESOURCES TO SUPPORT THE MENTORING EFFECTIVENESS OF BOYS & GIRLS CLUBS.
BOYS & GIRLS CLUBS REACH THOUSANDS OF AT-RISK YOUTH RESIDING IN OUR
NATION'S MOST DISTRESSED COMMUNITIES. TO THAT END BGCA HAS MADE
SIGNIFICANT COMMITMENTS TO OUR SUPPORTERS, CLUBS, NATIONAL YOUTH SERVING
ORGANIZATIONS AND OTHER INVESTED PARTIES, TO AGGRESSIVELY AND EFFECTIVELY
DEVELOP AND MOBILIZE STRATEGIES TO ADDRESS AND TAKE SIGNIFICANT STEPS
TOWARD MEETING THE MENTORING NEEDS OF ALL CLUB MEMBERS, WITH AN EMPHASIS
UPON ADDRESSING THE MINORITY MALE MENTOR SHORTAGE THAT CONTINUES TO GROW
AND NEGATIVELY IMPACT MENTORING OPPORTUNITIES FOR MINORITY YOUTH.
BGCA JOINED FORCES WITH THE MILITARY CHILD EDUCATION COALITION TO DEVELOP
THE BUILDING RESILIENCY IN YOUTH TRAINING BASED ON A DYNAMIC MODEL TO
HELP YOUTH DEVELOPMENT PROFESSIONALS NURTURE THE RESILIENCY IN CHILDREN
AND TEENS.
SSA
2E1228 1 000
50ZONY 1985
Schedule 0 (Form 990 or 990-EZ) 2012
V 12-6F T;PAGB 1-Nn p
• •Schedule 0 (Form 990 or 990-EZ)2012 Page 2
Name of the or9an ¢ation Employer identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
BGCA HAS COMMITTED TO PROVIDING MENTORING OPPORTUNITIES FOR APPROXIMATELY
50,000 AT-RISK YOUTH AT APPROXIMATELY 1,600 CLUB SITES THROUGH THE
SUCCESSFUL IMPLEMENTATION OF THE FIVE INDIVIDUAL PROGRAM GOALS.
LINE 4B
BGCA OFFERS GRANTS TO ORGANIZATIONS IN AN OUTREACH EFFORT TO NEW MEMBERS
CURRENTLY NOT ATTENDING AN AFTER-SCHOOL PROGRAM, AS WELL AS MEMBERS AT
RISK OF LEAVING A PROGRAM FOR LACK OF FUNDS. THE GRANTS TO LOCAL
ORGANIZATIONS PROVIDED SOME 5,000 KIDS WITH THE OPPORTUNITY TO JOIN THEIR
LOCAL CLUB AS OPPOSED TO BEING AT HOME ALONE OR AT RISK OF DELINQUENT
BEHAVIOR DURING AFTER-SCHOOL HOURS.
LINE 4C
THE MORE MEMBERS, MORE OFTEN GRANTS PROVIDED PARTICIPATING CLUBS WITH THE
RESOURCES NECESSARY TO INCREASE THEIR MEMBERSHIP AND/OR INCREASE THE
NUMBER OF TIMES A MEMBER ATTENDS EACH WEEK. OVER THE COURSE OF 2012,
CLUBS IMPLEMENTED BOTH PROVEN AND INNOVATIVE STRATEGIES WHICH ALLOWED
BGCA TO CAPTURE BEST PRACTICES TO SHARE THROUGHOUT THE ENTIRE BGCA
MOVEMENT TO MAXIMIZE THE DIRECT IMPACT THIS GRANT MAKES ON YOUTH. THIS
GRANT PROVIDED CLUBS WITH THE OPPORTUNITY TO TEST A BROAD RANGE OF
TACTICS TO DETERMINE WHAT WORKED BEST FOR THE YOUTH AND FAMILIES IN THE
Schedule 0 ( Form 990 or 990-Z) 2012JSA
2 E 1228 1 0005OZONY 1985 V 12-6F 430966 IRPAG& 132n 1
Schedule 0 (Form 990 or 990-EZ) 2012
•2
Name of the oryaruzaoon Employer Identlflc.Uon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976 1
LOCAL COMMUNITY. THROUGHOUT THE GRANT, GRANTEE SITES EXPERIENCED MUCH
SUCCESS IN INCREASING THEIR ADA OVER THE TERM OF THE GRANT. SITES
AVERAGED AN INCREASE OF 10% IN THEIR SCHOOL YEAR AVERAGE DAILY ATTENDANCE
BETWEEN FEBRUARY AND NOVEMBER. ATTENDANCE DATA ALSO INDICATE A STRONG
CORRELATION (.87) BETWEEN ADA GROWTH AND PROGRESSION OF THE GRANT TERM.
BGCA'S FORMULA FOR IMPACT (FFI) IS A RESEARCH-BASED THEORY OF CHANGE THAT
DESCRIBES HOW INDIVIDUAL CLUBS AND THE MOVEMENT AS A WHOLE WILL INCREASE
OUR IMPACT - EXPONENTIALLY - ON THE YOUNG PEOPLE OF AMERICA. IT IS A
ROADMAP FOR ALL CLUBS TO USE TO ENSURE THAT MEMBERS HAVE A LIFE-CHANGING
CLUB EXPERIENCE, AND LEAVE THE CLUB KNOWING THEY WILL HAVE A GREAT
FUTURE. MORE MEMBERS, MORE OFTEN IS A MAJOR COMPONENT OF THE FORMULA FOR
IMPACT, AND OUR ENTIRE ORGANIZATION IS FOCUSED ON AVERAGE DAILY
ATTENDANCE AS A COMPONENT OF THE FORMULA.
LINE 4D- OTHER PROGRAM SERVICES
BOYS & GIRLS CLUBS OF AMERICA HAS A LINE-UP OF TESTED AND PROVEN
NATIONALLY RECOGNIZED PROGRAMS THAT ADDRESS TODAY'S MOST PRESSING YOUTH
ISSUES, TEACHING YOUNG PEOPLE THE SKILLS THEY NEED TO SUCCEED IN LIFE.
NATIONAL PROGRAMS ARE AVAILABLE IN THE AREAS OF EDUCATION, HEALTH, THE
ARTS, CAREERS, ALCOHOL/DRUG AND PREGNANCY PREVENTION, GANG PREVENTION,
LEADERSHIP DEVELOPMENT AND ATHLETICS. BOYS b GIRLS CLUBS OF AMERICA'S
NATIONAL PROGRAMS HAVE TAKEN MEMBERS FROM THE CLUBHOUSE TO THE WHITE
JSA
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V 12-6F 430966 nP, G Wh q
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Name of the organ¢etron Employer Identifleation number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
HOUSE; FROM THE GAMES ROOM TO THE CORPORATE BOARDROOM; FROM THE HIGH
SCHOOL ORCHESTRA TO CARNEGIE HALL. THERE ARE SEVERAL OTHER PROGRAMS
FUNDED BY VARIOUS DONORS AT DIFFERENT LEVELS.
BUSINESS RELATIONSHIPS
FORM 990, PART VI, SECTION A, LINE 2
IN 2012, THE FOLLOWING MEMBERS OF BOYS & GIRLS CLUBS OF AMERICA BOARD OF
GOVERNORS HAD RELATIONSHIPS WITH ANOTHER MEMBER OF THE BOARD OF
GOVERNORS:
RELATED PARTIES
ANNE SZOSTAK, GOVERNOR
RICK GOINGS, GOVERNOR
ANNE SZOSTAK, GOVERNOR
JACK STAHL, GOVERNOR
RELATIONSHIP
BUSINESS
ANNE SZOSTAK IS ON THE BOARD OF
DIRECTORS OF THE FOR PROFIT
COMPANY THAT EMPLOYS RICK GOINGS.
BUSINESS
THESE TWO GOVERNORS SERVE
ON THE BOARD OF DIRECTORS FOR
THE SAME FOR PROFIT COMPANY.
NATIONAL COUNCIL
FORM 990, PART VI, SECTION A, QUESTION 7A
THE BOARD OF GOVERNORS IS ELECTED BY A PLURALITY VOTE AT THE ANNUAL
MEETING OF THE NATIONAL COUNCIL FOR A THREE-YEAR TERM.
