8868 Application for Extension of Time To File an Exempt Organization Return
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- Darrell Terry
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2 Form 8868 Appliation for Extension of Time To File an Exempt Organization Return (Rev. January 01) OMB Department of the Treasury Internal Revenue Servie File a separate appliation for eah return. If you are filing for an Automati -Month Extension, omplete only Part I and hek this ox ~~~~~~~~~~~~~~~~~~~ If you are filing for an Additional (t Automati) -Month Extension, omplete only Part II (on page of this form). Do not omplete Part II unless you have already een granted an automati -month extension on a previously filed Form Eletroni filing (e-file). You an eletronially file Form 8868 if you need a -month automati extension of time to file (6 months for a orporation required to file Form 990-T), or an additional (not automati) -month extension of time. You an eletronially file Form 8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exeption of Form 8870, Information Return for Transfers Assoiated With Certain Personal Benefit Contrats, whih must e sent to the IRS in paper format (see instrutions). For more details on the eletroni filing of this form, visit and lik on e-file for Charities & nprofits. Part I Automati -Month Extension of Time. Only sumit original (no opies needed). A orporation required to file Form 990-T and requesting an automati 6-month extension - hek this ox and omplete Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All other orporations (inluding 110-C filers), partnerships, REMICs, and trusts must use Form 700 to request an extension of time to file inome tax returns. Type or print File y the due date for filing your return. See instrutions. Name of exempt organization or other filer, see instrutions. Employer identifiation numer (EIN) or HELP HOSPITALIZED VETERANS, INC Numer, street, and room or suite no. If a P.O. ox, see instrutions. Soial seurity numer (SSN) 6585 PENFIELD LANE City, town or post offie, state, and ZIP ode. For a foreign address, see instrutions. WINCHESTER, CA 9596 Enter the Return ode for the return that this appliation is for (file a separate appliation for eah return) ~~~~~~~~~~~~~~~~~ 0 1 Appliation Is For Form 990 or Form 990-EZ Form 990-BL Form 70 (individual) Form 990-PF Form 990-T (se. 01(a) or 08(a) trust) 1 Return Code Appliation Form 990-T (trust other than aove) 06 Form 8870 HELP HOSPITALIZED VETERANS, INC. The ooks are in the are of 6585 PENFIELD LANE - WINCHESTER, CA 9596 Telephone FA. Is For Return Code Form 990-T (orporation) 07 Form 101-A Form 70 Form 57 Form 6069 If the organization does not have an offie or plae of usiness in the United States, hek this ox~~~~~~~~~~~~~~~~~ If this is for a Group Return, enter the organization s four digit Group Exemption Numer (GEN). If this is for the whole group, hek this ox. If it is for part of the group, hek this ox and attah a list with the names and EINs of all memers the extension is for. I request an automati -month (6 months for a orporation required to file Form 990-T) extension of time until MARCH 15, 01, to file the exempt organization return for the organization named aove. The extension is for the organization s return for: alendar year or tax year eginning AUG 1, 01, and ending JUL 1, If the tax year entered in line 1 is for less than 1 months, hek reason: Initial return Final return Change in aounting period a If this appliation is for Form 990-BL, 990-PF, 990-T, 70, or 6069, enter the tentative tax, less any nonrefundale redits. See instrutions. If this appliation is for Form 990-PF, 990-T, 70, or 6069, enter any refundale redits and estimated tax payments made. Inlude any prior year overpayment allowed as a redit. Balane due. Sutrat line from line a. Inlude your payment with this form, if required, y using EFTPS (Eletroni Federal Tax Payment System). See instrutions. Caution. If you are going to make an eletroni fund withdrawal with this Form 8868, see Form 85-EO and Form 8879-EO for payment instrutions. LHA For Privay At and Paperwork Redution At tie, see instrutions. Form 8868 (Rev. 1-01) 51 a $ $ $
3 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Part III Statement of Program Servie Aomplishments 1 a Chek if Shedule O ontains a response to any question in this Part III Briefly desrie the organization s mission: HELP HOSPITALIZED VETERANS (HHV) PRIMARY MISSION IS TO PROVIDE ARMED SERVICE AND MILITARY VETERAN PATIENTS RECEIVING CARE AT US FEDERAL, STATE, AND COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES WITH THERAPEUTIC ARTS AND CRAFTS KITS. Did the organization undertake any signifiant program servies during the year whih were not listed on the prior Form 990 or 990-EZ? If "Yes," desrie these new servies on Shedule O. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ease onduting, or make signifiant hanges in how it onduts, any program servies? ~~~~~~ If "Yes," desrie these hanges on Shedule O. Desrie the organization s program servie aomplishments for eah of its three largest program servies, as measured y expenses. Setion 501()() and 501()() organizations are required to report the amount of grants and alloations to others, the total expenses, and Yes Yes Page revenue, if any, for eah program servie reported. ( Code: ) ( Expenses $,8,19. inluding grants of $,6,9. ) ( Revenue $ ) THERAPEUTIC MATERIALS THAT INCLUDED 655,80 ARTS AND CRAFTS KITS THAT WERE DELIVERED FREE OF CHARGE IN 90 SHIPMENTS TO 98 VA MEDICAL FACILITIES; 0 MILITARY MEDICAL FACILITIES; 6 STATE VETERANS HOMES; COMMUNITY BASED CRAFTS LOCATIONS AND 10 VETERAN PROGRAMS. THIS NUMBER INCLUDES 7 CRAFT KITS WITH A RETAIL VALUE OF $1,17 TO THE MIDDLE EAST, 19 CRAFT KITS WITH A RETAIL VALUE OF $5,00 TO KOREA, CRAFT KITS WITH A RETAIL VALUE OF $51 TO GERMANY, AND 0 CRAFT KITS WITH A RETAIL VALUE OF $1 TO JAPAN. ADDITIONALLY, 0,89 ARTS AND CRAFTS KITS AND 16 COMPUTER SYSTEMS WERE SHIPPED TO THE INDIVIDUAL HOMES OF 15,00 VETERANS RECEIVING MEDICAL CARE FOR A TOTAL RETAIL VALUE OF $,90,18. SINCE INCEPTION TO JULY 1, 01, HHV HAS MADE 818,17 SHIPMENTS TO VA HOSPITALS, MILITARY HOSPITALS, STATE VETERANS NURSING ( Code: ) ( Expenses $,811,750. inluding grants of $ 11,97. ) ( Revenue $ ) VETERANS AWARENESS WHICH IS PRIMARILY ACCOMPLISHED BY INFORMING MILLIONS OF THE GENERAL PUBLIC ABOUT THE NEEDS OF AUGMENTED SERVICES FOR HOSPITALIZED VETERANS BY MAILING 1,07,71 LETTERS TO THOSE THAT PREVIOUSLY FINANCIALLY SUPPORTED THE ORGANIZATION AND MAILING 1,0,01 OF THREE ISSUES OF HHV S NEWSLETTER, THE "BUGLE CALL". ADDITIONALLY, 16,095,8 LETTERS WERE MAILED AND 1,90 S WERE SENT TO VARIOUS AMERICANS EDUCATING AND INFORMING THEM ABOUT VETERANS AND ACTIVE DUTY GI S THAT ARE HOSPITALIZED. THIS OUTREACH TO THE AMERICAN PUBLIC INCLUDES A CALL TO ACTION TO THE PUBLIC WHO HAS AN INTEREST AND OR THE ABILITY TO ACT TO ASSIST HHV IN REACHING ITS PROGRAM MISSION AND GOALS, AND AT THE SAME TIME TO INCLUDE A SUPPORT OF THE PROGRAMS AND SERVICES HHV PROVIDES. THE MAILINGS PROVIDE INFORMATION ON VARIOUS WAYS TO ( Code: ) ( Expenses $ 1,9,0. inluding grants of $ ) ( Revenue $ ) CRAFT CARE SPECIALISTS (CCS) ARE EMPLOYEES OF THE ORGANIZATION THAT ARE ASSIGNED TO 1 COMMUNITY BASED CRAFTS CLINICS, MILITARY HOSPITALS AS WELL AS 1 STATE VETERANS HOMES TO ASSIST STAFF IN CREATIVE ARTS COUNSELING AND CRAFT KIT DISTRIBUTION SERVICES. CCS S ARE PROVIDED AT NO CHARGE TO THE MEDICAL FACILITY AND WORK HAND IN HAND WITH THE MEDICAL FACILITIES IN CRAFT KIT THERAPY, PATIENT ASSISTANCE AND IN VOLUNTEER RECRUITMENT. CCS S HELP TO RECRUIT VOLUNTEERS FOR VA S WITH 9 REGULARLY SCHEDULED VOLUNTEERS THAT HAVE GIVEN 7,769 HOURS OF VOLUNTEER SERVICE THIS YEAR WITH AN ESTIMATED VALUE IN ECESS OF $1.6 MILLION. THROUGH THE VOLUNTEER RECRUITMENT PROGRAM, THE CCS S HAVE BEEN INSTRUMENTAL IN ASSISTING VA IN RECRUITMENT OF VOLUNTEERS. d Other program servies (Desrie in Shedule O.) ( Expenses $ inluding grants of $ ) ( Revenue $ ) e Total program servie expenses J 11,569,11. Form 990 (01) SEE SCHEDULE O FOR CONTINUATION(S)
4 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Part IV Cheklist of Required Shedules a a d e f 0a Is the organization desried in setion 501()() or 97(a)(1) (other than a private foundation)? If "Yes," omplete Shedule A~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization required to omplete Shedule B, Shedule of Contriutors? ~~~~~~~~~~~~~~~~~~~~~~ Did the organization engage in diret or indiret politial ampaign ativities on ehalf of or in opposition to andidates for puli offie? If "Yes," omplete Shedule C, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Setion 501()() organizations. Did the organization engage in loying ativities, or have a setion 501(h) eletion in effet during the tax year? If "Yes," omplete Shedule C, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization a setion 501()(), 501()(5), or 501()(6) organization that reeives memership dues, assessments, or similar amounts as defined in Revenue Proedure 98-19? If "Yes," omplete Shedule C, Part III ~~~~~~~~~~~~~~ Did the organization maintain any donor advised funds or any similar funds or aounts for whih donors have the right to provide advie on the distriution or investment of amounts in suh funds or aounts? If "Yes," omplete Shedule D, Part I Did the organization reeive or hold a onservation easement, inluding easements to preserve open spae, the environment, histori land areas, or histori strutures? If "Yes," omplete Shedule D, Part II~~~~~~~~~~~~~~ Did the organization maintain olletions of works of art, historial treasures, or other similar assets? If "Yes," omplete Shedule D, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount in Part, line 1, for esrow or ustodial aount liaility; serve as a ustodian for amounts not listed in Part ; or provide redit ounseling, det management, redit repair, or det negotiation servies? If "Yes," omplete Shedule D, Part IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization, diretly or through a related organization, hold assets in temporarily restrited endowments, permanent endowments, or quasi-endowments? If "Yes," omplete Shedule D, Part V ~~~~~~~~~~~~~~~~~~~~~~~~ If the organization s answer to any of the following questions is "Yes," then omplete Shedule D, Parts VI, VII, VIII, I, or as appliale. Did the organization report an amount for land, uildings, and equipment in Part, line 10? If "Yes," omplete Shedule D, Part VI ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for investments - other seurities in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "Yes," omplete Shedule D, Part VII ~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for investments - program related in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "Yes," omplete Shedule D, Part VIII ~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for other assets in Part, line 15 that is 5% or more of its total assets reported in Part, line 16? If "Yes," omplete Shedule D, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for other liailities in Part, line 5? If "Yes," omplete Shedule D, Part ~~~~~~ Did the organization s separate or onsolidated finanial statements for the tax year inlude a footnote that addresses the organization s liaility for unertain tax positions under FIN 8 (ASC 70)? If "Yes," omplete Shedule D, Part ~~~~ Did the organization otain separate, independent audited finanial statements for the tax year? If "Yes," omplete Shedule D, Parts I and II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization inluded in onsolidated, independent audited finanial statements for the tax year? If "Yes," and if the organization answered "" to line 1a, then ompleting Shedule D, Parts I and II is optional ~~~~~ Is the organization a shool desried in setion 170()(1)(A)(ii)? If "Yes," omplete Shedule E ~~~~~~~~~~~~~~ 1a Did the organization maintain an offie, employees, or agents outside of the United States? ~~~~~~~~~~~~~~~~ Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, usiness, investment, and program servie ativities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," omplete Shedule F, Parts I and IV ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report on Part I, olumn (A), line, more than $5,000 of grants or assistane to any organization or entity loated outside the United States? If "Yes," omplete Shedule F, Parts II and IV ~~~~~~~~~~~~~~~~~ Did the organization report on Part I, olumn (A), line, more than $5,000 of aggregate grants or assistane to individuals loated outside the United States? If "Yes," omplete Shedule F, Parts III and IV ~~~~~~~~~~~~~~~~~~~~~ Did the organization report a total of more than $15,000 of expenses for professional fundraising servies on Part I, olumn (A), lines 6 and 11e? If "Yes," omplete Shedule G, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,000 total of fundraising event gross inome and ontriutions on Part VIII, lines 1 and 8a? If "Yes," omplete Shedule G, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,000 of gross inome from gaming ativities on Part VIII, line 9a? If "Yes," omplete Shedule G, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization operate one or more hospital failities? If "Yes," omplete Shedule H ~~~~~~~~~~~~~~~~ If "Yes" to line 0a, did the organization attah a opy of its audited finanial statements to this return? a d 11e 11f 1a 1 1 1a a Yes Page 0 Form 990 (01)
