efile Public Visual Render
Submission Date - 2012-08-14
TIN: 20-1308308
Form
990-EZ
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
20
11
Open to Public
Inspection
A
For the 2011 calendar year, or tax year beginning
01-01-2011
, and ending
12-31-2011
B
Check if applicable:
Address change
Name change
Initial return
Terminated
Amended return
Application pending
C
Name of organization
Burlington Supportive Housing
Initiatives Inc
Number and street (or P. O. box, if mail is not delivered to street address)
65 Main Street
Room/suite
City or town, state or country, and ZIP + 4
Burlington
,
VT
05401
D Employer identification number
20-1308308
E
Telephone number
(802) 540-3208
F
Group Exemption
Number.
.
G
Accounting method:
Cash
Accrual
Other (specify)
H
Check
required to attach Schedule B
(Form 990, 990-EZ, or 990-PF).
I Website:
N/A
J Tax-Exempt status
(check only one)
501(c)(3)
501(c)
(
)
(insert no.)
4947(a)(1)
or
527
K
Check
if the organization is not a section 509(a)(3) supporting organization or a section 527 organization
and
its gross receipts are normally
not
more than
$50,000.
A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the
organization chooses to file a return, be sure to file a complete return.
L
Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25,
column (B) below) are $500,000 or more,file Form 990 instead of Form 990-EZ.
..........
$
40,439
Part I
Revenue, Expenses, and Changes in Net Assets or Fund Balances
(see the instructions for Part I.)
Check if the organization used Schedule O to respond to any question in this Part I
...........
1
Contributions, gifts, grants, and similar amounts received
...............
1
40,380
2
Program service revenue including government fees and contracts
............
2
3
Membership dues and assessments
......................
3
4
Investment income
...........................
4
59
5a
Gross amount from sale of assets other than inventory
........
5a
b
Less: cost or other basis and sales expenses
...........
5b
0
c
Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a)
......
5c
6
Gaming and fundraising events
a
Gross income from gaming (attach Schedule G if greater than $15,000)
.
6a
b
Gross income from fundraising events (not including $
of contributions
from fundraising events reported on line 1) (attach Schedule G if the
sum of such gross income and contributions exceeds $15,000)
6b
0
c
Less: direct expenses from gaming and fundraising events
.......
6c
0
d
Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c)
6d
7a
Gross sales of inventory, less returns and allowances
........
7a
b
Less: cost of goods sold
.................
7b
0
c
Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a)
.........
7c
8
Other revenue (describe in Schedule O)
.....................
8
9
Total revenue.
Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8
.................
9
40,439
10
Grants and similar amounts paid (list in Schedule O)
.................
10
11
Benefits paid to or for members
........................
11
12
Salaries, other compensation, and employee benefits
................
12
13
Professional fees and other payments to independent contractors
............
13
4,633
14
Occupancy, rent, utilities, and maintenance
...................
14
15
Printing, publications, postage, and shipping
...................
15
16
Other expenses (describe in Schedule O)
....................
16
56,286
17
Total expenses.
Add lines 10 through 16
....................
17
60,919
18
Excess or (deficit) for the year (Subtract line 17 from line 9)
............
18
-20,480
19
Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior years return)
................
19
66,706
20
Other changes in net assets or fund balances (explain in Schedule O)
..........
20
21
Net assets or fund balances at end of year. Combine lines 18 through 20
.........
21
46,226
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I
Form
990-EZ
(2011)
Form 990-EZ (2011)
Page
2
Part II
Balance Sheets
(see the instructions for Part II.)
Check if the organization used Schedule O to respond to any question in this Part II.
............
(See the instructions for Part II.)
(A)
Beginning of year
(B)
End of year
22
Cash, savings, and investments
................
64,982
22
46,316
23
Land and buildings
....................
23
24
Other assets (describe in Schedule O)
..........
2,761
24
25
Total assets
......................
67,743
25
46,316
26
Total liabilities
(describe in Schedule O)
.............
1,037
26
90
27
Net assets or fund balances
(line 27 of column (B)
must
agree with line 21)
..
66,706
27
46,226
Part III
Statement of Program Service Accomplishments
(see the instructions for Part III.)
Check if the organization used Schedule O to respond to any question in this Part III
.
Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose?
Housing Supportive Services
Describe the organizations program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28
The HelpFund is a collaborative effort of community service providers and organizations to consolidate assistance and information to more efficiently respond to the emergency needs of people in Chittenden County who are at risk of losing their housing. The fund is fueled by donations from individuals, supporting organizations, foundations and community members. All donations to the HelpFund go directly to those in need. Burlington Supportive Housing Initiatives, Inc. is the sponsoring agency. In 2011, the HelpFund served 107 adults and 96 children.