SSA Schedule 0 ( Form 990 or 990-EZ) 2012
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50ZONY 1985 V 12-6F 430966 nPAGPit 13+3n -1
Schedule 0 (Form 990 or 990-EZ) 2012 Page 2
Name of the oryanaauon Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
VOTING RIGHTS: THE BOARD OF GOVERNORS CONSISTS OF THREE CATEGORIES OF
BOARD MEMBERS: 1. GOVERNORS; 2. LIFE MEMBERS; AND 3. GOVERNORS
EMERITUS. ONLY THE GOVERNORS HAVE FULL VOTING RIGHTS AND PRIVILEGES.
DECISIONS OF THE GOVERNING BODY SUBJECT TO APPROVAL:
THE POLICIES OF BOYS & GIRLS CLUBS OF AMERICA ("BGCA") ARE DETERMINED BY
A NATIONAL COUNCIL WHICH ESTABLISHES THE REQUIREMENTS FOR MEMBERSHIP IN
THE CORPORATION; ESTABLISHES OPERATING STANDARDS; ELECTS MEMBERS OF THE
BOARD OF GOVERNORS; AND DETERMINES ANNUAL MEMBERSHIP DUES TO BE PAID BY
THE MEMBER ORGANIZATIONS. THE NATIONAL COUNCIL CONSISTS OF ONE DELEGATE
FROM EACH MEMBER ORGANIZATION.
GOVERNING BODY'S REVIEW OF FORM 990
FORM 990, PART VI, SECTION B, QUESTION 11
A DRAFT OF THE FORM 990 IS CIRCULATED TO THE AUDIT COMMITTEE OF THE BOARD
OF GOVERNORS FOR ITS REVIEW, RECOMMENDATIONS AND APPROVAL. CHANGES, IF
ANY, RECOMMENDED BY THE COMMITTEE ARE INCORPORATED IN THE FORM 990 BEFORE
ITS SUBMISSION. A DRAFT OF THE FORM 990 IS ALSO CIRCULATED TO ALL
GOVERNORS FOR THEIR REVIEW AND RECOMMENDATIONS, WHICH ARE CONSIDERED BY
THE AUDIT COMMITTEE IN ITS APPROVAL PROCESS. A FINALIZED VERSION OF THE
FORM 990 IS PROVIDED TO THE COMPLETE BOARD.
MONITORING CONFLICTS OF INTEREST
FORM 990, PART VI, SECTION B, QUESTION 12C
BOYS & GIRLS CLUBS OF AMERICA HAS DEVELOPED TWO SEPARATE CODES OF ETHICS
SSA Schedule 0 (Forth 990 or 990.EZ) 2012
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Name of the organization Employer Identification number
BOYS & G IRLS CLUBS OF AMERICA 13-5562976
POLICIES ONE FOR THE EMPLOYEES AND THE OTHER FOR GOVERNORS AND TRUSTEES,
BOTH OF WHICH ADDRESS CONFLICTS OF INTERESTS AND WHISTLE BLOWING POLICIES
WITHIN THEM. THESE POLICIES WERE APPROVED BY THE BOARD OF GOVERNORS. THE
CODE OF ETHICS FOR EMPLOYEES IS EXECUTED BY ALL NEW EMPLOYEES AT THE TIME
OF HIRE AND ANNUALLY ON AN ONGOING BASIS. LIKEWISE, THE CODE OF ETHICS
FOR GOVERNORS MUST BE EXECUTED BY ALL NEW GOVERNORS AND THEY ARE ASKED TO
REVIEW AND EXECUTE ON AN ANNUAL BASIS. THE HUMAN RESOURCE DEPARTMENT OF
BOYS & GIRLS CLUBS OF AMERICA IS RESPONSIBLE FOR MONITORING THE EXECUTION
OF THE EMPLOYEES' CODE OF ETHICS AND THE RESOURCE DEVELOPMENT DEPARTMENT
IS RESPONSIBLE FOR MONITORING THE EXECUTION CODE OF ETHICS FOR GOVERNORS
& TRUSTEES.
IN ADDITION, THE BOARD OF GOVERNORS HAS AN ETHICIST ON THE BOARD TO
MONITOR ETHICAL CONCERNS AT THAT LEVEL. BOYS & GIRLS CLUBS OF AMERICA
HAS AN ETHICS HOTLINE AND TWO ETHICS OFFICERS WHO MONITOR ETHICAL
CONCERNS ON AN ONGOING BASIS BY:
- ENSURING THE CODE OF ETHICS IS UPDATED AT LEAST ANNUALLY AND
CONTINUES TO REPLICATE BEST PRACTICES OF OTHER FOR-PROFIT AND
NOT-FOR-PROFIT ORGANIZATIONS;
- REVIEWING AND RESPONDING APPROPRIATELY TO ALL QUESTIONS, ISSUES,
AND COMPLAINTS AND ENSURING THE CODE OF ETHICS IS CLARIFIED AND/OR
REVISED BASED ON THE INPUT RECEIVED;
i
Schedule 0 (Form 990 or 990EZ) 2012JS/.
2E1228' 00050ZONY 1985 V 12-6F 430966 n2AG y 10fp 1
• •Schedule 0 (Form 990 or 990-F2) 2012 Page 2
Name of the oryankation Employer Idendftcatlon number
BOYS & GIRLS CLUBS O F AMERICA 13-5562976
- REPORTING ANY SIGNIFICANT ETHICAL-CONCERNS TO ALL NECESSARY
COMMITTEES OF THE BOARD AND/OR THE BOARD;
- REQUIRING PA MEMBER OF THE BOARD OF GOVERNORS RECEIVE ALL FORMAL
COMPLAINTS AND ENLIST THEIR INVOLVEMENT IN THE RESOLUTION AND RESPONSE TO
COMPLAINTS AS NEEDED; AND
- CONDUCTING TRAINING ON THE CODE OF ETHICS AS NEEDED.
PROCESS OF DETERMINING COMPENSATION
FORM 990, PART VI, SECTION B, QUESTION 15
THE TOTAL COMPENSATION FOR ALL SENIOR LEADERSHIP IS DETERMINED BY BOYS &
GIRLS CLUBS OF AMERICA'S ("BGCA'S") BOARD OF GOVERNORS THROUGH THE HUMAN
RESOURCES AND COMPENSATION COMMITTEE ("HRCC"), WHICH WORKS WITH AN
INDEPENDENT FIRM TO ASSESS THE MARKETPLACE THOROUGHLY TO DETERMINE
COMPARABLE SALARY PRACTICES, "PEER COMPARISON" COMPENSATION DATA, AND
OTHER RELATED TRENDS IN THE NOT-FOR-PROFIT SECTOR. THE INDEPENDENT FIRM
ALSO PROVIDES A DETAILED REPORT OF THEIR ANALYSIS, COMPARISONS AND
RECOMMENDATIONS TO THE HRCC. THIS REVIEW IS CONDUCTED ON A REGULAR BASIS.
IN ADDITION, EVERY MARCH, THE HRCC REVIEWS EACH SENIOR LEADERSHIP TEAM
MEMBER'S TOTAL COMPENSATION BASED ON PERFORMANCE FEEDBACK ON THE
INDIVIDUAL AS WELL AS THE ORGANIZATION, AND APPROVES THE UPCOMING ANNUAL
TOTAL COMPENSATION AND BENEFITS PACKAGE PRIOR TO ANY CHANGES IN
COMPENSATION AND/OR BENEFITS. ALL COMPENSATION AND BENEFIT DECISIONS OF
THE HRCC ARE COMPLETED AND DOCUMENTED AS REQUIRED TO MEET THE REBUTTABLE
PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS
JS, Schedule 0 (Form 990 or 990- Z) 2012
2E 1228 1 000
5OZONY 1985 V 12-6F 430966 R ZAGS 1Aft
• S .Schedule 0 ( Form 990 or 990-E2 ) 2012 Page 2
Name of the organ¢ahon Employer ident ficadon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
REGULATIONS.
