Short Form Return of Organization Exempt From Income Tax

Transcription

1 Form 990-EZ Short Form Return of Organization Exempt From Income Tax Under section 501 (c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) OMB No r*p LL Department of the Treasury Internal Revenue Service Do not enter Social Security numers on this form as it may e made pulic. Information aout Form 990-EZ and its instructions is at Inspection A For the 2013 calendar year, or tax year eginning January 1, 2013, and ending Decemer 31, B Check if applicale C Name of organization D Employer identification numer q Address change Gonstead Clinical Studies Society, Inc q Name change Numer and street (or P 0 ox, if mail is not delivered to street address) Room /suite E Telephone numer q Initial return th Avenue Ste q Terminated City or town, state or province, country, and ZIP or foreign postal code F Group Exemption q Amended return Application pending Santa Cruz CA Numer G Accounting Method : q Cash q Accrual Other (specify) H Check q if the organization is not I Wesite : required to attach Schedule B J Tax -exempt status (check only one) (c)(21) q 501 (c) ( ) 4 (insert no. ) q 4947 (a)( 1 ) or 0527 (Form 990, 990-EZ, or 990-PF). K Form of organization : q Corporation q Trust q Association q Other L Add lines 5, 6c, and 7, to line 9 to determine gross receipts. If gross receipts are $200, 000 or more, or if total assets (Part II, column (B) elow ) are $500,000 or more, file Form 990 instead of Form 990-EZ $ Ealy Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Char. k if the nrnani7atinn used Schedule () to respond to any auestinn in this Part I I71 1 Contriutions, gifts, grants, and similar amounts received ,367 2 Program service revenue including government fees and contracts Memership dues and assessments ,857 4 Investment income a Gross amount from sale of assets other than inventory.... 5a -0- Less : cost or other asis and sales expenses c Gain or ( loss) from sale of assets other than inventory (Sutract line 5 from line 5a).... 5c -0-6 Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than $15,000 ) a -0- Gross income from fundraising events (not including $ - 0- of contriutions from fundraising events reported on line 1 ) (attach Schedule G if the sum of such gross income and contriutions exceeds $ 15,000) c Less : direct expenses from gaming and fundraising events... 6c -0- d Net income or (loss ) from gaming and fundraising events (add lines 6a and 6 and sutract line 6c ) d -0-7a Gross sales of inventory, less returns and allowances a -0- Less : cost of goods sold c Gross profit or (loss) from sales of inventory (Sutract line 7 from line 7a) c -0-8 Other revenue (descrie in Schedule 0 ) Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and , Grants and similar amounts paid ( list in Schedule 0). 10\jE Benefits paid to or for memers ^^^ Salaries, other compensation, and employee enefits p Professional fees and other payments to independent con W ors rc J) , Occupancy, rent, utilities, and maintenance , Printing, pulications, postage, and shipping. 15 3, Other expenses (descrie in Schedule 0) , Total expenses. Add lines 10 throug h ,677 y 18 Excess or (deficit ) for the year (Sutract line 17 from line 9) , Net assets or fund alances at eginning of year (from line 27, column (A)) (must agree with end-of-year figure reported on prior year ' s return) , Other changes in net assets or fund alances (explain in Schedule 0) Z 21 Net assets or fund alances at end of year. Comine lines 18 throug h For Paperwork Reduction Act Notice, see the separate instructions. Cat No Form 88U-tL (2013) \\ U

