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Registration 2013-01 MAY-1-2013 00:11 FROM: TO:12392528400 P.1 1)(Y\ VETERANS' OUTREACH Corporate Office �^ � 524 Youngstown Poland Road (,y�JV` Struthers,OH 44471 Phone: (330)755-5792 Fax: (330)755-5930 e'`A To: From: V ho(4no`Ver .er■ _ Fauc a39- as? - 4 OR Paga 1 Phan .)3Ct- ;5a - -taLic oats: 5- I- L3 NI■c441'DA 0 Urgent X For Review 0 Please Comment 0 Please Reply 0 Please Recycle M(131 a4■n str4 - es - off' iw no-14 4.40- Kruated vv ore th govt. 1- Ok , w I II . t+tv-r'd cep c& c( . 4:!4-- 4s. • „cc_ --rs ; MAY-1-2013 00:11 FROM: T0:12392528408 P.2 11-80 Zv 1;1 Ub:44D veterenvuzreaonn W4 I 1 a01 LU f P.I 2392528408 COLUER VAS BOARD MINUTES NID RECORDS 12:10:09 p.m. 02-22-2013 1111 1 cC. _ From: Martha V"ergara POI Mailer_ Clerk to the Board/Minutes & Records ""'w Fax: 239-252-8408 Phone: 239-252-7240 1 r I_Dall 205intel TO: * . • I t 1 '_l: .L 1 ; A . c. a Fax #. 0 Comments: 11A' ` ate aiw I t'tS A tUet. f 1311 • I -1)/eA.4:4" O Its II' . :�� U. it, Q •, 6C ) 6 i. i i AA 'r i ----a A *. Aig 41_,O,1 AL 90(ICI LIANA_ i VEICGOOk . All OP 444, 104 C$ 4 bcan i! / '1- ‘Aluir it4. . Laufamivitsiferp PEci Fylt - 4t,' Vi, ark t Number of Pages (including cover sheet): 1 Date Sent: a ?-a' /3 Time Sent: i 1 = S I TA &.. GREGORY R. NOONAN Certified Public Accountant 530 Swede Street Norristown,Pennsylvania 19401 Telephone: (610)277-7899 Facsimile: (610)277-7884 April 8, 2013 Board of Collier County Commissioners 33-1 Tamiami Trial East, Building J Naples, FL 34112 Re: Veterans Outreach,Inc. 524 Youngstown Poland Road Struthers, OH 44471 Ladies/Gentlemen: I, Gregory R.Noonan, Esquire,hereby certify that the numbers provided in the January 4, 2013 Independent Report of Auditors for Veterans Outreach, Inc. for the period ending December 31, 2011 are true and correct. ___ Gregory 7)A Noonan, Esquire Sworn to and Subscribed before me this 8th day of April, 2013. k ),I, Notary Pu lic NOTARIAL SEAL DAVID J SCHILLER Notary Public NORRISTOWN BORO.,MONTGOMERY COUNTY My Commission Expires Oct 31,2013 MAY-1-2013 00:12 FROM: T0:12392528408 P.3 GREGORY R. NOONAN Ccctteed Public Accountant 530 Swede Street Norristown,Pennsylvania 19401 Telephone:(610)277-7899 Facsimile: (610)277-7884 April 8,2013 Board of Collier County Commissioners 33-1 Taroiami Trial East,Building J Naples,FL 34112 Re: Veterans Outreach,Inc. 524 Youngstown Poland Road Struthers,OH 44471 Ladies/Gentlemen: 1,Gregory It Noonan,Esquire, hereby certify that the numbers provided in the January 4, 2013 Independent Report of Auditors for Veterans Outreach, Inc. for the December 31,2011 are true and correct, period ending ---aMlatlidil ....._______ Gregory 7 Noonan,Esquire Sworn to and Subscribed before me this 8th day of April,2013. 1 q i i i ' .• No ary Public ` i '� �. i' NOTARIAL SEAL�..r DAVID J SCHII,I,Bi ' Notary Public NORRISTOWN son..MONTGOMERY COUNTY-"' `N -:-• -: yy Commission Expos Oct 31,2013 S MAY-1-2013 00:12 FROM: TO:12392528408 P.4 BUSINESS NAME REGISTRATION NO. APPLICATION FOR LICENSE FOR PUBLIC SOLICITATION OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 1976-57 COLLIER COUNTY,FLORIDA 1. (A) Name of Public Solicitor (PLEASE PRINT): Veit-awls' ()Oi P,cwC.Q, (B) Purpose for which contributions are being solicited: 70 'h.4 s, C S t ve A vo keravvs 04.4 -I-.aAY 4' -.Zt►I{' 2. (A) Principal(&Mailing)Address and Phone#/Fax#: Salt `.(ouvss144 fobu,d( S niKitrs o W 44441 I 330- /SS-5/(b. i`r-tc 330- 1Sx SQ30 (B) Local(&Mailing)Address and Phone#/Fax#: ►ONA (PL e(d (enac uxie, Sa sso' PL jLblf3 colt-155' ta05 Fol. 941- 155- lao? 3. Names and addresses of any Chapters,Branches or Affiliates in Collier County: NA 4. (A) Date public solicitor l e g a l l y established: 1— t' t- et ti J G , (Please attach copy of Department of State registration with business status update) (B) Address at the time that solicitor was legally established: SA- C) Means by which solicitations will be made: 0 u-MenAlA Pr t rr n (D) IF TAX-EXEMPT,state appropriate section of Internal Revenue Code and Tax-Exempt Number: go i (G) _3 a-a-3a�a5�b 5. Names and addresses of Officers,Directors,Trustees and Principal Salaried Executive Staff Officers (ATTACH A SEPARATE PAGE,If necessary): Name Tide Address Clty/State/lp Pbone/Fax ce_ ;fnw`a.t it 6. (A) Are you presently authorized by any governmental authority to solicit funds?&N) (B) IF YES,state the governmental authority&attach authorization: FL INA. 4C tOkri c I4z i . 4 CoASUVMer Sc rviu (C) Are you presently,or have you ever been enjoined by any court from soliciting funds?(Y/6) (D) IF YES,state the circumstances,including the Case Number and Style: MAY-1-2013 00:12 FROM: TO:12392528408 P.5 I-eo 40 h teD.40p leme temaUUerdcxuf JY f I,J;J 1 GV f �J.J 2392528408 COWER VAfi BOARD MINUTES AND RECORDS 12:1Z56 p.m. O2-22-2O13 3111 7. State ALL PURPOSES(or add:d atioue**cited SHALL.BE USED: �rirvies;1y.4n Si:svit, _ fir vt rO,. he *_ Aft , 0 . 8. Under WHAT NAME at NAMES will Pao ibnriee.he w!L ? NiekrztaA, ' Otitstfitt% 9. Meow Ma.Ad&erass&PMeae/Fsz Plumbers at ailagManktui wbo will haw 7, ,.............s., RESPONSIBILITY FOR and CUSTODY OF ,,AA kr its o-iie a4 .,ai 1: 904-voinv - , 0 . - .,• . i!t hpt!Qi 6 10. Muses,Wes.Addressee&PMa&Paz Notaben d AL I. nDiglALS who will It-• etc itOR FINAL DISTRDirT(ON of CO . C9��L'I'F.D: �� 1Sh, •rte aua / �� • • -bu�11 '0 + + ' ! •tifc Z�5i TC*_�, Sir viC.a.j 0* 411.14-11 *Avow c r•yVa.•.QvL{tect SIN. . 1►� 11. mew hnaisb a FINANCIAL STAT8lrt8NT � Mibmwmigagagisiging a bcaalcdewo atALL EXPENSES>KQ1RItBD �1DJ KIEWIFY�AMOUNT� - ,•"� • �`.:�•,, � yr' c aie3 OP SAID SOLICTTATIO , Ills 4 MC OIS, [r(dJS Mated Nano , & T VI/A,.► y.104.5 tr -,Gt - atrial strut&M s Address:_ .-Y ye.+rva�;a«r el rbt*vs A) 00 Vtiyli Svc t!eI. ( litisphosellrasfflosatt 33o lei 5?4i. 1S1553o ttkpL••• Pisa OW ABl.wr S1 rd Obi 3 Cagily Si reVaNtN6-' A' , appleadas was viers la aid admesOer u J)` _ad!K ALe bY 3 • J.... .ri .r wee i1 Peessaei Wows 4W11)ar As rroddca s as Mucha • whs Ad Aka as amO. I" ROTARY PUBLIC IN AND FOR THE lON EXPIRES al, ip / `t;' MYgp 7t ••••TbLs neibiratlss A/plkatid shalt ik steed ENDS>t +rid �- 'li_ Par .4! Oa*Os Clsl:et lM Made Cast :.ia' .i�d.r�!a Eve der$I 0/I y��tlae • a meat Skewing the Ssa>s d canals&s[tie es ms at Os irscdq►it O. calendar yam;SHALL RZ MAD will 6.43 11 tithe Obwaireaart.Tile Sastesna Asa be MIMED aid swam TO by a CPA Pr iebe Cider Esc:di a Me eras heir Sather. WILL THE APPLICANT DE EQlIS G TO •.+ Q i pit-' ROA- b CAAR1TARLE SOLICITATIONS? PROCEED TO RICHTT-OF WAY PERMITTE9G 4 4+ AT:MSS S.HORSESHOE DRIVE,NAPLES,FL MAY-1-2013 00:13 FROM: TO:12392528408 P.6 CURRENT OFFICERS, PERSONNEL,and KEY PERSONALITIES Board Members John O. Ely President 205 Red Rose Street, Butler, PA 16001 330-755-5792 Fax: 330-755-5930 Robert Julian Vice-President/Treasurer 506 Lowries Run Road, Pittsburgh, PA 15237 330-755-5792 Fax: 330-755-5930 Thomas Price Secretary 444 Valley View Drive, Monroeville, PA 15146 330-755-5792 Fax: 330-755-5930 State Agents Robert Graham FL State Agent 6402 42nd Street E.,Sarasota, FL 34243 941-755-1305 Fax: 941-755-1207 Michelle Lo Castro NY State Agent 782 Prospect Avenue, Buffalo, NY 14713 330-755-5792 Fax: 330-755-5930 Kathleen Carlson VA State Agent 118 Chowan Drive, Portsmouth,VA 23701 330-755-5792 Fax: 330-755-5930 Vicki Kerrigan WV State Agent 132 Cottage Avenue, Weston,WV 25302 304-269-9700 Fax: 304-269-9701 James Larsen KY State Agent 1803 Callihan Street, Flatwoods, KY 41139 606-475-0216 Fax: 606-475-0217 Robert Wheeler AL State Agent 401 Twin Oaks Drive NW, Hartselle AL 35640 256-353-4301 Fax: 256-353-4302 MAY-1-2013 00:13 FROM: T0:12392528408 P.7 Principle Salaried Staff John O. Ely Chief Executive Officer. 205 Red Rose Street, Butler, PA 16001 330-755-5792 Fax: 330-755-5930 Robert Julian Chief Financial Officer. 506 Lowries Run Road, Pittsburgh, PA 15237 330-755-5792 Fax: 330-755-5930 Theresa Ely Executive Director 205 Red Rose Street, Butler, PA 16001 330-755-5792 Fax: 330-755-5930 Karen Cook Field Manager 1656 Laurie Drive, Youngstown OH 44511 330-755-5792 Fax: 330-755-5930 James Larsen KY Regional Manager 1803 Callihan Street, Flatwoods, KY 41139 606-475-0216 Fax: 606-475-0217 Robert Graham FL Regional Manager 6402 42nd Street E, Sarasota FL 34243 941-755-1305 Fax: 941-755-1207 Robert Wheeler AL Regional Manager 401 Twin Oaks Drive NW, Hartselle AL 35640 256-353-4301 Fax: 256-353-4302 George Lillis Team Leader 146 Salinger Drive, Georgetown, KY 40324 859-246-0127 Fax: 850-246-0126 MAY-1-2013 00:09 FROM: TO:12392528408 P.1 VETERANS' OUTREACH Corporate Office 524 Youngstown Poland Road Struthers,OH 44471 Phone: (330)755-5792 Fax: (330)755-5930 To: from: M p 1 Fax a3q- asa - c 40k Pages 1 Phone: !}3q - a5a- 1a'c) Data 5 1- L3 R.' 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I- Cg ► I wi[I Ssbnii 444. d art o4k& cL Tcr IS. • ilzrt MAY-1-2013 00:09 FROM: TO:12392528408 P.2 Feb 2513 05:44o VeteranOutreachfl 9417551207 p.1 2392526408 COWER VAB BOARD MINUTES ARM RECORDS 12:18:09 p.m. O2-22-2013 1111 at FA.)( IFrom: Martha Vergara y' Clerk to the Board/Minutes & Records iiiim.IN ` Fax: 239-252-8408 Phone: 239-252-7240 r • Load 2eipui Fax #: --- - * 3 t _ 5 ' 0 Comments: thee are, Q:` 'QJt) trews , f revfirt, aff41101 . ief.&4, f4c, i 1 i 0 ifiLLA fIDY .Air reta715 1 s (ACM k ) 6 t ai_A. s ° 1. ---4 06 . . ..3o(ic; wird.. . .1.- I , Pir ti ` 4.4t, :,, u40414%-ftilitil F044- ( co }f itai-- kkiiir rii4; ffat--. if vu tAnue_ottyrs6) Ffri Fret tif T,,,,i au- %;,C. - 1 ritt , Number of Pages (including cover sheet): _ ‘ Date Sent: of ig-d: /3 Time Sent: i k = S I lut :.-7 MAY-1-2013 00:09 FROM: TO:12392528408 P.3 BUSINESS NAME REGISTRATION NO. APPLICATION FOR LICENSE FOR PUBLIC SOLICITATION OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 1976-57 COLLIER COUNTY,FLORIDA 1. (A) Name of Public Solicitor (PLEASE PRINT): \e Wns` L� ika& (B) Purpose for which contributions are being solicited: To th 0241,1C cc?" ei tiotticcild t/r-terms a.) -f f AeAY -f o 11 iry. 2. (A) Principal(&Mailing)Address and Phone#/Fax#: Sa-it 4Ouvvciw4 Poi( . %rv4e.er3 o N 4441 I 3;o- SS-5-1c1 - F 330- 1SS-S93o (B) Local(&Mailing)Address and Phone#/Fax#: 1433,i t k 4fie(d ( l,aae, So-fO.SOkr FL JL()'4.3 (NI-1;5' i3os FA,/ lift- 155- iao? 3. Names and addresses of any Chapters,Branches or Affiliates in Collier County: filt 4. (A) Date public solicitor legally established: 1 .?3-1/3 1 1- 1- q y 1 r4 C. , (Please attach copy of Department of State registration with business status update) (B) Address at the time that solicitor was legally established: S/4041E.- (C) Means by which solicitations will be made: 0 u+neo4n f r e. 4." (D) IF TAX-EXEMPT,state appropriate section of Internal Revenue Code and Tax-Exempt Number: 90 (e) 3 �a-3a-►a5"7b S. Names and addresses of Officers,Directors,Trustees and Principal Salaried Executive Staff Officers (ATTACH A SEPARATE PAGE,If necessary): Name e�AV�o+.dE- Address Clty/StateZp Phene/Fas 6. (A) Are you presently authorized by any governmental authority to solicit funds? I) (B) IF YES,state the governmental authority&attach authorization: FL O. 0.cpicsi whir,- 4 Consumer Sc rim (C) Are you presently,or have you ever been enjoined by any court from soliciting funds?(We (D) IF YES,state the circumstances,including the Case Number and Style: MAY-1-2013 00:09 FROM: T0:12392528408 P.4 reDGO e.5 VO.40p Vintri l/IVuuCGu,ll� r�rvvicur N.� 2392528408 COWERVA6 BOARD MINESANDRECORDS 12:1t56p.m. 02-22-2013 3!?1 LR 7. sate/ILL PURPOSES for wpb des sanded SHALL RE USED .dial S Mc. . - V6�►t)v, d le ArA_i'�t uS 8. Under WHAT NAME or NAMES will eootnibaaoee he eolith d? - .- s r - 4. 9. Nome,/Mee,Ade s R Pbeeeiraa Ntmbara of AUJIMMEsuith wrbo will have , RESPONSIRMITY FOR tad CUSTODY OF CONTRIBUTIONS: ' :_ arau��'M k�'•' 'r . 1s5- Ito5 • ' i',II C'It�►t�SS . _ . Oili�r4r.V ' `,. . r s 10. Nader,Tltbs.Addresser B PLO &Fns If aaebes of AL S who will .. t �s! FOR FINAL DLRTfIDVfON Of y I NS COLLECTED: ' s1 ' • • ,..• PS , .■L.7\c. i '' •+a _ fin• `�� . a. '0 , ,�i O- , - • _, w Sir vfl-err 0 41414-11 a sueae t (3Aia va QNrf-+�.-aces o.,Meoek.. �� I I. Meese furnieb a FINANQAL STATEMENT providing Y THE AMOUN OF • e•' /;."1,Ssve a breakdown of ALL$1OENiS6S INCURRED to the DISBURSEMENT OF SAID SOucrrAT o Tltb amincial aWea.eot C=V ld ,e0t1 APPOciat(.fywaarir}: --_4-ftkow w1, p tweet's Primed Name: RCP haf 14' t 44041 o„ A� - Ar >�a+ i�. Address: S+--y Y8•'w'c1 ...kr rot.t.ro .�.f .stirr«ois ors wry, suA T t o•755.s 5 742- 15-1513o * Coma wear Steed DAt/+D Coyaty d Mer a- »� fa ..y ye14efaw was wart se a0 a.Arerlbd daY K t 3• �-J. A ..*is 1� MI Idea. who Ad trite es i /1e�M�hews a (FM or jeti mutated it ilior i. I C Ii 0..1_.-0/1_ • N HOSPODIAR '� NOTARY MUD ,- IN AND FOR TIE STRiE OF OHIO "i-,4k. , WI COMMISSION S?SPIAEs 47 (g- ••a'T1@ Sglipratfse■Ap/BEatloabet he waded DNIDSSt R�= ----4.-= �"*' Pee is to Owl sf She Chz�Cptt by a Aers dollar Arj R.SLetntlee issughthmatmais, s Stlaateet*swag the fbw■dit ssailt.e efte a fle speda a was birder SI the Waal yaw.SHALL R MID wed&D Gloria et the CRe:kf riot.Tali Sttetsemet be Ma=eia SWORN TO by a CFA or Be Chid Eseattbe Oiliest trek Pub&S kk r: WILL TEE APPLICANT BB REQUII$1G TO ►,) ,.. IN-THBBOAD CAARITARLE SOLICITATIONS? Its PROCEED TO RICHT.OI.wwv PIRMITTING • ■ AT 2$U S.EOR,4ESEOE DRIVE,NAPLES,F7. • Transmission Report Date/Time 02-22-2013 12:22:46 p.m. Transmit Header Text BOARD MINUTES AND RECORDS Local ID 1 2392528408 Local Name 1 COLLIER VAB This document : Confirmed (reduced sample and details below) Document size : 8.5"x11" Nr FAX flo■ft From:Martha Vergara gip _ Clerk to the Board/Minutes&Records „r Fax: 239-252-8408 r Phone:239-252-7240 yfi UUiLt\ TO: P S ,rel, Fax#: C141 - 1 5 - I Zr)7 33/) =7'75-- 5136 Comments: litye, are, aftw finis Yttuirt Qf . -14g. e- f‘14.(-401,- ati-W-gy lair fermis is dam ek t-ctincuot '(' 2bI2-i ) rt . Tertij k, J J A-tl , rUrvi so44 Cal ► 045 kkihr Y.:4 ifloa-• tf(lett klup ay richn f;,1 f:, 1,,,,. aft Number of Pages (including cover sheet): \l� , Date Sent: ca fr?' 13 Time Sent: i t 51 Tim, Total Pages Scanned: 11 Total Pages Confirmed: 11 No. Job Remote Station Start Time Duration Pages Line Mode Job Type Results 001 425 9417551207 12:17:13 p.m.02-22-2013 00:04:44 11/11 1 EC HS CP14400 Abbreviations: HS: Host send PL: Polled local MP: Mailbox print CP:Completed TS:Terminated by system HR: Host receive PR: Polled remote RP: Report FA: Fail G3:Group 3 WS:Waiting send MS:Mailbox save FF: Fax Forward TU:Terminated by user EC: Error Correct E = g mot T�� FAX From: Martha Vergara � ®® Clerk to the Board / Minutes & Records �� Fax: 239-252-8408 Phone: 239-252-7240 i, Local fie �ua TO: UV -& I\f \.