12X_GBDS_V1 GREATERBOSTONDIABETESSOCIETY

User Manual: GREATERBOSTONDIABETESSOCIETY

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Form

Short Form
Return Under
of Organization
Exempt From Income Tax
section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code

990-EZ

OMB No. 1545-1150

2012

(except black lung benefit trust or private foundation)

Department of the Treasury
Internal Revenue Service

| 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. 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.

Open to Public
Inspection
| The organization may have to use a copy of this return to satisfy state reporting requirements.
A For the 2012 calendar year, or tax year beginning
and ending
B Check if
D Employer identification number
C Name of organization
applicable:
Address change
Name change
Initial return
Terminated

GREATER BOSTON DIABETES SOCIETY, INC
Number and street (or P.O. box, if mail is not delivered to street address)

04-2232419
Room/suite E Telephone number

15 WEST 65TH STREET

212-769-6200

City or town, state or country, and ZIP + 4

F Group Exemption
Number |
G
H Check | X if the organization is not
I
required to attach Schedule B
J
4947(a)(1) or
527
(Form 990, 990-EZ, or 990-PF).
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,
6,145.
line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ  | $
(see
the
instructions
for
Part
I)
Revenue,
Expenses,
and
Changes
in
Net
Assets
or
Fund
Balances
Part I
Amended return

NEW YORK, NY 10023
X Accrual Other (specify) |
Cash
Accounting Method:
WWW.GUILDHEALTH.ORG
Website: |
X 501(c)(3)
Tax-exempt status (check only one)
501(c) (
) § (insert no.)

b

c
d
7a
b
c
8
9
10
11
12
13
14
15
16
17

T

AF

1
2
3
4
5a
b
c
6
a

X
Check if the organization used Schedule O to respond to any question in this Part I 
6,145.
Contributions, gifts, grants, and similar amounts received ~~~~~~~~~~~~~~~~~~~~~~~~~~~
1
Program service revenue including government fees and contracts ~~~~~~~~~~~~~~~~~~~~~~~
2
Membership dues and assessments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
3
Investment income 
4
Gross amount from sale of assets other than inventory ~~~~~~~~~~~~~
5a
Less: cost or other basis and sales expenses ~~~~~~~~~~~~~~~~~
5b
Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ~~~~~~~~~~~~~~~
5c
Gaming and fundraising events
Gross income from gaming (attach Schedule G if greater than
$15,000) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
6a
Gross income from fundraising events (not including $
of contributions
from fundraising events reported on line 1) (attach Schedule G if the sum of such
6b
gross income and contributions exceeds $15,000) ~~~~~~~~~~~~~~
6c
Less: direct expenses from gaming and fundraising events ~~~~~~~~~~

DR

Revenue

Application pending

Net Assets

Expenses

Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) ~~~~~~~~~
Gross sales of inventory, less returns and allowances ~~~~~~~~~~~~~
7a
Less: cost of goods sold ~~~~~~~~~~~~~~~~~~~~~~~~~~
7b
Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) ~~~~~~~~~~~~~~~~~~~
Other revenue (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8  |
Grants and similar amounts paid (list in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Benefits paid to or for members ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Salaries, other compensation, and employee benefits ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Professional fees and other payments to independent contractors ~~~~~~~~~~~~~~~~~~~~~~~~
Occupancy, rent, utilities, and maintenance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Printing, publications, postage, and shipping ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
SEE SCHEDULE O
Other expenses (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Total expenses. Add lines 10 through 16  |
18 Excess or (deficit) for the year (Subtract line 17 from line 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~
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 year's return) ~~~~~~~~~~~~~~~~~~~~~~~
20 Other changes in net assets or fund balances (explain in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~
21 Net assets or fund balances at end of year. Combine lines 18 through 20  |
LHA For Paperwork Reduction Act Notice, see the separate instructions.

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6d

7c
8
9
10
11
12
13
14
15
16
17
18
19
20
21

6,145.
20,539.
1,735.
802.
2,825.
25,901.
<19,756.>
273,192.
0.
253,436.
Form 990-EZ (2012)

1
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

GREATER BOSTON DIABETES SOCIETY, INC
04-2232419
Balance Sheets (see the instructions for Part II)
Check if the organization used Schedule O to respond to any question in this Part II 

Form 990-EZ (2012)

Part II

(A) Beginning of year
22
23
24
25
26
27

Cash, savings, and investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Land and buildings ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
SEE SCHEDULE O
Other assets (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~
Total assets ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
SEE SCHEDULE O
Total liabilities (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~
Net assets or fund balances (line 27 of column (B) must agree with line 21) 

106,104.