5 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Part IV Cheklist of Required Shedules (ontinued) 1 a d 5a Setion 501()() and 501()() organizations. Did the organization engage in an exess enefit transation with a disqualified person during the year? If "Yes," omplete Shedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~ a Did the organization report more than $5,000 of grants and other assistane to any government or organization in the United States on Part I, olumn (A), line 1? If "Yes," omplete Shedule I, Parts I and II ~~~~~~~~~~~~~~~~~~ Did the organization report more than $5,000 of grants and other assistane to individuals in the United States on Part I, olumn (A), line? If "Yes," omplete Shedule I, Parts I and III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization answer "Yes" to Part VII, Setion A, line,, or 5 aout ompensation of the organization s urrent and former offiers, diretors, trustees, key employees, and highest ompensated employees? If "Yes," omplete Shedule J ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have a tax-exempt ond issue with an outstanding prinipal amount of more than $100,000 as of the last day of the year, that was issued after Deemer 1, 00? If "Yes," answer lines through d and omplete Shedule K. If "", go to line 5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization invest any proeeds of tax-exempt onds eyond a temporary period exeption? ~~~~~~~~~~~ Did the organization maintain an esrow aount other than a refunding esrow at any time during the year to defease any tax-exempt onds? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization at as an "on ehalf of" issuer for onds outstanding at any time during the year? ~~~~~~~~~~~ Is the organization aware that it engaged in an exess enefit transation with a disqualified person in a prior year, and that the transation has not een reported on any of the organization s prior Forms 990 or 990-EZ? If "Yes," omplete Shedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was a loan to or y a urrent or former offier, diretor, trustee, key employee, highest ompensated employee, or disqualified person outstanding as of the end of the organization s tax year? If "Yes," omplete Shedule L, Part II ~~~~~~~~~~~ Did the organization provide a grant or other assistane to an offier, diretor, trustee, key employee, sustantial ontriutor or employee thereof, a grant seletion ommittee memer, or to a 5% ontrolled entity or family memer of any of these persons? If "Yes," omplete Shedule L, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization a party to a usiness transation with one of the following parties (see Shedule L, Part IV instrutions for appliale filing thresholds, onditions, and exeptions): A urrent or former offier, diretor, trustee, or key employee? If "Yes," omplete Shedule L, Part IV ~~~~~~~~~~~ A family memer of a urrent or former offier, diretor, trustee, or key employee? If "Yes," omplete Shedule L, Part IV ~~ An entity of whih a urrent or former offier, diretor, trustee, or key employee (or a family memer thereof) was an offier, diretor, trustee, or diret or indiret owner? If "Yes," omplete Shedule L, Part IV~~~~~~~~~~~~~~~~~~~~~ Did the organization reeive more than $5,000 in non-ash ontriutions? If "Yes," omplete Shedule M ~~~~~~~~~ Did the organization reeive ontriutions of art, historial treasures, or other similar assets, or qualified onservation ontriutions? If "Yes," omplete Shedule M ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization liquidate, terminate, or dissolve and ease operations? If "Yes," omplete Shedule N, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization sell, exhange, dispose of, or transfer more than 5% of its net assets? If "Yes," omplete Shedule N, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization own 100% of an entity disregarded as separate from the organization under Regulations setions and ? If "Yes," omplete Shedule R, Part I ~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization related to any tax-exempt or taxale entity? If "Yes," omplete Shedule R, Part II, III, or IV, and Part V, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5a Did the organization have a ontrolled entity within the meaning of setion 51()(1)? ~~~~~~~~~~~~~~~~~~ If "Yes" to line 5a, did the organization reeive any payment from or engage in any transation with a ontrolled entity within the meaning of setion 51()(1)? If "Yes," omplete Shedule R, Part V, line ~~~~~~~~~~~~~~~~~~~ Setion 501()() organizations. Did the organization make any transfers to an exempt non-haritale related organization? If "Yes," omplete Shedule R, Part V, line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ondut more than 5% of its ativities through an entity that is not a related organization and that is treated as a partnership for federal inome tax purposes? If "Yes," omplete Shedule R, Part VI ~~~~~~~~ Did the organization omplete Shedule O and provide explanations in Shedule O for Part VI, lines 11 and 19? te. All Form 990 filers are required to omplete Shedule O 1 a d 5a a a Yes Page 8 Form 990 (01)
6 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 5 Part V Statements Regarding Other IRS Filings and Tax Compliane Chek if Shedule O ontains a response to any question in this Part V 1a Enter the numer reported in Box of Form Enter -0- if not appliale ~~~~~~~~~~~ a Enter the numer of Forms W-G inluded in line 1a. Enter -0- if not appliale ~~~~~~~~~~ 1 Did the organization omply with akup withholding rules for reportale payments to vendors and reportale gaming If at least one is reported on line a, did the organization file all required federal employment tax returns? ~~~~~~~~~~ te. If the sum of lines 1a and a is greater than 50, you may e required to e-file (see instrutions) 7 Organizations that may reeive dedutile ontriutions under setion 170(). a Did the organization reeive a payment in exess of $75 made partly as a ontriution and partly for goods and servies provided to the payor? d e f g h If the organization reeived a ontriution of ars, oats, airplanes, or other vehiles, did the organization file a Form 1098-C? 8 Sponsoring organizations maintaining donor advised funds and setion 509(a)() supporting organizations. Did the supporting organization, or a donor advised fund maintained y a sponsoring organization, have exess usiness holdings at any time during the year? a a a 1a Sponsoring organizations maintaining donor advised funds. Setion 501()(7) organizations. Enter: Setion 501()(1) organizations. Enter: 1a Setion 97(a)(1) non-exempt haritale trusts. Is the organization filing Form 990 in lieu of Form 101? a (gamling) winnings to prize winners? a Enter the numer of employees reported on Form W-, Transmittal of Wage and Tax Statements, filed for the alendar year ending with or within the year overed y this return ~~~~~~~~~~ Did the organization have unrelated usiness gross inome of $1,000 or more during the year? ~~~~~~~~~~~~~~ If "Yes," has it filed a Form 990-T for this year? If "," provide an explanation in Shedule O ~~~~~~~~~~~~~~~ a At any time during the alendar year, did the organization have an interest in, or a signature or other authority over, a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)?~~~~~~~ If "Yes," enter the name of the foreign ountry: J See instrutions for filing requirements for Form TD F 90-.1, Report of Foreign Bank and Finanial Aounts. 5a Was the organization a party to a prohiited tax shelter transation at any time during the tax year? ~~~~~~~~~~~~ Did any taxale party notify the organization that it was or is a party to a prohiited tax shelter transation? ~~~~~~~~~ If "Yes," to line 5a or 5, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6a Does the organization have annual gross reeipts that are normally greater than $100,000, and did the organization soliit any ontriutions that were not tax dedutile as haritale ontriutions? If "Yes," did the organization inlude with every soliitation an express statement that suh ontriutions or gifts were not tax dedutile? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," did the organization notify the donor of the value of the goods or servies provided? Setion 501()(9) qualified nonprofit health insurane issuers. te. See the instrutions for additional information the organization must report on Shedule O. Did the organization reeive any payments for indoor tanning servies during the tax year? ~~~~~~~~~~~~~~~~ If "Yes," has it filed a Form 70 to report these payments? If "," provide an explanation in Shedule O 1a a ~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization sell, exhange, or otherwise dispose of tangile personal property for whih it was required to file Form 88? ~~~~~~~~~~~~~~~ If "Yes," indiate the numer of Forms 88 filed during the year ~~~~~~~~~~~~~~~~ Did the organization reeive any funds, diretly or indiretly, to pay premiums on a personal enefit ontrat? Did the organization, during the year, pay premiums, diretly or indiretly, on a personal enefit ontrat? 7d 10a 10 11a ~~~~~~~ ~~~~~~~~~ If the organization reeived a ontriution of qualified intelletual property, did the organization file Form 8899 as required? ~ Did the organization make any taxale distriutions under setion 966? ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization make a distriution to a donor, donor advisor, or related person? ~~~~~~~~~~~~~~~~~~~ Initiation fees and apital ontriutions inluded on Part VIII, line 1 ~~~~~~~~~~~~~~~ Gross reeipts, inluded on Form 990, Part VIII, line 1, for puli use of lu failities ~~~~~~ Gross inome from memers or shareholders ~~~~~~~~~~~~~~~~~~~~~~~~~~ Gross inome from other soures (Do not net amounts due or paid to other soures against amounts due or reeived from them.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," enter the amount of tax-exempt interest reeived or arued during the year Is the organization liensed to issue qualified health plans in more than one state? ~~~~~~~~~~~~~~~~~~~~~ Enter the amount of reserves the organization is required to maintain y the states in whih the organization is liensed to issue qualified health plans ~~~~~~~~~~~~~~~~~~~~~~ Enter the amount of reserves on hand~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a a 5a 5 5 6a 6 7a 7 7 7e 7f 7g 7h 8 9a 9 1a 1a 1a Yes 1 Form 990 (01) 5
7 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 6 Part VI Governane, Management, and Dislosure For eah "Yes" response to lines through 7 elow, and for a "" response to line 8a, 8, or 10 elow, desrie the irumstanes, proesses, or hanges in Shedule O. See instrutions. Chek if Shedule O ontains a response to any question in this Part VI Setion A. Governing Body and Management Yes 1a Enter the numer of voting memers of the governing ody at the end of the tax year ~~~~~~ 1a 7 If there are material differenes in voting rights among memers of the governing ody, or if the governing a 9 Is there any offier, diretor, trustee, or key employee listed in Part VII, Setion A, who annot e reahed at the organization s mailing address? If "Yes," provide the names and addresses in Shedule O Setion B. Poliies (This Setion B requests information aout poliies not required y the Internal Revenue Code.) 1a a 16a exempt status with respet to suh arrangements? Setion C. Dislosure 17 List the states with whih a opy of this Form 990 is required to e filed JSEE SCHEDULE O ody delegated road authority to an exeutive ommittee or similar ommittee, explain in Shedule O. Enter the numer of voting memers inluded in line 1a, aove, who are independent ~~~~~~ Did any offier, diretor, trustee, or key employee have a family relationship or a usiness relationship with any other offier, diretor, trustee, or key employee? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization delegate ontrol over management duties ustomarily performed y or under the diret supervision of offiers, diretors, or trustees, or key employees to a management ompany or other person? ~~~~~~~~~~~~~~ Did the organization make any signifiant hanges to its governing douments sine the prior Form 990 was filed? ~~~~~ Did the organization eome aware during the year of a signifiant diversion of the organization s assets? ~~~~~~~~~ Did the organization have memers or stokholders? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7a Did the organization have memers, stokholders, or other persons who had the power to elet or appoint one or more memers of the governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are any governane deisions of the organization reserved to (or sujet to approval y) memers, stokholders, or persons other than the governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization ontemporaneously doument the meetings held or written ations undertaken during the year y the following: The governing ody? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Eah ommittee with authority to at on ehalf of the governing ody? Desrie in Shedule O the proess, if any, used y the organization to review this Form 990. Did the organization have a written onflit of interest poliy? If "," go to line 1 ~~~~~~~~~~~~~~~~~~~~ Were offiers, diretors, or trustees, and key employees required to dislose annually interests that ould give rise to onflits? ~~~~~~ Did the organization regularly and onsistently monitor and enfore ompliane with the poliy? If "Yes," desrie in Shedule O how this was done ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ for puli inspetion. Indiate how you made these availale. Chek all that apply. Own wesite Another s wesite Upon request Other (explain in Shedule O) 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 10a Did the organization have loal hapters, ranhes, or affiliates? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," did the organization have written poliies and proedures governing the ativities of suh hapters, affiliates, and ranhes to ensure their operations are onsistent with the organization s exempt purposes? ~~~~~~~~~~~~~ 11a Has the organization provided a omplete opy of this Form 990 to all memers of its governing ody efore filing the form? Did the organization have a written whistlelower poliy? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have a written doument retention and destrution poliy? ~~~~~~~~~~~~~~~~~~~~~~ Did the proess for determining ompensation of the following persons inlude a review and approval y independent persons, omparaility data, and ontemporaneous sustantiation of the delieration and deision? The organization s CEO, Exeutive Diretor, or top management offiial Other offiers or key employees of the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to line 15a or 15, desrie the proess in Shedule O (see instrutions). ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization invest in, ontriute assets to, or partiipate in a joint venture or similar arrangement with a taxale entity during the year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," did the organization follow a written poliy or proedure requiring the organization to evaluate its partiipation in joint venture arrangements under appliale federal tax law, and take steps to safeguard the organization s Setion 610 requires an organization to make its Forms 10 (or 10 if appliale), 990, and 990-T (Setion 501()()s only) availale Desrie in Shedule O whether (and if so, how), the organization made its governing douments, onflit of interest poliy, and finanial statements availale to the puli during the tax year. 0 State the name, physial address, and telephone numer of the person who possesses the ooks and reords of the organization: HELP HOSPITALIZED VETERANS, INC PENFIELD LANE, WINCHESTER, CA Form 990 (01) a 7 8a a 10 11a 1a a 15 16a 16 Yes