� ,c� Fax #: - 1 SS -- I 21) 33() -775 _6/3O O Comments: �1� P� are, eitVS –li lort i-With . -Rief,6e- V\c1"-t- :i1(4- 44042476Y lour iettas i s a off 6r.V n cc(1 212-0 rnC o( c - -arcs . Vorwak AI, tit? . ffrovinrctoibt--R s can yvve‘5 1\i- `(-'off-: • ()(,l_ kaUP Ci((1 / r(TY► FeCI kt. , bw • \ vcc.c. . jjt irr Number of Pages (including cover sheet): \\ Date Sent: cR g-D /3 Time Sent: 11 : 5 \ Thtt • BUSINESS NAME REGISTRATION NO. APPLICATION FOR LICENSE FOR PUBLIC SOLICITATION OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 1976-57 COLLIER COUNTY,FLORIDA 1. (A) Name of Public Solicitor (PLEASE PRINT): VAS` OL/j (B) Purpose for which contributions are being solicited: 70 - ,1)\ c G cS .or e ticalli`ed yr Atrayts 0-)ACk -f-ea ir -Q t I No 2. (A) Principal(&Mailing)Address and Phone#/Fax#: Ca-Li ■10 1V..J/4 Oob ,, . Skrvie4r.s 0 N 4 f 330- sS-��ga �s-,c 330- -gs- S930 (B) Local(&Mailing)Address and Phone#/Fax#: i3NA vk e(d ficr\C(.130() Scke o-solc1/4 FL 34.2 441- 1S5- 1305 FrA,c 9i{(- 155- (ao7 ► 3. Names and addresses of any Chapters,Branches or Affiliates in Collier County: NA 4. (A) Date public solicitor legally established: 1- -1/3 I- I- qy iNG , (Please attach copy of Department of State registration with business status update) (B) Address at the time that solicitor was legally established: CAM - (C) Means by which solicitations will be made: 0 triveatin Q r (D) IF TAX-EXEMPT,state appropriate section of Internal Revenue Code and Tax-Exempt Number: 5" I (C--) �-a-3a�a9'1b 5. Names and addresses of Officers,Directors,Trustees and Principal Salaried Executive Staff Officers (ATTACH A SEPARATE PAGE,if necessary): Name Tide . ` - Address Cih'/State/LP Pima /// ".‘'--K\QDCt olv---I 6. (A) Are you presently authorized by any governmental authority to solicit funds?(N) / (B) IF YES,state the governmental authority&attach authorization: FL ty. o�� �c vNtxt. CCnsvlAner (' (C) Are you presently,or have you ever been enjoined by any cowl from soliciting funds?(Y/7 (D) IF YES,state the circumstances,including the Case Number and Style: 7. State ALL PURPOSES for which contributions solicited SHALL BE USED: -Frim i k `4,- ct SQ.rvic,C • 4r Vt'1&++5 i settn el li, #0 k.(7 oitiMWS i1\ GUSTS , 8. Under WHAT NAME or NAMES will contributions be solicited? -4craw.3 ' (7V4IV.Ge,I',. 9. Names,Titles,Addresses&Phone/Fax Numbers of ALL INDIVIDUAJ c / \ 4. who will have I RESPONSIBILITY FOR and CUSTODY OF CONTRIBUTIONS: Pa r'\- Gr 0+a...1 , F L P,Isi.o•-v i( - 0l.- 0-�f;c.e.- tLACkCQ-3Sr_., Ph°� 10. Names,Titles,Addresses&Phone/Fax Numbers of ALL INDIVIDUALS who will I. SI 0-ea,t \ FOR FINAL DISTRIBUTION of CONTRIBUTIONS COLLECTED: Ct 0.J a�� a Vokv- 6ri y.ki.. F L �rF C.P. FINANCIAL STATEMENT providing \ 11. Please furnish a FINAN . . �,- ,,, .. ; i Specifically,IDENTIFY THE AMOUNT OF Dil'6- -,Zl i give a breakdown of ALL EXPENSES INCURRED in the DISBURSEMENT OF SAID SOLICITATIO Thii financial statement agilliallialinelaNNOMMIlaradatillaMaikata dikalligaidleanda .7 C P V CiQ.r m) f j Applicant(Signature): / •i T 1 G a S, r re V 0 JS Printed Name: RI)6 aT , kit/f I.l LI 5 OA -el le - °Ire Street&Mailing Address: I-1 yo N�?aw i`� /�L r+,ti,A g,) S „fµ 0/4- �/wi7i .su i 1ie-d. _ r Telephone/Farr/Email: i'30 755 5111- '755 5830 Telephone N Fax N Email Address State of O/ /-a County of M rt.i o n1 i II6-- Tipe foregoing r tigo application was sworn to and subscribed b e f o r on this I I day of i1rt y! 1 Ko 6MT ,who is personally known to as identiticatio ,d who did take an oath. ''''.a A� „'' or ha:produced .cc.. S' B ', 4. ii S.i�0 4/6 \\\I f,,F''; LINDSY M.HOSPODAR uty Cler "tzry Public 4.- 9r NOTARY PUBLIC 1 Y IN AND FOR THE STATE OF OHIO IC S - , * MY COMMISSION EXPIRES �/(p// ****This Registration Application shall be verified UNDER'6 T.'�,` ;eaccom by ( )Registration Fee pa able to the Clerk of the Circuit Court. '",,,,,enw .•` accompanied b a five dollar SS.00 **** I .on or before March Tee, a Statement showing the financial condition orthe calendar year,SHALL BE FILED with the Clerk of the Circuit Court.This Statement shall Mile VERIFIED and WORN TO by a CPA or the Chief Executive Officer of the Public Solicitor. WILL THE APPLICANT BE REQUESTING TO COND IN-THE-ROAD CHARITABLE SOLICITATIONS? CIRCLE(YES / `O)• If YES: PROCEED TO RIGHT-OF-WAY PERMITTING LOC D AT:2885 S.HORSESHOE DRIVE,NAPLES, FL bL/►71/Lbl� Lrrll;t Uth'UI r- bj/b, INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR A LICENSE FOR PUBLIC SOLICITATIONS OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 76-57. This application must be filled out for all individuals or firms who are soliciting public contributions in Collier County. All ten questions must be answered. Note: Under for the nderiQuestionsii, we will need a financial statement years, paying particular attention to the amount of funds raised and a breakdown of all expenses incurred in the disbursements of those funds. Note that this must be verified under oath and attested by the Chief Fiscal Officer of the solicitor. A $5.00 REGISTRATION FEE SHALL BE MADE PAYABLE TO THE CLERK OF THE CIRCUIT COURT; Remind the solicitor when he is making application that on or before March of each year, he must file with the Clerk of the Circuit Court s financial statement 'showing the condition of the public solicitor for the previous calendar year. This statement due on or before March 1, shall be verified by a certified public accountant or submitted under oath by the Executive Officer of the Public6Solicitor. Exceptions: The following individuals/organizations do not fall under this ordinance: 1) Religious institutions 2) Candidates for political office WMcN:db GREGORY R. NOONAN Certified Public Accountant 530 Swede Street Norristown,Pennsylvania 19401 Telephone:(610)277-7899 Facsimile: (610)277-7884 January 4, 2013 Report of Independent Auditors Board of Directors/Governors VETERANS OUTREACH, INC. 524 Youngstown Poland Road Struthers,OH 44471 In our opinion, the accompanying combined balance sheets and the related combined statements of operations and changes in net assets and cash flows present fairly, in all material respects,the financial position of Veterans Outreach, Inc.,at December 31, 2011, and the results of their operations and their cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. These financial statements are the responsibility of management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits of these statements in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management,and evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. /-� Very truly yours, -)(\ ( -.S10)imont e('; A K& egory Noonan, CPA GRN:cic • i J PI, i C` C� L � \JCI B . 1I. Y .- ORDINANCE NO. 2012 -01 N ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE NO. 76-57, AS AMENDED, RELATING TO PUBLIC SOLICITATIONS OF CONTRIBUTIONS, BY AMENDING SECTION THREE, "REGISTRATION OF PUBLIC SOLICITORS," IN ORDER TO REQUIRE SOLICITORS REPRESENTING THAT THEY ARE VETERANS OF THE MILITARY TO PROVIDE EVIDENCE OF PRESENT OR FORMER MILITARY SERVICE, AND BY AMENDING SECTION SEVEN, "PROHIBITED ACTS," IN ORDER TO REQUIRE A PUBLIC SOLICITOR TO (1) CARRY PROOF OF REGISTRATION; (2) DISPLAY A SIGN WHICH IDENTIFIES THE PUBLIC SOLICITOR; AND (3) OBTAIN AND CARRY PROOF OF WRITTEN PERMISSION TO SOLICIT ON PRIVATE PROPERTY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; PROVIDING FOR CONFLICT AND SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, on December 14, 1976, the Board of County Commissioners adopted Ordinance No. 76-57 in order to regulate solicitations of contributions in Collier County; and WHEREAS, Ordinance No. 76-57, as subsequently amended, requires public solicitors to register with the Clerk of the Circuit Court and maintain accurate records reflecting all income and expenses; and WHEREAS, Ordinance No. 76-57, as amended, prohibits a public solicitor from misrepresenting or misleading anyone to believe that the public solicitation is being conducted for a charitable organization or that the proceeds of such solicitation or sale will be used for charitable purposes, if such is not the fact; and WHEREAS, the Board of County Commissioners desires to amend Ordinance No. 76-57, as amended, in order to protect the public against unscrupulous solicitors, better inform the public as to who is requesting their contributions, and require solicitors representing that they are veterans of the military to provide evidence of present or former military service. NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA that: SECTION ONE: AMENDMENT TO SECTION THREE OF ORDINANCIIO. 10-57, AS AMENDED. �`� Section Three of Ordinance No. 76-57, as amended, is hereby amended as follows: vr,: • m° Page l of 5 c-�+ Words underlined are added; Words stwek-through are deleted. pm SECTION THREE: Registration of Public Solicitors. 1. Every public solicitor which intends to solicit contributions within this County, or to have funds solicited on its behalf, shall prior to any solicitation file a registration statement with the clerk of the circuit court disclosing the following information: 1) The name of the public solicitor and the purpose for which contributions are being solicited. 2) The principle address of the public solicitor and the address of any offices in this County. If the public solicitor does not maintain an office, the name and address of the person having custody of its financial records. 3) The names and addresses of any Chapters, branches or affiliates in the County. 4) The place where and the date when the public solicitor was legally established, the form of its public solicitation, and a reference to any determination of its tax exempt status under the Internal Revenue Code. 5) The names and addresses of the officers, directors, trustees and the principle salaried executive staff officer. 6) A financial statement which covers complete disclosure of all the fiscal activities of the public solicitor during the three preceding years. The report shall specifically identify the amount of funds raised and all costs and expenses incidental thereto, all publicity costs, and the cost of allocation or disbursement of funds raised. The financial statement shall be verified under oath and attested to by the Chief Fiscal Officer of the public solicitor. 7) Whether the public solicitor intends to solicit contributions from the public directly or to have it done in its behalf. 8) Whether the public solicitor is authorized by any other governmental authority to solicit contributions and whether it is or has ever been enjoined by any court from soliciting contributions. 9) The general purpose or purposes for which the contributions to be solicited shall be used. 10) The name or names under which it intends to solicit contributions. 11) The names of the individuals or officers of the public solicitor who will have final responsibility for the custody of the contributions. \ Q J 12) The names of the individuals or officers of the public solicitor responsible for the final distribution of the contributions. 13) Military Representation. During registration organizations whose solicitors represent that they are veterans of the military, or wear a military uniform or a distinctive part of a military uniform must provide evidence of present or former military service for each solicitor. Evidence that will be accepted includes, but is not limited to: Page 2 of S Words underlined are added;Words struck-through are deleted. \‘9.) \-e..i 0"' --", A. DD-214 or Statement of Service(Report of Separation); or B. Communication from military or veterans office that contains information regarding military service or an indication of military service. 'lil The registration forms shall be signed by an authorized officer and by the chief fiscal l officer of the public solicitor, shall be verified under oath and shall be accompanied by a $5.00 registration fee. 3. It shall be the duty of every public solicitor to furnish identification to persons who solicit contributions from the public on behalf of the public solicitor. The person so soliciting shall be required to have and produce or display on demand, identification indicating that the said solicitor has been duly authorized by the public solicitor for which he is soliciting. Such identification shall include, but not be limited to, the name of the holder of the identification and the name and number of the certificate of registration of the public solicitor. 4. Each public solicitor shall annually on or before March 1st after the end of the 9Y/ calendar year, file with the clerk of the circuit court a statement showing the financial condition v of the public solicitor as of the last day of the calendar year. The report shall be verified y edd a certified public accountant or be submitted under oath by the executive officer o the public 4___ s'•ftor. ..... ...... .0.11 _ SECTION TWO: AMENDMENT TO SECTION SEVEN OF ORDINANCE NO. 76-57, AS AMENDED. Section Seven of Ordinance No. 76-57, as amended, is hereby amended as follows: SECTION SEVEN: Prohibited Acts 1. It shall be unlawful for any public solicitor to solicit funds within Collier County without first filing a registration statement as provided by this Ordinance. Any person soliciting in Collier County must carry proof of having filed a registration statement, and upon request must show such proof. 2. No public solicitor subject to the provisions of this Ordinance, shall use or exploit the fact of registration so as to lead the public to believe that such registration in any manner constitutes an endorsement or approval by the Collier County Board of County Commissioner as required by Ordinance. Registration does not imply endorsement of a public solicitor for contribution. 3. No person shall, in connection with the solicitation of contributions for or the sale of goods or services of a person other than a charitable organization, misrepresent to or mislead anyone by any manner, means, practice or devise whatsoever, to believe that the person on whose behalf such solicitation or sale is being conducted is a charitable organization or that the proceeds of such solicitation or sale will be used for charitable purposes, if such is not the fact. Page 3 of 5 Words underlined are added: Words stRIA-thFough are deleted. 4. No person shall make any representation that he is soliciting contributions for or on behalf of a public solicitor or shall use or display any emblem, device or printed matter belonging to or associated with a public solicitor for the purpose of soliciting or inducing 09K1Q.) contributions from the public without first being authorized to do so by the public solicitor. 5. No public solicitor shall represent that he or she is a veteran of the military,p tary, or wear a military uniform or other indication of military service, when the solicitor is neither a present, nor a former member of the service indicated. 