22
23
24
25
26
27

307,622.
407,756.
134,564.
273,192.
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 X
What is the organization's primary exempt purpose?SEE SCHEDULE O

28

X

(B) End of year

100,134.

Describe the organization's 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.

Page 2

307,323.
413,427.
159,991.
253,436.
Expenses
(Required for section
501(c)(3) and 501(c)(4)
organizations and section
4947(a)(1) trusts; optional
for others.)

SEE SCHEDULE O

(Grants $

) If this amount includes foreign grants, check here  |

28a

(Grants $

) If this amount includes foreign grants, check here  |

29a

25,901.

T

29

AF

30

30a
(Grants $
) If this amount includes foreign grants, check here  |
31 Other program services (describe in Schedule O) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
31a
(Grants $
) If this amount includes foreign grants, check here  |
32 Total program service expenses (add lines 28a through 31a)  | 32

Part IV List of Officers, Directors, Trustees, and Key Employees
Check if the organization used Schedule O to respond to any question in this Part IV

25,901.

(a) Name and title

DR

List each one even if not compensated. (see the instructions for Part IV)

(b) Average hours
per week devoted to
position

ALAN R. MORSE
PRESIDENT AND CEO
JAMES M. DUBIN
CHAIRMAN
PAULINE RAIFF
CHAIRMAN, EXEC COMMITTEE
LAWRENCE E. GOLDSCHMIDT
TREASURER
ROBERT B. OKUN
SECRETARY
PHILIP ROSENTHAL
CHIEF OPERATING OFFICER
ELLIOT J. HAGLER
CHIEF FINANCIAL OFFICER
CATHLEEN WIRTS
SENIOR VP CORPORATE DEVELOPMENT
SARAH SPICEHANDLER
ASSISTANT SECRETARY

232172 01-11-13

11130909 132497 GBDS

(c) Reportable

compensation (Forms
W-2/1099-MISC)
(if not paid, enter -0-)


(d) Health benefits, (e) Estimated
contributions to
amount of other
employee benefit
plans, and deferred
compensation
compensation

0.50

0.

0.

0.

0.50

0.

0.

0.

0.50

0.

0.

0.

0.50

0.

0.

0.

0.50

0.

0.

0.

0.50

4,505.

597.

0.

0.50

0.

0.

0.

0.50

0.

0.

0.

0.50

0.

0.

0.

Form 990-EZ (2012)
2
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GREATER BOSTON DIABETES SOCIETY, INC
04-2232419
Page 3
Other Information (Note the Schedule A and personal benefit contract statement requirements in the
X
instructions for Part V) Check if the organization used Sch. O to respond to any question in this Part V
Yes No

Form 990-EZ (2012)

Part V
33
34
35 a
b
c
36

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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended
documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule O (see instructions) ~~~~~~
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)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O ~~~~~~~~~~
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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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 
0.
Enter amount of political expenditures, direct or indirect, as described in the instructions ~~~~~ | 37a

37 a
b Did the organization file Form 1120-POL for this year? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
38 a 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? 
N/A
38b
b If "Yes," complete Schedule L, Part II and enter the total amount involved ~~~~~~~~~~~~~~
39

d
e
41
42a
b

34

X

35a
35b

X
N/A

35c

X

36

X

37b

X

38a

X

N/A
N/A

0. ; section 4912 |
0. ; section 4955 |
0.
section 4911 |
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?
40b
If "Yes," complete Schedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers
0.
or disqualified persons during the year under sections 4912, 4955, and 4958 ~~~~~~~~~~~~~~~ |
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the
0.
organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter
40e
transaction? If "Yes," complete Form 8886-T ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
List the states with which a copy of this return is filed | MA
The organization's books are in care of | ELLIOT J. HAGLER
Telephone no. | 212-769-7806
15
WEST
65TH
STREET,
NEW
YORK,
NY
Located at |
ZIP + 4 | 10023
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
Yes
42b
account)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

AF

c

X

DR

b

39a
39b

T

Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on line 9 ~~~~~~~~~~~~~~~~~~~~~
b Gross receipts, included on line 9, for public use of club facilities ~~~~~~~~~~~~~~~~~~
40a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:

33

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.
42c
c At any time during the calendar year, did the organization maintain an office outside of the U.S.? ~~~~~~~~~~~~~~~~~~~~
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  |
N/A
and enter the amount of tax-exempt interest received or accrued during the tax year ~~~~~~~~~~~~~~~~~ | 43