8 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 7 Part VII Compensation of Offiers, Diretors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contrators Chek if Shedule O ontains a response to any question in this Part VII Setion A. Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees 1a Complete this tale for all persons required to e listed. Report ompensation for the alendar year ending with or within the organization s tax year. List all of the organization s urrent offiers, diretors, trustees (whether individuals or organizations), regardless of amount of ompensation. Enter -0- in olumns (D), (E), and (F) if no ompensation was paid. List all of the organization s urrent key employees, if any. See instrutions for definition of "key employee." List the organization s five urrent highest ompensated employees (other than an offier, diretor, trustee, or key employee) who reeived reportale ompensation (Box 5 of Form W- 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 offiers, key employees, and highest ompensated employees who reeived more than $100,000 of reportale ompensation from the organization and any related organizations. List all of the organization s former diretors or trustees that reeived, in the apaity as a former diretor or trustee of the organization, more than $10,000 of reportale ompensation from the organization and any related organizations. List persons in the following order: individual trustees or diretors; institutional trustees; offiers; key employees; highest ompensated employees; and former suh persons. Chek this ox if neither the organization nor any related organization ompensated any urrent offier, diretor, or trustee. (A) (B) (C) (D) (E) (F) Name and Title Average hours per week (list any hours for related organizations elow line) Position (do not hek more than one ox, unless person is oth an offier and a diretor/trustee) Individual trustee or diretor Institutional trustee Offier Key employee Highest ompensated employee Former Reportale ompensation from the organization (W-/1099-MISC) Reportale ompensation from related organizations (W-/1099-MISC) Estimated amount of other ompensation from the organization and related organizations (1) ROBERT D. BECKLEY 1.00 CHAIRMAN/DIRECTOR () LEONARD C. ROGERS 1.00 SECRETARY/TREASURER () THOMAS B. ARNOLD 1.00 VICE PRESIDENT 1, () GORHAM L. BLACK, III 1.00 BOARD MEMBER (5) MICHAEL LYNCH 0.00 PRESIDENT & CEO 55, ,68. (6) DIANE HARTMANN 1.00 BOARD MEMBER (7) MICHAEL W. HARTFORD 1.00 BOARD MEMBER (8) RUSS MASON 0.00 DEVELOPMENT DIRECTOR 196, ,68. (9) LUANN PETERSON 0.00 DEVELOPMENT MANAGER 19, ,751. (10) VERNE PURKEY 0.00 PLANT MANAGER 105, , Form 990 (01) 7
9 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 8 Part VII Setion A. Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees (ontinued) (A) (B) (C) (D) (E) (F) Name and title Average Position (do not hek more than one Reportale Reportale Estimated hours per ox, unless person is oth an ompensation ompensation amount of week offier and a diretor/trustee) from from related other (list any the organizations ompensation hours for organization (W-/1099-MISC) from the related (W-/1099-MISC) organization organizations and related elow organizations line) Individual trustee or diretor Institutional trustee Offier Key employee Highest ompensated employee Former 1 d Su-total~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total from ontinuation sheets to Part VII, Setion A ~~~~~~~~ Total (add lines 1 and 1) Did the organization list any former offier, diretor, or trustee, key employee, or highest ompensated employee on line 1a? If "Yes," omplete Shedule J for suh individual ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Did any person listed on line 1a reeive or arue ompensation from any unrelated organization or individual for servies rendered to the organization? If "Yes," omplete Shedule J for suh person Setion B. Independent Contrators 1 (A) (B) (C) Name and usiness address Desription of servies Compensation AMERICAN TARGET ADVERTISING CONSULTS ON DIRECT 965 SURVEYOR CT, #00, MANASSAS, VA 0110 MAIL PROGRAM,60,76. AMERICAN MAILING LIST CORPORATION 965 SURVEYOR CT, #00, MANASSAS, VA 0110 LIST RENTAL 778,550. DIRECT MAIL PROCESSORS 1150 CONRAD CT, HAGERSTOWN, MD 170 CAGING 70,898. FLUET, HUBER AND HOANG PLLC, 1580 GROUPE DR. SUITE 00, WOODBRIDGE, VA 19 LEGAL 707,86. DATA MANAGEMENT INC PO BO 86, STONEVILLE, NC 708 DATA PROCESSING 96,57. Total numer of individuals (inluding ut not limited to those listed aove) who reeived more than $100,000 of reportale ompensation from the organization For any individual listed on line 1a, is the sum of reportale ompensation and other ompensation from the organization and related organizations greater than $150,000? If "Yes," omplete Shedule J for suh individual~~~~~~~~~~~~~ Complete this tale for your five highest ompensated independent ontrators that reeived more than $100,000 of ompensation from the organization. Report ompensation for the alendar year ending with or within the organization s tax year. Total numer of independent ontrators (inluding ut not limited to those listed aove) who reeived more than $100,000 of ompensation from the organization , , , ,16. 5 Yes Form 990 (01) 8
10 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Part VIII Statement of Revenue Contriutions, Gifts, Grants and Other Similar Amounts Program Servie Revenue Other Revenue 1 a d e f g nash ontriutions inluded in lines 1a-1f: $ h a 5 d e f g 6 a d d 8 a 9 a 10 a Government grants (ontriutions) All other ontriutions, gifts, grants, and similar amounts not inluded aove ~~ 1a 1 1 1d 1e 1f Total. Add lines 1a-1f Total. Add lines a-f a a a Page 9 Chek if Shedule O ontains a response to any question in this Part VIII (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exluded exempt funtion usiness from tax under setions 51, revenue revenue 51, or 51 Federated ampaigns Memership dues ~~~~~~ ~~~~~~~~ Fundraising events ~~~~~~~~ Related organizations ~~~~~~ All other program servie revenue ~~~~~ Investment inome (inluding dividends, interest, and Business Code other similar amounts) ~~~~~~~~~~~~~~~~~ Inome from investment of tax-exempt ond proeeds Royalties Gross rents ~~~~~~~ Less: rental expenses~~~ Rental inome or (loss) ~~ Net rental inome or (loss) 7 a Gross amount from sales of assets other than inventory Less: ost or other asis and sales expenses ~~~ Gain or (loss) ~~~~~~~ (i) Real (ii) Personal (i) Seurities,50,000. (ii) Other Net gain or (loss) Gross inome from fundraising events (not inluding $ of ontriutions reported on line 1). See Part IV, line 18 ~~~~~~~~~~~~~ Less: diret expenses~~~~~~~~~~ Net inome or (loss) from fundraising events Gross inome from gaming ativities. See Part IV, line 19 ~~~~~~~~~~~~~ Less: diret expenses ~~~~~~~~~ Net inome or (loss) from gaming ativities Gross sales of inventory, less returns and allowanes ~~~~~~~~~~~~~ Less: ost of goods sold,9,76. 55,5. ~~~~~~~~ 5,9.,7, ,08. Net inome or (loss) from sales of inventory,79,575. Misellaneous Revenue Business Code 11 a INSURANCE RECOVERIES , ,900. OTHER INCOME , ,815.,60.,60. 75, , ,5. 55,5. d All other revenue ~~~~~~~~~~~~~ e Total. Add lines 11a-11d ~~~~~~~~~~~~~~~ 18, Total revenue. See instrutions.,71, , , Form 990 (01) 9
11 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Part I Statement of Funtional Expenses Setion 501()() and 501()() organizations must omplete all olumns. All other organizations must omplete olumn (A). Chek if Shedule O ontains a response to any question in this Part I Do not inlude amounts reported on lines 6, (A) (B) (C) (D) Total expenses Program servie Management and Fundraising 7, 8, 9, and 10 of Part VIII. expenses general expenses expenses 1 Grants and other assistane to governments and organizations in the United States. See Part IV, line 1 11,97. 11, a d e f g a d Grants and other assistane to individuals in the United States. See Part IV, line ~~~ Grants and other assistane to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 ~ Benefits paid to or for memers ~~~~~~~ Compensation of urrent offiers, diretors, trustees, and key employees ~~~~~~~~ Compensation not inluded aove, to disqualified persons (as defined under setion 958(f)(1)) and persons desried in setion 958()()(B) ~~~ Other salaries and wages ~~~~~~~~~~ Pension plan aruals and ontriutions (inlude setion 01(k) and 0() employer ontriutions) Other employee enefits ~~~~~~~~~~ Payroll taxes ~~~~~~~~~~~~~~~~ Fees for servies (non-employees): Management ~~~~~~~~~~~~~~~~ Legal ~~~~~~~~~~~~~~~~~~~~ Aounting ~~~~~~~~~~~~~~~~~ Loying ~~~~~~~~~~~~~~~~~~ Professional fundraising servies. See Part IV, line 17 Investment management fees ~~~~~~~~ Other. (If line 11g amount exeeds 10% of line 5, olumn (A) amount, list line 11g expenses on Sh O.) Advertising and promotion ~~~~~~~~~ Offie expenses~~~~~~~~~~~~~~~ Information tehnology ~~~~~~~~~~~ Royalties ~~~~~~~~~~~~~~~~~~ Oupany ~~~~~~~~~~~~~~~~~ Travel ~~~~~~~~~~~~~~~~~~~ Payments of travel or entertainment expenses for any federal, state, or loal puli offiials Conferenes, onventions, and meetings ~~ Interest ~~~~~~~~~~~~~~~~~~ Payments to affiliates ~~~~~~~~~~~~ Depreiation, depletion, and amortization ~~ Insurane ~~~~~~~~~~~~~~~~~ Other expenses. Itemize expenses not overed aove. (List misellaneous expenses in line e. If line e amount exeeds 10% of line 5, olumn (A) e All other expenses 5 Total funtional expenses. Add lines 1 through e 6 Joint osts. Complete this line only if the organization reported in olumn (B) joint osts from a omined,06,99.,06,99. 19, ,985. Page 10 68,51. 66, , ,066. 1,501,16. 1,5,87. 7,718. 7,86. 86,07. 78,85.,995. 0,58. 7,855. 6,81. 7,511. 1,50. 1, ,95.,91.,91.,61,81.,61,81. 10,97. 10,97. 1,,. 1,,. 1,050,85. 67,9. 7,5. 1,56. 1,0, , ,1.,85. 99,17. 6,059., ,57. 8, ,7. 101,7.,85. 51,860. 6, ,0. 7,91. 1,71. 6,18.,9.,9. 55,7. 5, ,718. amount, list line e expenses on Shedule O.) ~~ PRINTING 6,0,160. 1,69,. 8,78.,560,15. POSTAGE,56,16. 1,176, ,871.,570,167. LIST RENTAL 71,56. 19,6. 99,70. 0,90. DATA PROCESSING 6, ,85. 65,066. 7,07. 61,07. 5, ,155. 6,88, ,569,11. 6,1,1. 8,88,151. eduational ampaign and fundraising soliitation. Chek here if following SOP 98- (ASC ) 1,595,108.,90,679.,0,17. 8,611, Form 990 (01) 10
12 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 11 Part Balane Sheet Net Assets or Fund Balanes Liailities Assets Chek if Shedule O ontains a response to any question in this Part (A) (B) Beginning of year End of year 1 Cash - non-interest-earing ~~~~~~~~~~~~~~~~~~~~~~~~~ 9, ,56,11. Savings and temporary ash investments ~~~~~~~~~~~~~~~~~~ 99,85. 5,76. Pledges and grants reeivale, net ~~~~~~~~~~~~~~~~~~~~~ 0. 11,860. Aounts reeivale, net ~~~~~~~~~~~~~~~~~~~~~~~~~~ 0,06. 16,89. 5 Loans and other reeivales from urrent and former offiers, diretors, trustees, key employees, and highest ompensated employees. Complete Part II of Shedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 6 Loans and other reeivales from other disqualified persons (as defined under setion 958(f)(1)), persons desried in setion 958()()(B), and ontriuting employers and sponsoring organizations of setion 501()(9) voluntary employees enefiiary organizations (see instr). Complete Part II of Sh L ~~ 6 7 tes and loans reeivale, net ~~~~~~~~~~~~~~~~~~~~~~~ 9, , Inventories for sale or use ~~~~~~~~~~~~~~~~~~~~~~~~~~ 1,, ,190, Prepaid expenses and deferred harges ~~~~~~~~~~~~~~~~~~ 6,979. 9,0. 10a Land, uildings, and equipment: ost or other asis. Complete Part VI of Shedule D ~~~ 10a,079,66. Less: aumulated depreiation ~~~~~~ 10 1,6,1. 1,57, ,55, Investments - pulily traded seurities ~~~~~~~~~~~~~~~~~~~,0, ,57. 1 Investments - other seurities. See Part IV, line 11 ~~~~~~~~~~~~~~ 1 1 Investments - program-related. See Part IV, line 11 ~~~~~~~~~~~~~ 1 1 Intangile assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 15 Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~ 1, , Total assets. Add lines 1 through 15 (must equal line ) 7,05, ,680, Aounts payale and arued expenses ~~~~~~~~~~~~~~~~~~ 1,5,8. 17,10, Grants payale ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 57, , Deferred revenue ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 19 0 Tax-exempt ond liailities ~~~~~~~~~~~~~~~~~~~~~~~~~ 0 1 Esrow or ustodial aount liaility. Complete Part IV of Shedule D ~~~~ 1 Loans and other payales to urrent and former offiers, diretors, trustees, key employees, highest ompensated employees, and disqualified persons. Complete Part II of Shedule L ~~~~~~~~~~~~~~~~~~~~~~~ Seured mortgages and notes payale to unrelated third parties ~~~~~~ Unseured notes and loans payale to unrelated third parties ~~~~~~~~ 5 Other liailities (inluding federal inome tax, payales to related third parties, and other liailities not inluded on lines 17-). Complete Part of Shedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1,510, ,08, Total liailities. Add lines 17 through 5,56,55. 6,698,19. Organizations that follow SFAS 117 (ASC 958), hek here and omplete lines 7 through 9, and lines and. 7 Unrestrited net assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~,869,8. 7 1,770, Temporarily restrited net assets ~~~~~~~~~~~~~~~~~~~~~~ , Permanently restrited net assets ~~~~~~~~~~~~~~~~~~~~~ 9 Organizations that do not follow SFAS 117 (ASC 958), hek here and omplete lines 0 through. 0 1 Capital stok or trust prinipal, or urrent funds ~~~~~~~~~~~~~~~ Paid-in or apital surplus, or land, uilding, or equipment fund ~~~~~~~~ 0 1 Retained earnings, endowment, aumulated inome, or other funds ~~~~ Total net assets or fund alanes ~~~~~~~~~~~~~~~~~~~~~~,869,8. 1,98,577. Total liailities and net assets/fund alanes 7,05,96. 5,680,769. Form 990 (01)