2 Form 990 -EZ (2013) Page 2 IUCM Balance Sheets (see the instructions for Part II) Check if the organization used Schedule 0 to respond to any question in this Part II.. q (A) Beginning of year (B) End of year 22 Cash, savings, and investments , , Land and uildings o Other assets (descrie in Schedule 0) o Total assets , , Total liailities (descrie in Schedule 0 ) Net assets or fund alances (line 27 of column ( B) must ag ree with line 21 ) 81, ,233 Statement of Program Service Accomplishments (see the instructions for Part III) Expenses Check if the organization used Schedule 0 to respond to any question in this Part III - q (Required for section What is the organization's primary exempt purpose? Chiropractic Research and Education 501(c)(3) and 501(c)(4) organizations and section Descrie the organization's program service accomplishments for each of its three largest program services, 4947(a)(1) trusts; optional as measured y expenses. In a clear and concise manner, descrie the services provided, the numer of for others.) persons enefited, and other relevant information for each program title. 28 Pulished & presented " History or Science. The Controversy over Chiropractic - Spinograohy" in Chiropractic History Journal and at Assoc. for History of Chiropractic in Greeley, CO & the_ Annual semianr of the Grant_ Adams-Chiro.-Societ-y, Moses Lake, WA:_also presented tofaculty at Palmer Chiro_Colleoe_ DavenpoL IA (Grants $ -0-) If this amount includes foreign grants, check here. q 28a 16, Article on x-raypro1ection errors relating to retrolisthesis continues Chir to - e - presented : rejected y Canadian Chic Assoc. Re-writes were unsuccessful. Now in process at the Journal of Chiropractic Medicine Grants $ -0-) If this amount includes forei g n grants, check here. q 29a 16, Meeting of the Minds Annual Research Conference held in Daveport, Iowa Gonstead Extravaganza Gonstead Technique Seminar held in Mt. Hore, WI pulications of The Scope and 4 pulications of "The G Note " plus one Memership-Directorypulished (Grants $ -o-) If this amount includes foreign grants, check here. q 30a 13, Other program services (descrie in Schedule 0) (Grants $ -0-) If this amount includes forei gn g rants, check here. q 31a Total program service expenses (add lines 28a through 31 a) , 734 IMM List of Officers. Directors. Trustees. and Kev Emolovees (list each one even if not compensated-see the instructions for Part IV) Check if the organization used Schedule 0 to respond to an question in this Part IV. q () Average (c) Reportale (d) Health enefits, (a) Name and title hos per week devoted to position compensation contriutions to employee (e) Estimated amount of (Forms W- 2/1099 -MISC) enefit plans, and other compensation (d not paid, enter -0 -) deferred compensation Jeanne Taylor, Roger Coleman, DC Director of Research , C ---- Executi e -- irector , Michele Hohmann, Exeuctive Secretary 35 19, Steven T Tanaka,- DC Director of Pulications , Patrick Ryan, DC President Rocco Perugini, DC V. P Perrx Chinn,_ DC Sec 'UTreas Peter DeLoe, DC Past President _yaia_ De_v_er,_DC Michael Tomasello, DC Dennis O'Hara, DC David Gea ry, DC Randall Johnson, DC Trac Gaert, DC William Pollock, - DC Roger Heschong, DC Steven Rindal, DC Da I Chapman, DC Gerttan Van_ Koert, - DC Form 990-EZ (2013)

