E0026LA6 NAPVI Form 990 EZ PIC
User Manual: NAPVI-Form-990-EZ-PIC
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Form
OMB No. 1545-1150
Short Form
Return of Organization Exempt From Income Tax
990-EZ
À¾µº
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
I
I
Department of the Treasury
Internal Revenue Service
Information about Form 990-EZ and its instructions is at www.irs.gov/form990.
A For the 2016 calendar year, or tax year beginning
C Name of organization
B Check if applicable:
X
, 2016, and ending
, 20
D Employer identification number
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Address change
Name change
Number and street (or P.O. box, if mail is not delivered to street address)
Initial return
Final return/terminated
74-2095442
Room/suite
E Telephone number
250 WEST 64TH STREET
(212 ) 769 -6200
City or town, state or province, country, and ZIP or foreign postal code
Amended return
NEW YORK, NY 10023
X Accrual Other (specify)
Accounting Method:
Cash
WWW.LIGHTHOUSEGUILD.ORG
Website:
Tax-exempt status (check only one) - X 501(c)(3)
501(c) (
)
(insert no.)
Trust
Association
Form of organization: X Corporation
Application pending
G
I
J
Open to Public
Inspection
Do not enter social security numbers on this form as it may be made public.
F Group Exemption
I
I
H Check
I
Number
I
if the organization is not
required to attach Schedule B
J
4947(a)(1) or
527
(Form 990, 990-EZ, or 990-PF).
Other
K
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
166,421.
mmmmmmmmmmmmmmI
X
Check if the organization used Schedule O to respond to any question in this Part I m m m m m m m m m m m m m m m
166,379.
m m m m m mPUBLIC
m m m m m COPY
m mINSPECTION
mmmmmmmmmm
mmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmm
0.
mmmmmmmmmmm
mmmmmmmmmm
(Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ
Part I
Revenue
1
2
3
4
5a
b
c
6
a
Program service revenue including government fees and contracts
Membership dues and assessments
Investment income
5a
5b
Gross amount from sale of assets other than inventory
Less: cost or other basis and sales expenses
5c
Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a)
Gaming and fundraising events
Gross income from gaming (attach Schedule G if greater than
mmmmmmmmmmmmmmmmmmmmmmmmmmmm
6a
of contributions
Gross income from fundraising events (not including $
from fundraising events reported on line 1) (attach Schedule G if the
mm
mmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmm
0.
mmmmmmmmmmmmmmmmmmmmm
m
m
m
m
m
m
m
m
m
m
m
m
m
mm
m m m m m ATCH
m m m mm mm 1mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm mm m m
m m m m m m m m m m m m m m m m m m m m m m m m Im
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmm
m m mm mm mm mm mm mm mm mm mm mm mm mm ATCH
mm mm mm mm mm 2mm mm mm mm mm mm mm mm mm mm m m
m m m m m m m m m m m m m m m m m m m m m Im
mmmmmmmmmmmmmmmmmmmmmmmmmmm
m m mm mm mm mm mm mm mm mm mm mm mm mm mm m m
I
sum of such gross income and contributions exceeds $15,000)
7a
b
c
8
9
10
11
12
13
14
15
16
17
18
19
6b
6c
Less: direct expenses from gaming and fundraising events
Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract
line 6c)
Expenses
1
2
3
4
Contributions, gifts, grants, and similar amounts received
$15,000)
b
c
d
Net Assets
$
Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I)
Less: cost of goods sold
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
Other expenses (describe in Schedule O)
Total expenses. Add lines 10 through 16
Excess or (deficit) for the year (Subtract line 17 from line 9)
7c
8
9
10
11
12
13
14
15
16
17
18
42.
166,421.
302,117.
1,397.
9,855.
49,380.
362,749.
-196,328.
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
21
6d
7a
7b
Gross sales of inventory, less returns and allowances
Other changes in net assets or fund balances (explain in Schedule O)
Net assets or fund balances at end of year. Combine lines 18 through 20
For Paperwork Reduction Act Notice, see the separate instructions.