13 Form 990 (01) HELP HOSPITALIZED VETERANS, INC Page 1 Part I Reoniliation of Net Assets Chek if Shedule O ontains a response to any question in this Part I Net assets or fund alanes at end of year. Comine lines through 9 (must equal Part, line, olumn (B)) 10 1,98,577. Part II Finanial Statements and Reporting Chek if Shedule O ontains a response to any question in this Part II Yes 1 Aounting method used to prepare the Form 990: Cash Arual Other a Total revenue (must equal Part VIII, olumn (A), line 1) Total expenses (must equal Part I, olumn (A), line 5) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Revenue less expenses. Sutrat line from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net assets or fund alanes at eginning of year (must equal Part, line, olumn (A)) ~~~~~~~~~~ Net unrealized gains (losses) on investments Donated servies and use of failities Investment expenses Prior period adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other hanges in net assets or fund alanes (explain in Shedule O) ~~~~~~~~~~~~~~~~~~~ If the organization hanged its method of aounting from a prior year or heked "Other," explain in Shedule O. Were the organization s finanial statements ompiled or reviewed y an independent aountant? ~~~~~~~~~~~~ If "Yes," hek a ox elow to indiate whether the finanial statements for the year were ompiled or reviewed on a separate asis, onsolidated asis, or oth: Separate asis Consolidated asis Both onsolidated and separate asis Were the organization s finanial statements audited y an independent aountant? ~~~~~~~~~~~~~~~~~~~ If "Yes," hek a ox elow to indiate whether the finanial statements for the year were audited on a separate asis, onsolidated asis, or oth: Separate asis Consolidated asis Both onsolidated and separate asis If "Yes" to line a or, does the organization have a ommittee that assumes responsiility for oversight of the audit, review, or ompilation of its finanial statements and seletion of an independent aountant?~~~~~~~~~~~~~~~ If the organization hanged either its oversight proess or seletion proess during the tax year, explain in Shedule O. a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit At and OMB Cirular A-1? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 Shedule O and desrie any steps taken to undergo suh audits ,71,978. 6,88,675. -,168,697.,869,8. -0,05. 01,95. a a Form 990 (01)
14 SCHEDULE A (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Complete if the organization is a setion 501()() organization or a setion 97(a)(1) nonexempt haritale trust. Attah to Form 990 or Form 990-EZ. See separate instrutions. OMB Open to Puli Inspetion Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC Part I Reason for Puli Charity Status (All organizations must omplete this part.) See instrutions. The organization is not a private foundation eause it is: (For lines 1 through 11, hek only one ox.) e f g h A hurh, onvention of hurhes, or assoiation of hurhes desried in setion 170()(1)(A)(i). A shool desried in setion 170()(1)(A)(ii). (Attah Shedule E.) A hospital or a ooperative hospital servie organization desried in setion 170()(1)(A)(iii). A medial researh organization operated in onjuntion with a hospital desried in setion 170()(1)(A)(iii). Enter the hospital s name, ity, and state: An organization operated for the enefit of a ollege or university owned or operated y a governmental unit desried in setion 170()(1)(A)(iv). (Complete Part II.) A federal, state, or loal government or governmental unit desried in setion 170()(1)(A)(v). An organization that normally reeives a sustantial part of its support from a governmental unit or from the general puli desried in setion 170()(1)(A)(vi). (Complete Part II.) A ommunity trust desried in setion 170()(1)(A)(vi). (Complete Part II.) An organization that normally reeives: (1) more than 1/% of its support from ontriutions, memership fees, and gross reeipts from ativities related to its exempt funtions - sujet to ertain exeptions, and () no more than 1/% of its support from gross investment inome and unrelated usiness taxale inome (less setion 511 tax) from usinesses aquired y the organization after June 0, See setion 509(a)(). (Complete Part III.) An organization organized and operated exlusively to test for puli safety. See setion 509(a)(). An organization organized and operated exlusively for the enefit of, to perform the funtions of, or to arry out the purposes of one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(). See setion 509(a)(). Chek the ox that desries the type of supporting organization and omplete lines 11e through 11h. a Type I Type II Type III - Funtionally integrated d Type III - n-funtionally integrated By heking this ox, I ertify that the organization is not ontrolled diretly or indiretly y one or more disqualified persons other than foundation managers and other than one or more pulily supported organizations desried in setion 509(a)(1) or setion 509(a)(). If the organization reeived a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, hek this ox Sine August 17, 006, has the organization aepted any gift or ontriution from any of the following persons? (i) (ii) (iii) Puli Charity Status and Puli Support ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A person who diretly or indiretly ontrols, either alone or together with persons desried in (ii) and (iii) elow, the governing ody of the supported organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A family memer of a person desried in (i) aove? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A 5% ontrolled entity of a person desried in (i) or (ii) aove? ~~~~~~~~~~~~~~~~~~~~~~~~ Provide the following information aout the supported organization(s) g(i) 11g(ii) 11g(iii) Yes (i) Name of supported (ii) EIN (iii) Type of organization (iv) Is the organization (v) Did you notify the (vi) Is the (vii) (desried on lines 1-9 in ol. (i) listed in your organization in ol. organization in ol. Amount of monetary organization (i) organized in the support aove or IRC setion governing doument? (i) of your support? U.S.? (see instrutions) ) Yes Yes Yes Total LHA For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule A (Form 990 or 990-EZ)
15 Shedule A (Form 990 or 990-EZ) 01 HELP HOSPITALIZED VETERANS, INC Page Part II Support Shedule for Organizations Desried in Setions 170()(1)(A)(iv) and 170()(1)(A)(vi) (Complete only if you heked the ox on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed elow, please omplete Part III.) Setion A. Puli Support Calendar year (or fisal year eginning in) 1 5 Total. Add lines 1 through ~~~ 6 Puli support. Sutrat line 5 from line. (a) 008 () 009 () 010 (d) 011 (e) 01 (f) Total Calendar year (or fisal year eginning in) (a) 008 () 009 () 010 (d) 011 (e) 01 (f) Total 7 Amounts from line ~~~~~~~ assets (Explain in Part IV.) ~~~~ Total support. Add lines 7 through 10 First five years. If the Form 990 is for the organization s first, seond, third, fourth, or fifth tax year as a setion 501()() 17a 10% -fats-and-irumstanes test If the organization did not hek a ox on line 1, 16a, or 16, and line 1 is 10% or more, 18 Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.") ~~ Tax revenues levied for the organization s enefit and either paid to or expended on its ehalf ~~~~ The value of servies or failities furnished y a governmental unit to the organization without harge ~ The portion of total ontriutions y eah person (other than a governmental unit or pulily supported organization) inluded on line 1 that exeeds % of the amount shown on line 11, olumn (f) ~~~~~~~~~~~~ Setion B. Total Support Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures ~ Net inome from unrelated usiness ativities, whether or not the usiness is regularly arried on ~ Other inome. Do not inlude gain or loss from the sale of apital , , Gross reeipts from related ativities, et. (see instrutions) ~~~~~~~~~~~~~~~~~~~~~~~ 1/% support test If the organization did not hek a ox on line 1 or 16a, and line 15 is 1/% or more, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~ 10% -fats-and-irumstanes test If the organization did not hek a ox on line 1, 16a, 16, or 17a, and line 15 is 10% or more, and if the organization meets the "fats-and-irumstanes" test, hek this ox and stop here. Explain in Part IV how the organization meets the "fats-and-irumstanes" test. The organization qualifies as a pulily supported organization ~~~~~~~~ Private foundation. If the organization did not hek a ox on line 1, 16a, 16, 17a, or 17, hek this ox and see instrutions ,50. 1, , ,07., , ,07. 96, , ,51. 89, organization, hek this ox and stop here Setion C. Computation of Puli Support Perentage 1 Puli support perentage for 01 (line 6, olumn (f) divided y line 11, olumn (f)) ~~~~~~~~~~~~ Puli support perentage from 011 Shedule A, Part II, line 1 ~~~~~~~~~~~~~~~~~~~~~ a 1/% support test If the organization did not hek the ox on line 1, and line 1 is 1/% or more, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Shedule A (Form 990 or 990-EZ) 01 % %
16 Shedule A (Form 990 or 990-EZ) 01 Part III Support Shedule for Organizations Desried in Setion 509(a)() Calendar year (or fisal year eginning in) The value of servies or failities furnished y a governmental unit to the organization without harge ~ Total. Add lines 1 through 5 ~~~ 7a Amounts inluded on lines 1,, and reeived from disqualified persons Amounts inluded on lines and reeived from other than disqualified persons that exeed the greater of $5,000 or 1% of the amount on line 1 for the year ~~~~~~ Add lines 7a and 7 ~~~~~~~ 8 Puli support (Sutrat line 7 from line 6.) Calendar year (or fisal year eginning in) 9 Amounts from line 6 ~~~~~~~ 10a Gross inome from interest, dividends, payments reeived on seurities loans, rents, royalties and inome from similar soures ~ Unrelated usiness taxale inome (less setion 511 taxes) from usinesses aquired after June 0, 1975 ~~~~ (a) 008 () 009 () 010 (d) 011 (e) 01 (f) Total (a) 008 () 009 () 010 (d) 011 (e) 01 (f) Total 1 First five years. If the Form 990 is for the organization s first, seond, third, fourth, or fifth tax year as a setion 501()() organization, hek this ox and stop here Setion C. Computation of Puli Support Perentage Puli support perentage from 011 Shedule A, Part III, line 15 Setion D. Computation of Investment Inome Perentage Page Puli support perentage for 01 (line 8, olumn (f) divided y line 1, olumn (f)) ~~~~~~~~~~~~ 15 % 19a 1/% support tests If the organization did not hek the ox on line 1, and line 15 is more than 1/%, and line 17 is not 0 (Complete only if you heked 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 omplete Part II.) Setion A. Puli Support Gifts, grants, ontriutions, and memership fees reeived. (Do not inlude any "unusual grants.") ~~ Gross reeipts from admissions, merhandise sold or servies performed, or failities furnished in any ativity that is related to the organization s tax-exempt purpose Gross reeipts from ativities that are not an unrelated trade or usiness under setion 51 ~~~~~ Tax revenues levied for the organization s enefit and either paid to or expended on its ehalf ~~~~ Setion B. Total Support Add lines 10a and 10 ~~~~~~ Net inome from unrelated usiness ativities not inluded in line 10, whether or not the usiness is regularly arried on ~~~~~~~ Other inome. Do not inlude gain or loss from the sale of apital assets (Explain in Part IV.) ~~~~ Total support. (Add lines 9, 10, 11, and 1.) Investment inome perentage for 01 (line 10, olumn (f) divided y line 1, olumn (f)) Investment inome perentage from 011 Shedule A, Part III, line 17 ~~~~~~~~~~~~~~~~~~ 16 ~~~~~~~~ 17 % more than 1/%, hek this ox and stop here. The organization qualifies as a pulily supported organization ~~~~~~~~~~ 1/% support tests If the organization did not hek a ox on line 1 or line 19a, and line 16 is more than 1/%, and line 18 is not more than 1/%, hek this ox and stop here. The organization qualifies as a pulily supported organization~~~~ Private foundation. If the organization did not hek a ox on line 1, 19a, or 19, hek this ox and see instrutions Shedule A (Form 990 or 990-EZ) % %
17 Shedule A (Form 990 or 990-EZ) 01 HELP HOSPITALIZED VETERANS, INC Page Part IV Supplemental Information. Complete this part to provide the explanations required y Part II, line 10; Part II, line 17a or 17; and Part III, line 1. Also omplete this part for any additional information. (See instrutions). SCHEDULE A, PART II, LINE 10, EPLANATION FOR OTHER INCOME: LIST ROYALTY & MISCELLANEOUS INCOME 008 AMOUNT: $ 880, AMOUNT: $ 96, AMOUNT: $ 578, AMOUNT: $ 551, AMOUNT: $ 9,76. INSURANCE RECOVERIES 01 AMOUNT: $ 01, Shedule A (Form 990 or 990-EZ) 01 16
18 SCHEDULE D (Form 990) Complete if the organization answered "Yes," to Form 990, Part IV, line 6, 7, 8, 9, 10, 11a, 11, 11, 11d, 11e, 11f, 1a, or 1. Department of the Treasury Internal Revenue Servie Attah to Form 990. See separate instrutions. OMB Open to Puli Inspetion Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Aounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6. (a) Donor advised funds () Funds and other aounts a d a Total numer at end of year ~~~~~~~~~~~~~~~ Aggregate ontriutions to (during year) Aggregate grants from (during year) Aggregate value at end of year (i) (ii) ~~~~~~~~ ~~~~~~~~~~ ~~~~~~~~~~~~~ Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization s property, sujet to the organization s exlusive legal ontrol?~~~~~~~~~~~~~~~~~~ Did the organization inform all grantees, donors, and donor advisors in writing that grant funds an e used only for haritale purposes and not for the enefit of the donor or donor advisor, or for any other purpose onferring impermissile private enefit? Part II Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7. Purpose(s) of onservation easements held y the organization (hek all that apply). Preservation of land for puli use (e.g., rereation or eduation) Protetion of natural haitat Preservation of open spae a d Yes Yes Preservation of an historially important land area Preservation of a ertified histori struture Complete lines a through d if the organization held a qualified onservation ontriution in the form of a onservation easement on the last day of the tax year. Total numer of onservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total areage restrited y onservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~ Numer of onservation easements on a ertified histori struture inluded in (a) ~~~~~~~~~~~~ Numer of onservation easements inluded in () aquired after 8/17/06, and not on a histori struture listed in the National Register ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Held at the End of the Tax Year Numer of onservation easements modified, transferred, released, extinguished, or terminated y the organization during the tax year Numer of states where property sujet to onservation easement is loated Does the organization have a written poliy regarding the periodi monitoring, inspetion, handling of violations, and enforement of the onservation easements it holds? ~~~~~~~~~~~~~~~~~~~~~~~~~ Staff and volunteer hours devoted to monitoring, inspeting, and enforing onservation easements during the year Amount of expenses inurred in monitoring, inspeting, and enforing onservation easements during the year $ Does eah onservation easement reported on line (d) aove satisfy the requirements of setion 170(h)()(B)(i) and setion 170(h)()(B)(ii)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In Part III, desrie how the organization reports onservation easements in its revenue and expense statement, and alane sheet, and inlude, if appliale, the text of the footnote to the organization s finanial statements that desries the organization s aounting for onservation easements. Part III Organizations Maintaining Colletions of Art, Historial Treasures, or Other Similar Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 8. 