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIALS
FORM 990, PART VI, SECTION C, QUESTION 19
BOYS & GIRLS CLUBS OF AMERICA MAINTAINS A COMPREHENSIVE WEBSITE
WWW.BGCA.ORG THAT INCLUDES MULTIPLE YEARS OF ANNUAL REPORTS AND FORMS 990
TO WHICH THE GENERAL PUBLIC HAS ACCESS. THE WEBSITE ALSO PROVIDES
INFORMATION REGARDING THE HISTORY OF THE ORGANIZATION, BOARD OF
GOVERNORS, MISSION OF THE ORGANIZATION, DETAILS OF VARIOUS PROGRAMS,
PARTNERS, ALUMNI, PRIVACY POLICY ETC.
COMPENSATION
FORM 990, PART VII
OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ALL WORK AT LEAST 40 HOURS PER
WEEK.
RECONCILIATION OF NET ASSETS
FORM 990, PART XI, LINE 9
RENT PER FASB RULES
CHANGE IN VALUE - CHARITABLE GIFT ANNUITY
TOTAL
$ (488, 631)
$ 28,324
$(460,307)
APPLICATION FOR RECOGNITION OF EXEMPTION
FORM 990, PART VI, SECTION C, QUESTION 18
BOYS & GIRLS CLUBS OF AMERICA DOES NOT HAVE FORMS 1023 OR 1024. THE
Schedule 0 (Form 990 or 990-EZ) 2012JSA
2E12281000 i50ZONY 1985 V 12-6F 430966
nPAW
41
h
+J
Schedule 0 (Form 990 or 990-EZ) 2012 Page 2
Name of the oryanizeuon Employer Identiflcidon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ORGANIZATION HAS BEEN CHARTERED UNDER PUBLIC LAW 84 - 988, S. 4184,
APPROVED AUGUST 6, 1956, AS AMENDED BY PUBLIC LAW 102-199, H.R. 525,
APPROVED DECEMBER 10, 1991.
ATTACHMENT 1FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION
BOYS & GIRLS CLUBS OF AMERICA'S MISSION IS TO ENABLE ALL YOUNG
PEOPLE, ESPECIALLY THOSE WHO NEED US MOST, TO REACH THEIR FULL
POTENTIAL AS PRODUCTIVE, CARING, RESPONSIBLE CITIZENS.
BOYS & GIRLS CLUBS OF AMERICA (BGCA) PROMOTES THE HEALTH, SOCIAL,
EDUCATION, VOCATIONAL AND CHARACTER DEVELOPMENT OF YOUNG PEOPLE
THROUGHOUT THE UNITED STATES. THE NATIONAL ORGANIZATION WAS FOUNDED
IN 1906, AND CHARTERED BY CONGRESS IN 1956. BGCA DEVELOPS INNOVATIVE
PROGRAMS AND SERVICES FOR YOUNG PEOPLE; PROVIDES TRAINING, TECHNICAL
ASSISTANCE AND RESOURCE MATERIALS TO LOCAL CLUBS; PROMOTES PUBLIC
AWARENESS AND SUPPORT FOR THE MISSION AND IMPACT OF THE BOYS & GIRLS
CLUB MOVEMENT; AND ADDRESSES SOCIAL, EDUCATIONAL, VOCATIONAL AND
ECONOMIC ISSUES AFFECTING YOUNG PEOPLE. AFFILIATED LOCAL BOYS & GIRLS
CLUBS PROVIDE A SAFE PLACE TO LEARN AND GROW; ONGOING RELATIONSHIPS
WITH CARING, ADULT PROFESSIONAL STAFF; LIFE-ENHANCING PROGRAMS;
CHARACTER DEVELOPMENT EXPERIENCES; AND HOPE AND OPPORTUNITY.
THE BOYS & GIRLS CLUB MOVEMENT COMPRISES MORE THAN 1,100 INDEPENDENT
ORGANIZATIONS AND THE NATIONAL ORGANIZATION, BOYS & GIRLS CLUBS OF
AMERICA. LOCAL ORGANIZATIONS SERVE YOUNG PEOPLE AND COMMUNITIES
THROUGH SOME 4,000 CLUB LOCATIONS, 50,000 TRAINED ADULT PROFESSIONAL
JSA
2Et228 t 000
50ZONY 1985
Schedule 0 (Form 990 or 990-EZ( 2012
V 12-6F 430966 a PA( 14 'j
0 0Schedule 0 ( Form 990 or 990-EZ) 2012 Pace 2
Name of the organization Employer Identiflcatlon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ATTACHMENT 1 (CONT'D)FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION
STAFF, 199,000 PROGRAM VOLUNTEERS AND 27,000 BOARD MEMBERS. WHILE
BOYS & GIRLS CLUBS OF AMERICA SERVES ITS LOCAL ORGANIZATIONS, THE
NATIONAL ORGANIZATION DOES NOT CONTROL THE AFFAIRS OF INDIVIDUAL
CLUBS, WHICH ARE GOVERNED LOCALLY.
HOW THE NATIONAL ORGANIZATION SERVES LOCAL CLUBS
THE BOYS & GIRLS CLUB MOVEMENT BEGAN IN 1906 WHEN 53 LOCAL CLUBS
BANDED TOGETHER TO ESTABLISH A NATIONAL FEDERATION. SINCE THEN, THE
NATIONAL ORGANIZATION AND LOCAL CLUBS HAVE WORKED CLOSELY TOGETHER TO
HELP AMERICA'S YOUTH REACH THEIR FULL POTENTIAL.
THROUGH ITS HEADQUARTERS IN ATLANTA, SIX REGIONAL SERVICE CENTERS AND
A GOVERNMENT RELATIONS OFFICE IN WASHINGTON, D.C., BGCA PROVIDES
ASSISTANCE AND SUPPORT TO CLUBS IN PROGRAM DEVELOPMENT, BOARD AND
STAFF DEVELOPMENT, ORGANIZATIONAL PLANNING, RESOURCE DEVELOPMENT,
SECURING STATE AND FEDERAL FUNDING, MARKETING AND COMMUNICATIONS, AND
ADMINISTRATION AND MANAGEMENT. KEY FUNCTIONS INCLUDE:
" DEVELOPING AND TESTING NEW PROGRAMS FOR YOUTH;
" ASSISTING CLUBS WITH QUALITY PROGRAM PLANNING AND EVALUATION;
if PROVIDING TRAINING EXPERIENCES , MANAGEMENT CONSULTATIONS AND
RESOURCE MATERIALS FOS STAFF DEVELOPMENT, VOLUNTEER RECRUITMENT,
MARKETING, FUNDRAISING, COMPENSATION AND BENEFITS ADMINISTRATION, AS
Schedule 0 (Form 990 or 990.EZ) 2012JSA
2E 1228 1 000
5OZONY 1985 V 12-6F 430966 n (3E 1i9
Schedule 0 (Form 990 or 990- EZ) 2012
Name of the organhahon
BOYS & GIRLS CLUBS OF AMERICA
FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION
WELL AS FACILITY DESIGN, CONSTRUCTION, SAFETY AND MAINTENANCE;
" HELPING COMMUNITY LEADERS ESTABLISH NEW CLUBS AND EXPAND
EXISTING ONES;
of PROMOTING GREATER PUBLIC AND MEDIA AWARENESS ABOUT THE
MOVEMENT'S MISSION AND IMPACT;
" ASSISTING CLUBS IN ACQUIRING STATE AND FEDERAL FUNDING;
P O2
Employer Identification number
• 13-5562976
'TACHMENT 1 (CONT'D)
ADDRESSING LEGISLATIVE AND PUBLIC POLICY ISSUES AFFECTING YOUNG
PEOPLE; AND
it PASSING THROUGH FUNDS TO MEMBER CLUBS.