19
20
21
-1,079,026.
-1,275,354.
990-EZ (2016)
Form
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PAGE 2
Form
8868
Application for Automatic Extension of Time To File an
Exempt Organization Return
(Rev. January 2017)
Department of the Treasury
Internal Revenue Service
I
I
OMB No. 1545-1709
File a separate application for each return.
Information about Form 8868 and its instructions is at www.irs.gov/form8868.
Electronic filing (e-file). You can electronically file Form 8868 to request a 6-month automatic extension of time to file any of the
forms listed below with the exception of Form 8870, Information Return for Transfers Associated W ith Certain Personal Benefit
Contracts, for which an extension request must be sent to the IRS in paper format (see instructions). For more details on the electronic
filing of this form, visit www.irs.gov/efile, click on Charities & Non-Profits, and click on e-file for Charities and Non-Profits.
Automatic 6-Month Extension of Time. Only submit original (no copies needed).
All corporations required to file an income tax return other than Form 990-T (including 1120-C filers), partnerships, REMICs, and trusts
must use Form 7004 to request an extension of time to file income tax returns.
Enter filer's identifying number, see instructions
Name of exempt organization or other filer, see instructions.
Type or
print
File by the
due date for
filing your
return. See
instructions.
Employer identification number (EIN) or
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
74-2095442
Number, street, and room or suite no. If a P.O. box, see instructions.
Social security number (SSN)
250 WEST 64TH STREET
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
NEW YORK, NY 10023
Enter the Return Code for the return that this application is for (file a separate application for each return)
Application
Is For
Return
Code
Form 990 or Form 990-EZ
Form 990-BL
Form 4720 (individual)
Form 990-PF
Form 990-T (sec. 401(a) or 408(a) trust)
Form 990-T (trust other than above)
%
The books are in the care of
I
01
02
03
04
05
06
mmmmmmmmmmmm
Application
Is For
0 1
Return
Code
Form 990-T (corporation)
Form 1041-A
Form 4720 (other than individual)
Form 5227
Form 6069
Form 8870
07
08
09
10
11
12
CHRISTINA WONG
250 WEST 64TH STREET NEW YORK NY 10023
I
I
212 769-6273
Telephone No.
Fax No.
If the organization does not have an office or place of business in the United States, check this box
If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
. If this is
for the whole group, check this box
. If it is for part of the group, check this box
and attach
a list with the names and EINs of all members the extension is for.
11/15 , 20 17 , to file the exempt organization return
1
I request an automatic 6-month extension of time until
for the organization named above. The extension is for the organization’s return for:
%
%
mmmmmmI
IX
I
calendar year 20 16
tax year beginning
mmmmmmmmmmmmmmmI
mmmmmmmI
or
, 20
, and ending
, 20
.
If the tax year entered in line 1 is for less than 12 months, check reason:
Initial return
Final return
Change in accounting period
3 a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions.
3a $
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit.
3b $
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required, by using EFTPS
(Electronic Federal Tax Payment System). See instructions.
3c $
2
0.
0.
0.
Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment
instructions.
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form
8868
(Rev. 1-2017)
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PAGE 1
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
74-2095442
Form 990-EZ (2016)
Part ll
22
23
24
25
26
27
Page
Balance Sheets (see the instructions for Part ll)
Check if the organization used Schedule O to respond to any question in this Part ll
m m m m ATTACHMENT
m m m m m m m m m m m 3m m m m m m m m m
m m m m m m m m m m ATTACHMENT
mmmmmmmmmmmmmmmmmmmm
m m m m m m m m m m m m 4m m m m m m m m m
m m m m m m m m m m m m m ATTACHMENT
m m m m m m m m m m m 5m m m m m m m m m
m m m m m m m m m m m m m m m m m m mm mm
Cash, savings, and investments
Land and buildings
Other assets (describe in Schedule O)
Total assets
Total liabilities (describe in Schedule O)
Net assets or fund balances (line 27 of column (B) must agree with line 21)
Part III
Check if the organization used Schedule O to respond to any question in this Part III
mmm
X
ATTACHMENT 6
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.