6. It shall be unlawful for any public solicitor to solicit funds within Collier County without having a sign which identifies: 1) The name of the public solicitor and the purpose for which contributions are being solicited: and 2) The principal address of the public solicitor and the address of any offices in this County. If the public solicitor does not maintain an office, the name and address of the person having custody of its financial records. Such sign shall beprominently displayed at all times, and shall be no less than two square feet in size,and no more than four square feet in size. 7. It shall be unlawful for any public solicitor to solicit funds in Collier County on private commercial property without first obtaining_the express written permission of the owner, lessee, agent or occupant of the property. Any person soliciting on private property in Collier County must carry proof of such written permission, and upon request must show such proof. 8. The County may,but it is not limited to. enforce this ordinance through the issuance of a citation, by a notice to appear in County Court, or by arrest as provided for in Florida Statutes ch. 901. SECTION THREE: INCLUSION IN THE CODE OF LAWS AND ORDINANCE. The provisions of this Ordinance shall become and be made a part of the Code of Laws and Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re-lettered to accomplish such, and the word "ordinance" may be changed to "section," "article," or any other appropriate word. SECTION FOUR: CONFLICT AND SEVERABILITY. In the event this Ordinance conflicts with any other Ordinance of Collier County or other applicable law, the more restrictive shall apply. If any phrase or portion of the Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a Page 4 of 5 Words underlined are added; Words sttt►ek-threttgh are deleted. separate, distinct and independent provision and such holding shall not affect the validity of the remaining portion. SECTION FIVE: EFFECTIVE DATE. This Ordinance shall become effective upon filing with the Department of State. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this 10 day of QM u► , 2012. ATTEST: ,. BOARD OF COUNTY COMMISSIONERS DWIGHAI'lpfROCIVC,ftRIC COLLIER COUNTY, FLORIDA By: •,/ By: (^)- A P • :!� FRED W. COYLE,CHAI N Appr v • to form an�l� f c'ftsncy: Jeffre . .tzkow Count A is rney This ordinance filed with the Secretary of tote's Office the and acknowledgemenA of thot fili received day of� o.wn� Page S of S Words underlined are added; Words struck through are deleted. STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true and correct copy of: ORDINANCE 2012-02 Which was adopted by the Board of County Commissioners on the 10th day of January, 2012, during Regular Session. WITNESS my hand and the official seal of the Board of County Commissioners of Collier County, Florida, this 13th day of January, 2012 . DWIGHT E. BROCK Clerk of Courts • ..c].e►xk Ex-officio to,#, County Comm' A`Toriefee.. L13' By: Martha V- •' mar'• Deputy Q1.eor ,.. Transmission Report Date/Time 02-22-2013 12:15:58 p.m. Transmit Header Text BOARD MINUTES AND RECORDS Local ID 1 2392528408 Local Name 1 COLLIER VAB This document : Failed (reduced sample and details below) Document size : 8.5"x11" Arr Nr FAX From:Martha Vergara ® Clerk to the Board/Minutes&Records ,� Fax: 239-252-8408 r Phone:239-252-7240 nyi S 0A a� L°c 2e�% TO: \l e P Fax#: q41 - 1 SS ` I2h7 83D -7 0 Comments: ate, a&i uirt Ceffe06. ---4Cece- (1‘91`(-40k" aff40444(6tri'maure I ' J 2b12—O) re d"� i go(;ci-( i s, \.1911. ,k Pk-a off , luiralkinc-brotkni s lam S U a h r 1 .ti'0 5 1-. Ef Cat (Aloe a1��rj� 19\ j i o le i� eat. i� . 1 tettosn T Number of Pages (including cover sheet): Vt Date Sent: ca/P-a' /3 Time Sent: : 51 Total Pages Scanned: 11 Total Pages Confirmed:0 No. Job Remote Station Start Time Duration Pages Line Mode Job Type Results 001 423 913307755930„80707 12:14:38 p.m.02-22-2013 00:00:00 0/11 1 -- HS FA Abbreviations: HS: Host send PL: Polled local MP:Mailbox print CP:Completed TS:Terminated by system HR: Host receive PR: Polled remote RP: Report FA: Fall G3:Group 3 WS:Waiting send MS:Mailbox save FF: Fax Forward TU:Terminated by user EC: Error Correct Transmission Report Date/Time 02-22-2013 12:14:05 p.m. Transmit Header Text BOARD MINUTES AND RECORDS Local ID 1 2392528408 Local Name 1 COLLIER VAB This document : Failed (reduced sample and details below) Document size : 8.5"x11" -:&: * FAX From:Martha Vergara gip ...A Clerk to the Board/Minutes&Records •`� Fax: 239-252-8408 r Phone:239-252-7240 Li,,,t r?_,-avoid TO: \ififfyaylIS 1)0i veldt\ lair;G." Fax#: CV-H - 1 Ss - ( Zh 7 33t) -77S—<513O Comments: ' 111 are; A/Se s Yelfirt, C eof Tail, Itkie- A9L 444S-rot r emiats is acopci et t)rainpAkre 2r12—O) rn (ic;-ks. i rvav4. Pk-tl oA '4k %viral;rr'cmrvi-tari so` 4- l can ► , 4..5 ksir- `C:t 101. K Lill recl fet V to aw . ,. t� . c q , , Number of Pages (including cover sheet): Date Sent: aZ 19-2' /3 Time Sent: 11 , 51 114 Total Pages Scanned: 11 Total Pages Confirmed:0 No. Job Remote Station Start Time Duration Pages Line Mode Job Type Results 001 421 919417751207„80707 12:12:46 p.m.02-22-2013 00:00:00 0/11 1 -- HS FA Abbreviations: HS: Host send PL: Polled local MP: Mailbox print CP:Completed TS:Terminated by system HR: Host receive PR: Polled remote RP: Report FA: Fail G3:Group 3 WS:Waiting send MS: Mailbox save FF: Fax Forward TU:Terminated by user EC: Error Correct BUSINESS NAME REGISTRATION NO. APPLICATION FOR LICENSE FOR PUBLIC SOLICITATION OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 1976-57 COLLIER COUNTY,FLORIDA 1. (A) Name of Public Solicitor (PLEASE PRINT): v/"A1nS` DUi (B) Purpose for which contributions are being solicited: To -fixq, s be& fir- 5 t ckt ri`e.01 v itrco s r"0k. -Mnar - ,.<< 11'40 2. (A) Principal(&Mailing)Address and Phone#/Fax#: Say{ �Uvv�S r•/ eob ( i S -3 0 N 44471 330- ZSS-S'lq - F?-,c 330 - ,cs 5110 (B) Local(&Mailing)Address and Phone#/Fax#: 1 i33A vIni}f id(d 1C , Sc.ro.sc EL 941 - 155- tbo5 F 14t- 155- 1407 3. Names and addresses of any Chapters,Branches or Affiliates in Collier County: NA 4. (A) Date public solicitor legally established: "1-a3-t/3 I- I- q \ N c- (Please attach copy of Department of State registration with business status update) (B) Address at the time that solicitor was legally established: SA,,. (C) Means by which solicitations will be made: 0 u-1-020.4A Qrxr ' (D) IF TAX-EXEMPT,state appropriate section of Internal Revenue Code and Tax-Exempt Number: 90 I (C-) 5. Names and addresses of Officers,Directors,Trustees and Principal Salaried Executive Staff Officers (ATTACH A SEPARATE PAGE,if necessary): Name Address City/State/Zip Phone/Fax. _ � IAQQA 6n12-1 "M 6. (A) Are you presently authorized by any governmental authority to solicit finds?( ) (B) IF YES,state the governmental authority&attach authorization: FL . 0-C Act;(.,ofizArt, 4 CnS.Wner 1 k (C) Are you presently,or have you ever been enjoined by any court from soliciting funds?(Y/ y (D) IF YES, state the circumstances,including the Case Number and Style: • 7. State ALL PURPOSES for which contributions solicited SHALL BE USED: jn v o.r i It.j sin..c.„-4 SW is c,es. 4r vi4e3rov5 ; Wiwi Zvi, oo I4, p, ,,1M`Sirtxo'1 . COS'S , 0 8. Under WHAT NAME or NAMES will contributions be solicited? Ot-1ex-Ap..5 ' Wield, 9. Names,Titles,Addresses&Phone/Fax Numbers of ALL INDIVIDUALS who will have FINAT RESPONSIBILITY FOR and CUSTODY OF CONTRIBUTIONS: (j wk- 6 040 , Ft- Rls i'cr`oc.s( /A - V i_ o4 f e,- t,_AirQ-- Sr_ 10. Names,Titles,Addresses&Phone/Fax Numbers of ALL INDIVIDUALS who will have REST C FOR FINAL DISTRIBUTION of CONTRIBUTIONS COLLECTED: G p,J Q`�0�I�) � IZokr - 6md w. ` FL ORce. Please furnish a FINANCIAL STATEMENT providing „ + Specifically,IDENTIFY THE AMOUNT OF FUNDS RAISED and give a breakdown of ALL EXPENSES INCURRED in the DISBURSEMENT OF SAID SOLICITATIONS.This financial statement balintakiallingtehMINI c t U&d col! Applicant(Signature): /7 ileal - ��C,,,,—■_ TANxlG c , preVi 0JS Printed Name: ,/'S b6Ec1 • oG/ ,..1 � ,� (� - 04160-7 Street&Mailing Address: 3-1--.1 yo✓N6s 7-0,4 'i l'43 L 4,vr� Ril -51- $1"4-61-et Ors VW7i Su�w�i Telephone/Fax/Email: 33O'155 5?ql- 153 5`13o Telephone# Fax# Email Address State of OAS/b County of NI itifon/ii/6 i The foregoing reeistraatiqn application was sworn to and subscribed befog a on this I I day of AR-1 ,by 1 (L f)a:T Ol ■/i'N ,who is personally known tong r��..,,� (YIN)or has produced as identificatio a,d who did take an oath. R.AL , � P\\1 I//`r0= LINDSY M. HOSPODAR B Ai .'/1. II ./�` - � ab �= NOTARY PUBLIC I .uty Cler e,tary Public " t --- = IN AND FOR THE STATE OF OHIO '* * MY COMMISSION EXPIRES �I(�j�F' s _ F ****This Registration Application shall be verified UNDER 6 : \ : :' ,,, accompanied by a five dollar($5.00)Registration Fee pa able to the Clerk of the Circuit Court. g �''�,uu,,,,,,,pw,`` ******64,year, on or before March 1st, a Statement showing the financial condition oftbe u Iic-Solie for 5s of the btct dry-bf the calendar ear SHALL BE FILED with the Clerk of the Circuit Court.This Statement shall be VERIFIED and SWORN TO by a CPA or the Chief Executive Officer of the Public Solicitor. WILL THE APPLICANT BE REQUESTING TO COND IN-TIM-ROAD CHARITABLE SOLICITATIONS? CIRCLE(YES / O)• If YES: PROCEED TO RIGHT-OF-WAY PERMITTING LOC• D AT:2885 S.HORSESHOE DRIVE,NAPLES,FL eli tll gal i tl. litrU I MAIL M 11:1b 1 ur t ll;t MAIL i/tli INSTRUCTIONS FOR COMPLETING THE APPLICATION FOR A LICENSE FOR PUBLIC SOLICITATIONS OF CONTRIBUTIONS IN ACCORDANCE WITH ORDINANCE 76-57. This application must be filled out for all individuals or firms who are •soliciting public contributions in Collier County. All ten questions must be answered. Note: Under Question 11, me will need a financial statement for the previous 3 years, paying particular attention to the amount of funds raised and a breakdown of all expenses incurred in the disbursements of those funds. Note that this must be verified under oath and attested by the Chief Fiscal Officer of the solicitor. A $5.00 REGISTRATION FEE SHALL BE MADE PAYABLE TO. THE CLERK OF THE CIRCUIT COURT. Remind the solicitor when he is making application that on or before March of each year, he must file with the Clerk of the Circuit Court a financial statement showing the condition of the public solicitor for the previous calendar year. This statement due on or before March 1, shall be verified by a certified public accountant or submitted under oath by the Executive Officer of the Public'Solicitor. Exceptions: . • The following individuals/organizations do not fall under this ordinance: 1) Religious institutions 2) Candidates for political office l MeN:db GREGORY R. NOONAN Certified Public Accountant 530 Swede Street Norristown,Pennsylvania 19401 Telephone:(610)277-7899 Facsimile: (610)277-7884 January 4, 2013 Report of Independent Auditors Board of Directors/Governors VETERANS OUTREACH,INC. 524 Youngstown Poland Road Struthers,OH 44471 In our opinion,the accompanying combined balance sheets and the related combined statements of operations and changes in net assets and cash flows present fairly, in all material respects,the financial position of Veterans Outreach, Inc., at December 31, 2011, and the results of their operations and their cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. These financial statements are the responsibility of management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits of these statements in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining,on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, and evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. Very truly yours, 'SIO>r6011± t. c.P4 O Gregory .Noonan, CPA UPAGIDA-GRN:cic D'A o„J BY , ♦ ,� Y ■■■■• ORDINANCE NO. 2012 -01 ' N ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA, AMENDING ORDINANCE NO. 76-57, AS AMENDED, RELATING TO PUBLIC SOLICITATIONS OF CONTRIBUTIONS, BY AMENDING SECTION THREE, "REGISTRATION OF PUBLIC SOLICITORS," IN ORDER TO REQUIRE SOLICITORS REPRESENTING THAT THEY ARE VETERANS OF THE MILITARY TO PROVIDE EVIDENCE OF PRESENT OR FORMER MILITARY SERVICE, AND BY AMENDING SECTION SEVEN, "PROHIBITED ACTS," IN ORDER TO REQUIRE A PUBLIC SOLICITOR TO (1) CARRY PROOF OF REGISTRATION; (2) DISPLAY A SIGN WHICH IDENTIFIES THE PUBLIC SOLICITOR; AND (3) OBTAIN AND CARRY PROOF OF WRITTEN PERMISSION TO SOLICIT ON PRIVATE PROPERTY; PROVIDING FOR INCLUSION IN THE CODE OF LAWS AND ORDINANCES; PROVIDING FOR CONFLICT AND SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, on December 14, 1976, the Board of County Commissioners adopted Ordinance No. 76-57 in order to regulate solicitations of contributions in Collier County; and WHEREAS, Ordinance No. 76-57, as subsequently amended, requires public solicitors to register with the Clerk of the Circuit Court and maintain accurate records reflecting all income and expenses; and WHEREAS, Ordinance No. 76-57, as amended, prohibits a public solicitor from misrepresenting or misleading anyone to believe that the public solicitation is being conducted for a charitable organization or that the proceeds of such solicitation or sale will be used for charitable purposes, if such is not the fact; and WHEREAS,the Board of County Commissioners desires to amend Ordinance No. 76-57, as amended, in order to protect the public against unscrupulous solicitors, better inform the public as to who is requesting their contributions, and require solicitors representing that they are veterans of the military to provide evidence of present or former military service. NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA that: SECTION ONE: AMENDMENT TO SECTION THREE OF ORDINANCE21O. AS AMENDED. r- ^� S' p' Section Three of Ordinance No. 76-57, as amended, is hereby amended as follows: uz"., v ;- r -. c tit Page 1 of 5 ;q Words underlined are added;Words Amok-through are deleted. nm --� • SECTION THREE: Registration of Public Solicitors. 1. Every public solicitor which intends to solicit contributions within this County, or to have funds solicited on its behalf, shall prior to any solicitation file a registration statement with the clerk of the circuit court disclosing the following information: 1) The name of the public solicitor and the purpose for which contributions are being solicited. 2) The principle address of the public solicitor and the address of any offices in this County. If the public solicitor does not maintain an office, the name and address of the person having custody of its financial records. 3) The names and addresses of any Chapters, branches or affiliates in the County. 