FORM 990, PART V, LINE 4B - FOREIGN COUNTRIES
CAYMAN ISLANDS
BERMUDA
NETHERLANDS
ATTACHMENT 2
ATTACHMENT 3FORM 990, PART VI, LINE 17 - STATES
AL,AZ,AR,CA,CO,CT,DE,
DC, FL,.GA, HI, I D, IL, IN, KS, KY, I.A, ME, MD, MA, MI,
MN,MS,MO,MT,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,
RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI,
SSA Schedule 0 (Form 990 or 990 -EZ) 2012
2E1228 1 000
50ZONY 1985 V 12-6F 430966 Wgcm 1emq
Schedule 0 (Form 990 or 990-EZ) 2012
Name of the oryanaation Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ATTACHMENT 4
990, PART VII- COMPENSATION OF THE FIVE HIGHEST PAID IND. CONTRACTORS
NAME AND ADDRESS DESCRIPTION OF SERVICES COMPENSATION
THE CREATIVE GROUP TEMP STAFFING SVCS 203,739.
12400 COLLECTIONS CENTER DRIVE
CHICAGO, IL 60693
FIRSTPIC, INC. TECH ASST/CONSULTING 1,057,478.
2127 EPSEY COURT SUITE 302
CROFTON, MD 21114
KPMG LLP AUDIT AND TAX 285,603.
303 PEACHTREE STREET, SUITE 2000
ATLANTA, GA 30308
BRIDGESPAN GROUP, INC PROJECT MANAGEMENT 275,001.
535 BOYLSTON DT. 10TH FLOOR
BOSTON, MA 02116
KINETIX , LLC STAFFING SERVICES 256,982.
50 GLENLAKE PARKWAY, STE 625
ATLANTA, GA 30328
10Pace 2
Schedule 0 (Form 990 or 990.EZ) 2012JSA
2Et22e 1 000 n
PACM loin 1050ZONY 1985 V 12-6F 430966
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULE R Related Organizations and Unrelated Partnerships(Form 990)
Department of the Treasury ► Complete If the organization answered "Yes" to Form 990, Part IV , line 33 , 34, 35 , 36, or 37.
Internal Revenue Ser * ► Attach to Form 990 . ► See separate Instructions.
B No 1545.0047
2©12
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Mll Identification of Disregarded Entities (Complete if the organization answered 'Yes" to Form 990, Part IV, line 33.) •
(a) (b) (c) (d) (a) (f)Name, address , and EIN (if applicable) of disregarded entity Primary activity Legal domicile (state Total Income Endo1-year assets Direct controlling
-C1 I------------------------------------------------------
........................................................
-L4l........................................................
_C61-------------------------------------------------------
E"M Identification of Related Tax-Exempt Organizations ( Complete if the organization answered "Yes" to Form 990, Part IV , line 34 because it hadone or more related tax-exempt oraanizatlons dunna the tax vear.)
For Paperwork Reduction Act Notice , see the Instructions for Form 990.
JSA
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ca 50ZONY 1985 V 12-6F 430966
Schedule R (Form 990) zulz
PAGE 142
S
( e) (b) (c) (d) (e ) ( t) (g)
Name . address , and EIN of related organization Primary actnnty Legal domicile (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)control
ledrolled
or foreign country) (H section 501 (cX3)) enti ty entity?
Yes NoALABAMA ALLIANCE OF BGC INC 63-LZ-_----- ----_123---
----------------------P o Box 1016 ALEXANDER CITY , AL 35011 YOUTH DEVELOP AL 501(C)4 BGCA XARIZONA ALLIANCE OF BGC INC
-^Z^--------------------------------86_I03996810515 E IAICEVIEw DR SCOTTSDALE , Az Bszse YOUTH DEVELOP AZ 501(C)4 BGCA X
3 ARKANSAS ALLIANCE OF BGC INC 71-0822051
--611 MAIN STREET N LITTLE RocK, AR X2114 YOUTH DEVELOP AR 501(C)4 BGCA X
_L4! CALIFORNIA ALLIANCE OF 8GC INC 91_____________________ --_208----
_P O BOY. 360 ROUGH READY , CA 95975 YOUTH DEVELOP CA 501(C)4 BGCA XCOLORADO ALLIANCE OF BGC INC 06_1653186
-^SZ --------------------------------103 st1OHEY STREET FORT COLLINS, co eoszs YOUTH DEVELOP CO 501(C)4 BGCA XCONNECTICUT ALLIANCE OF BGC INC --_-_---33_1069638
----------------ONE POSITIVE P1ACE , Po Box zo9 SHELTON , cT 06^e^ YOUTH DEVELOP CT 501(C)4 BGCA Xr 7 FLORIDA ALLIANCE OF BGC INC 65-0839955
X39. NLCOID: CIRYCE TEOIJESTA , FL 33 69 YOUTH DEVELOP FL 501 (C) 4 BGCA X
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULE R Related Organizations and Unrelated Partnerships OMB No 1545-0047(Form 990)
2012Department of the Treasury
► Complete If the organization answered -Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
Internal Revenue Service ► Attach to Form 990. ► See separate Instructions.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.) •
(a) (b) (c) (d) (e) mName , address , and EIN (d applicable ) of disregarded entity Primary actmty Legal domicile ( state Total income End-of-year assets Direct controlling
or foreig n country ) enti ty
_01--------------------------------------------------------
2
3
4
_C51 --------------------------------------------------------
J61
of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it hadone or more related tax-exempt organizations during the tax year )
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
g JSA2E13071000
5OZONY 1985 V 12-6F
(a) (b) 1c) (d) (a) (t) (9)Name. address , and EIN of related organization Primary actrvtty Legal domicile (state Exempt Code section Public chanty status Direct controlling Section 512(bx13)
or foreign country ) ( d section 501 ( c)(3)) entitycontrolled
enbtl/r
Yes No
-^^ZGEORGIA ALLIANCE OF BGC INC 01
-------------------------------_0557882
--P Box 3130 ALBANY ALBANY , GA 317026 YOUTH DEVELOP GA 501(C)4 BGCA X
-LZlHAWAII ALLIANCE OF BGC INC 30
'------------------------------_045---
-P BOX 427 KAHULUI , HI 96733d YOUTH DEVELOP HI 501 (C) 4 BGCA XIDAHO ALLIANCE OF BGC INC_3!___-__--_ 89_1674661_
--------------10424 BARNSALE DR BOISE , ID 83704 YOUTH DEVELOP ID 501(C)4 BGCA X
-L4lILLINOIS ALLIANCE OF BGC INC 36-4327562----- _ ------------------------44D W. STE 206 SPRINGFIELD , IL 62704R151 R& YOUTH DEVELOP IL 501(C)4 BGCA XINDIANA ALLIANCE OF BGC INC5 35_2129067-2236 E 10TH sr, STE 2000 INDIANAPOLIS , IN 04620 YOUTH DEVELOP IN 501 (C) 4 BGCA XIOWA ALLIANCE OF BGC INC 42-1516490_1516990
-1350E WASHINGTON AVENUE DES MOINES , IA 50312WO YOUTH DEVELOP IA 501 (C) 4 BGCA XKANSAS ALLIANCE OF BGC INC 01-0650318_^7Z _____
--------------------------------215o sW WESTPORT DR, spire 204 TOPEKA , ES 66624 YOUTH DEVELOP KS 501 (C) 4 BGCA X
430966
Schedule R (Form 990) 2012
PAGE 143
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULER I Related Organizations and Unrelated Partnerships1oMn©12°"(Form 990) a
JSA
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a 50ZONY 1985 V 12-6F 430966
Scneouto n trorm vdut zuic
PAGE 144
is
Department of the Treasury 10, Complete N the organization answered "Yes" to Form 990, Part IV, line 33 , 34, 35, 16, or 37. e .
internal Revenue Serowe ► Attach to Form 990. ► See separate Instructions.
Name of the organ iz ation Fsn yr td%T& t:attom nnmbm
BOYS & GIRLS CLUBS OF AMERICA 13 -5562976
Identification of Disregarded Entities ( Complete if the organization answered "Yes" to Form 990 , Part IV, line 33 )
(a) (b) (c) (d) (e) (f) •Name , address , and EIN (d applicable ) of disregarded entity Primary activity legal domicile ( state Total income Endedyear assets Direct controlling
or foreign country) entity
-^L-------------------------------------------------------
J31....................................................... .
5
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it hadone or more related tax-exempt organtzatlons durina the tax vear.)