28
X
(B) End of year
32,246.
780.
29,183.
62,209.
1,141,235.
-1,079,026.
Statement of Program Service Accomplishments (see the instructions for Part lll)
What is the organization's primary exempt purpose?
mmmmmmmmmmmmmmmmmmm
(A) Beginning of year
2
22
23
24
25
26
27
66,215.
830.
62,785.
129,830.
1,405,184.
-1,275,354.
Expenses
(Required for section
501(c)(3) and 501(c)(4)
organizations; optional for
others.)
ATTACHMENT 7
(Grants $
) If this amount includes foreign grants, check here
mmmmmmmI
28a
(Grants $
) If this amount includes foreign grants, check here
mmmmmmmI
29a
(Grants $
) If this amount includes foreign grants, check here
29
30
31 Other program services (describe in Schedule O)
271,167.
mmmmmmm
m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Im m m m
271,167.
m m m m m m m m m m m m m m m m m m m m m Im m I
mmmmmmmmmmmmmmmmmmmmmmm X
30a
) If this amount includes foreign grants, check here
31a
32
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
(Grants $
32 Total program service expenses (add lines 28a through 31a)
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
ATTACHMENT 8
JSA
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990-EZ
(2016)
PAGE 3
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
74-2095442
Form 990-EZ (2016)
Part V
Page
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
mm
3
X
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
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 organization's name. Otherwise, explain the
change on Schedule O (see instructions)
34
35 a
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)?
b
c
36
37 a
b
38 a
b
39
a
b
40 a
b
c
d
e
41
42 a
b
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmm
mmmm
mmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmm
m m m m m m m m m m m m m m m m m Im m m m m m m m m m m m m m
mmm
mmmmmmmm
mmmmmmmmmmmmmmmm
mmmmmmmmmmmm
0.
0.
0.
I
I
mmm
If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule O
X
X
X
35a
35b
Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice,
X
reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III
35c
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets
X
during the year? If "Yes," complete applicable parts of Schedule N
36
Enter amount of political expenditures, direct or indirect, as described in the instructions
37a
Did the organization file Form 1120-POL for this year?
37b
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
X
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?
38a
If "Yes," complete Schedule L, Part II and enter the total amount involved
38b
Section 501(c)(7) organizations. Enter:
Initiation fees and capital contributions included on line 9
39a
Gross receipts, included on line 9, for public use of club facilities
39b
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911
; section 4912
; section 4955
Section 501(c)(3), 501(c)(4), and 501(c)(29) 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
X
that has not been reported on any of its prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I
40b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax imposed
on organization managers or disqualified persons during the year under sections 4912,
0.
4955, and 4958
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Enter amount of tax on line
0.
40c reimbursed by the organization
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter
X
transaction? If "Yes," complete Form 8886-T
40e
AL,AK,CO,CT,HI,ME,MA,NH,NM,NY,NC,ND,OR,PA,SC,
List the states with which a copy of this return is filed
212-769-6273
The organization's books are in care of CHRISTINA WONG
Telephone no.
250
WEST
64TH
STREET
NEW
YORK,
NY
10023
Located at
ZIP + 4
Yes No
At any time during the calendar year, did the organization have an interest in or a signature or other authority over
X
a financial account in a foreign country (such as a bank account, securities account, or other financial account)? 42b
If "Yes," enter the name of the foreign country:
See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and
Financial Accounts (FBAR).
X
At any time during the calendar year, did the organization maintain an office outside the United States?
42c
If "Yes," enter the name of the foreign country:
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
Did the organization maintain any donor advised funds during the year? If "Yes," Form 990 must be
X
completed instead of Form 990-EZ
44a
Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must be
X
completed instead of Form 990-EZ
44b
X
Did the organization receive any payments for indoor tanning services during the year?