1a If the organization eleted, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and alane sheet works of art, historial treasures, or other similar assets held for puli exhiition, eduation, or researh in furtherane of puli servie, provide, in Part III, the text of the footnote to its finanial statements that desries these items. If the organization eleted, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and alane sheet works of art, historial treasures, or other similar assets held for puli exhiition, eduation, or researh in furtherane of puli servie, provide the following amounts relating to these items: Revenues inluded in Form 990, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ Assets inluded in Form 990, Part ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If the organization reeived or held works of art, historial treasures, or other similar assets for finanial gain, provide the following amounts required to e reported under SFAS 116 (ASC 958) relating to these items: Revenues inluded in Form 990, Part VIII, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ Assets inluded in Form 990, Part Supplemental Finanial Statements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ $ 01 Yes Yes LHA For Paperwork Redution At tie, see the Instrutions for Form 990. Shedule D (Form 990)
19 Shedule D (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Page Part III Organizations Maintaining Colletions of Art, Historial Treasures, or Other Similar Assets (ontinued) Using the organization s aquisition, aession, and other reords, hek any of the following that are a signifiant use of its olletion items 5 a d e f d e If "Yes," explain the arrangement in Part III. Chek here if the explanation has een provided in Part III Part V Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10. d e f g a (i) (ii) Desrie in Part III the intended uses of the organization s endowment funds. Part VI Land, Buildings, and Equipment. See Form 990, Part, line 10. 1a (hek all that apply): Puli exhiition Sholarly researh Preservation for future generations Loan or exhange programs Provide a desription of the organization s olletions and explain how they further the organization s exempt purpose in Part III. During the year, did the organization soliit or reeive donations of art, historial treasures, or other similar assets to e sold to raise funds rather than to e maintained as part of the organization s olletion? Yes Part IV Esrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or reported an amount on Form 990, Part, line 1. 1a Is the organization an agent, trustee, ustodian or other intermediary for ontriutions or other assets not inluded on Form 990, Part? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ (a) Current year () Prior year () Two years ak (d) Three years ak (e) Four years ak 1 1d 1e 1f Yes Yes a(i) a(ii) (a) Cost or other () Cost or other () Aumulated (d) Book value asis (investment) asis (other) depreiation 675, ,78. 1,66, ,5. 701,7. Leasehold improvements ~~~~~~~~~~ d Equipment ~~~~~~~~~~~~~~~~~ 01,99. 6,56. 6,76. e Other 56,05. 5,5. 1,771. Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part, olumn (B), line 10().) 1,55,519. Other If "Yes," explain the arrangement in Part III and omplete the following tale: Beginning alane Additions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Distriutions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Ending alane ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a Did the organization inlude an amount on Form 990, Part, line 1? ~~~~~~~~~~~~~~~~~~~~~~~~~ 1a Beginning of year alane Contriutions ~~~~~~~~~~~~~~ Net investment earnings, gains, and losses Grants or sholarships Other expenditures for failities and programs Administrative expenses End of year alane ~~~~~~~ ~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~~~~~ ~~~~~~~~~~ Provide the estimated perentage of the urrent year end alane (line 1g, olumn (a)) held as: Board designated or quasi-endowment % Permanent endowment % Temporarily restrited endowment % The perentages in lines a,, and should equal 100%. a Are there endowment funds not in the possession of the organization that are held and administered for the organization y: unrelated organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" to a(ii), are the related organizations listed as required on Shedule R? ~~~~~~~~~~~~~~~~~~~~~~ Desription of property Land ~~~~~~~~~~~~~~~~~~~~ Buildings ~~~~~~~~~~~~~~~~~~ Amount Yes Shedule D (Form 990)
20 Shedule D (Form 990) 01 Page Part VII Investments - Other Seurities. See Form 990, Part, line 1. (a) Desription of seurity or ategory (inluding name of seurity) () Book value () Method of valuation: Cost or end-of-year market value (1) () () (I) Total. (Col. () must equal Form 990, Part, ol. (B) line 1.) Part VIII Investments - Program Related. See Form 990, Part, line 1. (a) Desription of investment type () Book value () Method of valuation: Cost or end-of-year market value (10) Total. (Col. () must equal Form 990, Part, ol. (B) line 1.) Part I Other Assets. See Form 990, Part, line 15. (a) Desription () Book value (1) CASH SURRENDER VALUE OF OFFICER LIFE INSURANCE 8,77. (10) Total. (Column () must equal Form 990, Part, ol. (B) line 15.) Part Other Liailities. See Form 990, Part, line (a) Desription of liaility () Book value (11) Total. (Column () must equal Form 990, Part, ol. (B) line 5.) Finanial derivatives Closely-held equity interests Other (A) (B) (C) (D) (E) (F) (G) (H) (1) () () () (5) (6) (7) (8) (9) () () () (5) (6) (7) (8) (9) (1) () () () (5) (6) (7) (8) (9) (10) HELP HOSPITALIZED VETERANS, INC ~~~~~~~~~~~~~~~ ~~~~~~~~~~~ Federal inome taxes UNDERFUNDED PENSION LIABILITY 1,08,110. 1,08,110. FIN 8 (ASC 70) Footnote. In Part III, provide the text of the footnote to the organization s finanial statements that reports the organization s liaility for unertain tax positions under FIN 8 (ASC 70). Chek here if the text of the footnote has een provided in Part III 8,77. Shedule D (Form 990) 01 19
21 Shedule D (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Page Part I Reoniliation of Revenue per Audited Finanial Statements With Revenue per Return 1 Total revenue, gains, and other support per audited finanial statements ~~~~~~~~~~~~~~~~~~~ 1 7,68,65. a d e a Add lines a through d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ e Sutrat line e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts inluded on Form 990, Part VIII, line 1, ut not on line 1: Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines a and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 0. 5 Total revenue. Add lines and. (This must equal Form 990, Part I, line 1.) 5,71,978. Part II Reoniliation of Expenses per Audited Finanial Statements With Expenses per Return 1 Total expenses and losses per audited finanial statements ~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 9,57,05. a d e a Amounts inluded on line 1 ut not on Form 990, Part VIII, line 1: Net unrealized gains on investments Donated servies and use of failities ~~~~~~~~~~~~~~~~~~~~~~ Reoveries of prior year grants Other (Desrie in Part III.) Add lines a through d ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Investment expenses not inluded on Form 990, Part VIII, line 7 Amounts inluded on line 1 ut not on Form 990, Part I, line 5: Sutrat line e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts inluded on Form 990, Part I, line 5, ut not on line 1: ~~~~~~~~ Donated servies and use of failities ~~~~~~~~~~~~~~~~~~~~~~ Prior year adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other losses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other (Desrie in Part III.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Investment expenses not inluded on Form 990, Part VIII, line 7 Other (Desrie in Part III.) ~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines a and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 Total expenses. Add lines and. (This must equal Form 990, Part I, line 18.) Part III Supplemental Information Complete this part to provide the desriptions required for Part II, lines, 5, and 9; Part III, lines 1a and ; Part IV, lines 1 and ; Part V, line ; Part, line ; Part I, lines d and ; and Part II, lines d and. Also omplete this part to provide any additional information. PART, LINE : THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TA POSITIONS a d a a d a -0,05.,57,70.,57,70. e 5,55,676.,71,978.,57,70. 6,88, ,88,675. UNDER FASB ASC 70, INCOME TAES. FASB ASC 70 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAES RECOGNIZED IN AN ENTERPRISE S FINANCIAL STATEMENTS. FASB ASC 70 PRESCRIBES A COMPREHENSIVE MODEL FOR RECOGNIZING, MEASURING, PRESENTING, AND DISCLOSING IN FINANCIAL STATEMENTS TA POSITIONS TAKEN OR EPECTED TO BE TAKEN ON A TA RETURN, INCLUDING POSITIONS THAT THE ORGANIZATION IS EEMPT FROM INCOME TAES. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TA Shedule D (Form 990)
22 Shedule D (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Part III Supplemental Information (ontinued) Page 5 POSITIONS TAKEN AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TA POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION S FEDERAL RETURN OF ORGANIZATION EEMPT FROM INCOME TA (FORM 990) IS SUBJECT TO EAMINATION BY THE INTERNAL REVENUE SERVICE, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED Shedule D (Form 990) 01 1
23 SCHEDULE F (Form 990) Department of the Treasury Internal Revenue Servie Name of the organization Statement of Ativities Outside the United States Complete if the organization answered "Yes" to Form 990, Part IV, line 1, 15, or 16. Attah to Form 990. See separate instrutions. 01 OMB Open to Puli Inspetion Employer identifiation numer HELP HOSPITALIZED VETERANS, INC Part I General Information on Ativities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 1. 1 For grantmakers. Does the organization maintain reords to sustantiate the amount of its grants and other assistane, the grantees eligiility for the grants or assistane, and the seletion riteria used to award the grants or assistane? ~~ Yes For grantmakers. Desrie in Part V the organization s proedures for monitoring the use of its grants and other assistane outside the United States. Ativities per Region. (The following Part I, line tale an e dupliated if additional spae is needed.) (a) Region () Numer of () Numer of (d) Ativities onduted in region (e) If ativity listed in (d) (f) Total offies in the region employees, agents, and independent ontrators in region (y type) (e.g., fundraising, program servies, investments, grants to reipients loated in the region) is a program servie, desrie speifi type of servie(s) in region expenditures for and investments in region THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND SOUTH ASIA 0 0 PROGRAM SERVICES MILITARY RECEIVING 1,17. THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED EAST ASIA & THE TO U.S. VETERANS AND PACIFIC 0 0 PROGRAM SERVICES MILITARY RECEIVING 5,17. THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND NORTH AMERICA 0 0 PROGRAM SERVICES MILITARY RECEIVING 170. THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED EUROPE (INCLUDING TO U.S. VETERANS AND ICELAND & GREENLAND) 0 0 PROGRAM SERVICES MILITARY RECEIVING 51. a Su-total ~~~~~~ Total from ontinuation sheets to Part I ~~~ , Totals (add lines a and ) ,985. LHA For Paperwork Redution At tie, see the Instrutions for Form 990. Shedule F (Form 990) 01 SEE PART V FOR COLUMN (E) DESCRIPTIONS
24 Shedule F (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Part II Grants and Other Assistane to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any reipient who reeived more than $5,000. Part II an e dupliated if additional spae is needed. Page 1 (a) Name of organization () IRS ode setion and EIN (if appliale) () Region (d) Purpose of (e) Amount (f) Manner of (g) Amount of (h) Desription (i) Method of non-ash of non-ash valuation (ook, FMV, grant of ash grant ash disursement assistane assistane appraisal, other) Enter total numer of reipient organizations listed aove that are reognized as harities y the foreign ountry, reognized as tax-exempt y the IRS, or for whih the grantee or ounsel has provided a setion 501()() equivaleny letter ~~~~~~~~~~~~~~~~~~~~~~~ Enter total numer of other organizations or entities Shedule F (Form 990)
25 Shedule F (Form 990) 01 Part III Grants and Other Assistane to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16. Part III an e dupliated if additional spae is needed. (a) Type of grant or assistane HELP HOSPITALIZED VETERANS, INC () Region () Numer of (d) Amount of (e) Manner of (f) Amount of (g) Desription of (h) Method of reipients ash grant ash disursement non-ash non-ash assistane valuation assistane (ook, FMV, appraisal, other) THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO UNITED THERAPEUTIC MATERIALS FOR ACTIVE DUTY MILITARY AND VETERAN PATIENTS INCLUDING CRAFT KITS CONTAINING SOUTH ASIA ,17.STATES ACTIVE DUTY FMV THERAPEUTIC MATERIALS FOR THERAPEUTIC ARTS AND HOSPITALIZED MILITARY AND CRAFT KITS WERE VETERAN PATIENTS INCLUDING EAST ASIA & THE SHIPPED TO UNITED CRAFT KITS CONTAINING PACIFIC ,17.STATES ACTIVE DUTY FMV THERAPEUTIC MATERIALS FOR THERAPEUTIC ARTS AND HOSPITALIZED MILITARY AND CRAFT KITS WERE VETERAN PATIENTS INCLUDING SHIPPED TO UNITED CRAFT KITS CONTAINING NORTH AMERICA STATES ACTIVE DUTY FMV THERAPEUTIC MATERIALS FOR THERAPEUTIC ARTS AND HOSPITALIZED MILITARY AND EUROPE (INCLUDING CRAFT KITS WERE VETERAN PATIENTS INCLUDING ICELAND & SHIPPED TO UNITED CRAFT KITS CONTAINING GREENLAND) STATES ACTIVE DUTY FMV Page SEE PART V FOR COLUMN (A) AND COLUMN (G) DESCRIPTIONS Shedule F (Form 990) 01