(Grants $
26,479
)
If this amount includes foreign grants, check here
...
28a
29
The Money Camp Financial Literacy Program is a financial literacy program for children ages 10-14. In 2011, we served 12 children who reside in the BHA public housing family developments. The Money Camp Financial Literacy Curriculum focuses, not only on the basic principles of money, money flow, financial vocabulary, financial statements, and basic investing, but also on the important concept that the beliefs and attitudes children develop about money early on in life, have a direct and lasting effect on their financial futures.
(Grants $
649
)
If this amount includes foreign grants, check here
...
29a
30
Newman's Own Foundation Grant provides programming for seniors and adults with disabilities. Examples of programming include transportation, educational events and therapeutic workshops. Additionally, this funding source is utilized to provide a subsidized homemaker program at one site. This program provides residents with a subsidy for essential housekeeping services to ensure independent housing is achieved. Individualized care management plans are created and adjusted depending on need. This subsidy program is funded in full by the Newman's Own Foundation and can be credited with saving 9 residents from eviction due to inability to maintain one's apartment due to hoarding or other issues.
(Grants $
3,595
)
If this amount includes foreign grants, check here
...
30a
The Summer Lunch Program is a partnership between the Burlington Parks and Recreation Department, Burlington Schools Food Service, and the Burlington Housing Authority, to administer the Recreation and Nutrition Summer Drop-In Programs at three of BHA's low-income housing communities: Franklin Square, Riverside Apartments and Bobbin Mill Apartments. The program enables low-income children to have summer access to nutritious meals and supervised programming and served 278 Burlington children in the summer of 2011.
(Grants $
12,007
)
If this amount includes foreign grants, check here
...
The Summer Program Coordinator (SPC) works with families living in all three (3) of the Burlington Housing Authority's family developments - Franklin Square, Hillside Terrace, and Riverside Apartments. The SPC is in charge of creating new summer programming opportunities for the children in the developments, as well as coordinating the summer schedule of events offered by our partner agencies. During the summer of 2011, a total of 133 children participated in daily programming at the sites.
(Grants $
4,250
)
If this amount includes foreign grants, check here
...
The Fanny Allen Grant serves people with disabilities and seniors living in two (2) of the Burlington Housing Authority's (BHA) public housing sites - Decker Towers located at 230 St. Paul Street and 10 North Champlain Street apartments - housing a total of 218 people. This grant pays for recreational and educational activities and services for the people living in these units. Some examples of programming funded by this grant include a Resource Fair with community agencies, Tai Chi classes, trip to Vermont Historical Museum and the annual Fall Gala in which residents are recognized for their volunteer contributions.
(Grants $
5,602
)
If this amount includes foreign grants, check here
...
31
Other program services (describe in Schedule O)
..................
(Grants $
)
If this amount includes foreign grants, check here
...
31a
32 Total program service expenses
(add lines 28a through 31a)
..............
32
52,582
Part IV
List of Officers, Directors, Trustees, and Key Employees.
List each one even if not compensated. (see the instructions for Part IV.)
Check if the organization used Schedule O to respond to any question in this Part IV
..........
(a)
Name and title
(b)
Average
hours per week
devoted to position
(c)
Reportable compensation
(Forms W-2/1099-MISC)
(if not paid, enter -0-)
(d)
Health benefits, contributions to employee benefit plans,
and deferred compensation
(e)
Estimated amount
of other compensation
Jeanne Hutchins
792 College Parkway Ste 205
Colchester
,
VT
05446
Director
0.50
0
Cheryl Fatnassi
PO Box 67
Winooski
,
VT
05404
Director
0.50
0
Sheila Gorski
300 Lake Street 405
Burlington
,
VT
05401
Secretary
0.50
0
Bruce Plumley
9 Franklin Square
Burlington
,
VT
05401
Vice President
0.50
0
Brian Pine
149 Church St Rm 32 City Hall
Burlington
,
VT
05401
President
0.50
0
Form
990-EZ
(2011)
Form 990-EZ (2011)
Page
3
Part V
Other Information
(Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Schedule O to respond to any question in this Part V
Yes
No
33
Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a
detailed description of each activity in Schedule O
...................
33
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy
of the amended documents if they reflect a change to the organizations name. Otherwise, explain the change
on Schedule O (see instructions).
..........................