44c
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
X
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
45a
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
X
Form 990-EZ (see instructions)
45b
I
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmI
mmmmmmmmmmmmmmmmmmmmmmmmmI
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
I
I
I
I
I
I
c
43
44 a
b
c
d
45 a
b
mmmm
I
mmmmmmmmmmmI
mmmmmmmmm I
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
JSA
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Form
V 16-7.6F
3215144
990-EZ
(2016)
PAGE 4
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
74-2095442
Form 990-EZ (2016)
4
No
Page
Yes
mmmmmmmmmmmmmmmmmmmmmmmmm
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
Part VI
47
48
49 a
b
50
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
mmmmmmmmmmmmmm
X
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
X
mmmmmmmm
X
mmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmm
Yes No
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
Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
48
Did the organization make any transfers to an exempt non-charitable related organization?
49a
If "Yes," was the related organization a section 527 organization?
49b
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."
(b) Average
hours per week
devoted to position
(a) Name and title of each employee
(d) Health benefits,
(c) Reportable
contributions to employee (e) Estimated amount of
compensation
benefit plans, and deferred
other compensation
(Forms W-2/1099-MISC)
compensation
NONE
f
51
mmmmmmmI
0.
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 organization. If there is none, enter "None."
(a) Name and business address of each independent contractor
(b) Type of service
(c) Compensation
NONE
d
52
m m m I 0.
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm IX
Total number of other independent contractors each receiving over $100,000
Did the organization complete Schedule A? Note: All section 501(c)(3) organizations 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
M
M CHRISTINA WONG
11/14/2017
Signature of officer
Date
CFO
Type or print name and title
Print/Type preparer's name
Preparer's signature
Paid
DAVID M HIGHFILL
Preparer
KPMG LLP
Use Only Firm's name
345 PARK AVENUE
Firm's address
NEW YORK, NY 10154-0102
I
I
May the IRS discuss this return with the preparer shown above? See instructions
Date
11/14/2017
Check
if
self-employed
PTIN
P01517891
13-5565207
212-758-9700
I
m m m m m m m m m m m m m m m m m m m m I X 990-EZ
Firm's EIN
Phone no.
Yes
Form
No
(2016)
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PAGE 5
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
OMB No. 1545-0047
Public Charity Status and Public Support
SCHEDULE A
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
I
I
Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
À¾µº
Open to Public
Inspection
Employer identification number
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
Part I
Name of the organization
The organization is not a private foundation because it is: (For lines 1 through 12, 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 (Form 990 or 990-EZ).)
3
A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4
A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the
hospital's name, city, and state:
5
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(b)(1)(A)(iv). (Complete Part II.)
6
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7
An organization that normally receives a substantial part of its support from a governmental unit or from the general public
described in section 170(b)(1)(A)(vi). (Complete Part II.)
8
A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9
An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college
or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college or
university:
10 X An organization that normally receives: (1) more than 331/3 % 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 331/3 %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.)
11
An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
12
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 in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving
the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the
supporting organization. You must complete Part IV, Sections A and B.
Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having
control or management of the supporting organization vested in the same persons that control or manage the supported
organization(s). You must complete Part IV, Sections A and C.
Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.
Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.
Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III
functionally integrated, or Type III non-functionally integrated supporting organization.
Enter the number of supported organizations
Provide the following information about the supported organization(s).
a
b
c
d
e
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm
f
g
(i) Name of supported organization
(ii) EIN
(iii) Type of organization
(described on lines 1-10
above (see instructions))
(iv) Is the organization
listed in your governing
document?
Yes
(v) Amount of monetary
support (see
instructions)
(vi) Amount of
other support (see
instructions)
No
(A)
(B)
(C)
(D)
(E)
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
Page
2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under
Part 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)
I
1
Gifts,
grants,
contributions,
and
membership fees received. (Do not
include any "unusual grants.")