44a Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be completed instead of
Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
b Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be completed instead
of Form 990-EZ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
c Did the organization receive any payments for indoor tanning services during the year? ~~~~~~~~~~~~~~~~~~~~~~~~
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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
45 a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ~~~~~~~~~~~~~~~~~~~~~~~~
45 b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section
512(b)(13)? If "Yes," Form 990 and Schedule R may need to be completed instead of Form 990-EZ (see instructions) 

X

X

No
X
X

Yes No
44a

X

44b
44c

X
X

44d
45a

X

45b
Form 990-EZ (2012)

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3
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

Form 990-EZ (2012)
46

GREATER BOSTON DIABETES SOCIETY, INC

04-2232419

Yes No

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 

Part VI

Page 4

X

46

Section 501(c)(3) organizations only
All section 501(c)(3) organizations must answer questions 47-49b and 52, and complete the tables for lines 50 and 51
Check if the organization used Schedule O to respond to any question in this Part VI 

Yes No

X
47
X
48
X
49a
b If "Yes," was the related organization a section 527 organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
49b
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."
(d) Health benefits, (e) Estimated
(a) Name and title of each employee
(b) Average hours
(c) Reportable
contributions to
compensation (Forms
paid more than $100,000
per week devoted to
amount of other
employee benefit
W-2/1099-MISC)
plans,
and deferred
position
compensation
NONE
compensation

AF

T

47 Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Sch. C, Part II
48 Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ~~~~~~~~~~~~~~~~~~~
49 a Did the organization make any transfers to an exempt non-charitable related organization? ~~~~~~~~~~~~~~~~~~~~~~

Total number of other employees paid over $100,000 ~~~~~~~~~~~~~~~~ |
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the
NONE
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

DR

f
51

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 

|

X

Yes

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

=
=

No

Date

Signature of officer

ELLIOT J. HAGLER, CHIEF FINANCIAL OFFICER
Type or print name and title

Print/Type preparer's name

Paid
Preparer FREDERICK H.
Use Only Firm's name LOEB
655
Firm's address
NEW

9
9

Preparer's signature

ROTHMAN
& TROPER LLP
THIRD AVENUE
YORK, NY 10017

Date

Check
if
self- employed
Firm's EIN
Phone no.

9

PTIN

P01275277
13-1517563
212-867-4000

May the IRS discuss this return with the preparer shown above? See instructions  |

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11130909 132497 GBDS

X

Yes
No
Form 990-EZ (2012)

4
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

SCHEDULE A
(Form 990 or 990-EZ)

2012

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
| Attach to Form 990 or Form 990-EZ. | See separate instructions.

Department of the Treasury
Internal Revenue Service

Name of the organization

Part I

OMB No. 1545-0047

Public Charity Status and Public Support

Open to Public
Inspection
Employer identification number

GREATER BOSTON DIABETES SOCIETY, INC
Reason for Public Charity Status (All organizations must complete this part.) See instructions.

04-2232419

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)
3
A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name,
4
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7

X

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from
activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.
See section 509(a)(2). (Complete Part III.)
An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that
describes the type of supporting organization and complete lines 11e through 11h.
Type I
Type II
Type III - Functionally integrated
Type III - Non-functionally integrated
a
b
c
d
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than
foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III
supporting organization, check this box ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below,
Yes No
the governing body of the supported organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11g(i)
(ii) A family member of a person described in (i) above? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11g(ii)
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ~~~~~~~~~~~~~~~~~~~~~~~~ 11g(iii)
Provide the following information about the supported organization(s).

e
f
g

h

(i) Name of supported
organization

DR

10
11

AF

T

8
9

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
section 170(b)(1)(A)(vi). (Complete Part II.)
A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

(ii) EIN

(vi) Is the
(iii) Type of organization (iv) Is the organization (v) Did you notify the organization
in col. (vii) Amount of monetary
in
col.
(i)
listed
in
your
organization
in
col.
(described on lines 1-9
support
(i) organized in the
above or IRC section governing document? (i) of your support?
U.S.?
(see instructions))
Yes
No
Yes
No
Yes
No

Total
LHA For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
232021
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11130909 132497 GBDS

Schedule A (Form 990 or 990-EZ) 2012

5
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

GREATER BOSTON DIABETES SOCIETY, INC
04-2232419
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)

Schedule A (Form 990 or 990-EZ) 2012

Part II

Page 2

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization
fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support
Calendar year (or fiscal year beginning in) |
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~

(a) 2008

(b) 2009

(c) 2010

(d) 2011

(e) 2012

(f) Total

59,154.

66,093.

8,726.

8,803.

6,145. 148,921.

59,154.

66,093.

8,726.

8,803.

6,145. 148,921.