4) The place where and the date when the public solicitor was legally established, the form of its public solicitation, and a reference to any determination of its tax exempt status under the Internal Revenue Code. 5) The names and addresses of the officers, directors, trustees and the principle salaried executive staff officer. 6) A financial statement which covers complete disclosure of all the fiscal activities of the public solicitor during the three preceding years. The report shall specifically identify the amount of funds raised and all costs and expenses incidental thereto, all publicity costs, and the cost of allocation or disbursement of funds raised. The financial statement shall be verified under oath and attested to by the Chief Fiscal Officer of the public solicitor. 7) Whether the public solicitor intends to solicit contributions from the public directly or to have it done in its behalf. 8) Whether the public solicitor is authorized by any other governmental authority to solicit contributions and whether it is or has ever been enjoined by any court from soliciting contributions. 9) The general purpose or purposes for which the contributions to be solicited shall be used. 10) The name or names under which it intends to solicit contributions. 11) The names of the individuals or officers of the public solicitor who will have final responsibility for the custody of the contributions. 12) The names of the individuals or officers of the public solicitor responsible for the final distribution of the contributions. 13) Military Representation. During registration organizations whose solicitors represent that they are veterans of the military, or wear a military uniform or a distinctive part of a military uniform must provide evidence of present or former military service for each solicitor. Evidence that will be accepted includes, but is not limited to:. Page 2 of 5 Words underlined are added;Words strek-through are deleted. • A. DD-214 or Statement of Service(Report of Separation); or B. Communication from military or veterans office that contains information regarding military service or an indication of military service. 2. The registration forms shall be signed by an authorized officer and by the chief fiscal officer of the public solicitor, shall be verified under oath and shall be accompanied by a $5.00 registration fee. 3. It shall be the duty of every public solicitor to furnish identification to persons who solicit contributions from the public on behalf of the public solicitor. The person so soliciting shall be required to have and produce or display on demand, identification indicating that the said solicitor has been duly authorized by the public solicitor for which he is soliciting. Such identification shall include, but not be limited to, the name of the holder of the identification and the name and number of the certificate of registration of the public solicitor. 4. Each public solicitor shall annually on or before March 1st after the end of the calendar year, file with the clerk of the circuit court a statement showing the financial condition of the public solicitor as of the last day of the calendar year. The report shall be verified by a certified public accountant or be submitted under oath by the executive officer of the public solicitor. SECTION TWO: AMENDMENT TO SECTION SEVEN OF ORDINANCE NO. 76-57, AS AMENDED. Section Seven of Ordinance No. 76-57, as amended, is hereby amended as follows: SECTION SEVEN: Prohibited Acts 1. It shall be unlawful for any public solicitor to solicit funds within Collier County without first filing a registration statement as provided by this Ordinance. Any person soliciting in Collier County must carry proof of having filed a registration statement, and upon request must show such proof. 2. No public solicitor subject to the provisions of this Ordinance, shall use or exploit the fact of registration so as to lead the public to believe that such registration in any manner constitutes an endorsement or approval by the Collier County Board of County Commissioner as required by Ordinance. Registration does not imply endorsement of a public solicitor for contribution. 3. No person shall, in connection with the solicitation of contributions for or the sale of goods or services of a person other than a charitable organization, misrepresent to or mislead anyone by any manner, means, practice or devise whatsoever, to believe that the person on whose behalf such solicitation or sale is being conducted is a charitable organization or that the proceeds of such solicitation or sale will be used for charitable purposes, if such is not the fact. Page 3 of 5 Words underlined are added;Words struslk-t rouugh are deleted. 4. No person shall make any representation that he is soliciting contributions for or on behalf of a public solicitor or shall use or display any emblem, device or printed matter belonging to or associated with a public solicitor for the purpose of soliciting or inducing contributions from the public without first being authorized to do so by the public solicitor. 5. No public solicitor shall represent that he or she is a veteran of the military, or wear a military uniform or other indication of military service, when the solicitor is neither a present, nor a former member of the service indicated. 6. It shall be unlawful for any public solicitor to solicit funds within Collier County without having a sign which identifies: 1) The name of the public solicitor and the purpose for which contributions are being solicited; and 2) The principal address of the public solicitor and the address of any offices in this County. If the public solicitor does not maintain an office, the name and address of the person having custody of its financial records. Such sign shall beprominently displayed at all times, and shall be no less than two square feet in size, and no more than four square feet in size. 7. It shall be unlawful for any public solicitor to solicit funds in Collier County on private commercial property without first obtaining the express written permission of the owner, lessee, agent or occupant of the property. Any person soliciting on private property in Collier County must carry proof of such written permission, and upon request must show such proof. 8. The County may, but it is not limited to, enforce this ordinance through the issuance of a citation, by a notice to appear in County Court, or by arrest as provided for in Florida Statutes ch. 901. SECTION THREE: INCLUSION IN THE CODE OF LAWS AND ORDINANCE. The provisions of this Ordinance shall become and be made a part of the Code of Laws and Ordinances of Collier County, Florida. The sections of the Ordinance may be renumbered or re-lettered to accomplish such, and the word "ordinance" may be changed to "section," "article," or any other appropriate word. SECTION FOUR: CONFLICT AND SEVERABILITY. In the event this Ordinance conflicts with any other Ordinance of Collier County or other applicable law, the more restrictive shall apply. If any phrase or portion of the Ordinance is held invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a Page 4 of 5 Words underlined are added;Words struck-threugh are deleted. separate, distinct and independent provision and such holding shall not affect the validity of the remaining portion. SECTION FIVE: EFFECTIVE DATE. This Ordinance shall become effective upon filing with the Department of State. PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this 10 day of QM�„e,.y , 2012. f; JOARD `�� ATTEST: ..,K4";.- BOARD OF COUNTY COMMISSIONERS DWIGFI III C I KIC COLLIER COUNTY, FLORIDA ' ,* B C M. 4 By: .11......k " . . I.! . • FRED W. COYLE,CHAI N Appr ve • to form and 1 •. r. a Ency: .44111p I 1 .iIA Jeffre 1• . tzkow Count A ,l rney This ordinance filed with the Secretary of tote's Offic�e i 1"' day of � , 20 2 and acknowledAQmen 24 that filing received - ;-- day of `)a"`r a 2 By Deport c Page 5 of 5 Words underlined are added;Words dough are deleted. STATE OF FLORIDA) COUNTY OF COLLIER) I, DWIGHT E. BROCK, Clerk of Courts in and for the Twentieth Judicial Circuit, Collier County, Florida, do hereby certify that the foregoing is a true and correct copy of : ORDINANCE 2012-02 Which was adopted by the Board of County Commissioners on the 10th day of January, 2012, during Regular Session. WITNESS my hand and the official seal of the Board of County Commissioners of Collier County, Florida, this 13th day of January, 2012 . DWIGHT E. BROCK Clerk of Courts, . •• ..C,].eek Ex-officio to - . 6111q, ` County Comm. = ofi f , 41 , ! ,: 04117: r" .i.,/ * By: Martha V- 4''=74;•,�` C� Deputy 1`2^r{ Veteran's Outreach, Inc. 524 Youngstown Poland Road Struthers,Ohio 44471 Income Statement January 1 to December 31, 2011 Revenue Grants 18,441.00 Program Services 1,215,768.00 Invesment Income 162.00 Other Revenue 460.00 Total Revenue 1,234,831.00 Operating Expenses Salaries 768,084.00 Legal Fees 528.00 Accounting 3,150.00 Advertising& Promotin 2,394.00 Office Expenses 7,435.00 Information Technology 8,511.00 Occupancy 53,518.00 Travel 5,807.00 Insurance 42,988.00 Donations 625.00 Postage 2,269.00 Program Expenses 338,371.00 Bank Fees 1,868.00 1,235,548.00 Net Operating Revenue -717.00 Veteran's Outreach, Inc. Balance Sheet December 31,2011 Assets Checking Accounts 66,149.00 Investments Savings Accounts 63,898.00 Other Assets 0.00 Office Equipment 30,000.00 Total Assets 160,047.00 Liabilities Accounts Payable 250.00 Credit Cards 10,000.00 Total Liabilities Capital Fund Balances 150,047.00 Total Assets&Liabilities&Capital 160,047.00 CURRENT OFFICERS, PERSONNEL, and KEY PERSONALITIES Board Members John O. Ely President 205 Red Rose Street, Butler, PA 16001 Robert Julian Vice-President/Treasurer 506 Lowries Run Road, Pittsburgh, PA 15237 Thomas Price Secretary 444 Valley View Drive, Monroeville, PA 15146 State Agents Robert Olsheski FL State Agent 7214 Harbor View Drive, Leesburg, FL 33803 David Clendaniel DE State Agent 102 Kings Highway, Milford, DE 19963 Michelle Lo Castro NY State Agent 782 Prospect Avenue, Buffalo, NY 14713 Kathleen Carlson VA State Agent 118 Chowan Drive, Portsmouth, VA 23701 Vicki Kerrigan WV State Agent 132 Cottage Avenue, Weston, WV 25302 James Larsen KY State Agent 1803 Callihan Street, Flatwoods, KY 41139 Robert Wheeler AL State Agent 401 Twin Oaks Drive NW, Hartselle AL 35640 Principle Salaried Staff John O. Ely Chief Executive Officer. 205 Red Rose Street, Butler, PA 16001 Robert Julian Chief Financial Officer. 506 Lowries Run Road, Pittsburgh, PA 15237 Theresa Ely Executive Director 205 Red Rose Street, Butler, PA 16001 Judy McArdle Regional Field Manager 579 Fifth Street, Struthers, OH 44471 Barb Kelley Office Aid 44 Crescent, Struthers, OH 44471 Linda White Office Aid 524 Youngstown Poland Rd., Struthers, OH 44471 Karen Cook Regional Field Manager 1656 Laurie Drive, Youngstown OH 44511 James Larsen KY Regional Manager 1803 Callihan Street, Flatwoods, KY 41139 Robert Graham FL Regional Manager 6402 42nd Street E, Sarasota FL 34243 Robert Wheeler AL Regional Manager 401 Twin Oaks Drive NW, Hartselle AL 35640 George Lillis Team Leader 146 Salinger Drive, Georgetown, KY 40324 • OMB No.1545-0047 Form 990 Return of Organization Exempt From Income Tax 2 Under section 501(c),527,or 4947(0(1)of the Internal Revenue Code(except black lung benefit trust or private foundation) Open to Public Department of the Treasury Internal Revenue Service The organization may have to use a copy of this return to satisfy state reporting requirements. Inspection A For the 2011 calendar year,or tax year beginning ,and ending_ B Check if applicable:C Name of organization Veterans Outreach, Inc. D Employer identification number 0 Address change Doing Business As 22-3272976 ❑Name change Number and street(or P.O.box if mail is not delivered to street address) Room/suite E Telephone number ❑Initial return 524 Youngstown Poland Road 888-283-8638 ❑Terminated City or town,state or country,and ZIP+4 0 Amended retum Struthers OH 44471 G Gross receipts$ 1,234,831 ❑Application pending F Name and address of principal officer. H(a)Is this a group return for affiliates? DU*la No John Ely 205 Red Rose St, Butler, PA 16001 H(b)Are all affiliates included? [JYes❑ No I Tax-exempt status: © 501(cx3)❑501(c) ( ) 4(insert no.) ❑4947(a)(1)or ❑527 If"No,"attach a list.(see instructions) J Website: ► H(c)Group exemption number• K Form of organization: © Corporation El Trust 0 Association ❑Other • I L Year of formation: I M State of legal domicile: Part I Summary 1 Briefly describe the organization's mission or most significant activities: Veterans Outreach has the primary mission of honoring and serving all veterans. Each veteran has unigue needs that are •• identified through personal one-on-one interviews.We endeavor to use our program resources "E to offer a hand up not just a hand out to benefit veterans and, in turn,communities and g2 Check this box ►1=1 if 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 1 a) 3 3 8 4 Number of independent voting members of the governing body(Part VI, line lb) 4 1 A, 5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) 5 6 Total number of volunteers(estimate if necessary) 6 7a Total unrelated business revenue from Part VIII,column(C), line 12 7a b Net unrelated business taxable income from Form 990-T, line 34 7b Prior Year Current Year 8 Contributions and grants(Part VIII, line 1h) 30,238 18,441 • • 9 Program service revenue(Part VIII, line 2g) 1,263,641 1,215,768 • 10 Investment income(Part VIII,column(A), lines 3,4,and 7d) 162 11 Other revenue(Part VIII,column(A),lines 5,6d,8c,9c, 10c, and 11e). . . 30 460 12 Total revenue—add lines 8 through 11 (must equal Part VIII,column(A),line 12) . . 1,293,909 1,234,831 13 Grants and similar amounts paid(Part IX,column(A), lines 1-3) 14 Benefits paid to or for members(Part IX,column(A), line 4) 15 Salaries,other compensation,employee benefits(Part IX,column(A),lines 5-10) . . 653,024 768,084 I16a Professional fundraising fees(Part IX, column(A), line 11e) . b Total fundraising expenses(Part IX,column(D), line 25) • m 17 Other expenses(Part IX,column(A), lines 11a-11d, 11f--24e) 629,110 467,464 18 Total expenses.Add lines 13-17(must equal Part IX, column(A), line 25). . 1,282,134 1,235,548 19 Revenue less expenses. Subtract line 18 from line 12 11,775 -717 S i Beginning of Current Year End of Year II 20 Total assets(Part X, line 16) 183,351 160,047 = A 21 Total liabilities(Part X, line 26) 23,500 10,000 a. 22 Net assets or fund balances.Subtract line 21 from line 20 159,851_ 150,047 Part II Signature Block Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,it is true,correct,and complete.Declaration of preparer(other than officer)is based on all information of which preparer has any knowledge. Sign 'i _-�.