2
Tax
revenues
levied
for
the
organization's benefit and either paid
to or expended on its behalf
3
The value of services or facilities
furnished by a governmental unit to the
organization without charge
4
Total. Add lines 1 through 3
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)
Public support. Subtract line 5 from line 4.
6
(a) 2012
(b) 2013
(c) 2014
(d) 2015
(e) 2016
(f) Total
(a) 2012
(b) 2013
(c) 2014
(d) 2015
(e) 2016
(f) Total
mmmmmm
mmmmmmm
mmmmmmm
mmmmmmm
mmmmmmm
Section B. Total Support
m m m m m m m m mIm
Calendar year (or fiscal year beginning in)
7
8
Amounts from line 4
Gross income from interest, dividends,
payments received on securities loans,
rents, royalties and income from similar
sources
mmmmmmmmmmmmmmmmm
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 VI.)
11
12
Total support. Add lines 7 through 10
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
mmmmmmmmmm
mmmmmmmmmmm
mm
mmmmmmmmmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm I
Section C. Computation of Public Support Percentage
mmmmmmmm
mmmmmmmmmmmmmmmmmmm
mmmmmmmmmmmmmmmmmm I
mmmmmmmmmmmmmmm I
Gross receipts from related activities, etc. (see instructions)
12
14
14 Public support percentage for 2016 (line 6, column (f) divided by line 11, column (f))
15
15 Public support percentage from 2015 Schedule A, Part II, line 14
16a 33 1/3 % support test - 2016. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check
this box and stop here. The organization qualifies as a publicly supported organization
b 33 1/3 % support test - 2015. 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 - 2016. 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 VI how the organization meets the "facts-and-circumstances” test. The organization qualifies as a publicly supported
organization
b 10%-facts-and-circumstances test - 2015. 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 VI 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
%
%
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm I
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm I
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm I
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
3
Page
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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
Part III
Calendar year (or fiscal year beginning in)
1
I
received. (Do not include any "unusual grants.")
2
(a) 2012
(b) 2013
(c) 2014
(d) 2015
(e) 2016
(f) Total
Gifts, grants, contributions, and membership fees
220,917.
354,194.
33,584.
16,386.
32,680.
181,128.
166,379.
955,298.
Gross receipts from admissions, merchandise
sold
or
services
performed,
or
facilities
mmmmmm
m
furnished in any activity that is related to the
organization's tax-exempt purpose
3
49,970.
Gross receipts from activities that are not an
0.
unrelated trade or business under section 513
4
Tax
revenues
levied
for
the
to or expended on its behalf
mmmmmmm
The
or
organization’s benefit and either paid
5
value
of
services
0.
facilities
mmmmmmm
mmmmmmm
mmmm
furnished by a governmental unit to the
organization without charge
6
Total. Add lines 1 through 5
0.
254,501.
370,580.
32,680.
7 a Amounts included on lines 1, 2, and 3
received from disqualified persons
b Amounts included on lines 2 and 3
181,128.
166,379.
1,005,268.
140,400.
149,861.
290,261.
140,400.
149,861.
290,261.
received
from
other than
disqualified
persons that exceed the greater of $5,000
or 1% of the amount on line 13 for the year
mmmmmmmmmmm
mmmmmmmmmmmmmmmmm
Section B. Total Support
m m m m m m m m m m Im
0.
c Add lines 7a and 7b
8 Public support. (Subtract line 7c from
line 6.)
Calendar year (or fiscal year beginning in)
9 Amounts from line 6
10 a Gross income from interest, dividends,
payments received on securities loans,
rents, royalties and income from similar
sources
mmmmmmmmmmmmmmmmm
715,007.
(a) 2012
(b) 2013
(c) 2014
(d) 2015
(e) 2016
(f) Total
254,501.
370,580.
32,680.
181,128.
166,379.
1,005,268.
25.
25.
44.
66.
42.
202.
25.
25.
44.
66.
42.