3 The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
4 Total. Add lines 1 through 3 ~~~
5 The portion of total contributions
by each person (other than a
governmental unit or publicly
supported organization) included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f) ~~~~~~~~~~~~
6 Public support. Subtract line 5 from line 4.

Section B. Total Support

(a) 2008

(b) 2009

(c) 2010

AF

7 Amounts from line 4 ~~~~~~~
8 Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
9 Net income from unrelated business
activities, whether or not the
business is regularly carried on ~
10 Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part IV.) ~~~~
11 Total support. Add lines 7 through 10

59,154.

66,093.

592.

263.

DR

Calendar year (or fiscal year beginning in) |

T

2 Tax revenues levied for the organization's benefit and either paid to
or expended on its behalf ~~~~

8,726.

64.

(d) 2011

8,803.

76,759.
72,162.
(e) 2012

(f) Total

6,145. 148,921.

919.

149,840.

12 Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~ 12
13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and stop here  |

Section C. Computation of Public Support Percentage

48.16 %
14 Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) ~~~~~~~~~~~~ 14
55.15 %
15 Public support percentage from 2011 Schedule A, Part II, line 14 ~~~~~~~~~~~~~~~~~~~~~ 15
16a 33 1/3% support test - 2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | X
b 33 1/3% support test - 2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
17a 10% -facts-and-circumstances test - 2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,
and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
b 10% -facts-and-circumstances test - 2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or
more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions  |
Schedule A (Form 990 or 990-EZ) 2012

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Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III Support Schedule for Organizations Described in Section 509(a)(2)

(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to
qualify under the tests listed below, please complete Part II.)

Section A. Public Support
Calendar year (or fiscal year beginning in) |

(a) 2008

(b) 2009

(c) 2010

(d) 2011

(e) 2012

(f) Total

(e) 2012

(f) Total

1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
2 Gross receipts from admissions,
merchandise sold or services performed, or facilities furnished in
any activity that is related to the
organization's tax-exempt purpose
3 Gross receipts from activities that
are not an unrelated trade or business under section 513 ~~~~~
4 Tax revenues levied for the organization's benefit and either paid to
or expended on its behalf ~~~~
5 The value of services or facilities
furnished by a governmental unit to
the organization without charge ~

from other than disqualified persons that
exceed the greater of $5,000 or 1% of the
amount on line 13 for the year ~~~~~~

c Add lines 7a and 7b ~~~~~~~
8 Public support (Subtract line 7c from line 6.)

Section B. Total Support

9 Amounts from line 6 ~~~~~~~
10a Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
b Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975 ~~~~

(a) 2008

(b) 2009

DR

Calendar year (or fiscal year beginning in) |

AF

T

6 Total. Add lines 1 through 5 ~~~
7 a Amounts included on lines 1, 2, and
3 received from disqualified persons
b Amounts included on lines 2 and 3 received

(c) 2010

(d) 2011

c Add lines 10a and 10b ~~~~~~
11 Net income from unrelated business
activities not included in line 10b,
whether or not the business is
regularly carried on ~~~~~~~
12 Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part IV.) ~~~~
13 Total support. (Add lines 9, 10c, 11, and 12.)
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here  |

Section C. Computation of Public Support Percentage

15 Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) ~~~~~~~~~~~~
16 Public support percentage from 2011 Schedule A, Part III, line 15 

Section D. Computation of Investment Income Percentage

15
16

%
%

17 Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ~~~~~~~~ 17
%
18 Investment income percentage from 2011 Schedule A, Part III, line 17 ~~~~~~~~~~~~~~~~~~ 18
%
19 a 33 1/3% support tests - 2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% , and line 17 is not
more than 33 1/3% , check this box and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~ |
b 33 1/3% support tests - 2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% , and
line 18 is not more than 33 1/3% , check this box and stop here. The organization qualifies as a publicly supported organization~~~~ |
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions  |
232023 12-04-12
Schedule A (Form 990 or 990-EZ) 2012

11130909 132497 GBDS

7
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

SCHEDULE O
(Form 990 or 990-EZ)

2012

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
| Attach to Form 990 or 990-EZ.

Department of the Treasury
Internal Revenue Service

Name of the organization

OMB No. 1545-0047

Supplemental Information to Form 990 or 990-EZ

Open to Public
Inspection
Employer identification number

GREATER BOSTON DIABETES SOCIETY, INC

04-2232419

FORM 990-EZ, PART I, LINE 16, OTHER EXPENSES:
DESCRIPTION OF OTHER EXPENSES:

AMOUNT:

PROGRAM SUPPLIES AND EXPENSES

1,787.

OTHER EXPENSES

1,038.

TOTAL TO FORM 990-EZ, LINE 16

2,825.