3 Form 990-EZ (2013) Page 3 Other Information (Note the Schedule A and personal enefit contract statement requirements in the instructions for Part V) Check if the organization used Schedule 0 to respond to any Question in this Part V q Yes No 33 Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule 0 (see instructions) a 36 c 37a 38a 39 a 40a c d e 41 42a 43 c 44a c d 45a 45 Did the organization have unrelated usiness gross income of $1,000 or more during the year from usiness activities (such as those reported on lines 2, 6a, and 7a, among others)? a If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule Was the organization a section 501 (c)(4), 501 (c)(5), or 501 (c)(6) organization suject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III c Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicale parts of Schedule N Enter amount of political expenditures, direct or indirect, as descried in the instructions 37a -0- Did the organization file Form 1120-POL for this year? Did the organization orrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered y this return?. 3 If "Yes," complete Schedule L, Part II and enter the total amount involved Section 501(c)(7) organizations. Enter: Initiation fees and capital contriutions included on line a.0- Gross receipts, included on line 9, for pulic use of clu facilities Section 501 (c)(3) organizations. Enter amount of tax imposed on the organization during the year under: section ; section ; section Section 501 (c)(3) and 501 (c)(4) organizations. Did the organization engage in any section 4958 excess enefit transaction during the year, or did it engage in an excess enefit transaction in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimursed y the organization All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transaction? If "Yes," complete Form 8886-T e List the states with which a copy of this return is filed CA, WI The organization's ooks are in care of Jeanne Taylor, DC Telephone no Located at th Ave., Ste. 101, Santa Cruz, CA ZIP At any time during -----the calendar year, did the organization have an interest in or a signature or other authority over Yes No a financial account in a foreign country (such as a ank account, securities account, or other financial account)? 42 If "Yes," enter the name of the foreign country: See the instructions for exceptions and filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. At any time during the calendar year, did the organization maintain an office outside the U.S.? c 3 If "Yes," enter the name of the foreign country: Section 4947(a)(1) nonexempt charitale trusts filing Form 990-EZ in lieu of Form Check here... q and enter the amount of tax-exempt interest received or accrued during the tax year Yes No Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must e completed instead of Form EZ a 3 Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must e completed instead of Form 990-EZ Did the organization receive any payments for indoor tanning services during the year? If "Yes" to line 44c, has the organization filed a Form 720 to report these payments? If "No," provide an explanation in Schedule c 3 Did the organization have a controlled entity within the meaning of section 512()(13) Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512 ()(13)? If "Yes," Form 990 and Schedule R may need to e completed instead of Form 990-EZ (see instructions ) Form 990-EZ (2013) 44d

4 Form 990 -EZ (2013) Page 4 'I No 46 Did the organization engage, directly or indirectly, in political campaign activities on ehalf of or in opposition ' to candidates for pulic office? If "Yes," complete Schedule C, Part I q6 3 GCMW Section 501 (c)(3) organizations only All section 501 (c)(3) organizations must answer questions and 52, and complete the tales for lines 50 and 51. Check if the organization used Schedule 0 to respond to an y q uestion in this Part VI. q Yes No 47 Did the organization engage in loying activities or have a section 501(h) election in effect dunng the tax year? If "Yes," complete Schedule C, Part II Is the organization a school as descried in section 170 ()(1)(A)(ii)? If "Yes," complete Schedule E a Did the organization make any transfers to an exempt non-charitale related organization? a 3 If "Yes," was the related organization a section 527 organization? Complete this tale for the organization ' s five highest compensated employees (other than officers, directors, trustees and key employees ) who each received more than $ 100,000 of compensation from the organization. If there is none, enter "None." (a) Name and title of each employee NONE () Average hours per week devoted to position (c) Reportale compensation (Forms W-2/1099-MISc) (d) Health enefits, contriutions to employee enefit plans, and deferred compensation (e) Estimated amount of other compensation f Total numer of other employees paid over $100, Complete this tale for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None." (a) Name and usiness address of each independent contractor I () Type of service I (c) Compensation NONE d Total numer of other independent contractors each 52 Did the organization complete Schedule A? Note. All nonexempt charitale trusts must attach a completes Under penalties of penury, I declare that I have examined this return, including accorr true, correct, and complete Decl Lion of preparer (other than officer) is ased on all Sign Sig ture of officer Here Paid Preparer Use Only t Patrick Ryan, DC President Type or print name and title Pnnt/Type preparer's name Firm's name Preparer's signature Firm's address May the IRS discuss this return with the preparer shown aove? Si