26 Shedule F (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Part IV Foreign Forms Page 1 Was the organization a U.S. transferor of property to a foreign orporation during the tax year? If "Yes," the organization may e required to file Form 96, Return y a U.S. Transferor of Property to a Foreign Corporation (see Instrutions for Form 96) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may e required to file Form 50, Annual Return to Report Transations with Foreign Trusts and Reeipt of Certain Foreign Gifts, and/or Form 50-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instrutions for Forms 50 and 50-A) [[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[ Yes Did the organization have an ownership interest in a foreign orporation during the tax year? If "Yes," the organization may e required to file Form 571, Information Return of U.S. Persons With Respet To Certain Foreign Corporations. (see Instrutions for Form 571) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes 5 6 Was the organization a diret or indiret shareholder of a passive foreign investment ompany or a qualified eleting fund during the tax year? If "Yes," the organization may e required to file Form 861, Information Return y a Shareholder of a Passive Foreign Investment Company or Qualified Eleting Fund. (see Instrutions for Form 861) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may e required to file Form 8865, Return of U.S. Persons With Respet To Certain Foreign Partnerships. (see Instrutions for Form 8865) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have any operations in or related to any oyotting ountries during the tax year? If "Yes," the organization may e required to file Form 571, International Boyott Report. (see Instrutions Yes for Form 571) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Shedule F (Form 990)
27 Shedule F (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Page 5 Part V Supplemental Information Complete this part to provide the information required y Part I, line (monitoring of funds); Part I, line, olumn (f) (aounting method; amounts of investments vs. expenditures per region); Part II, line 1 (aounting method); Part III (aounting method); and Part III, olumn () (estimated numer of reipients), as appliale. Also omplete this part to provide any additional information. SCHEDULE F, PART I, LINE : ASSISTANCE PROVIDED BY HHV TO UNITED STATES ACTIVE DUTY MILITARY PATIENTS AT VARIOUS UNITED STATES FOREIGN MILITARY FACILITIES AND MEDICAL CENTERS ARE MONITORED THROUGH FREQUENT COMMUNICATION BETWEEN HHV AND PERSONNEL AT THE UNITED STATES MILITARY FACILITIES AND POSITIVE FEEDBACK FROM UNITED STATES MILITARY PATIENTS WHO RECEIVED CRAFT KITS. SCHEDULE F, PART I, LINE : EPENDITURES ARE REPORTED BASED ON THE ACCRUAL ACCOUNTING METHOD. PART I, LINE, COLUMN (E): REGION: SOUTH ASIA (E) SPECIFIC TYPES OF SERVICES IN REGION: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND MILITARY RECEIVING MEDICAL CARE. REGION: EAST ASIA & THE PACIFIC (E) SPECIFIC TYPES OF SERVICES IN REGION: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND MILITARY RECEIVING MEDICAL CARE. REGION: NORTH AMERICA (E) SPECIFIC TYPES OF SERVICES IN REGION: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND MILITARY RECEIVING MEDICAL CARE. REGION: EUROPE (INCLUDING ICELAND & GREENLAND) (E) SPECIFIC TYPES OF SERVICES IN REGION: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO U.S. VETERANS AND MILITARY RECEIVING MEDICAL CARE Shedule F (Form 990) 01 6
28 Shedule F (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Page 5 Part V Supplemental Information Complete this part to provide the information required y Part I, line (monitoring of funds); Part I, line, olumn (f) (aounting method; amounts of investments vs. expenditures per region); Part II, line 1 (aounting method); Part III (aounting method); and Part III, olumn () (estimated numer of reipients), as appliale. Also omplete this part to provide any additional information. PART III, COLUMNS (A) AND (G): REGION: SOUTH ASIA (A) TYPE OF GRANT OR ASSISTANCE: THERAPEUTIC MATERIALS FOR ACTIVE DUTY MILITARY AND VETERAN PATIENTS INCLUDING CRAFT KITS CONTAINING LEATHER, PAINT AND MODELING ACTIVITIES. (G) DESCRIPTION OF NON-CASH ASSISTANCE: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO UNITED STATES ACTIVE DUTY MILITARY PATIENTS AT VARIOUS MILITARY FACILITIES IN AFGHANISTAN. REGION: EAST ASIA & THE PACIFIC (A) TYPE OF GRANT OR ASSISTANCE: THERAPEUTIC MATERIALS FOR HOSPITALIZED MILITARY AND VETERAN PATIENTS INCLUDING CRAFT KITS CONTAINING LEATHER, PAINT AND MODELING ACTIVITIES. (G) DESCRIPTION OF NON-CASH ASSISTANCE: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO UNITED STATES ACTIVE DUTY MILITARY PATIENTS AT VARIOUS MILITARY FACILITIES IN SEOUL, KOREA, AND JAPAN. REGION: NORTH AMERICA (A) TYPE OF GRANT OR ASSISTANCE: THERAPEUTIC MATERIALS FOR HOSPITALIZED MILITARY AND VETERAN PATIENTS INCLUDING CRAFT KITS CONTAINING LEATHER, PAINT AND MODELING ACTIVITIES. (G) DESCRIPTION OF NON-CASH ASSISTANCE: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO UNITED STATES ACTIVE DUTY MILITARY PATIENTS AT VARIOUS MILITARY FACILITIES IN CANADA. REGION: EUROPE (INCLUDING ICELAND & GREENLAND) (A) TYPE OF GRANT OR ASSISTANCE: THERAPEUTIC MATERIALS FOR HOSPITALIZED Shedule F (Form 990) 01 7
29 Shedule F (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Page 5 Part V Supplemental Information Complete this part to provide the information required y Part I, line (monitoring of funds); Part I, line, olumn (f) (aounting method; amounts of investments vs. expenditures per region); Part II, line 1 (aounting method); Part III (aounting method); and Part III, olumn () (estimated numer of reipients), as appliale. Also omplete this part to provide any additional information. MILITARY AND VETERAN PATIENTS INCLUDING CRAFT KITS CONTAINING LEATHER, PAINT AND MODELING ACTIVITIES. (G) DESCRIPTION OF NON-CASH ASSISTANCE: THERAPEUTIC ARTS AND CRAFT KITS WERE SHIPPED TO UNITED STATES ACTIVE DUTY MILITARY PATIENTS AT VARIOUS MILITARY FACILITIES IN GERMANY. SCHEDULE F, PART III, COL (C): THE NUMBER OF INDIVIDUAL RECIPIENTS ASSISTED IS AN ESTIMATE CALCULATED AS THE TOTAL NUMBER OF THERAPEUTIC ARTS AND CRAFT KITS SHIPPED Shedule F (Form 990) 01 8
30 SCHEDULE G (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Part I d Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Attah to Form 990 or Form 990-EZ. See separate instrutions. (iii) Did fundraiser (iv) Gross reeipts have ustody or ontrol of from ativity ontriutions? OMB Open To Puli Inspetion Employer identifiation numer HELP HOSPITALIZED VETERANS, INC a Did the organization have a written or oral agreement with any individual (inluding offiers, diretors, trustees or f g If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under whih the fundraiser is to e (i) Fundraising Ativities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ filers are not required to omplete this part. 1 Indiate whether the organization raised funds through any of the following ativities. Chek all that apply. a Mail soliitations e Soliitation of non-government grants Internet and soliitations Phone soliitations In-person soliitations (ii) Ativity Soliitation of government grants Speial fundraising events key employees listed in Form 990, Part VII) or entity in onnetion with professional fundraising servies? ompensated at least $5,000 y the organization. Name and address of individual or entity (fundraiser) Supplemental Information Regarding Fundraising or Gaming Ativities 01 Yes (v) Amount paid to (or retained y) fundraiser listed in ol. (i) (vi) Amount paid to (or retained y) organization AMERICAN TARGET ADVERTISING - CONSULTS ON DIRECT MAIL Yes 965 SURVEYOR CT, #00, PROGRAM 19,50,808. 1,910,. 17,59,575. CREATIVE DIRECT RESPONSE - CONSULTS ON DIRECT MAIL SCIENCE DRIVE #10, PROGRAM,77,11. 86,05.,091,069. Total,879,99.,196,85. 0,68,6. List all states in whih the organization is registered or liensed to soliit ontriutions or has een notified it is exempt from registration or liensing. AL,AK,AZ,AR,CA,CO,CT,FL,GA,HI,IL,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,NH,NJ,NM,NY NC,ND,OH,OK,OR,PA,RI,SC,TN,T,UT,VA,WA,WV,WI LHA Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule G (Form 990 or 990-EZ) 01 SEE PART IV FOR CONTINUATIONS
31 Shedule G (Form 990 or 990-EZ) 01 HELP HOSPITALIZED VETERANS, INC Page 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 ontriutions and gross inome on Form 990-EZ, lines 1 and 6. List events with gross reeipts greater than $5,000. Revenue (a) Event #1 () Event # () Other events (d) Total events (event type) (event type) (total numer) (add ol. (a) through ol. ()) 1 Gross reeipts ~~~~~~~~~~~~~~ Less: Contriutions ~~~~~~~~~~~ Gross inome (line 1 minus line ) Cash prizes ~~~~~~~~~~~~~~~ Diret Expenses nash prizes ~~~~~~~~~~~~~ Rent/faility osts ~~~~~~~~~~~~ Food and everages ~~~~~~~~~~ 8 Entertainment ~~~~~~~~~~~~~~ 9 Other diret expenses ~~~~~~~~~~ 10 Diret expense summary. Add lines through 9 in olumn (d) ~~~~~~~~~~~~~~~~~~~~~~~~ ( ) 11 Net inome summary. Comine line, olumn (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. () Pull tas/instant (a) Bingo () Other gaming ingo/progressive ingo Revenue 1 Gross revenue (d) Total gaming (add ol. (a) through ol. ()) Diret Expenses Cash prizes ~~~~~~~~~~~~~~~ nash prizes ~~~~~~~~~~~~~ Rent/faility osts ~~~~~~~~~~~~ 5 6 Other diret expenses Volunteer laor ~~~~~~~~~~~~~ Yes % Yes % Yes % 7 Diret expense summary. Add lines through 5 in olumn (d) ~~~~~~~~~~~~~~~~~~~~~~~~ ( ) 8 Net gaming inome summary. Comine line 1, olumn d, and line 7 9 Enter the state(s) in whih the organization operates gaming ativities: a Is the organization liensed to operate gaming ativities in eah of these states? ~~~~~~~~~~~~~~~~~~~~ If "," explain: Yes 10a Were any of the organization s gaming lienses revoked, suspended or terminated during the tax year? ~~~~~~~~~ If "Yes," explain: Yes Shedule G (Form 990 or 990-EZ) 01 0
32 Shedule G (Form 990 or 990-EZ) 01 HELP HOSPITALIZED VETERANS, INC Page 11 1 Does the organization operate gaming ativities with nonmemers? ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization a grantor, enefiiary or trustee of a trust or a memer of a partnership or other entity formed to administer haritale gaming? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Yes 1 Indiate the perentage of gaming ativity operated in: a The organization s faility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a % An outside faility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 % 1 Enter the name and address of the person who prepares the organization s gaming/speial events ooks and reords: Name Address 15a Does the organization have a ontrat with a third party from whom the organization reeives gaming revenue? ~~~~~~ Yes If "Yes," enter the amount of gaming revenue reeived y the organization $ and the amount of gaming revenue retained y the third party $. If "Yes," enter name and address of the third party: Name Address 16 Gaming manager information: Name Gaming manager ompensation $ Desription of servies provided Diretor/offier Employee Independent ontrator 17 Mandatory distriutions: a Is the organization required under state law to make haritale distriutions from the gaming proeeds to retain the state gaming liense? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes Enter the amount of distriutions required under state law to e distriuted to other exempt organizations or spent in the organization s own exempt ativities during the tax year $ Part IV Supplemental Information. Complete this part to provide the explanations required y Part I, line, olumns (iii) and (v), and Part III, lines 9, 9, 10, 15, 15, 16, and 17, as appliale. Also omplete this part to provide any additional information (see instrutions). SCHEDULE G, PART I, LINE B, LIST OF TEN HIGHEST PAID FUNDRAISERS: (I) NAME OF FUNDRAISER: AMERICAN TARGET ADVERTISING (I) ADDRESS OF FUNDRAISER: 965 SURVEYOR CT, #00, MANASSAS, VA 0110 (I) NAME OF FUNDRAISER: CREATIVE DIRECT RESPONSE (I) ADDRESS OF FUNDRAISER: SCIENCE DRIVE #10, BOWIE, MD Shedule G (Form 990 or 990-EZ) 01 1
33 SCHEDULE I (Form 990) Department of the Treasury Internal Revenue Servie Name of the organization Part I 1 Grants and Other Assistane to Organizations, Governments, and Individuals in the United States Complete if the organization answered "Yes" to Form 990, Part IV, line 1 or. Attah to Form 990. OMB Open to Puli Inspetion Employer identifiation numer HELP HOSPITALIZED VETERANS, INC General Information on Grants and Assistane Does the organization maintain reords to sustantiate the amount of the grants or assistane, the grantees eligiility for the grants or assistane, and the seletion riteria used to award the grants or assistane? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Desrie in Part IV the organization s proedures for monitoring the use of grant funds in the United States. Part II Grants and Other Assistane to Governments and Organizations in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 1, for any 01 reipient that reeived more than $5,000. Part II an e dupliated if additional spae is needed. 1 (a) Name and address of organization () EIN () IRC setion (d) Amount of (e) Amount of (f) Method of (g) Desription of (h) Purpose of grant valuation (ook, or government if appliale ash grant non-ash non-ash assistane or assistane FMV, appraisal, assistane other) RE-CREATION, USA: TO RE-CREATION, USA ASSIST IN THE DAILY P.O. BO 0 OPERATIONAL AND DELIVERY PORT TREVORTON, PA (C)() 100, OF ENTERTAINMENT BY A DEPARTMENT OF VETERANS AFFAIRS - VA NATIONAL VALENTINES NATIONAL VALENTINES FOR VETERANS FOR VETERANS CONCERT: HHV CONCERTS VERMONT AVE NW - SUPPORTS THIS PROGRAM AS WASHINGTON, DC DEPARTMENT OF VA 117, ITS CONCERT PROGRAM SHOWS BUGLES ACROSS AMERICA: BUGLES ACROSS AMERICA THE ORGANIZATION PROVIDES 18 SOUTH CUYLER AVE BUGLERS AT MILITARY AND BERWYN, IL (C)() 15, VETERAN FUNERALS; TO HELP Yes LHA Enter total numer of setion 501()() and government organizations listed in the line 1 tale Enter total numer of other organizations listed in the line 1 tale ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For Paperwork Redution At tie, see the Instrutions for Form 990. Shedule I (Form 990) (01) SEE PART IV FOR COLUMN (H) DESCRIPTIONS. 0.