FORM 990-EZ, PART II, LINE 24, OTHER ASSETS:
BEG. OF YEAR

END OF YEAR

T

DESCRIPTION

307,622.

307,323.

BEG. OF YEAR

END OF YEAR

134,564.

159,991.

AF

DUE FROM GREATER BOSTON GUILD FOR THE BLIND

FORM 990-EZ, PART II, LINE 26, OTHER LIABILITIES:
DESCRIPTION

JEWISH GUILD HEALTHCARE

DR

DUE TO THE JEWISH GUILD FOR THE BLIND D/B/A

FORM 990-EZ, PART III, PRIMARY EXEMPT PURPOSE - FUNCTIONS AS A SUBSIDIARY
OF GREATER BOSTON GUILD FOR THE BLIND (GBGB) AND PROVIDES COMMUNITY
EDUCATION AND SUPPORT TO PEOPLE WITH, AND THOSE AT RISK FOR, VISION
LOSS AND PROVIDES EDUCATION AND SUPPORT FOR PEOPLE AT RISK OF
DEVELOPING DIABETES AND DIABETES RELATED COMPLICATIONS.

FORM 990-EZ, PART III, LINE 28, PROGRAM SERVICE ACCOMPLISHMENTS:
DIABETES EDUCATION PROGRAMS ARE CONDUCTED FOR ADULTS WITH
DIABETES TO INCREASE AWARENESS ABOUT DIABETES, CURRENTLY
AN EPIDEMIC IN OUR COUNTRY, ABOUT DIABETES RELATED
SERVICES, AND ABOUT THE IMPORTANCE OF MANAGING THE DISEASE TO PREVENT
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
232211
01-04-13

11130909 132497 GBDS

Schedule O (Form 990 or 990-EZ) (2012)

8
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1

SCHEDULE O
(Form 990 or 990-EZ)

Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
| Attach to Form 990 or 990-EZ.

Department of the Treasury
Internal Revenue Service

Name of the organization

GREATER BOSTON DIABETES SOCIETY, INC

OMB No. 1545-0047

2012

Open to Public
Inspection
Employer identification number

04-2232419

COMPLICATIONS SUCH AS BLINDNESS, KIDNEY DISEASE AND AMPUTATION.
DIABETES PREVENTION PROGRAMS ARE CONDUCTED FOR ADULTS TO ALERT PEOPLE
ABOUT RISK FACTORS AND POSSIBLE SIGNS AND SYMPTOMS OF THE DISEASE, AND
MOST IMPORTANTLY, TO PROMOTE HEALTHY BEHAVIORS REGARDING NUTRITION AND
EXERCISE THAT CAN DIRECTLY REDUCE THEIR RISK OF DEVELOPING TYPE 2
DIABETES.
PROGRAMS FOR CHILDREN FOCUS ON INCREASING AWARENESS OF THE RELATIONSHIP

T

BETWEEN DIABETES AND NUTRITION, AND TO HELP CHILDREN LEARN TO MAKE
POSITIVE DECISIONS ABOUT EATING AND EXERCISE THAT WILL PREVENT THEIR

AF

DEVELOPING TYPE 2 DIABETES. IF NOTHING CHANGES, ONE IN EVERY THREE
CHILDREN BORN IN THE U.S. WILL DEVELOP THE DISEASE IN THEIR LIFETIME.
PROGRAMS ARE CONDUCTED IN SCHOOLS AND AFTERSCHOOL PROGRAMS, AND OFFER

DR

INTERACTIVE EXERCISES FOR LEARNING ABOUT NUTRITION AND PHYSICAL
ACTIVITY, AND TAKE HOME MATERIALS FOR PARENTS.
VISION LOSS AND DIABETES PREVENTION PROGRAM ARE ALSO OFFERED FOR
EDUCATORS AND CARE PROVIDERS, TO INCREASE AWARENESS OF THE DIABETES
EPIDEMIC AND CAUSATIVE RELATIONSHIP OF DIABETES AND VISION LOSS.
INSTRUCTORS PROVIDE STRATEGIES AND ACTIVITIES THEY CAN IMPLEMENT TO
REDUCE INCIDENCE OF THESE DISEASES AMONG THE CHILDREN AND ADULTS THEY
TEACH AND CARE FOR.

FORM 990-EZ, PART V, INFORMATION REGARDING PERSONAL BENEFIT CONTRACTS:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,
OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.
THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,
OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
232211
01-04-13

11130909 132497 GBDS

Schedule O (Form 990 or 990-EZ) (2012)

9
2012.04000 GREATER BOSTON DIABETES SOC GBDS___1



---

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