5 SCHEDULE A (Form 990 or 990-EZ) Pulic Charity Status and Pulic Support Complete if the organization is a section 501 (c )(3) organization or a section 4947(a)(1) nonexempt charitale trust. OMB No Department of the Treasury Do- Attach to Form 990 or Form 990-FZ. " Internal Revenue Service Information aout Schedule A (Form 990 or 990-EZ) and Its instructions is at Name of the organization Employer identification numer Reason for Pulic Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation ecause it is: (For lines 1 through 11, check only one ox.) 1 q A church, convention of churches, or association of churches descried in section 170 ()(1)(A)(). 2 q A school descried in section 170 ()(1)(A)(i). (Attach Schedule E.) 3 q A hospital or a cooperative hospital service organization descried in section 170()(1)(A)(iii). 4 q A medical research organization operated in conjunction with a hospital descried in section 170 ()(1)(A)(iii). Enter the hospital's name, city, and state: own------ed --- or------operated E] An organization operated for the acoll ege----- g----ōv---ernm ent-al-----un- ȳ ā it --- enefit of or univers---i--ty ---o- de--s---c---ried insection 170()(1)(A)(v). (Complete Part II.) 6 q A federal, state, or local government or governmental unit descried in section 170 ()(1)(A)(v). 7 q An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic descried in section 170( )(1)(A)(vi). (Complete Part II.) 8 q A community trust descried In section 170 ()(1)(A)(vi). (Complete Part II.) 9 q An organization that normally receives: (1) more than 33'/3% of its support from contriutions, memership fees, and gross receipts from activities related to its exempt functions-suject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated usiness taxale income (less section 511 tax) from usinesses acquired y the organization after June 30, See section 509(a )(2). (Complete Part III.) 10 q An organization organized and operated exclusively to test for pulic safety. See section 509(a)(4). 11 q An organization organized and operated exclusively for the enefit of, to perform the functions of, or to carry out the purposes of one or more pulicly supported organizations descried in section 509(a)(1) or section 509(a)(2). See section 509(a )(3). Check the ox that descries the type of supporting organization and complete lines 11 a through 11 h. (A) (B) (C) (D) (E) a q Type I q Type II c q Type III-Functionally integrated d q Type III-Non-functionally integrated e q By checking this ox, I certify that the organization is not controlled directly or indirectly y one or more disqualified persons other than foundation managers and other than one or more pulicly supported organizations descried 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 ox q Since August 17, 2006, has the organization accepted any gift or contriution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons descried in (ii) and Yes No (iii) elow, the governing ody of the supported organization? (1) (ii) A family memer of a person descried in (I) aove? itg(i) (iii) A 35% controlled entity of a person descried in (I) or (II) aove? lgfii) Provide the following information aout the supported organization(s). () Name of supported organization (ii) EIN (ii) Type of organization (descned on lines 1-9 aove or IRC section (see instructions)) (rv) Is the organization in col (1) listed in your governing document? (v) Did you notify the organization in col () of your support? (vi) Is the organization in col (1) organized in the US? Yes No Yes No Yes No (vi) Amount of monetary support Total For Paperwork Reduction Act Notice, see the Instructions for Cat No 11285F Schedule A (Form 990 or 990 -EZ 2013 Form 990 or 990-E1.

6 Schedule A (Form 990 or 990-Q ) 2013 Page 2 jjm Support Schedule for Organizations Descried in Sections 170()( 1)(A)(iv) and 170()(1)(A)(vi) (Complete only if you checked the ox 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 elow, please complete Part III.) Section A. Pulic Support Calendar year (or fiscal year eginning in ) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total 1 Gifts, grants, contriutions, and memership fees received. (Do not include any 'unusual grants.")... 2 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf... 3 The value of services or facilities furnished y a governmental unit to the organization without charge Total. Add lines 1 through The portion of total contriutions y each person (other than a governmental unit or pulicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. 6 Pulic support. Sutract line 5 from line 4. Section B. Total Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total 7 Amounts from line Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources Net income from unrelated usiness activities, whether or not the usiness is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) Total support. Add lines 7 through Gross receipts from related activities, etc. (see instructions) 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 ox and stop here D Section C. Computation of Pulic Support Percentage 14 Pulic support percentage for 2013 (line 6, column (f) divided y line 11, column (f)) % - 15 Pulic support percentage from 2012 Schedule A, Part II, line % 16a 33 1,3% support test If the organization did not check the ox on line 13, and line 14 is 331,3% or more, check this ox and stop here. The organization qualifies as a pulicly supported organization El 33',3% support test If the organization did not check a ox on line 13 or 16a, and line 15 is 331,3% or more, check this ox and stop here. The organization qualifies as a pulicly supported organization D 17a 10%-facts -and-circumstances test If the organization did not check a ox on line 13, 16a, or 16, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a pulicly supported organization %-facts -and-circumstances test If the organization did not check a ox on line 13, 16a, 16, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a pulicly supported organization El 18 Private foundation. If the organization did not check a ox on line 13, 16a, 16, 17a, or 17, check this ox and see instructions q Schedule A (Form 990 or 990-EA 2013