�0 _/ �- IS- c4v0-- Here Signature of officer / Date Robert Julian Vice President Type or print name and title Print/Type preparer's name Preparer's signature Date PTIN Paid Check ❑ if Preparer Thomas Price Thomas Price 8/13/2012 self-employed P00068361 Use Only Firm's name •Price CompuTAX, Inc. Firm's EIN •25-1843621 Firm's address •P 0 Box 351, Monroeville, PA 15146 Phone no. (412)542-8132 May the IRS discuss this return with the preparer shown above?(see instructions) © Yes ❑No For Paperwork Reduction Act Notice,see the separate instructions. Form 990(2011) (HTA) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 2 Part HI Statement of Program Service Accomplishments Check if Schedule 0 contains a response to any question in this Part III 1 Briefly describe the organization's mission: We provide financial assistance for a variety of needs determined through interviews. Needs addressed range from but are not limited to,shelter, rent,utilities,_food,auto repair, clothing, relocation, and registration for National WWII Memorial.We Maintain a work program for veterans that are not capable of meeting mainstream work demands due to mental, 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? 0 Yes El No If"Yes,"describe these new services on Schedule 0. 3 Did the organization cease conducting,or make significant changes in how it conducts,any program services? Yes © No If"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 by expenses. Section 501(c)(3)and 501(c)(4)organizations and section 4947(a)(1)trusts 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$ including grants of$ )(Revenue$ Our Direct Aid Program for veterans provides immediate relief for vets after they provide documentation of service and need.These services vary but the most common requests are for providing shelter or rent,keeping utilites turned on,repairing a car for work clothing/shoes for work and food that food banks don't offer. Our Outreach Program is a work program designed for veterans that are otherwise unable to holdgainful employment due to various health and mental factors.They are able to gain work skills such as communication with both the public and co-workers,cleanliness and grooming,respect of authority,understanding simple document completion,the value of fulfilling scheduled time commitments,etc.This program creates a sense of belonging and personal worth that man/have not experienced since their time in the service. 4b (Code: )(Expenses$ including grants of$ )(Revenue$ ) 4c (Code: )(Expenses$_ including grants of$ )(Revenue$ 4d Other program services. (Describe in Schedule 0.) (Expenses $ including grants of $ )(Revenue $ 4e Total program service expenses P. Form 990(2011) r Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 4 Part IV 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 I, Parts I 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 I, Parts I and 111 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 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year,that was issued after December 31,2002? 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 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 d Did the organization act as an"on behalf of'issuer for bonds outstanding at any time during the year? 24d 25a Section 501(c)(3)and 501(c)(4)organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If"Yes,"complete Schedule L, Part I 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year,and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?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"Yes,"complete Schedule L, Part ll . 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 III 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 X b 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,"complete 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, Part I 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 ll 32 X 33 Did the organization own 100%of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If"Yes,"complete Schedule R, Part I 33 X 34 Was the organization related to any tax-exempt or taxable entity? If"Yes,"complete Schedule R, Parts II, III, IV, and V, line 1 34 X 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 35a X b 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-charitable related organization?If"Yes,"complete Schedule R, Part V, line 2 36 X 37 Did the organization conduct more than 5%of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If"Yes,"complete Schedule R, Part VI 37 X 38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 and 19?Note.All Form 990 filers are required to complete Schedule O. 38 X Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule 0 contains a response to any question in this Part V Yes No 1a Enter the number reported in Box 3 of Form 1096. Enter-0-if not applicable 1a 1 b I b Enter the number of Forms W-2G included in line 1 a. Enter-0-if not applicable c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming(gambling)winnings to prize winners? 1c NI 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 b If at least one is reported on line 2a,did the organization file all required federal employment tax returns'?. . . . 2b Note.If the sum of lines 1 a and 2a is greater than 250,you may be required to a-file. (see instructions) 3a Did the organization have unrelated business gross income of$1,000 or more during the year? 3a X b If"Yes,"has it filed a Form 990-T for this year? If"No,"provide an explanation in Schedule 0 3b 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 financial account)? 4a X b If"Yes,"enter the name of the foreign country: • See 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? 5a X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction'?. . . 5b X c If"Yes"to line 5a or 5b,did the organization file Form 8886-T? 5c X 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? 6a X b If"Yes,"did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 6b X 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? 7a X b If"Yes,"did the organization notify the donor of the value of the goods or services provided? 7b X c Did the organization sell,exchange,or otherwise dispose of tangible personal property for which it was required to file Form 8282? 7c X d If"Yes,"indicate the number of Forms 8282 filed during the year I 7d e Did the organization receive any funds,directly or indirectly,to pay premiums on a personal benefit contract?. . . 7e X f Did the organization,during the year, pay premiums,directly or indirectly,on a personal benefit contract'?. . . . 7f X g If the organization received a contribution of qualified intellectual property,did the organization file Form 8899 as required? . . 7g X h If the organization received a contribution of cars,boats,airplanes,or other vehicles,did the organization file a Form 1098-C? . 7h X 8 Sponsoring organizations maintaining donor advised funds and section 509(aX3)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? g X 9 Sponsoring organizations maintaining donor advised funds. a Did the organization make any taxable distributions under section 4966? 9a X b Did the organization make a distribution to a donor,donor advisor, or related person? 9b . X 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 I 11 Section 501(cx12)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 12a Section 4947(a)(1)non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?. . . b If"Yes,"enter the amount of tax-exempt interest received or accrued during the year. . . . I12b 13 Section 501(cx29)qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? 121111M X 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 which the organization is licensed to issue qualified health plans 13b 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 If"Yes,"has it filed a Form 720 to report these payments? If"No,"provide an explanation in Schedule 0 . . . . 14b X Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 6 Part VI Governance,Management,and Disclosure For each "Yes"response to lines 2 through 7b below, and for a"No" response to line 8a, 8b, or 10b 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 ❑ Section A.Governing Body and Management Yes No 1a Enter the number of voting members of the governing body at the end of the tax year. . . 1a 3 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 la,above,who are independent. . . lb 1 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 goveming 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? 7a X b Are any governance decisions of the organization reserved to(or subject to approval by)members, stockholders, or persons other than the governing body? 7b X 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? 8a X b Each committee with authority to act on behalf of the governing body? 8b X 9 Is there any officer,director,trustee,or key employee listed in Part VII, Section A,who cannot be reached at the organization's mailing address? If"Yes,"provide the names and addresses in Schedule 0 9 X Section B.Policies (This Section B requests information about policies not required by the Internal Revenue Code.j Yes No 10a Did the organization have local chapters,branches,or affiliates? 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 11a Has the organization provided a complete copy of this Form 990 to all members of its goveming body before filing the form?. 11a X b Describe in Schedule 0 the process, if any, used by the organization to review this Form 990. 12a 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," describe in Schedule 0 how this was done 12c X 13 Did the organization have a written whistleblower policy? 13 X 14 Did the organization have a written document retention and destruction policy? 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data,and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director,or top management official 15a X b Other officers or key employees of the organization 15b X If"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 arrangement with a taxable entity during the year? 16a X b If"Yes,"did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements? 16b X Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed ■ AL,_FL,KY,NY OH,VA, V 18 Section 6104 ...........................c)(3)s only) 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. ❑ Own website ❑ Another's website © Upon request 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. 20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization: • Robert Julian 412-366-0946 4501 Peoples Road, Pittsburgh, PA 15237 Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 7 Part VII Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check if Schedule 0 contains a response to any question in this Part VII Section A. Officers, Directors, Trustees, Key Employees,and Highest Compensated Employees la Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. • List all of the organization's current officers, directors,trustees(whether individuals or organizations), regardless of amount of compensation. Enter-0-in columns (D), (E),and(F)if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of"key employee." • List the organization's five current highest compensated employees (other than an officer,director,trustee,or key employee) who received reportable compensation(Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC)of more than$100,000 from the organization and any related organizations. • List all of the organization's former officers, key employees,and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than$10,000 of reportable compensation from the organization and any related organizations. List persons in the following order; individual trustees or directors; institutional trustees;officers; key employees;highest compensated employees; and former such persons. 1 I Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (c) Position (A) (B) (do not check more than one (D) (E) (F) Name and Title Average box,unless person is both an Reportable Reportable Estimated hours per officer and a director/trustee) compensation compensation week p• pensation amount of Q X cox -n from from related other hours(be 52` ` ` . the organizations compensation related o. c 3 , s5, organization (W-2/1099-MISC) from the Q v $ 8 (W-211099-MfSC) organization A.'organizations g a o c 3 and related in S hedule a w 2 ,� organizations S i _(1) John Ely Cheif Executive Officer 40.00 X X X X 48,425 (21 Robert Julian Chief Financial Officer 40.00 X X X 43,637 (31 Theresa Ely Executive Director 40.00 X X 43,637 -(41 Judy McArte Regional Field Manager 24.00 X 20,800 _(5) Barbara Kelly OfficeAid 24.00 X 9,734 _01 James Larsen Ky Regional Manager 4os 2 X sw, O$ _(71 Karen Cook Regional Field Manager 30.00 X 12,329 _(81 Brad Coleman Fl Regional Manager 30.00 X 6,285 -(91 Melissa Smith Office Aid 30.00 X 2,400 (101 Robert Wheeler AL Regional Manager 30.00 X 23.904 (111 Carol Wheeler AL Office Manager 20.00 X 7.788 (121 Dana Mercado Office Aid 24.00 X 4,896 (131 (141 Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 8 Part VII Section A.Officers,Directors,Trustees,Key Em ployees,and Highest Compensated Employees(continued) (C) Position (A) (B) (do not check more than one (D) (E) (F) Name and title Average box,unless person is both an Reportable Reportable Estimated hours per officer and a director/trustee) compensation compensation amount of week T . 7k o x ,r from from related other (describe n 2. S 3 °c °O the organizations compensation hours for c , ,°e °a i6 organization (W-2/1099-MISC) from the related m $ $ (W-2/1099-MISC) organization organizations g !b .