34 Shedule I (Form 990) (01) HELP HOSPITALIZED VETERANS, INC Part III Grants and Other Assistane to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line. Part III an e dupliated if additional spae is needed. Page (a) Type of grant or assistane () Numer of () Amount of (d) Amount of nonash (e) Method of valuation (f) Desription of non-ash assistane reipients ash grant assistane (ook, FMV, appraisal, other) THERAPEUTIC MATERIALS FOR HOSPITALIZED AND 670,580 THERAPEUTIC ARTS AND HOMEBOUND VETERANS INCLUDING CRAFT KITS CONTAINING CRAFT KITS WERE SHIPPED TO LEATHER, PAINT AND MODELING ACTIVITIES AND OTHER MILITARY AND VETERAN PATIENTS CRAFTS ,190,700.FMV AND HOMEBOUND VETERANS. HHV'S 16 STATE OF THE ART COMPUTER SYSTEMS WERE SHIPPED TO 16 VETERAN PATIENTS AT THEIR COMPUTER SYSTEMS ,16.FMV HOMES. INCLUDED WITH THE Part IV Supplemental Information. Complete this part to provide the information required in Part I, line, Part III, olumn (), and any other additional information. SCHEDULE I, PART I, LINE : GRANT FUNDS ARE MONITORED THROUGH RECEIPTS OF AFTER ACTION REPORTS FROM THE GRANTEE. PART II, LINE 1, COLUMN (H): NAME OF ORGANIZATION OR GOVERNMENT: RE-CREATION, USA (H) PURPOSE OF GRANT OR ASSISTANCE: RE-CREATION, USA: TO ASSIST IN THE DAILY OPERATIONAL AND DELIVERY OF ENTERTAINMENT BY A PATRIOTICALLY-ENTHUSIASTIC TROUPE OF TALENTED YOUNG PERFORMERS. WITH NEAR-DAILY PERFORMANCES AT VA MEDICAL CENTERS NATIONWIDE, THEIR SEE PART IV FOR COLUMN (F) DESCRIPTIONS Shedule I (Form 990) (01)
35 Shedule I (Form 990) HELP HOSPITALIZED VETERANS, INC Part IV Supplemental Information Page DEDICATION TO LIFTING THE SPIRITS OF OUR NATION S HOSPITALIZED VETERAN POPULATION IS INSPIRING, IF NOT DOWNRIGHT MOTIVATIONAL. ASSIST IN PERFORMANCES THAT RANGE FROM VARIETY-SHOW SONG & DANCE BASED ON HIT MOVIES SUCH AS FLASHDANCE, FOOTLOOSE AND TITANIC AS WELL AS CLASSIC CHILDHOOD TITLES RANGING FROM CHITTY CHITTY BANG BANG TO CINDERELLA AND DELIVERING PATRIOTIC-THEMES, WHICH OFTEN ELICIT EMOTIONAL RESPONSES FROM VETERAN PATIENTS AND ALL IN ATTENDANCE. NAME OF ORGANIZATION OR GOVERNMENT: DEPARTMENT OF VETERANS AFFAIRS - NATIONAL VALENTINES FOR VETERANS CONCERTS (H) PURPOSE OF GRANT OR ASSISTANCE: VA NATIONAL VALENTINES FOR VETERANS CONCERT: HHV SUPPORTS THIS PROGRAM AS ITS CONCERT PROGRAM SHOWS APPRECIATION TO AMERICA S VETERANS; INCREASES COMMUNITY AWARENESS OF THE LOCAL VA MEDICAL CENTER; ENCOURAGES CITIZENS TO VISIT HOSPITALIZED VETERANS AND CONSIDER BECOMING VA VOLUNTEERS; INCREASES COMMUNITY AWARENESS TO THE ISSUES FACING SEVERELY WOUNDED SOLDIERS/VETERANS AND THEIR FAMILIES; SHOWS RESPECT AND APPRECIATION TO AMERICA S GOLD STAR FAMILIES; AND SERVES AS AN OUTREACH TO ALL VETERANS TO REGISTER WITH THEIR LOCAL VA MEDICAL FACILITY FOR THEIR HEALTHCARE. NAME OF ORGANIZATION OR GOVERNMENT: BUGLES ACROSS AMERICA (H) PURPOSE OF GRANT OR ASSISTANCE: BUGLES ACROSS AMERICA: THE ORGANIZATION PROVIDES BUGLERS AT MILITARY AND VETERAN FUNERALS; TO HELP ENSURE THAT ALL VETERANS HAVE A LIVE BUGLER TO PLAY TAPS AT THEIR FUNERALS. (F) DESCRIPTION OF NON-CASH ASSISTANCE: 670,580 THERAPEUTIC ARTS AND Shedule I (Form 990)
36 Shedule I (Form 990) HELP HOSPITALIZED VETERANS, INC Part IV Supplemental Information Page CRAFT KITS WERE SHIPPED TO MILITARY AND VETERAN PATIENTS AND HOMEBOUND VETERANS. HHV S MISSION IS TO PROVIDE MILITARY AND VETERAN PATIENTS OF DEPARTMENT OF VETERANS AFFAIRS (VA) AND MILITARY FACILITIES WITH ACTIVITIES THAT KEEP THEIR HANDS ACTIVE AND THEIR MINDS ALERT WHILE ASSISTING IN THEIR RECOVERIES. ARTS AND CRAFTS KITS ALONG WITH OTHER THERAPEUTIC PRODUCTS AND SERVICES HHV PROVIDES, COME AS A VERY WELCOME ASSURANCE TO PATIENTS THAT THEY HAVE NOT BEEN FORGOTTEN - THAT SOMEONE OUT THERE REALLY DOES CARE. WITH INCREASED DEMAND FOR SERVICES PLACED UPON THE VA AND MILITARY HOSPITAL SYSTEMS, HHV S PROGRAMS FOCUS ON AUGMENTING THEIR DELIVERY OF SERVICES AND SUPPORT TO THE PATIENTS. (F) DESCRIPTION OF NON-CASH ASSISTANCE: 16 STATE OF THE ART COMPUTER SYSTEMS WERE SHIPPED TO 16 VETERAN PATIENTS AT THEIR HOMES. INCLUDED WITH THE COMPUTER SYSTEMS WERE PRINTING PAPER AND COMPUTER SOFTWARE INCLUDING: WORD PROCESSING PROGRAMS, SPREADSHEET PROGRAMS, PRESENTATION PROGRAMS, WORLD BOOK ENCYCLOPEDIA PROGRAMS, PHOTO SHOP, GAMES, ETC. SCHEDULE I, PART III, LINE 1, COLUMN B: THE NUMBER OF INDIVIDUAL RECIPIENTS ASSISTED IS AN ESTIMATE CALCULATED AS THE TOTAL NUMBER OF THERAPEUTIC ARTS AND CRAFT KITS SHIPPED TO VARIOUS FACILITIES AND VETERANS RECEIVING THERAPEUTIC ARTS AND CRAFT KITS AT THEIR HOMES Shedule I (Form 990) 5
37 OMB SCHEDULE J (Form 990) For ertain Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees 01 Complete if the organization answered "Yes" to Form 990, Department of the Treasury Part IV, line. Open to Puli Internal Revenue Servie Attah to Form 990. See separate instrutions. Inspetion Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC Part I Questions Regarding Compensation 1a Chek the appropriate ox(es) if the organization provided any of the following to or for a person listed in Form 990, Part VII, Setion A, line 1a. Complete Part III to provide any relevant information regarding these items. First-lass or harter travel Housing allowane or residene for personal use Travel for ompanions Payments for usiness use of personal residene Tax indemnifiation and gross-up payments Disretionary spending aount Compensation Information Health or soial lu dues or initiation fees Personal servies (e.g., maid, hauffeur, hef) Yes If any of the oxes on line 1a are heked, did the organization follow a written poliy regarding payment or reimursement or provision of all of the expenses desried aove? If "," omplete Part III to explain~~~~~~~~~~~ Did the organization require sustantiation prior to reimursing or allowing expenses inurred y all offiers, diretors, trustees, and the CEO/Exeutive Diretor, regarding the items heked in line 1a? ~~~~~~~~~~~~~~~~~~~~~ 1 Indiate whih, if any, of the following the filing organization used to estalish the ompensation of the organization s CEO/Exeutive Diretor. Chek all that apply. Do not hek any oxes for methods used y a related organization to estalish ompensation of the CEO/Exeutive Diretor, ut explain in Part III. Compensation ommittee Written employment ontrat Independent ompensation onsultant Compensation survey or study Form 990 of other organizations Approval y the oard or ompensation ommittee a During the year, did any person listed in Form 990, Part VII, Setion A, line 1a, with respet to the filing organization or a related organization: Reeive a severane payment or hange-of-ontrol payment? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Partiipate in, or reeive payment from, a supplemental nonqualified retirement plan? ~~~~~~~~~~~~~~~~~~~~ Partiipate in, or reeive payment from, an equity-ased ompensation arrangement? ~~~~~~~~~~~~~~~~~~~~ If "Yes" to any of lines a-, list the persons and provide the appliale amounts for eah item in Part III. a a a LHA Only setion 501()() and 501()() organizations must omplete lines 5-9. For persons listed in Form 990, Part VII, Setion A, line 1a, did the organization pay or arue any ompensation ontingent on the revenues of: The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Any related organization? If "Yes" to line 5a or 5, desrie in Part III. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For persons listed in Form 990, Part VII, Setion A, line 1a, did the organization pay or arue any ompensation ontingent on the net earnings of: The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Any related organization? If "Yes" to line 6a or 6, desrie in Part III. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For persons listed in Form 990, Part VII, Setion A, line 1a, did the organization provide any non-fixed payments not desried in lines 5 and 6? If "Yes," desrie in Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Were any amounts reported in Form 990, Part VII, paid or arued pursuant to a ontrat that was sujet to the initial ontrat exeption desried in Regulations setion (a)()? If "Yes," desrie in Part III ~~~~~~~~~~~ If "Yes" to line 8, did the organization also follow the reuttale presumption proedure desried in Regulations setion ()? For Paperwork Redution At tie, see the Instrutions for Form 990. Shedule J (Form 990) 01 5a 5 6a
38 Shedule J (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Part II Offiers, Diretors, Trustees, Key Employees, and Highest Compensated Employees. Use dupliate opies if additional spae is needed. For eah individual whose ompensation must e reported in Shedule J, report ompensation from the organization on row (i) and from related organizations, desried in the instrutions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII. te. The sum of olumns (B)(i)-(iii) for eah listed individual must equal the total amount of Form 990, Part VII, Setion A, line 1a, appliale olumn (D) and (E) amounts for that individual. Page (A) Name and Title (B) Breakdown of W- and/or 1099-MISC ompensation (C) Retirement and (D) ntaxale (E) Total of olumns (F) Compensation other deferred enefits (B)(i)-(D) reported as deferred (i) Base (ii) Bonus & (iii) Other ompensation inentive reportale ompensation in prior Form 990 ompensation ompensation (1) MICHAEL LYNCH (i) 5,11. 0., ,68. 89, PRESIDENT & CEO (ii) () RUSS MASON (i) 196, ,68. 1, DEVELOPMENT DIRECTOR (ii) () LUANN PETERSON (i) 19, , , DEVELOPMENT MANAGER (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) 7 Shedule J (Form 990) 01
39 Shedule J (Form 990) 01 HELP HOSPITALIZED VETERANS, INC Part III Supplemental Information Complete this part to provide the information, explanation, or desriptions required for Part I, lines 1a, 1,, a,,, 5a, 5, 6a, 6, 7, and 8, and for Part II. Also omplete this part for any additional information. Page PART I, LINE 1A: HHV S WRITTEN TRAVEL AND ENTERTAINMENT EPENSE POLICY AUTHORIZES FIRST CLASS TRAVEL FOR THE CEO. WITH PRIOR APPROVAL FROM THE CEO, MEMBERS OF THE BOARD OF DIRECTORS WHILE TRAVELLING ARE ALLOWED TO BE ACCOMPANIED BY THEIR SPOUSES OR COMPANIONS IF THEY ARE CONSIDERED AN ASSET IN THE DELIVERY OF HHV S MISSION AND GOODWILL FOR THE ORGANIZATION. ANY EPENSES ASSOCIATED WITH THE SPOUSES OR COMPANIONS TRAVEL WILL CAUSE A FORM 1099 TO BE ISSUED TO THE RESPONSIBLE DIRECTOR OR MEMBER, WHICH WILL HAVE TO BE CLAIMED AS INCOME ON HIS/HER PERSONAL INCOME TA FILING WITH THE IRS. Shedule J (Form 990)
40 SCHEDULE M (Form 990) OMB J Complete if the organizations answered "Yes" on Form Department of the Treasury Internal Revenue Servie 990, Part IV, lines 9 or 0. J Attah to Form 990. Open to Puli Inspetion Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC Part I Types of Property (a) () () (d) Chek if Method of determining appliale nonash ontriution amounts Art - Works of art ~~~~~~~~~~~~~ Art - Historial treasures ~~~~~~~~~ Art - Frational interests ~~~~~~~~~~ Books and puliations ~~~~~~~~~~ Clothing and household goods ~~~~~~ Cars and other vehiles ~~~~~~~~~~ Boats and planes ~~~~~~~~~~~~~ Intelletual property Seurities - Pulily traded ~~~~~~~~~~~ ~~~~~~~~ Seurities - Closely held stok~~~~~~~ Seurities - Partnership, LLC, or trust interests Seurities - Misellaneous ~~~~~~~~~~~~~~ Qualified onservation ontriution - Histori strutures ~~~~~~~~ ~~~~~~~~~~~~ Qualified onservation ontriution - Other~ Real estate - Residential Real estate - Commerial ~~~~~~~~~ Real estate - Other ~~~~~~~~~ ~~~~~~~~~~~~ Colletiles ~~~~~~~~~~~~~~~~ Food inventory ~~~~~~~~~~~~~~ Drugs and medial supplies ~~~~~~~~ Taxidermy Historial artifats Sientifi speimens ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~ Numer of ontriutions or items ontriuted nash ontriution amounts reported on Form 990, Part VIII, line 1g Arheologial artifats ~~~~~~~~~~ Other J ( LEATHER ) 165,6. COST Other J ( MISC. ITEMS ) 0. COST Other J ( ) Other J ( ) Numer of Forms 88 reeived y the organization during the tax year for ontriutions for whih the organization ompleted Form 88, Part IV, Donee Aknowledgement ~~~~ 0a During the year, did the organization reeive y ontriution any property reported in Part I, lines 1-8 that it must hold for at least three years from the date of the initial ontriution, and whih is not required to e used for exempt purposes for the entire holding period? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," desrie the arrangement in Part II. Does the organization have a gift aeptane poliy that requires the review of any non-standard ontriutions? ~~~~~~ a Does the organization hire or use third parties or related organizations to soliit, proess, or sell nonash LHA ontriutions? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," desrie in Part II. If the organization did not report an amount in olumn () for a type of property for whih olumn (a) is heked, desrie in Part II. nash Contriutions 01 For Paperwork Redution At tie, see the Instrutions for Form 990. Shedule M (Form 990) (01) 0a 1 a Yes