(a) (b) (c) (d) (e ) (f) (B)
Name, address, and EIN of related organ iz ation Primary actrvmty Legal domicile ( state Exempt Code section Public chanty statue Direct controlling Section 512 (b)(13)wnt
or foreign country) (if section 501 (cX3)) entityity?
entA)R
Yes NoKENTUCKY ALLIANCE Or BGC INC 61-1364080__________ ------
--------------------------P o BOx 4 989 LOUISVILLE , KY 40204 YOUTH DEVELOP KY 501(C)4 BGCA XLOUISIANNA ALLIANCE OF BGC INC-L22---
------------- - -EVERGREEN NEST MONROE , IA 71291 YOUTH DEVELOP LA 501(C)4 BGCA XMAINE ALLIANCE OF BGC INC_L3Z____ -_-20_2953315-
'277 CUMBERLAND AVE, P0 BOX 7 pb7.. ND, WE 04112 YOUTH DEVELOP ME 501(C)4 BGCA XMARYLAND ALLIANCE OF BGC INC
_ ----52_2312688_
-L4l-------- -404 AGGIES UNIT L 8EL AIR, 1^ 230101017E, YOUTH DEVELOP MD 501(0)4 BGCA XMASSACHUSETTS ALLIANCE OF BGC
LSZ----------CE OFBGC INC
NC --------06_1684675cHARLtis GARDN6R LANE -OBURN. tnA OFro I YOUTH DEVELOP MA 501(C)4 BGCA XMICHIGAN ALLIANCE OF BGC INC_L6Z_ --- --38_3636955-
-------------------- - - - --
I5C5 EAST LINCOLN AVE ROYALOAK, 7 B 7MI 0 6 YOUTH DEVELOP MI 501(C)4 BGCA X
7Z MINNESOTA ALLIANCE OF BGC INC 80-0037988_
-
_6500 NICOLLET AVE, 01
_ _ _ _ _ _MINNEAPOLIS, P04
_55425
_STE 2 OUTH DEVELOP N 01(0)4 GCA X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULER Related Organizations and Unrelated PartnershipsOM
No . 1545-0047(Form 990)
2012
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
JSA
2E1307 1 000
50ZONY 1985 V 12-6F 430966
nf•J
Schedule R (Form 990) 2012
PAGE 145
Department of the Tieiry 10- Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35 , 36, or 37.
Intemal Revenue Service Do- Attach to Form 990. IN- See separate instructions.
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33 )
(a) ib) (C) Id) ( e) InName , address , and EIN ( d applicable) of disregarded entity Primary act" Legal domicile ( state Total income End-of-year assets Direct controlling
or fornon counhzy) entity
_01--------------------------------------------------------
- z ........................................................
-^31........................................................
-L41--------------------------------------------------------
-L51-------------------------------------------------------
-L61-------------------------------------------------------
Identification of Related Tax-Exempt Organizations (Complete if the organ ization answered "Yes" to Form 990, Part IV, line 34 because it hadone or more related tax-exempt organizations durina the tax year.)
(a) (b) (c) (d) (a) (0 l9)Name • address . and EIN of related organization Primary activity Legal domicile ( state Exempt Code seabn Public chanty status Direct controlling Section 512(b)(13)
or foreign country) (if section 501 (cx3)) entityententity
lty?)
Yes NoMISSISSIPPI ALLIANCE OF BGC INC 64-0932322-^^L---------- -- - - -
--------------1500 NORTH HARPER RD. STE 38 CORI? , MS 35834 YOUTH DEVELOP MS 501(C)4 BGCA X
-LZZMISSOURI ALLIANCE OF BGC INC 43-1870548---------------------------------I46o 8EE CREEK ROAD BanNSON , ti0 65616 YOUTH DEVELOP MO 501 (C) 4 BGCA XMONTANA ALLIANCE OF BGC INC 81- 0-L3Z------- ----- -------------------------------- -505 ORCHARD LANE BILLINGS , MT 59101 YOUTH DEVELOP MT 501(C)4 BGCA X
-Lq NEBRASKA ALLIANCE OF BGC INC 0924---------------------------- - ----------------2610 HAMILTON ST OMAHA , NE 68131 YOUTH DEVELOP NE 501(C)9 BGCA XNEVADA ALLIANCE OF BGC INC 74-3128043
26e0 E 9TH STREET RENO , NV 89512 YOUTH DEVELOP NV 501(C)4 BGCA X
-^slNEW HAMPSHIRE ALLIANCE OF BGC INC 56 ----------------------------------_292563147 GRAND AVE NASHUA , NH 03060
-
YOUTH DEVELOP NH 501(C)4 BGCA X
-L71 --NEW
-----JERSEY
---.................ALLIANCE OF BGC INC
------22-3621285
-
ezz CLIFTON AVE CLIFTON , Ns 07015 YOUTH DEVELOP NJ 501(C)4 BGCA X
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULER Related Organizations and Unrelated Partnershi psOMB No 1545.0047
(Form 990 ) GAO 2(6
Department of the Treasury ► Complete If the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37. •,
internal Revenue Service ► Attach to Form 990. ► See separate Instructions.
Name of the organ iz ation Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33) •
(a) (b) (c) (d) (a) (f)Name , address , and EIN (I applicable ) of disregarded entity Primary actnnry Legal domicile (state Total income Endof-year assets Direct controlling
or foreign country) entity
--1L-------------------------------------------------------
z
3 ------------------------------------------------
4- -------------------------------------------------------
A51 -------------------------------------------------------
--------------Identification of Related Tax-Exempt Organizations ( Complete if the organization answered "Yes" to Form 990, Part IV , line 34 because it hadone or more related tax-exempt oraanizations durlna the tax year)
QA For Paperwork Reduction Act Notice, see the Instruction for Form 990.
JSA
2E13011000
50ZONY 1985 V 12-6F
(a) (b) (c) (d) (a) (f) (9)
Name, address, and EIN of related organization Primary activity Legal domicile (state Exempt Code section Public cbeny status Direct controlling Section 512(b)(13)ent
or foreign country) ( if section 501(c)(3)) entity entAyity?r
Yes NoNEW MEXICO ALLIANCE OF BGC INC_L1^--_93-1950851-
------------------ ------- - ---ssl CORDOVA Rio BOX 325 SANTA-1E , NN 97505 YOUTH DEVELOP NM 501 (C) 4 BGCA X
NEW YORK ALLIANCE OF BGC INC -_L2Z-- - ----13_9065911-------------------- -ze2 BABCOK sT, FL 2 BFFALO ,U NY 14210 YOUTH DEVELOP NY 501 (C) 9 BGCA X
NORTH CAROLINA ALLIANCE OF BGC INC 55-0856392_____-----------------------------701 N RALEIGH BLVD RALEIGH , NC 27610 YOUTH DEVELOP NC 501(C ) 9 BGCA X
-L4l OHIO ALLIANCE OF BGC INC--- 31-1704802--------------------- -- -- ------ ----- - ----600 DAI,TON AVE CINCINNATI , off 45203 YOUTH DEVELOP OH 501 (C) 9 BGCA X
-SZ OKLA OA ALLIANCE OF BGC INCL__ ___ _ ___ _ _ _ 73_1598475__130 E 15TH ST. STE 150 ED!l050
_
OK 73103 YOUTH DEVELOP OK 501(C) 4 BGCA XOREGON ALLIANCE OF BGC INC 93_1303337_L6Z_______ --
------------ ---- -_ _
- -139 StThO R ST HE SALEM , OR 97301
-
YOUTH DEVELOP OR 501 (C) 9 BGCA XPENNSYLVANIA ALLIANCE OP BGC IHC 25_1857970
-LIZ - -- --------- - ---
------122 7BERRYHILL ST. HARRISBURG , PA 17104 YOUTH DEVELOP PA 501(C)9 BGCA X
430966
Scneaufe N (Form SSUf zulz
PAGE 14 6
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULE R Related Organizations and Unrelated Partnerships(Form 990)
Department of the Treasury► Complete if the organization answered "Yes" to Form 990, Part IV , line 33, 34, 35, 36, or 37.
Internal Revenue Sense ► Attach to Form 990. ► See separate Instructions.