°� 3 and related in Schedule a 3 'R organizations °) a a 115) J16) (17) J18) 119) j20) J21) 122) 1323) 124) 125) 1b Sub-total • 203,035 c Total from continuation sheets to Part VII,Section A • d Total(add lines 1b and 1c) • 203,035 2 Total number of individuals(including but not limited to those listed above)who received more than$100,000 of reportable compensation from the organization • Yes No 3 Did the organization list any former officer,director,or trustee,key employee,or highest compensated employee on line 1a? If"Yes,"complete Schedule J for such individual X 4 For any individual listed on line la, is the sum of reportable compensation and other compensation from the organization and related organizations greater than$150,000? If"Yes,"complete Schedule J for such individual X 5 Did any person listed on line la receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If"Yes,"complete Schedule J for such person 5 X Section B.Independent Contractors 1 Complete this table for your five highest compensated independent contractors that received more than$100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. (A) (B) (C) Name and business address Description of services Compensation 2 Total number of independent contractors(including but not limited to those listed above)who received more than$100,000 of compensation from the organization • Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 9 Part VIII Statement of Revenue (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exempt business excluded from function revenue tax under sections revenue 512 513 or 514 c 1a Federated campaigns 1a LIE b Membership dues lb • c Fundraising events 1c O `a d Related organizations 1d c E e Government grants(contributions). . le o f All other contributions,gifts,grants,and ▪ 0 similar amounts not included above. . If 18,441 ▪ g Noncash contributions included in lines la-1f: $ ci a h Total.Add lines la-1f ► 18 441 Business Code 3 2a Outreach Income 1,196,007 1,196,007 b Misc Income 19,761 19,761 • c •• d E F f All other program service revenue. . . . n g Total.Add lines 2a-2f ► 1,215,768 3 Investment income(including dividends, interest,and other similar amounts) • 162 4 Income from investment of tax-exempt bond proceeds. . .• 5 Royalties • (i)Real (ii)Personal 6a Gross rents b Less:rental expenses. . . c Rental income or(loss). . . d Net rental income or(loss) • 7a Gross amount from sales of (i)Securities (ii)Other assets other than inventory. b Less:cost or other basis and sales expenses. . . c Gain or(loss) d Net gain or(loss) m • 8a Gross income from fundraising • events(not including$ • of contributions reported on line 1c). O b See Part IV, line 18 a Less:direct expenses b 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 • —r 10a Gross sales of inventory, less returns and allowances a b Less: cost of goods sold b c Net income or(loss)_from sales of inventory • Miscellaneous Revenue Business Code 11a Loan Repayment 460 b c d All other revenue e Total.Add lines 11a-11d • 460 12 Total revenue.See instructions. • 1,234,831 1,215,768 Form 990(2011) Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 10 Part IX Statement of Functional Expenses Section 501(c)(3)and 501(c)(4)organizations must complete all columns.All other organizations must complete column(A)but are not required to complete columns(B), (C), and(D). Check if Schedule 0 contains a response to any question in this Part IX el Do not include amounts reported on lines 6b, (A) (B) (c) (D) 7b,8b,9b,and 106 of Part VIII. Total expenses Program service Management and Fundraising expenses metal e rase ass 1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2 Grants and other assistance to individuals in the United States. See Part IV, line 22 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 135,699 62,528 73,171 6 Compensation not included above,to disqualified persons(as defined under section 4958(0(1))and persons described in section 4958(c)(3)(B) 7 Other salaries and wages 591,309 591,309 8 Pension plan accruals and contributions(include section 401(k)and 403(b)employer contributions). 9 Other employee benefits 10 Payroll taxes 41,076 36,854 4,222 11 Fees for services(non-employees): a Management b Legal 528 528 c Accounting 3,150 3,150 d Lobbying e Professional fundraising services.See Part IV,line 17 . . f Investment management fees g Other 12 Advertising and promotion 2,394 2,394 13 Office expenses 7,435 2,974 4,461 14 Information technology 8,511 8,511 15 Royalties 16 Occupancy 53,518 26,759 26,759 17 Travel 5,807 5,517 290 18 Payments of travel or entertainment expenses for any federal,state, or local public officials 19 Conferences,conventions, and meetings 20 Interest 21 Payments to affiliates 22 Depreciation,depletion, and amortization 23 Insurance 42 988 1 200 41 788 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 expenses on Schedule 0.) a Donations 625 625 b Postage 2,269 567 1,702 c Program expenses 338,371 338,371 d Bank Service Fees 1,868 1,868 e All other expenses 25 Total functional expenses.Add lines 1 through 24e. 1,235,548 1,069,626 165,922 26 Joint costs.Complete this line only if the organization reported in column(B)joint costs from a combined educational campaign and fundraising solicitation. Check here •1=1 if following SOP 98-2(ASC 958-720) Form 990(2011) f Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 11 Part X Balance Sheet (A) (B) Beginning of year End of year 1 Cash—non-interest-bearing 89,453 1 66,149 2 Savings and temporary cash investments 63,898 2 63,898 3 Pledges and grants receivable, net 3 4 Accounts receivable, net 4 5 Receivables from current and former officers,directors,trustees,key employees, and highest compensated employees. Complete Part ll of Schedule L 5 6 Receivables from other disqualified persons(as defined under section 4958(f)(1)),persons described in section 4958(c)(3)(B),and contributing employers and sponsoring organizations of section 501(c)(9)voluntary 9 co employees'beneficiary organizations(see instructions) 6 a 7 Notes and loans receivable, net 7 < 8 Inventories for sale or use 8 9 Prepaid expenses and deferred charges 9 10a Land,buildings, and equipment:cost or other basis. Complete Part VI of Schedule D 10a b Less:accumulated depreciation 10b 10c 11 Investments—publicly traded securities 11 12 Investments—other securities. See Part IV, line 11 12 13 Investments—program-related. See Part IV, line 11 13 14 Intangible assets 30,000 14 30,000 15 Other assets. See Part IV, line 11 15 16 Total assets.Add lines 1 through 15(must equal line 34) 183,351 16 160,047 17 Accounts payable and accrued expenses 250 17 18 Grants payable 18 19 Deferred revenue 19 20 Tax-exempt bond liabilities 20 21 Escrow or custodial account liability. Complete Part IV of Schedule D. . 21 m 22 Payables to current and former officers, directors,trustees, key employees, highest compensated employees,and disqualified : persons. Complete Part ll of Schedule L 22 23 Secured mortgages and notes payable to unrelated third parties. . . . 23 24 Unsecured notes and loans payable to unrelated third parties 24 25 Other liabilities(including federal income tax, payables to related third parties,and other liabilities not included on lines 17-24). Complete Part X of Schedule D 23,250 25 10,000 26 Total liabilities.Add lines 17 through 25 23 500 26 10 000 Organizations that follow SFAS 117,check here ►0 and u• complete lines 27 through 29,and lines 33 and 34. CO 27 Unrestricted net assets 27 a 28 Temporarily restricted net assets 28 TI/ 29 Permanently restricted net assets 29 3 a Organizations that do not follow SFAS 117,check here ►ID `o and complete lines 30 through 34. O 30 Capital stock or trust principal,or current funds 30 IC• 31 Paid-in or capital surplus,or land, building, or equipment fund 31 0 32 Retained earnings,endowment,accumulated income,or other funds. 159,851 32 150,047 Z 33 Total net assets or fund balances 159,851 33 150,047 34 Total liabilities and net assets/fund balances 183,351 34 160,047 Form 990(2011) • Form 990(2011) Veterans Outreach, Inc. 22-3272976 Page 12 Part XI Reconciliation of Net Assets Check if Schedule 0 contains a response to any question in this Part XI El 1 Total revenue(must equal Part VIII, column(A), line 12) 1 1,234,831 2 Total expenses(must equal Part IX, column(A), line 25) 2 1,235,548 3 Revenue less expenses. Subtract line 2 from line 1 3 -717 4 Net assets or fund balances at beginning of year(must equal Part X, line 33,column(A)) 4 159,851 5 Other changes in net assets or fund balances(explain in Schedule 0) 5 717 6 Net assets or fund balances at end of year. Combine lines 3,4,and 5(must equal Part X, line 33, column(B)) 6 150,047 Part XII Financial Statements and Reporting Check if Schedule 0 contains a response to any question in this Part XII Yes No 1 Accounting method used to prepare the Form 990: © Cash El Accrual El Other If the organization changed its method of accounting from a prior year or checked"Other,"explain in Schedule O. 2a Were the organization's financial statements compiled or reviewed by an independent accountant? 2a II b Were the organization's financial statements audited by an independent accountant? 2b c If"Yes"to line 2a or 2b,does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant'?. . . . 2c If the organization changed either its oversight process or selection process during the tax year,explain in Schedule O. d If"Yes"to line 2a or 2b,check a box below to indicate whether the financial statements for the year were issued on a separate basis,consolidated basis, or both: 13 Separate basis []Consolidated basis El Both consolidated and separate basis 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? 3a X b If"Yes,"did the organization undergo the required audit or audits?If the organization did not undergo the required audit or audits,explain why in Schedule 0 and describe any steps taken to undergo such audits. 3b X Form 990(2011) SCHEDULE A OMB No.1545-0047 (Form 990 or 990-EZ) Public Charity Status and Public Support 2 O Complete If the organization is a section 501(c)(3)organization or a section Department of the Treasury 4947(a)(1)nonexempt charitable trust. Open to Public, Internal Revenue Service •Attach to Form 990 or Form 990-EZ See■ separate instructions. I 11 s pectic)n Name of the organization Employer Identification number Veterans Outreach, Inc. 22-3272976 Part I Reason for Public Charity Status(All organizations must complete this part.)See instructions. The or anization is not a private foundation because it is:(For lines 1 through 11,check only one box.) 1 Lj A church, convention of churches,or association of churches described in section 170(b)(1)(A)(i). 2 0 A school described in section 170(b)(1XA)(ii). (Attach Schedule E.) 3 El A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii). 4 ❑ A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(AXiii). Enter the hospital's name, city,and state: 5 0 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv).(Complete Part II.) 6 ❑ A federal, state,or local government or governmental unit described in section 170(b)(1 XA)(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)(1XA)(vi).(Complete Part II.) 8 [] A community trust described in section 170(b)(1)(A)(vi).(Complete Part II.) 9 [] An organization that normally receives: (1)more than 33 1/3%of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and(2)no more than 33 1/3%of its support from gross investment income and unrelated business taxable income(less section 511 tax)from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.) 10 ❑ An organization organized and operated exclusively to test for public safety.See section 509(a)(4). 11 fl An organization organized and operated exclusively for the benefit of,to perform the functions of,or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1)or section 509(a)(2). See section 509(aX3). Check the box that describes the type of supporting organization and complete lines 11e through 11h. a [ Type I b El Type II c ID Type III–Functionally integrated d El Type III–Other e 0 By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(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 supporting organization, check this box g El Since August 17,2006,has the organization accepted any gift or contribution from any of the following persons? (i) A person who directly or indirectly controls,either alone or together with persons described in(ii) Yes No and(iii)below,the governing body of the supported organization? 119(1) (ii) A family member of a person described in(i)above? 11g(ii) (iii) A 35%controlled entity of a person described in(i)or(ii)above? 11g(Ill) h Provide the following information about the supported organization(s); (i)Name of supported (ii)EIN (Ill)Type of organization (iv)Is the organization rg (v)Did you notify (vi)Is the (vii)Amount of organization (described on lines 1-9 in col.(I)listed in your the organization in organization in col. support above or IRC section governing document? col.(I)of your (i)organized in the (see Instructions)) support? U.S.? Yes No Yes No Yes No (A) (B) (C) (D) (E) Total For Paperwork Reduction Act Notice,see the Instructions for Schedule A(Form 990 or 990-EZ)2011 Form 990 or 990-EZ (HTA) • Schedule A(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 2 Part II 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 qualify under Part Ill. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support Calendar year(or fiscal year beginning in) ■ (a)2007 (b)2008 (c)2009 (d)2010 (e)2011 (f)Total 1 Gifts,grants, contributions,and membership fees received. (Do not include any"unusual grants") 614,806 732,730 860,909 1,263,641 1,215,768 4,687,854 2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 3 The value of services or facilities furnished by a governmental unit to the organization without charge 4 Total.Add lines 1 through 3 614 806 732 730 860 909 1 263 641 1 215 768 4 687 854 5 The portion of total contributions by each person(other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column(f) 6 Public support.Subtract line 5 from line 4. 4687 854 Section B.Total Support Calendar year(or fiscal year beginning in) N. (a)2007 (b)2008 (c)2009 (d)2010 (e)2011 (f)Total 7 Amounts from line 4 614,806 732,730 860,909 1,263,641 1,215,768 4,687,854 8 Gross income from interest,dividends, payments received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities,whether or not the business is regularly carried on 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) 11 Total support.Add lines 7 through 10. . 4 687 854 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 here P.El Section C.Computation of Public Support Percentage 14 Public support percentage for 2011 (line 6,column(f)divided by line 11, column(f)) 14 100.00% 15 Public support percentage from 2010 Schedule A, Part II, line 14 15 100.00% 16a 33 1/3%support test-2011. If the organization did not check the box on line 13, and line 14 is 33 1/3%or more, check this box and stop here.The organization qualifies as a publicly supported organization ► b 33 1/3%support test-2010. If the organization did not check a box on line 13 or 16a,and line 15 is 33 1/3%or more,check this box and stop here.The organization qualifies as a publicly supported organization ► 17a 10%-facts-and-circumstances test-2011. If the organization did not check a box on line 13, 16a,or 16b,and line 14 is 10%or more,and if the organization meets the"facts-and-circumstances"test, check this box and stop here. Explain in Part IV how the organization meets the"facts-and-circumstances"test.The organization qualifies as a publicly supported organization. ► b 10%-facts-and-circumstances test-2010. 