41 Shedule M (Form 990) (01) HELP HOSPITALIZED VETERANS, INC Page Part II Supplemental Information. Complete this part to provide the information required y Part I, lines 0,, and, and whether the organization is reporting in Part I, olumn (), the numer of ontriutions, the numer of items reeived, or a omination of oth. Also omplete this part for any additional information. SCHEDULE M, PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS IN SCHEDULE M, PART I, COLUMN (B) Shedule M (Form 990) (01) 0
42 SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Internal Revenue Servie Name of the organization Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to speifi questions on Form 990 or 990-EZ or to provide any additional information. Attah to Form 990 or 990-EZ. 01 OMB Open to Puli Inspetion Employer identifiation numer HELP HOSPITALIZED VETERANS, INC FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES WITH THERAPEUTIC ARTS AND CRAFTS KITS. WITH INCREASED DEMAND FOR SERVICES PLACED UPON THE FEDERAL, STATE AND COMMERCIAL HOSPITAL AND NURSING HOME CARE FACILITIES, HHV CONTINUES TO FOCUS ON ITS DELIVERY OF PRODUCT AND SUPPORT TO THE VETERANS OF PAST AND PRESENT. HHV WILL PROMOTE THE GENERAL WELFARE OF ARMED SERVICE VETERANS AND MILITARY PATIENTS SO THAT, DESPITE PROFOUND DISABILITIES AND PAIN, THEY MAINTAIN A SENSE OF PRIDE, SELF-CONFIDENCE AND DIGNITY DURING THEIR REHABILITATION PROCESS. HHV SEEKS TO INVOLVE THE PUBLIC IN HELPING TO ACCOMPLISH THIS MISSION THROUGH THE PROGRAMS DESCRIBED IN ITS PUBLICATIONS AND OTHER MATERIALS. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: WITH INCREASED DEMAND FOR SERVICES PLACED UPON THE FEDERAL, STATE AND COMMERCIAL HOSPITAL AND NURSING HOME CARE FACILITIES, HHV CONTINUES TO FOCUS ON ITS DELIVERY OF PRODUCT AND SUPPORT TO THE VETERANS OF PAST AND PRESENT. HHV WILL PROMOTE THE GENERAL WELFARE OF ARMED SERVICE VETERANS AND MILITARY PATIENTS SO THAT, DESPITE PROFOUND DISABILITIES AND PAIN, THEY MAINTAIN A SENSE OF PRIDE, SELF-CONFIDENCE AND DIGNITY DURING THEIR REHABILITATION PROCESS. HHV SEEKS TO INVOLVE THE PUBLIC IN HELPING TO ACCOMPLISH THIS MISSION THROUGH THE PROGRAMS DESCRIBED IN ITS PUBLICATIONS AND OTHER MATERIALS. LHA For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-EZ. Shedule O (Form 990 or 990-EZ) (01)
43 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC FORM 990, PART III, LINE, NEW PROGRAM SERVICES: THE ORGANIZATION EPANDED THEIR THERAPEUTIC MATERIAL PROGRAM SERVICES TO ASSIST HOMEBOUND VETERNS. SEE FORM 990, PART III, LINE A FOR FURTHER DETAIL. FORM 990, PART III, LINE A, PROGRAM SERVICE ACCOMPLISHMENTS: HOMES, COMMUNITY BASED CRAFT LOCATION, VETERAN PROGRAMS AND TO INDIVIDUAL HOMEBOUND VETERANS TOTALING OVER 0 MILLION CRAFT KITS AND PRODUCTS WITH A RETAIL VALUE OF OVER $1 MILLION (INCLUDING THE COST OF USPS POSTAGE). THE ORGANIZATION CONTINUES TO EPAND ITS CRAFT KIT DISTRIBUTION TO ACTIVE DUTY MILITARY PERSONNEL HOSPITALIZED IN WALTER REED ARMY MEDICAL CENTER, TRIPLER ARMY MEDICAL CENTER, AND BROOKE ARMY MEDICAL CENTER BY CONTINUING THE ASSIGNMENTS OF CRAFT CARE SPECIALISTS FOR THOSE MILITARY FACILITIES. THE YOUNG MEN AND WOMEN MILITARY PATIENTS ARE MOST APPRECIATIVE OF THIS "MEDICINE THAT DOES NOT COME IN A BOTTLE". THROUGH THE INTRODUCTION OF IT S NEW COMMUNITY BASED ARTS AND CRAFTS (CBC) DISTRIBUTION CENTERS IN BERWYN, CHICAGO; BAY PINES, FLORIDA; TEMPLE, TEAS AND GRAND JUNCTION, COLORADO, HHV IS ABLE TO PROVIDE THERAPEUTIC ARTS AND CRAFTS DIRECTLY INTO THESE COMMUNITIES. IN ADDITION TO THESE DISTRIBUTION CENTERS, HHV HAS ESTABLISHED COMMUNITY BASED ARTS AND CRAFTS CENTERS (CBC) TO FURTHER EPAND ITS SERVICE TO ALL VETERAN AND MILITARY MEDICAL PATIENTS ACROSS THE NATION WITH COMMUNITY BASED ARTS & CRAFTS CENTERS (CBC). ELIGIBILITY FOR PARTICIPATION REQUIRES MEETING ANY ONE OF THE FOLLOWING: * A VETERAN WHO HAS RECEIVED ANY FORM OF HEALTH CARE FROM ANY PUBLIC OR PRIVATE HEALTHCARE PROVIDER WITHIN THE LAST SI MONTHS Shedule O (Form 990 or 990-EZ) (01)
44 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC * A RESERVIST OR ON ACTIVE MILITARY DUTY AND HAVE RECEIVED HEALTH CARE FROM ANY PUBLIC OR PRIVATE HEALTHCARE PROVIDER WITHIN THE LAST SI MONTHS. * A VETERAN OR SERVED - PAST OR PRESENT - IN THE U.S. MILITARY AND RESIDE IN ANY PUBLIC OR PRIVATE NURSING CARE HOME. MANY MILITARY AND VETERAN PATIENTS ARE RELEASED TO HOME-BASED AND OTHER OUTPATIENT THERAPY AND REHABILITATION PROGRAMS AND AS SUCH, ARE NO LONGER ABLE TO ACCESS HHV ARTS AND CRAFTS AS THEY HAD IN THE PAST. HHV S GOAL IS TO CONTINUE TO MOVE FORWARD IN ALLOWING ALL MILITARY AND VETERAN PATIENTS ACCESS TO ITS THERAPEUTIC ARTS AND CRAFT KITS TO WORK ON AT CBC LOCATIONS, OR EVEN AT HOME. HHV CURRENTLY HAS A CBC PRESENCE IN: STATE CITY PHONE ALABAMA BIRMINGHAM (05) CALIFORNIA FRESNO (559) 0- LOMA LINDA (909) COLORADO DENVER (0) GRAND JUNCTION(970) -099 FLORIDA BAY PINES (77) GAINESVILLE (5) TAMPA (81) Shedule O (Form 990 or 990-EZ) (01)
45 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC ILLINOIS CHICAGO (77) HINES (60) NORTH CHICAGO (77) IOWA DES MOINES (515) MARYLAND PERRY POINT () NEW MEICO ALBUQUERQUE (505) NEW YORK BATH (607) BUFFALO (716) CANANDAIGUA (585) NORTH CAROLINA DURHAM (919) PENNSYLVANIA BUTLER (7) 91-0 TEAS TEMPLE (5) UTAH SALT LAKE CITY (801) VIRGINIA RICHMOND (80) ADDITIONALLY, HHV HAS TAKEN STEPS TO KEEP UP WITH THE DEMAND FOR ITS THERAPEUTIC ARTS & CRAFTS KITS BY INCREASING ITS OUTREACH. DELIVERY OF ARTS & CRAFTS TO MILITARY AND VETERAN PATIENTS AT THEIR HOMES IS NOW Shedule O (Form 990 or 990-EZ) (01)
46 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC AVAILABLE THROUGH HHV S NEW PATIENT HOME REHABILITATION (PHR) PROGRAM. THIS PROGRAM IS PROVIDED FOR ALL U.S. VETERANS AND MEMBERS OF THE MILITARY THAT HAVE RECEIVED ANY MEDICAL OR NURSING CARE WITHIN THE LAST SI MONTHS AT ANY MEDICAL OR NURSING CARE FACILITY. FORM 990, PART III, LINE B, PROGRAM SERVICE ACCOMPLISHMENTS: ASSIST THE VETERAN PATIENT COMMUNITY EITHER THROUGH FINANCIAL SUPPORT TO PROVIDE THE PRODUCTS AND SERVICES, VOLUNTEERING AT VA MEDICAL FACILITIES, BECOMING PEN-PALS, AND OFFER A MEANS OF SHOWING SUPPORT AND CARE FOR VETERAN PATIENTS. ADDITIONALLY, PUBLIC AWARENESS AND SUPPORT IS ACCOMPLISHED THROUGH SPONSORSHIPS OF VA S NATIONAL SALUTE TO VETERAN PATIENT CONCERTS, PUBLIC SERVICE ANNOUNCEMENTS AND THROUGH MAILINGS THAT SUPPORT OTHER VETERANS ASSISTANCE PROGRAMS AS A MEDICAL TREATMENT TOOL THROUGH THE USE OF AUTHORIZED PHOTOS AND INFORMATION RECEIVED FROM PATIENTS, FAMILIES, CLINICIANS AND ADMINISTRATORS. ACCORDING TO SIGMA TECHNOLOGY TRACKING DEVELOPED BY NIELSEN MEDIA RESEARCH; 8,888 PUBLIC SERVICE ANNOUNCEMENT AIRINGS WERE BROADCAST DURING THE YEAR ON 91 STATIONS IN TELEVISION MARKETS; RESULTING IN A TOTAL ESTIMATED AUDIENCE REACH OF,778,100 PEOPLE AND AN ESTIMATED AD VALUE OF $,099,550. ADDITIONAL SPONSORSHIPS INCLUDE SUPPORT OF NOT FOR PROFIT ORGANIZATIONS "RE-CREATION, USA" AND BUGLES ACROSS AMERICA. IN ADDITION, HHV STAFF MEMBERS MADE PERSONAL CONTACT WITH SENIOR STAFF, PATIENTS, AND CLINICIANS OF MILITARY HOSPITALS AND STATE VETERANS NURSING HOMES TO ENSURE THE QUALITY OF PRODUCTS AND SERVICES HHV PROVIDES ARE MEETING THE NEEDS OF THE VETERAN PATIENTS Shedule O (Form 990 or 990-EZ) (01) 5
47 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC FORM 990, PART VI, SECTION A, LINE : THE ORGANIZATION S ARTICLES OF INCORPORATION WERE AMENDED IN NOVEMBER, 01, TO INCLUDE THE FOLLOWING: ARTICLE II.B. OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION IS AMENDED TO READ AS FOLLOWS: THE GENERAL PURPOSES FOR WHICH THIS CORPORATION IS FORMED ARE CHARITABLE PURPOSES, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING SPECIFIC PURPOSES: (A)TO SUPPLEMENT THE UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES THAT PROVIDES HEALTH OR NURSING CARE TO U. S. VETERANS AND ARMED SERVICES MILITARY HOSPITAL PROGRAMS FOR THERAPEUTIC PATIENT CARE. (B)TO SEEK INDIVIDUALS TO PROVIDE VOLUNTARY SERVICES TO UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES AND ARMED SERVICES MILITARY HOSPITALS. (C)TO ENCOURAGE CONTINUING DIALOGUE BETWEEN THE UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS AND THE GENERAL PUBLIC TO HELP DEVELOP SELF-ESTEEM AND CONFIDENCE WITHIN THE PATIENT COMMUNITY. (D)TO ENCOURAGE AND SEEK UNDERSTANDING AND INVOLVEMENT IN THE GENERAL PUBLIC OF THE SACRIFICES OF UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS AND THE FUTURE NEED TO PROVIDE CARE IN MEDICAL AND NURSING FACILITIES WHILE PROMOTING THE PATIENTS GENERAL WELFARE SO THAT, DESPITE PROFOUND DISABILITIES AND PAIN, THE PATIENTS MAINTAIN A SENSE OF Shedule O (Form 990 or 990-EZ) (01) 6
48 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC PRIDE, SELF-CONFIDENCE AND DIGNITY DURING THEIR REHABILITATION PROCESS, AS THE ORGANIZATION STRIVES TO ACCOMPLISH THIS THROUGH PROGRAMS DESCRIBED IN ITS PUBLICATIONS AND OTHER MATERIALS. (E)TO DEVELOP COMMUNITY BASED PROGRAMS TO DISTRIBUTE ARTS AND CRAFTS MATERIALS IN KIT FORM TO UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS THAT RECEIVE THEIR CARE AT A UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES AND ARMED SERVICES MILITARY HOSPITALS. (F)TO DISTRIBUTE ARTS AND CRAFTS MATERIALS IN KIT FORM TO RECREATIONAL THERAPY, OCCUPATIONAL THERAPY, ACTIVITIES AND VOLUNTARY DEPARTMENTS OF THE UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES AND ARMED SERVICES MILITARY HOSPITALS. (G)TO DISTRIBUTE ARTS AND CRAFTS MATERIALS IN KIT FORM TO THE RESIDENCES OF UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS THAT RECEIVE THEIR CARE FROM A UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES AND ARMED SERVICES MILITARY HOSPITALS. (H) TO ASSIST THE UNITED STATES FEDERAL, STATE OR COMMERCIAL MEDICAL OR NURSING HOME CARE FACILITIES AND ARMED SERVICES MILITARY HOSPITALS IN PROVIDING REHABILITATIVE PROGRAMS AND SPECIAL EVENTS TO UNITED STATES ARMED SERVICES VETERANS AND MILITARY PATIENTS. (I)TO HELP PROVIDE SUPPORT AND PRODUCTS TO MEMBERS OF THE UNITED STATES ARMED SERVICES WHO ARE IN COMBAT OR COMBAT SUPPORT AREAS OUTSIDE OF THE UNITED STATES AND RECEIVE HEALTHCARE THROUGH ARMED SERVICES MILITARY Shedule O (Form 990 or 990-EZ) (01) 7
49 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC MEDICAL FACILITIES. (J)TO HELP PROVIDE SUPPORT FOR RECREATIONAL ENTERTAINMENT OF UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS. (K)TO HELP TO PROVIDE A MEANINGFUL WAY FOR INDIVIDUALS, CORPORATIONS AND OTHER NOT FOR PROFIT ORGANIZATIONS TO HELP SEVERELY WOUNDED AND DISABLED UNITED STATES ARMED SERVICES VETERAN AND MILITARY PATIENTS AND THEIR FAMILIES TO REBUILD THEIR LIVES. (L)TO DISTRIBUTE GIFTS TO UNITED STATES DISABLED WAR VETERANS THAT ARE EDUCATIONAL, ENTERTAINING AND/OR ACTIVITY ORIENTED THAT REPRESENT A MEANINGFUL AND WELCOME EPRESSION OF CARE AND APPRECIATION BY THEIR FELLOW CITIZENS. (M) TO HELP LIFT THE SPIRITS AND MORALE OF UNITED STATES VETERAN AND MILITARY PATIENTS AND TO ASSIST THEM TO SPEND THEIR TIME IN A SATISFYING AND CONSTRUCTIVE WAY. (N) TO HELP TO ENSURE THAT ALL VETERANS ARE HONORED AT THEIR GRAVESITE. (O) TO OBTAIN DONATIONS AND RECEIVE CONTRIBUTIONS IN ORDER TO ACCOMPLISH THE ABOVE PROGRAMS AND PURPOSES. FORM 990, PART VI, SECTION B, LINE 11: FORM 990 IS PREPARED BY A CERTIFIED PUBLIC ACCOUNTING FIRM. A DRAFT OF FORM 990 IS SENT TO HHV S MANAGEMENT FOR THEIR REVIEW AND THE 990 IS ALSO REVIEWED BY HHV S LEGAL COUNSEL. FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. A Shedule O (Form 990 or 990-EZ) (01) 8
50 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC BOARD MEETING TAKES PLACE TO DISCUSS THE RETURN AND RESPOND TO QUESTIONS BEFORE ITS FILING. FORM 990, PART VI, SECTION B, LINE 1C: THE CONFLICT OF INTEREST POLICY IS REVIEWED AND ACKNOWLEDGED ANNUALLY BY OFFICERS AND DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15: THE BOARD OF DIRECTORS REVIEW OF CONTRACT AND SALARY REQUIREMENTS IS BASED ON A SALARY COMPARISON DATA PROVIDED BY AN INDEPENDENT SURVEY AND CONTEMPORANEOUS DOCUMENTATION OF THE DECISION WAS MADE FOR THE PRESIDENT/DIRECTOR EMPLOYMENT CONTRACT. FORM 990, PART VI, LINE 17, LIST OF STATES RECEIVING COPY OF FORM 990: AL,AK,AR,AZ,CA,CO,CT,FL,GA,IL,LA,KY,ME,MD,MI,MA,MN,MS,MO,NH,NJ,NY,NM,NC,ND OH,OK,OR,PA,RI,SC,TN,T,UT,VA,WA,WV,WI FORM 990, PART VI, SECTION C, LINE 18: HHV COMPLIES WITH IRC SECTION 610 AND MAKES ITS FORMS 990 AND 990-T (IF APPLICABLE) AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORMS 990 AND 990-T (IF APPLICABLE) CAN ALSO BE FOUND ON HHV S WEBSITE. FORM 990, PART VI, SECTION C, LINE 19: HHV MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATIONS GOVERNING DOCUMENTS MAY BE MADE AVAILABLE UPON REQUEST. FORM 990, PART VIII, LINE 1G NONCASH CONTRIBUTIONS INCLUDED IN LINES 1A-1F: THIS AMOUNT INCLUDES DONATED LEATHER, AND OTHER MISCELLANEOUS NONCASH ITEMS. SEE FORM 990 SCHEDULE M FOR ADDITIONAL INFORMATION Shedule O (Form 990 or 990-EZ) (01) 9
51 Shedule O (Form 990 or 990-EZ) (01) Page Name of the organization Employer identifiation numer HELP HOSPITALIZED VETERANS, INC FORM 990, PART I, LINE 9, CHANGES IN NET ASSETS: PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 01, Shedule O (Form 990 or 990-EZ) (01) 50
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