B No 1545-0047
2012
Name of the organization Employer Identification number
BOYS & GIRLS CLUBS OF AMERICA 13-55 6 2976
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV , line 33 )
(a) (b) (c) (d) (o) (f)Name , address , and EIN ( d applicable ) of daregarded entity Primary activity Legal domicile (state Total income Enda1-year assets Direct controlling
or foreran countrvl entity
1- -------------------------------------------------------
-LZl........................................................
3
J-51
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it hadone or more related tax-exempt organizations during the tax year )
_C71
For Paperwork Reduction Act Notice , see the Instructions for Form 990.
JSA
2E1307 t 000
,h 5OZONY 1985 V 12-6F
(a) (b) (c) (d) (e ) ( f) (9)
Name , address and EIN of related organization Primary activity Legal domicile (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
or foreign country) (if section 501 (cX3)) entitycontrolled
entity?
Yes NoRHODE ISLAND ALLIANCE OF BGC INC 05_0504932
--------------LIZ------------ - - - - - - - - PROVID180 S MAIN ST ENCE, RI 0-2903 YOUTH DEVELOP RI 501(C)4 BGCA X
-LzZSOUTH CAROLINA ALLIANCE OF BGC INC 57-1092504
---------------------------P 0O BOX 4 23 COLU}BIA , Sc 29201 YOUTH DEVELOP SC 501(C)4 BGCA X
SOUTH DAKOTA ALLIANCE OF BGC INC 79-- ---------------------------------_308---
P 0 BOX 833 WATERTOWN , SD 57201 YOUTH DEVELOP SD 501(C)4 BGCA X
-^4lTENNESSEE ALLIANCE OF BGC INC 62-1835398..............220 CARRICK ST, STE 318 KNOXVILLE, TN 37921 YOUTH DEVELOP TN 501(C)4 BGCA XTEXAS ALLIANCE OF THE BGC INC 75-2939705
_C51 --------------------------------------------10D COMMONS RD STE 7 #206 DRIPPING SPRINGS, TX '76620 YOUTH DEVELOP TX 501(C)4 BGCA XUTAH ALLIANCE OF BGC INC 82-0562906-- ---------------------------------------------244 E VINE ST P O BOX 57071 MURRAY , UT 84107 YOUTH DEVELOP UT 501(C)4 BGCA XVERMONT ALLIANCE OF BGC INC 20-431991062 OAK sr BURLINGTON, VT 05101 YOUTH DEVELOP VT 1501(C)4 BGCA X
430966
n
Schedule R (Form 990) 2012
PAGE 147
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
SCHEDULE R Related Organizations and Unrelated PartnershipsOHS No 1545-0047
(Form 990) 2©12
Department of the Trowury► Complete If the organization answered "Yes" to Form 990, Part IV, One 33 , 34, 35 , 36, or 37. • ,
Internal RewnusSennce ► Attach to Form 990 . ► See separate instructions.
Name of the organization Employer IdontificaUon number
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
ri • Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a) (b) (c) (d) (e) (nName . address . and EIN ( if applicable ) of disregarded entity Primary activity Legal domicile (state Total income End-of-year assets Direct controlling
or foreign country) entity
--1l-------------------------------------------------------
-(-2Z-------------------------------------------------------
4
-LSl-------------------------------------------------------
-L6Z-------------------------------------------------------
FUM Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990. Part IV, line 34 because it hadone or more related tax-exempt ornanizations dunnn the tax year 1
For Paperwork Reduction Act Notice . see the Instructions for Form 990.
JSA
2E1307 1 000
5OZONY 1985 V 12-6F 430966
Schedule K (1-orm VU U) YO1z
PAGE ]4R
(a) (b) (C) (d) (e) (n (g)Name , address. and EIN of related organization Pnmary activity Legal domicile ( state Exempt Code seann Publ i c chanty status Direct controlling Section 512(b)(13)
controlledor foreign country) ( if section 501 (c)(3)) entity entity?
Yes NoVIRGINIA ALLIANCE OF BGC INC 54_ 199 6 5 64-Lt2-_-----_ _ __ _-----------5511 STAPLES MILL RD , STE 301 RICHMOND , VA 23226 YOUTH DEVELOP VA 501(C)4 BGCA X
WASHINGTON ALLIANCE OF BGC INC 91 57587_ 2 1_ __ __2 _ _ _____ ________ __ _ ___ ___
-__
_`! 0 03 SUN3 NASET NNE ATER,Y S TU NA 98 5 0 1 YOUTH DEVELOP WA 501(C)4 BGCA XWEST VIRGINIA ALLIANCE OF BGC INC 20-1472867
--
L3Z P O Box 1184 MARTINSBURG , NV 25402 YOUTH DEVELOP WV 501(C)4 BGCA XNISCONSIN ALLIANCE OF BGC INC_L4^___ 39-2008889
-------------------------- -----925 N S I LVERBROO- 6R NEST BEND , WI 53090 YOUTH DEVELOP WI 501(C)4 BGCA XWYOMING ALLIANCE OF BGC INC_L5Z20-53B6022-_
------------------------ ----------- -- -1761 E K ST GASPER , NY 82601 YOUTH DEVELOP WY 501(C)4 BGCA XBOYS a . GIRLS CLUBS IN NEW JERSEY, INC_ 27_0185288_LeZ__ _ _--
ST
_SO
------------------------310 UTH RE
-ET MORRISTONN , NJ 07940 YOUTH DEVELOP NJ 501(C)3 7 BGCA X
BOYS G GIRLS CLUBS IN TENNESSEE, INC7 -- -_26_4568096- -
-zzo ^aRnlcx sT, sre 318 KNOxvILLE , W 379zi - YOUTH DEVELOP TN 1501(C)3 7 BGCA X
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule R (Forth 990) 2012 Pape 2
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34because it had one or more related organizations treated as a partnership during the tax year )
(a) (b) ' (c) (d) (e) (f) (9) (h) (1) 0) (k)Name, address , and EIN of Primary activity Legal Direct controlling Predominant Share of total Share of endof- cin,^ CodeV -U81 General or Percentage
related organization domicile entity income (related ,rated,
income year assets .r r.T amount in box 20 managing ownership(state or fromfrom of Scof Schedule K-1 Pginner1iforeign lax under (Form 1065)country) sections 512-514)
ii--------------------
L--------------------
AL --------------------
J4L--------------------
(SL
(ZL------
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV,line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a) (b)(C)
(d) (a ) (0 (9) (h) 0)Name , address , and EIN of related organization Primary activity Legal domiole Direct controlling Type of entity Share of total Share of Perron. Section
(state or roregn entity (C corp. S corp. or income end-of year assets rape 512 ( b)(13)
country ) trust) ownership Can
-QL --------------------------------------------
AL--------------------------------------------
L--------------------------------------------
JR-------------------------- ------------------
t6L--------------------------------------------
p --------------------------------------------
Schedule R (Form 990) 2012
JSA
NE 1308 9 000
a 5OZONY 1985 V 12-6F 430966 PAGE 149
is
•
J
BOYS 6 GIRLS CLt3BS OF AMERICA 13-5562976Schedule R (Form 990) 2012 Page 3
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note . Complete line 1 if any entity is listed in Parts ii , III, or IV of this schedule Yes No
I During the tax year , did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?a Receipt of ( t) interest ( ii) annuities ( iii) royalties or (iv) rent from a controlled entity . . . .. ....... . .. . ..... . ... .. . ... ......... . . 1 a Xb Gift, grant , or capital contribution to related organization ( s) , , , , , , , , ,, , ,, , .. , . ..i .b Xc Gift, grant , or capital contribution from related organization( s) ...................................................... 1c Xd Loans or loan guarantees to or for related organization(s) 1d Xe Loans or loan guarantees by related organization ( s)............................................................ 1e X
t Dividends from related organization(s) . . . . . .. . . . .. . .... . . . .. , ....... ... , , , .. , , . , .... Ifg Sale of assets to related organization(s) ..... ........... .. .. . . 1 Xh Purchase of assets from related organization(s) , , , , , , , , , , , , , , , , , ,,,,,,, , , ,, , , , ,, , , , , , , , ,, , , , , ,, , , , , , , , , , ,, , , , 1h Xi Exchange of assets with related organization(s) , , , , , , , , , , , , , , , , 11 Xj Lease of facilities, equipment, or other assets to related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , X
k Lease of facilities, equipment, or other assets from related organization(s) , , , , , , , , , , , , , , , , , , , , , !.!I Performance of services or membership or fundraising solicitations for related organization(s) . . ... . .. . ......... ..... ........ .. . .. . 11 Xm Performance of services or membership or fundraising solicitations by related organization(s) . . . .. . ......... ......... . ....... ... ... 1 m Xn Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) , , , , .... ... .. .. ... . .. . .... .. ........ .. .. in Xo Sharing of paid employees with related organization(s) . . . . . . . . . . . . . ... .. . .... . . ... . .... . . ... . . . .. . . . . .. , , , . , , , io X
p Reimbursement paid to related organization(s) for expenses ... .. .. ...... .... ....... . ..... ............... ..........