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 ►Ej 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 ► Schedule A(Form 990 or 990-EZ)2011 Schedule A(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 3 Part III 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 qualify under the tests listed below, please complete Part II.) Section A.Public Support Calendar year(or fiscal year beginning in) ■ (a)2007 (b)2008 (c)2009 (d)2010 (e)2011 (f)Total 1 Gifts,grants,contributions,and membership fees received.(Do not include any"unusual grants.") 614,606 732,590 860,909 1,263,641 1,215,768 4,687,514 2 Gross receipts from admissions,merchandise sold or services performed,or facilities furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or business under section 513. 4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf 5 The value of services or facilities furnished by a governmental unit to the organization without charge 6 Total.Add lines 1 through 5 614,606 732,590 860,909 1,263,641 1,215,768 4,687,514 7a Amounts included on lines 1,2,and 3 received from disqualified persons b 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 c Add lines 7a and 7b 8 Public support(Subtract line 7c from line 6.) Section B.Total Support 4,687,514 Calendar year(or fiscal year beginning in) ■ (a)2007 (b)2008 (c)2009 (d)2010 (e)2011 (f)Total 9 Amounts from line 6 614,606 732,590 860,909 1,263,641 1,215,768 4,687,514 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 business activities not included in line 10b,whether or not the business is regularly carried on. . . 12 Other income.Do not include gain or loss from the sale of capital assets (Explain in Part IV.) 13 Total support.(Add lines 9, 10c, 11, and 12.) 614,606 732,590 860,909 1,263,641 1,215,768 4,687,514 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 •❑ Section C.Computation of Public Support Percentage 15 Public support percentage for 2011 (line 8,column(t)divided by line 13,column(f)) 15 100.00% 16 Public support percentage from 2010 Schedule A,Part III,line 15 16 _ 100.00% Section D.Computation of Investment Income Percentage 17 Investment income percentage for 2011 (line 10c,column(f)divided by line 13,column(f)) 17 18 Investment income percentage from 2010 Schedule A,Part III,line 17 18 19a 33 1/3%support tests-2011.If the organization did not check the box on line 14,and line 15 is more than 33 1/3%,and line 17 is not more than 33 1/3%,check this box and stop here.The organization qualifies as a publicly supported organization ■ b 33 1/3%support tests-2010.If the organization did not check a box on line 14 or line 19a,and line 16 is more than 33 1/3%,and line 18 is not more than 33 1/3%,check this box and stop here.The organization qualifies as a publicly supported organization ►i'J 20 Private foundation.If the organization did not check a box on line 14, 19a,or 19b,check this box and see instructions ■ Schedule A(Forth 990 or 990-EZ)2011 Schedule A(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 4 Part IV Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part Ill, line 12.Also complete this part for any additional information. (See instructions). Schedule A(Form 990 or 990-EZ)2011 Schedule B Schedule of Contributors OMB No.1545-0047 (Form 990,990-EZ, or 990-PF) 20 Department of the Treasury ',Attach to Form 990,Form 990-EZ,or Form 990-PF. Internal Revenue Service Name of the organization Employer Identification number Veterans Outreach, Inc. 22-3272976 Organization type(check one): Filers of: Section: Form 990 or 990-EZ © 501(c)( 3 )(enter number)organization ❑ 4947(a)(1)nonexempt charitable trust not treated as a private foundation ❑ 527 political organization Form 990-PF ❑ 501(c)(3)exempt private foundation ❑ 4947(a)(1)nonexempt charitable trust treated as a private foundation ❑ 501(c)(3)taxable private foundation Check if your organization is covered by the General Rule or a Special Rule. Note.Only a section 501(c)(7),(8), or(10)organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule ❑ For an organization filing Form 990, 990-EZ, or 990-PF that received,during the year, $5,000 or more(in money or property)from any one contributor. Complete Parts I and II. Special Rules ❑ For a section 501(c)(3)organization filing Form 990 or 990-EZ that met the 33 1/3%support test of the regulations under sections 509(a)(1)and 170(b)(1)(A)(vi)and received from any one contributor,during the year,a contribution of the greater of(1)$5,000 or(2)2%of the amount on(i)Form 990, Part VIII, line 1 h, or(ii)Form 990-EZ, line 1. Complete Parts I and II. ❑ For a section 501(c)(7), (8),or(10)organization filing Form 990 or 990-EZ that received from any one contributor,during the year,total contributions of more than$1,000 for use exclusively for religious,charitable,scientific, literary, or educational purposes,or the prevention of cruelty to children or animals. Complete Parts I, II,and III. ❑ For a section 501(c)(7), (8),or(10)organization filing Form 990 or 990-EZ that received from any one contributor,during the year,contributions for use exclusively for religious, charitable,etc., purposes,but these contributions did not total to more than$1,000. If this box is checked,enter here the total contributions that were received during the year for an exclusively religious, charitable,etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious,charitable,etc.,contributions of$5,000 or more during the year $ Caution.An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B(Form 990, 990-EZ, or 990-PF), but it must answer"No"on Part IV, line 2,of its Form 990;or check the box on line H of its Form 990-EZ or on Part I, line 2, of its Form 990-PF,to certify that it does not meet the filing requirements of Schedule B(Form 990, 990-EZ,or 990-PF). For Paperwork Reduction Act Notice,see the Instructions for Form 990,990-EZ,or 990-PF. Schedule B(Form 990,990-EZ,or 990-PF)(2011) (HTA) • Schedule B(Form 990,990-EZ,or 990-PF)(2011) Page 2 Name of organization Employer identification number Veterans Outreach, Inc. 22-3272976 Part I Contributors(see instructions). Use duplicate copies of Part I if additional space is needed. (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 1 Home Savings Bak Person CI Feaderal Plaza Payroll ❑ Youngstown OH 44502 $ 10,000 Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country:, a noncash contribution.) (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 2 Person ❑ Payroll ❑ $ Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country:, a noncash contribution.) (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 3 Person ❑ Payroll ❑ $ Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country:. a noncash contribution.) (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 4 Person ❑ Payroll El $ Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country:_ a noncash contribution.) (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 5 Person ❑ Payroll ❑ $ Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country:. a noncash contribution.) (a) (b) (c) (d) No. Name,address,and ZIP+4 Total contributions Type of contribution 6 Person El Payroll p $ Noncash ❑ Foreign State or Province: (Complete Part II if there is Foreign Country: a noncash contribution.) Schedule B(Form 990,990-EZ,or 990-PF)(2011) Schedule B(Form 990,990-EZ,or 990-PF)(2011) Page 3 Name of organization Employer identification number Veterans Outreach, Inc. 22-3272976 Part II Noncash Property(see instructions). Use duplicate copies of Part II if additional space is needed. (a)No. (b) (c) (d) from Description of noncash property given FMV(or estimate) Date received Part I (see instructions) $, (a)No. (c) (d) (b) from Description of noncash property given FMV(see Instruct ons)) Date received $. Part I (a)No. (b) given FMV(or estimate) (d) from Description of noncash property gi Date received Part I (see instructions) (a)No. (b) (c) (d) from Description of noncash property given FMV(or estimate) Date received Part I (see instructions) $ (a)No. (b) (c) (d) from Description of noncash property given FMV(or estimate) Date received Part I (see Instructions) $, (a)No. (c) (d) from Description of noncash property given FMV(or estimate) Date received Part I (see Instructions) Schedule B(Form 990,980-EZ,or 990-PF)(2011) Schedule B(Form 990,990-EZ,or 990-PF)(2011) Page 4 Name of organization Employer identification number Veterans Outreach, Inc. 22-3272976 Part III Exclusively religious,charitable,etc.,individual contributions to section 501(c)(7),(8),or(10)organizations total more than$1,000 for the year. Complete columns(a)through(e)and the following line entry. For organizations completing Part Ill,enter the total of exclusively religious,charitable,etc., contributions of$1,000 or less for the year. (Enter this information once. See instructions.) ► $ Use duplicate copies of Part Ill if additional space is needed. (a)No. from (b)Purpose of gift (c)Use of gift (d)Description of how gift is held Part I (e)Transfer of gift Transferee's name,address,and ZIP +4 Relationship of transferor to transferee For.Prov. Country (a)No. from (b)Purpose of gift (c)Use of gift (d)Description of how gift is held Part I (e)Transfer of gift Transferee's name,address,and ZIP +4 Relationship of transferor to transferee For.Prov. Country (a)No. from (b)Purpose of gift (c)Use of gift (d)Description of how gift is held Part I (e)Transfer of gift Transferee's name,address,and ZIP +4 Relationship of transferor to transferee For.Prov. Country (a)No. from (b)Purpose of gift (c)Use of gift (d)Description of how gift is held Part I (e)Transfer of gift Transferee's name,address,and ZIP +4 Relationship of transferor to transferee For.Prov. Country Schedule B(Form 990,990-EZ,or 990-PF)(2011) SCHEDULE D OMB No.1545-0047 (Form 990) Supplemental Financial Statements 2 0 ► Complete if the organization answered"Yes,"to Form 990, Part IV,line 6,7,8,9,10,11a,11b,11c,11d,11e,11f,12a,or 12b. Open to Public Department of me treasury Internal Revenue Service _ ►Attach to Form 990. •See separate instructions. I n s p e c non Name of the organization Employer Identification number Veterans Outreach, Inc. 22-3272976 Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered"Yes"to Form 990, Part IV, line 6. (a)Donor advised funds (b)Funds and other accounts 1 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? ❑ Yes ❑ No 6 Did the organization inform all grantees,donors,and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor,or for any other purpose conferring impermissible private benefit? ❑ Yes ❑ No Part I I Conservation Easements. Complete if the organization answered"Yes"to Form 990, Part IV, line 7. 1 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 area ❑ Protection of natural habitat ❑ Preservation of a certified historic structure ❑ Preservation of open space 2 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 8/17/06,and not on a historic structure listed in the National Register 2d 3 Number of conservation easements modified,transferred, released,extinguished, or terminated by the organization during the tax 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? ❑ Yes ❑ No 6 Staff and volunteer hours devoted to monitoring, inspecting,and enforcing conservation easements during the year • 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)? p Yes ❑ No 9 In Part XIV,describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable,the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements. Part Ill 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 sheet works of art,historical treasures,or other similar assets held for public exhibition,education,or research in furtherance of public service,provide, in Part XIV,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 sheet works of art, historical treasures,or other similar assets held for public exhibition,education, or research in furtherance of public service,provide the following amounts relating to these items: (i) Revenues included in Form 990, Part VIII,line 1 • $ (ii)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 the following 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)2011 (HTA) Veterans Outreach, Inc. 22-3272976 Schedule D(Form 990)2011 Page 2 Part III Organizations Maintaining Collections of Art, Historical Treasures,or Other Similar Assets(continued) 3 Using the organization's acquisition, accession,and other records,check any of the following that are a significant use of its collection items(check all that apply): a ❑ Public exhibition d ❑ Loan or exchange programs b ❑ Scholarly research e ❑ 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 XIV. 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 organization's collection'?. . . . ❑ Yes ❑ No Part IV Escrow 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. 1a Is the organization an agent,trustee,custodian or other intermediary for contributions or other assets not included on Form 990, Part X? ❑ Yes ❑ No b If"Yes,"explain the arrangement in Part XIV and complete the following table: - Amount c Beginning balance 1c d Additions during the year 1d e Distributions during the year le f Ending balance If - 2a Did the organization include an amount on Form 990, Part X, line 21? ❑ Yes El No b If"Yes,"explain the arrangement in Part XIV. Part V Endowment Funds. Complete if the organization answered"Yes"to Form 990 Part IV, line 10. (a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back la 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 2 Provide the estimated percentage of the current year end balance(line 1g,column(a))held as: a Board designated or quasi-endowment • 1 b Permanent endowment • c Temporarily restricted endowment • The percentages in lines 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 (i) unrelated organizations 3a(i) (ii) related organizations 3a(i1) b If"Yes"to 3a(ii),are the related organizations listed as required on Schedule R? 3b 4 Describe in Part XIV the intended uses of the organization's endowment funds. Part VI Land,Buildings,and Equipment. See Form 990, Part X, line 10. Description of property (a)Cost or other basis (b)Cost or other (c)Accumulated (d)Book value (investment) basis(other) depreciation 1a Land b Buildings c Leasehold improvements d Equipment e Other - Total.Add lines la through 1e. (Column(d)must equal Form 990, Part X, column(B),line 10(c)) Schedule D(Forth 880)2011 Veterans Outreach, Inc. 22-3272976 Schedule D(Form 990)2011 Page 3 Part VII 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 security) Cost or end-of-year market value (1) Financial derivatives (2) Closely-held equity interests (3) Other IA1 IB1 Ic1 (Dl (E). IF1 (GZ (H1 (I) Total.(Column(b)must equal Form 990,Part X,col.