7 Schedule A (Form 990 or 990-EZ) 2013 Page 3 Support Schedule for Organizations Descried in Section 509(a)(2) (Complete only if you checked the ox 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 elow, please complete Part II.) Section A. Pulic Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 Total I Gifts, grants, contriutions, and memership fees received. (Do not include any "unusual grants.") 97, , , , , ,423 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 Gross receipts from activities that are not an unrelated trade or usiness under section Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf o The value of services or facilities furnished y a governmental unit to the organization without charge o Total. Add lines 1 through , , , , , ,423 7a Amounts included on lines 1, 2, and 3 received from disqualified persons 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 97, ,481 99, , , ,423 c Add lines 7a and Pulic support (Sutract line 7c from line 6.) ,423 Section B. Total Support Calendar year (or fiscal year eginning in) (a) 2009 () 2010 (c) 2011 (d) 2012 (e) 2013 (t) Total 9 Amounts from line , , , , , ,423 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources Unrelated usiness taxale income (less section 511 taxes) from usinesses acquired after June 30, c Add lines 10a and Net income from unrelated usiness activities not included in line 1 O, whether or not the usiness is regularly carried on Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) I Total support. (Add lines 9, 10c, 11, and 12.) , , , , , , 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 ox and stop here Section C. Computation of Pulic Support Percentage 15 Pulic support percentage for 2013 (line 8, column (f) divided y line 13, column (f)) % 16 Pulic support percentage from 2012 Schedule A, Part III, line % Section D. Computation of Investment Income Percentage 17 Investment income percentage for 2013 (line 10c, column (f) divided y line 13, column (f)) 17 0% 18 Investment income percentage from 2012 Schedule A, Part III, line % 19a 331x,% support tests If the organization did not check the ox on line 14, and line 15 is more than 331,3%, and line 17 is not more than 331,3%, check this ox and stop here. The organization qualifies as a pulicly supported organization. 331,3% support tests If the organization did not check a ox on line 14 or line 19a, and line 16 is more than 331,3%, and line 18 is not more than 331,3%, check this ox and stop here. The organization qualifies as a pulicly supported organization 20 Private foundation. If the organization did not check a ox on line 14, 19a, or 19, check this ox and see instructions Schedule A (Form 990 or 990-EZ) 2013

8 Schedule A (Form 990 or 990-EZ ) 2013 Page 4 Supplemental Information. Provide the explanations required y Part II, line 10; Part II, line 17a or 17; and Part III, line 12. Also complete this part for any additional information. (See instructions). Schedule A (Form 990 or 990-EZ) 2013

9 SCHEDULE 0 (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Service Name of the organization Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-FZ. Information aout Schedule 0 (Form 990 or 990-EZ) and its instructions is at OMB No Employer identification numer Banking $2.204 Continuin Education 1,430 Entertainment 2, Gifts for Speakers Memerships Office Supplies - 2, Reimursements Taxes 92 Travel 1, TOTAL $10,789 For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Cat. No 51056K Schedule 0 (Form 990 or 990-EZ) (2013)