.
1 Xq Reimbursement paid by related organization(s) for expenses ......................... . ................ . ............ 1 X
r Other transfer of cash or property to related organization(s) , , , , , , , , , ,,,,, , , , ,, , , , , ,, , , ,, , , , , ,, , , , , , , , , , , , , , , , , , , , , , 1r Xs Other transfer of cash or erope rty from related o antzatlon s 1s X
2 If the answer to any of the above is "Yes." see the instructions for information on who must cmmnlete this line tndudina cnvered relationshtos and transaction thresholds
(a)Name of other organ ization
(b)Transaction
type (a-s)
(c)Amount mvoNed
(d)Method or determining
amount Involved
ARIZONA ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 10,000. FMV
( 2) COLORADO ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 22,500. FMV
( 3 ) CONNECTICUT ALLIANCE OF BOYS & GIRLS CLUBS B 5,000. FMV
( 4) IDAHO ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 6,000. FMV
5 IOWA ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 15,000. FMV
6 KANSAS ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 10,000. FMV
JSA
E 1309 t 000
SOZONY 1985 V 12-6F 430966
Schedule R (Form 990) 2012
PAGE 150
BOYS & GIRLS CLUBS OF AMERICA 13-5562976Schedule R (Form 9 )2012 Pape 3
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note . Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule. Yee No
I During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?a Receipt of (I) interest ( ii) annuities (iii) royalties or (iv) rent from a controlled entity , , , , , , , , , , , , , ,, , , , , , , , , , ,, , , , ,, , , , , , , , , , , , , , lab Gift, grant, or capital contribution to related organlzatlon(s) , ,, , , , , , , , , , , , , , , , , , ,,,,,,, , , , ,, , , , ,,, , , , .. ... 1bc Gift, grant, or capital contribution from related organization( s) . . . . . . . . . . . . . . . . . . .. .. . . .. .. ... . . ... 1c
d Loans or loan guarantees to or for related organLzation( s) , , , , , , , , , , , , , , , , , , , , , , , , , , , ,, , ,,, , , ,,, ,, , , , , , , , , , , , , , . .ide Loans or loan guarantees by related organization( s) . . . . . . . . . . . . . . . . . . . .. . . . . ........ . ... . . . . . . . .......... . . . . .. Ile
f Dividends from related organization(s ) .......... . .. ............................................. ...... .
g Sale of assets to related organization(s) .... .. .. . ... ... . ..... ....... ....... ....... . . ... ... . ..... . . ... . . . . . .h Purchase of assets from related organization(s) . . . . . . .. . . .. .. .. . . . . . ... . ... .. . .... . .. . . . ... . .. . . ..... . . .. ... . .i Exchange of assets with related organization( s) . . . . . . . . . . . . . . . . . . . ..... .. .. .. . . . . . ..... . . .... ... . ... .
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . .. . . . .... . .... ... . . ... . . . . . . .. . . . . .
k Lease of facilities, equipment, or other assets from related organization(s) , , , , , , , , , ,
I Performance of services or membership or fundraising solicitations for related organization(s)
m Performance of services or membership or fundraising solicitations by related organization(s)n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) , ,o Sharing of paid employees with related organization(s), , , , , , , , , , , , , , ,, , , , , ,
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... .. .. . . . ......... . ... . .q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . .. . . . ... . ... . . . . .. . . ..... ............ ..... .
r Other transfer of cash or property to related organization( s) .......... ......... . .. .. . . . ... .. . ... .. . .... .. ... . 1 rs Other transfer of cash or property from related organization(s). 1s
2 If the a nswer to any of the above is "Yes" see the instructions for information on who must rmmnlete this IlnA inrluriinn rnvered reIatlnnchlns and transaction thresholrte
V
( a)Name of other organization
(b)Transactiontype (a-a)
(c)Amount mwhed
(d)Method of determining
amount Inhoroed
LOUISIANA ALLIANCE OF BOYS & GIRLS CLUBS INC. B 12,000. FMV
( 2 ) MARYLAND ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 15,000. FMV
( 3 ) MICHIGAN ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 6,000. FMV
J 4) NEW MEXICO ALLIANCE OF BOYS & GIRLS CLUBS INC B 20,000. FMV
$ RHODE ISLAND ALLIANCE OF BOYS & GIRLS CLUBS B 13,000. FMV
( 6) SOUTH CAROLINA ALLIANCE OF BOYS & GIRLS CLUBS B 15,000. FMV
JSe
^E 7 s09 1 000
5OZONY 1985 V 12-6F 430966
I
Schedule R (Form 990) 2012
PAGE 151
BOYS & GIRLS CLUBS OF AMERICA 13-5562976 r.Schedule R (Form 99O) 2012
page 3
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36) -
Note . Complete line 1 if any entity is listed in Parts II, III, or IV of this scheduleI During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV'a Receipt of (1) interest (it) annuities (iii) royalties or (iv) rent from a controlled entity , , , , , , , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , ,, , , , , , ,b Gift, grant, or capital contribution to related organization(s) . .. . . . . ... . ............................ . .. . .... . . . . . ... .c Gift, grant, or capital contribution from related organization (s) . . . . . . ... . .. . . .... . . .. . . . . . . ... . ... . .. . . .. . ..... . ... . . .d Loans or loan guarantees to or for related organization(s) , , , , , , , , , , , ,,, .. .. ... ............... .e Loans or loan guarantees by related organization(s) . . . . . ... . . . . .... . ... . ... . ..... . . ..... . .. . . ........... . . . . . .. .
f Dividends from related orgari¢ation(s) . . . . . . . . . . . . . . . . . . . . ................. . . ....... . . . ............ . . . ... .g Sale of assets to related organization(s) , , , , , , , , , , , , , , , , , , , ,,, .. ..... , .. . , ... ........ , .. .... ,h Purchase of assets from related organization(s) , , , , , , , , , , , , , , , , , , , , , ,,,, , ,,,,,, , , ,,, , , , ,, , , , ,, , , , ,, , , , ,, , , , , , ,I Exchange of assets with related organization(s) , , , , , , , , , , , , , , , ,, , ... ..... , . ........ . ... ........... ........ ,J Lease of facilities, equipment, or other assets to related organization(s) , , , , , , ,,, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , .
k Lease of facilities, equipment, or other assets from related organization(s) , , , , , ,, , , , , , , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , , , .I Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . ... . . . ... . . ... . ... . ...... . . . .. .m Performance of services or membership or fundraising solicitations by related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,,,,,,, , , ,n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . .. . . .... . .... . . . . . . . . . . . . ..... .o Sharing of paid employees with related organization(s) . . . . . . . . .. . . . ....... .... , .. _ .. , , ... _ . ... _ , , , . , , , .. , , , , . .
p Reimbursement paid to related organization(s) for expenses . . .... . .. . .. . ... . .. . ...... . . ..... . . . . . . . . . ....... . . . . . . .q Reimbursement paid by related organization(s) for expenses . . ... . . . . .. . ... . .. . . . .... . ...... . . . .. . .... . .. . . . . . . . .. .