34
No
35a
Did the organization have unrelated business gross income of $1,000 or more during the year from business
activities (such as those reported on lines 2, 6a, and 7a, among others)?
............
35a
No
b
If Yes to line 35a, has the organization filed a
Form 990-T
for the year? If No, provide
an explanation in Schedule O.
35b
No
c
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e)
notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III.
35c
No
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during
the year? If Yes, complete applicable parts of Schedule N
................
36
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions.
37a
b
Did the organization file
Form 1120-POL
for this year?
...................
37b
No
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee
or
were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?
..
38a
No
b
If Yes, complete Schedule L, Part II and enter the total amount involved
.
38b
39
Section 501(c)(7) organizations.
Enter:
a
Initiation fees and capital contributions included on line 9
.......
39a
0
b
Gross receipts, included on line 9, for public use of club facilities
.....
39b
0
40a
Section 501(c)(3) organizations.
Enter amount of tax imposed on the organization during the year under:
section 4911
; section 4912
; section 4955
b
Section 501(c)(3) and 501(c)(4) organizations.
Did the organization engage in any section 4958 excess benefit
transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been
reported on any of its prior Forms 990 or 990-EZ? If Yes, complete Schedule L, Part I.
......
40b
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or
disqualified persons during the year under sections 4912, 4955, and 4958
...
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization
....................
e
All organizations.
At any time during the tax year, was the organization a party to a prohibited tax shelter
transaction? If "Yes," complete Form 8886-T.
......................
40e
No
41
List the states with which a copy of this return is filed.
42a
The organization's books are in care of
James Brown
Telephone no.
(802) 540-3208
Located at
65 Main Street
Burlington
,
VT
ZIP + 4
05401
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
No
If Yes, enter the name of the foreign country:
See the instructions for exceptions and filing requirements for
Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside the U.S.?
42c
No
If Yes, enter the name of the foreign country:
43
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of
Form 1041
Check here
.......
and enter the amount of tax-exempt interest received or accrued during the tax year
....
43
Yes
No
44a
Did the organization maintain any donor advised funds during the year?
If "Yes," Form 990 must be completed instead of
Form 990-EZ.
................................
44a
No
b
Did the organization operate one or more hospital facilities during the year?
If Yes, Form 990 must be completed
instead of Form990-EZ
.............................
44b
No
c
Did the organization receive any payments for indoor tanning services during the year?
.........
44c
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments?
If No, provide an explanation
in Schedule O
................................
44d
No
45a
Did the organization have a controlled entity within the meaning of
section 512(b)(13)?
............................
45a
No
45b
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead
of Form990-EZ (see instructions)
.....................
45b
No
Form
990-EZ
(2011)
Form 990-EZ (2011)
Page
4
Yes
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to
candidates for public office? If Yes, complete Schedule C, Part I.
..............
46
No
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only.
All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52.
Check if the organization used Schedule O to respond to any question in this Part VI
...........
Yes
No
47
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year?
If "Yes," complete Schedule C, Part II
.......................
47
No
48
Is the organization a school described in section 170(b)(1)(A)(ii)?
If "Yes," complete Schedule E
....
48
No
49a
Did the organization make any transfers to an exempt non-charitable related organization?
......
49a
No
b
If "Yes," was the related organization a section 527 organization?
................
49b
No
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a)
Name and title of each employee paid more than $100,000
(b)
Average
hours per week
devoted to position
(c)
Reportable compensation
(Forms W-2/1099-MISC)
(d)
Health benefits, contributions to employee benefit plans, and deferred compensation
(e)
Estimated amount of other compensation
NONE
f
Total number of other employees paid over $100,000
.................
51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a)
Name and address of each independent contractor paid more than $100,000
(b)
Type of service
(c)
Compensation
NONE
d
Total number of other independent contractors each receiving over $100,000
..........
52
Did the organization complete Schedule A?
NOTE:
All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts
must attach a completed Schedule A
.....................
Yes
No
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
2012-08-14
Signature of officer
Date
Brian Pine
President
Type or print name and title
Paid preparer use only
Print/type preparer's name
Preparer's signature
Colleen L Montgomery CPA
Date
Check
if
self-employed
PTIN
Firm's name
Montgomery & Merrill PC
Firm's EIN
Firm's address
110 Main Street
Burlington
,
VT
054018451
Phone no.
(802) 864-6565
May the IRS discuss this return with the preparer shown above? See instructions
.........
Yes
No
Form
990-EZ
(2011)
Additional Data
Software ID:
11000144
Software Version:
2011v1.2
Form 990-EZ, Special Condition Description:
Special Condition Description