(B)line 12.) • Part VIII Investments—Program Related. See Form 990, Part X, line 13. (a)Description of investment type (b)Book value (c)Method of valuation: Cost or end-of-year market value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total.(Column(b)must equal Form 990,Part X,col.(B)line 13.) • Part I X Other Assets.See 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.) • Part X Other Liabilities.See Form 990, Part X, line 25. 1. (a)Description of liability (b)Book value (1)Federal income taxes (2)A P-Credit card debts used for Outreach 10,000 (3)Line 25-Other liabilities-out reach due in 201 (4) (5) (6) (7) (8) (9) (10) (11) Total.(Column(b)must equal Form 990,Part X,col.(B)line 25) • 10,000 2.FIN 48(ASC 740)Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48(ASC 740). Schedule D(Form 990)2011 Veterans Outreach, Inc. 22-3272976 Schedule D(Form 990)2011 Page 4 Part XI Reconciliation of Change in Net Assets from Form 990 to Audited Financial Statements 1 Total revenue(Form 990, Part VIII,column(A), line 12) 1 1,234,831 2 Total expenses(Form 990, Part IX,column(A), line 25) 2 1,235,548 3 Excess or(deficit)for the year. Subtract line 2 from line 1 3 -717 4 Net unrealized gains(losses)on investments 4 5 Donated services and use of facilities 5 6 Investment expenses 6 7 Prior period adjustments 7 8 Other(Describe in Part XIV.) 8 9 Total adjustments(net).Add lines 4 through 8 9 10 Excess or(deficit)for the year per audited financial statements. Combine lines 3 and 9 10 -717 Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return 1 Total revenue,gains,and other support per audited financial statements 1 2 Amounts included on line 1 but not on Form 990, Part VIII, line 12: a Net unrealized gains on investments 2a b Donated services and use of facilities 2b c Recoveries of prior year grants 2c d Other(Describe in Part XIV.) 2d e Add lines 2a through 2d 3 Subtract line 2e from line 1 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. . . . 4a b Other(Describe in Part XIV.) 4b c Add lines 4a and 4b 4c 5 Total revenue.Add lines 3 and 4c.(This must equal Form 990, Part I,line 12) 5 1,234,831 Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return I Total expenses and losses per audited financial statements 1 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 XIV.) 2d e Add lines 2a through 2d 3 Subtract line 2e from line 1 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. . . . 4a b Other(Describe in Part XIV.) 4b c Add lines 4a and 4b 4c 5 Total expenses.Add lines 3 and 4c. (This must equal Form 990, Part I, line 18) 5 1,235,548 Part XIV Supplemental Information Complete 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, line 8; Part XII, lines 2d and 4b;and Part XIII,lines 2d and 4b.Also complete this part to provide any additional information. Schedule D(Form 990)2011 Veterans Outreach, Inc. 22-3272976 Schedule D(Form 990)2011 Page 5 Part X I V Supplemental Information (continued) Schedule D(Form 990)2011 SCHEDULE G Supplemental Information Regarding OMB No.1545-0047 (Form 990 or 990-EZ) Fundraising or Gaming Activities 20 Complete if the organization answered"Yes"to Form 990,Part IV,lines 17,18,or 19,or lithe Department of the Treasury organization entered more than$15,000 on Form 990-EZ,line 6a. O p<,n Internal Revenue Service •Attach to Form 990 or Form 990-EZ. •See separate instructions. I n s I>e tor, Name of the organization Employer identification number Veterans Outreach, Inc. 22-3272976 Part I 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. 1 Indicate whether the organization raised funds through an of the following activities. Check all that apply. a ❑Mail solicitations e 11 Solicitation of non-government grants b ❑ Internet and email solicitations f ❑Solicitation of government grants c ❑ Phone solicitations g ❑Special fundraising events d ❑ In-person solicitations 2a Did the organization have a written or oral agreement with any individual(including officers,directors,trustees or key employees listed in Form 990, Part VII)or entity in connection with professional fundraising services? ❑Yes ❑No b If"Yes,"list the ten highest paid individuals or entities(fundraisers)pursuant to agreements under which the fundraiser is to be compensated at least$5,000 by the organization. (v)Amount paid to (III)Did fundraiser have (vi)Amount paid to (i)Name and address of individual (Iv)Gross receipts (or retained by) (ii)Activity custody or control of (or retained by) or entity(fundraiser) contributions? from activity fundraiser listed in organization col.(i) Yes No 1 2 3 4 5 6 7 8 9 10 Total • - 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. Paperwork Reduction Act Notice,see the Instructions for Form 990 or 990-EZ. Schedule G(Form 990 or 990-EZ)2011 (HTA) Schedule G(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 2 Part II Fundraising Events. Complete if the organization answered"Yes"to Form 990, Part IV, line 18, or reported more than$15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000. (a)Event#1 (b)Event#2 (c)Other events (d)Total events CD Sales Text (add col.(a)through (event type) (event type) (total number) COL(c)) (1) 3 tg I Gross receipts 1,868 -1,868 tY 2 Less:Charitable contributions 3 Gross income(line 1 minus line 2) 4 Cash prizes 5 Noncash prizes c6 Rent/facility costs. . . . a) a w 7 Food and beverages. . . a� rj 8 Entertainment 9 Other direct expenses. . 10 Direct expense summary.Add lines 4 through 9 in column(d) • 11 Net income summary.Combine line 3,column(d),and line 10 • Part III Gaming.Complete if the organization answered"Yes"to Form 990, Part IV, line 19,or reported more than$15,000 on Form 990-EZ, line 6a. (b)Pull tabs/instant (d)Total gaming(add (a)Bingo bingo/progressive bingo (c)Other gaming col.(a)through col.(c)) m m 1 Gross revenue Q 2 Cash prizes a3 Noncash prizes m4 Rent/facility costs. . . . 0 5 Other direct expenses. Yes El Yes D Yes 6 Volunteer labor No No El No 7 Direct expense summary.Add lines 2 through 5 in column(d) • 8 Net gaming income summary. Combine line 1,column d,and line 7 • 9 Enter the state(s)in which the organization operates gaming activities: a Is the organization licensed to operate gaming activities in each of these states? ❑Yes ❑No b If"No,"explain: 10a Were any of the organization's gaming licenses revoked,suspended or terminated during the tax year'?. . El Yes []No b If"Yes,"explain: Schedule G(Form 990 or 980-EZ)2011 Schedule G(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 3 11 Does the organization operate gaming activities with nonmembers? ❑Yes ❑No 12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to administer charitable gaming? ❑Yes ❑No 13 Indicate the percentage of gaming activity operated in: a The organization's facility 13a b An outside facility 13b 14 Enter the name and address of the person who prepares the organization's gaming/special events books and records: Name • Address • 15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? ❑Yes ❑No b If"Yes,"enter the amount of gaming revenue received by the organization •$ and the amount of gaming revenue retained by the third party • $ c If"Yes,"enter name and address of the third party: Name ■ Address • 16 Gaming manager information: Name ■ Gaming manager compensation ► $ Description of services provided ■ ❑ Director/officer ❑ Employee ❑ Independent contractor 17 Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license? ❑Yes ❑No b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the organization's own exempt activities during the tax year ► $ Part IV Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii)and (v), and Part Ill, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable.Also complete this part to provide any additional information(see instructions). Schedule G(Form 990 or 990-EZ)2011 SCHEDULE L OMB With Interested Persons No.1545-0047 (Porto 990 or 990-EZ) • Complete if the organization answered 20 "Yes"on Form 990,Part IV,line 25a,25b,26,27,28a,28b,or 28c, Department of the Treasury or Form 990-EZ,Part V,line 38a or 40b. o p,n To P: h I , Internal Revenue Service _ ►Attach to Form 990 or Form 990-EZ. •See separate Instructions. Name of the organization Employer Identification number Veterans Outreach, Inc. 22-3272976 Part I Excess Benefit Transactions (section 501(c)(3)and section 501(c)(4)organizations only). Complete if the organization answered"Yes"on Form 990, Part IV, line 25a or 25b,or Form 990-EZ, Part V,line 40b. 1 (a)Name of disqualified person (b)Description of transaction (c)Corrected? Yes No (1) (2) (3) (4) (5) (6) 2 Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958 • $ 3 Enter the amount of tax, if any,on line 2, above, reimbursed by the organization ► $ Part II Loans to and/or From Interested Persons. Complete if the organization answered"Yes"on Form 990, Part IV, line 26,or Form 990-EZ, Part V, line 38a. (a)Name of interested person and purpose (b)Loan to or from (c)Original (d)Balance due (e)In default? (t)Approved (g)Written the organization? principal amount by board or agreement? committee? To From Yes No Yes No Yes No (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) _ Total • $ Part III Grants or Assistance Benefiting Interested Persons. Complete if the organization answered"Yes"on Form 990, Part IV, line 27. (a)Name of interested person (b)Relationship between interested person and the (c)Amount and type of assistance organization (1) (2) (3) (4) (5) - (6) (7) (8) (9) (10) For Paperwork Reduction Act Notice,see the instructions for Form 990 or 990-EZ. Schedule L(Form 990 or 990-EZ)2011 (HTA) • Schedule L(Form 990 or 990-EZ)2011 Veterans Outreach, Inc. 22-3272976 Page 2 Part IV Business Transactions Involving Interested Persons. Complete if the organization answered"Yes"on Form 990, Part IV, line 28a,28b,or 28c. (a)Name of interested person (b)Relationship between (c)Amount of (d)Description of transaction (0)Sharing of interested person and the transaction organizations organization revenues? Yes No (1) (2) (3) (4) (5) (6) (7) (8) (9) 10 Part V Supplemental Information Complete this part to provide additional information for responses to questions on Schedule L(see instructions). Schedule L(Form 990 or 990-EZ)2011 SCHEDULE 0 OMB No.1545-0047 (Form 990 or990-EZ) Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to specific questions on O Form 990 or 990-EZ or to provide any additional information. Open to Public Internal Treasury • Attach to Form 990 or 990-EL Internal Revenue Service Inspection Name of the organization Employer Identification number Veterans Outreach, Inc. 22-3272976 Form 990 Part IX Line 5 the difference of 717 indicates the Veterans Outreach spent 717.00 more than colleacted. Form 990 Part X Line 25 Verterans Outreach reduced is outstandinadebts For Paperwork Reduction Act Notice,see the Instructions for Form 990 or 990-EZ. Schedule 0(Form 990 or 990-EZ)(2011) (HTA) 1 • u. Schedule 0(Form 990 or 990-EZ)(2011) Page 2 Name of the organization Employer identification number Veterans Outreach, Inc. 22-3272976 Schedule 0(Form 990 or 990-EZ)(2011) 2013 FOREIGN NON PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# F03000003498 Jan 18, 2013 Entity Name: VETERANS' OUTREACH, INC. Secretary of State Current Principal Place of Business: 1933A WHITFIELD PARK LOOP SARASOTA, FL 34243 Current Mailing Address: 524 YOUNGSTOWN POLAND ROAD STRUTHERS, OH 44471 US FEI Number: 22-3272976 Certificate of Status Desired: No Name and Address of Current Registered Agent: GRAHAM,ROBERT 6402 42ND ST.E SARASOTA,FL 34243 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida. SIGNATURE: ROBERT GRAHAM 01/18/2013 Electronic Signature of Registered Agent Date Officer/Director Detail : Title CP Title VVT Name ELY,JOHN Name JULIAN, ROBERT Address 205 RED ROSE STREET Address 4501 PEOPLES ROAD City-State-Zip: BUTLER PA 16001 City-State-Zip: PITTSBURGH PA 15237 Title SD Name PRICE,THOMAS Address 444 VALLEY VIEW DRIVE City-State-Zip: MONROEVILLE PA 15146 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:ROBERT JULIAN VP/TREASURER 01/18/2013 Electronic Signature of Signing Officer/Director Date Gift Giver's Guide Page 1 of 1 F(cr, s. C fe c G GSJV [ RS ' GUID[' ' 1 E,k fr,e,e,ki L e gal t ''e r r°l C?,k-1 `(t t 5 to tot rp e!- Veterans'Outreach, Bonita Springs, FL Registration Number:CH15902 Expiration Date : 7/23/2013 Revenue Source :08- IRS 990 w/Sch.A (12/31/2011) Total Revenue : $1,234,831.00 Program Services Expenses : $1,069,626.00 87% Total Expenses : $1,235,548.00 Administrative Expenses : $165,922.00 13% Surplus/Deficit : -$717.00 Fundraising Expenses : $.00 0% https://csapp.800helpfla.com/cspublicapp/giftgiversquery/giftgiversquery.aspx 2/21/2013 www.sunbiz.org - Department of State Page 1 of 2 FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS &aw Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return To U.S Entity Name Search No Events No Name History I Submit I Detail by Entity Name Foreign Non Profit Corporation VETERANS'OUTREACH, INC. This detail screen does not contain information about the 2013 Annual Report. Click the 'Search Now' button to determine if the 2013 Annual Report has been filed. I Search Now I Filing Information Document Number F03000003498 FEI/EIN Number 223272976 Date Filed 07/11/2003 State VA Status ACTIVE Principal Address 27725 OLD 41 RD STE 103 BONITA SPRINGS FL 34135 Changed 04/28/2008 Mailing Address 524 YOUNGSTOWN POLAND ROAD STRUTHERS OH 44471 Registered Agent Name & Address COLEMAN, BRAD 8701 ESTERO BLVD. #1001 FT. MYERS BEACH FL 33931 US Name Changed: 02/23/2011 Address Changed:02/23/2011 Officer/Director Detail Name&Address Title CP ELY, JOHN 205 RED ROSE STREET BUTLER PA 16001 Title VVT JULIAN, ROBERT http://www.sunbiz.org/scripts/cordet.exe?action—DETFII,&incLdoc number=F030000034... 2/21/2013 www.sunbiz.org - Department of State Page 2 of 2 4501 PEOPLES ROAD PITTSBURGH PA 15237 Title SD PRICE,THOMAS 444 VALLEY VIEW DRIVE MONROEVILLE PA 15146 Annual Reports Report Year Filed Date 2010 02/15/2010 2011 02/23/2011 2012 01/13/2012 Document Images 01/13/2012 --ANNUAL REPORT I View image in PDF format 02/23/2011 —ANNUAL REPORT I View image in PDF format 02/15/2010--ANNUAL. REPORT I View image in PDF format 04/10/2009--ANNUALREPOR 1::I View image in PDF format 04/28/2008--ANNUAL RE PORT View image in PDF format 05/09/2007--ANNUAL REIPOR-r I View image in PDF format 02/03/2006 ANNUAL REPU ' View image in PDF format 04/25/2005 .-.-ANNUAL., REPORT I View image in PDF format 03/29/2004--ANNUAL I EFOR.fi View image in PDF format 07/11/2003--Foreign Non-Profit I View image in PDF format Note:This is not official record.See documents if question or conflict. Previous on List Next on List ketum ,0 LOT Entity Name Search No Events No Name History I Submit http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&ingdoc_number=F030000034... 2/21/2013