No
r Other transfer of cash or property to related organization(s) 1rs Other transfer of cash or property from related organization(s) . 1s
2 If the answer to any of the above is "Yes." see the Instructions for information on who must ,-mmnlptp this line mcludinn rnvurad relatinnshinc ar1r1 transaction thresholds
b
V
•
(a)Name of other organ iz ation
(b)Transaction
type (e -s)
(c)Amount Invoked
(d)Method of determining
amount mwtred
1 SOUTH DAKOTA ALLIANCE OF BOYS & GIRLS CLUBS B 10,000. FMV
2 UTAH ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 8,000. FMV
3 VERMONT ALLIANCE OF BOYS & GIRLS CLUBS, INC. B 15,000. FMV
4 WASHINGTON ALLIANCE OF BOYS & GIRLS CLUBS B 5,000. FMV
(5) WEST VIRGINIA ALLIANCE OF BOYS & GI RLS CLUBS B 15,000. FMV
g ILLINOIS ALLIANCE OF BOYS & GIRLS CLUBS, INC. Q 314,550. FMV
M JSA
E1309 1 000
50ZONY 1985 V 12-6F 430966
Scheduto R (Form 990) 2012
PAGE 152
:7
BOYS & GIRLS CLUBS OF AMERICA 13-5562916S ch edule R (Form 990) 2012 pogo 3
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36 )
Note . Complete l i ne 1 if any entity i s listed in Parts II, III, or IV of this schedule yen No
1 During the tax year , did the organ i zation engage in any of the following transactions with one or more related organizations listed in Parts f14V'
a Receipt of ( i) interest ( ii) annuities ( iii) royalties or ( iv) rent from a controlled entity , , , , , , , , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , , , , , 1a
b Gift, grant , or capital contribution to related organizat i on(s) . . . . . . . . . .. . . .. . . .. .. . .. . . . . . .. . . . ... . . . ... . . ... . . . ... 1b
c Gift, grant , or capital contribution from related organization (s) , , , , , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1c
d Loans or loan guarantees to or for related organization ( s) 1d •e Loans or loan guarantees by related organ ization(s) . . . . . . . . . . . . . . . . . . ... . .... . . . . . .. . .. . . .......... . . ... . . . .... le
If Dividends from related organization(s) . ... . . . .. ..... ....... .. ... _ . .
g Sale of assets to related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , , , , , , , , , . , , . , ,h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . .... . . .... . . .. .. . . . . . . . .. ..... .. . ... .. , ... , , .. .
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . .... . . . .. . . . . ... . .. . . . . ........ .. . .. . ,
j Lease of facilities, equipment, or other assets to related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
k Lease of facilities, equipment, or other assets from related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
I Performance of services or membership or fundraising solicitations for related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,, ,
m Performance of services or membership or fundraising solicitations by related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,o Sharing of paid employees with related organization(s) , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,, , , , , , , , , , , , , , , , , , , , ,
p Reimbursement paid to related organization(s) for expenses , ,, , , , , , , , , , ,, , , , , , , , , , , ,, , , , ,, , , , , , , , , , , , , , , , , , , , , , , , , ,q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . ... . . . . . . . . ... . .. . ..... . ..... . ....... . . . .... .
r Other transfer of cash or property to related organ ization(s) , , , , , , , ,, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
2 If the answer to any of the above is "Yes-" see the instructions for information on who must cmmnlete this line ineludinn covered relatinnshins and transaction thresholds
(a)Name of other organization
(b)Transaction
type (a-a)
(s)Amount involved
Id)Method of determining
amount involved
GEORGIA ALLIANCE OF BOYS & GIRLS CLUBS, INC. Q 203,861. FMV
2
( 3 )
( 4 )
5
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r2E 1309 1 000ae 5OZONY 1985 V 12-6F 430966
Schedule R (Form 990) 2012 h
PAGE 153
BOYS & GIRLS CLUBS OF AMERICA 13-5562976
Schedule R (Form 990) 2012 Page 4
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37 )
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assetsor gross revenue) that was not a related organization See instructions regarding exclusion for certain investment partnerships
(V (b) (c) (d) ( e) (q (9) (h ) 0) U) (q
Name, address , and EIN of entity Printery awoty Legal domicile Predomarant Are an Partners Shyof Share of pdp,^h^r. Code v11e1 General or P«^^
(.tare or foreign income ( related secton total mcorne end-d-year eecsea li amount In box 20 non 9n9 ownenfxp
country) unrelated exfuded51(c)(3 ) assets of Schedule K•1 Partner?
from tax under wk s? ( Form 1CC5)
section 5125141 Yes No Yes No Yee No
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JSA2E13101000
5OZONY 1985 V 12-6F 430966
Schedule R (Form 990) 2012
PAGE 154
481,
0 BOYS & GIRLS CLUBS OF AMERICA0. 13-5562976
Schedule R (Forth 990) 2012 pme 5
Supplemental InformationComplete this part to provide additional information for responses to questions on Schedule R (seeinstructions).
Schedule R (Form 990) 2012
2E1510 1 00050ZONY 1985 V 12-6F 430966 i'AGEI 1550 'fl
lLkl)
Form 8868 Application for Extension of Time To File an(Rev. January 2013 ) Exempt Organization Return OMB No. 1545-1709Department of the TreasuryInterval Revenue Service ► File a separate sppllcatfon for each rat un.
• If you are filing for an Automatic 3-Month Extension. complete only Part I and check this box . . . .... ... . .... ► LJX• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).Do not complete Paf U unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing (81e). You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months fora corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form8868 to request an extension of time to file any of the forms listed In Part I or Part II with the exception of Form 8870, InformationReturn for Transfers Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (seeInstructions). For more details on the electronic filing of this form, visit www.lrs.gov/ef le and click on e-file for Charities & Nonprofits.
Automatic 3-Month Extension of Time. Only submit original (no copies needed).A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and completePart IoM' ......................... .. qAll other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time
Name of exempt organization or other Her, see instnicttons.Type or
printBOYS & GIRLS CLUBS OF AMERICA
File by the Number, street, and room or suite no . If a P.O. box, see Instructions.due date brfiling your 1275 PEACHTREESTREET, N.E.rewm. Soo City, town or post office, state, and ZIP code . For a foreign address. seeInstructions I
Employer Identification number (EIN) or
Social securty number (SSN)
Enter the Return code for the return that this application Is for (file a separate application for each return) ........... .
Application
Is For
Return
Code
Application
Is ForReturn
Code
Form 990 or Form 990-EZ 01 Form 990-T (corporation ) 07
Form 990-SL 02 Form 1041-A 08
Form 4720- individual 03 Form 4720 09
Form 990-PF 04 Form 5227 10
Form 990-T (sec. 401 a or 408 (a ) trust ) 05 Form 6069 11
Form 990-T (trust other than above ) 06 Form 8870 12
• The books are in the care of ► ANAND S. I•IEHTA
404-487-5713 FAX No. ______________________________• If the organization does not have an office or place of business In the United States, check this box , , , , , , , , , , , , , , , ►• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) N/A . If this Is
for the whole group, check this box , , , , . , lo- q . If it Is for part of the group, check this box, , , .... ► L_j and attach
a list with the names and EINs of all members the extension is for.
7 I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time
until 08/15 . 20 13 , to file the exempt organization return for the organization named above. The extension is
for the organization's return for,
► •; calendar year 20 12 or
► tax year beginning , 20 , and ending , 20
2 If the tax year entered In line 1 is for less than 12 months , check reason : Initial return E] Final return
D Change in accounting period
3a If this application is for Farm 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions. 3a
b If this application is for Form 990-PF. 990-T. 4720, or 6069, enter any refundable credits and
estimated tax payments made Include any prior year overpayment allowed as a credit. 3b
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS
(Electronic Federal Tax Payment System) See instructions. 3c
Caution. If you are going to make an electronic fund withdrawal with this Form 8868 . see Form 8453-EO and Form 8879-EO for payment instructions.
For Privacy Act and Paperwork Reduction Act Notice, see trtstructkrns . Farm 8888 (Rev 1.2013)
JSA
2F6054 2.000
KPMG LLP 13-5585207300 N Greene St, Suke 400
Green sboro , Not}t Carol na 27401
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