202.
b Unrelated business taxable income (less
section 511
taxes) from businesses
m m m mm mm mm mm mm mm
acquired after June 30, 1975
c Add lines 10a and 10b
11
0.
Net income from unrelated business
activities not included in line 10b,
whether or not the business is regularly
carried on
Other income. Do not include gain or
loss from the sale of capital assets
(Explain in Part VI.) ATCH 1
mmmmmmmmmmmmmmm
12
mmmmmmmmmmm
mmmmmmmmmmmmmmmm
0.
1,520.
5,529.
372,125.
38,253.
7,049.
13
Total support. (Add lines 9, 10c, 11,
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)
and 12.)
organization, check this box and stop here
254,526.
181,194.
166,421.
1,012,519.
m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m mI
70.62
99.38
m m m m m m m m m mm mm mm mm mm mm mm mm mm mm mm mm mm mm
Section C. Computation of Public Support Percentage
15
Public support percentage for 2016 (line 8, column (f) divided by line 13, column (f))
15
16
Public support percentage from 2015 Schedule A, Part III, line 15
16
Section D. Computation of Investment Income Percentage
mmmmmmmmmm
mmmmmmmmmmmmmmmmmmmm
17
Investment income percentage for 2016 (line 10c, column (f) divided by line 13, column (f))
17
18
Investment income percentage from 2015 Schedule A, Part III, line 17
18
.02 %
.01 %
19 a 33 1/3 % support tests - 2016. 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 - 2015. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3 %, and
20
line 18 is not more than 33 1/3 %, check this box and stop here. The organization qualifies as a publicly supported organization
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
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%
I
I
I
X
Schedule A (Form 990 or 990-EZ) 2016
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Page 4
Supporting Organizations
(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes No
Schedule A (Form 990 or 990-EZ) 2016
Part IV
1
2
3a
b
c
4a
b
c
5a
b
c
Are all of the organization’s supported organizations listed by name in the organization’s governing
documents? If "No," describe in Part VI how the supported organizations are designated. If designated by
class or purpose, describe the designation. If historic and continuing relationship, explain.
1
Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported
organization was described in section 509(a)(1) or (2).
2
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer
(b) and (c) below.
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and
satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the
organization made the determination.
3a
3b
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)
purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
Was any supported organization not organized in the United States ("foreign supported organization")? If
"Yes," and if you checked 12a or 12b in Part I, answer (b) and (c) below.
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization? If "Yes," describe in Part VI how the organization had such control and discretion
despite being controlled or supervised by or in connection with its supported organizations.
4b
Did the organization support any foreign supported organization that does not have an IRS determination
under sections 501(c)(3) and 509(a)(1) or (2)? If "Yes," explain in Part VI what controls the organization used
to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)
purposes.
4c
Did the organization add, substitute, or remove any supported organizations during the tax year? If "Yes,"
answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN
numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action;
(iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action
was accomplished (such as by amendment to the organizing document).
5a
Type I or Type II only. Was any added or substituted supported organization part of a class already
designated in the organization's organizing document?
Substitutions only. Was the substitution the result of an event beyond the organization's control?
3c
4a
5b
5c
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to
6
anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited
by one or more of its supported organizations, or (iii) other supporting organizations that also support or
7
8
9a
b
c
10 a
b
benefit one or more of the filing organization’s supported organizations? If "Yes," provide detail in Part VI.
6
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor
(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with
regard to a substantial contributor? If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
7
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ).
8
Was the organization controlled directly or indirectly at any time during the tax year by one or more
disqualified persons as defined in section 4946 (other than foundation managers and organizations described
in section 509(a)(1) or (2))? If "Yes," provide detail in Part VI.
9a
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which
the supporting organization had an interest? If "Yes," provide detail in Part VI.
9b
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit
from, assets in which the supporting organization also had an interest? If "Yes," provide detail in Part VI.
Was the organization subject to the excess business holdings rules of section 4943 because of section
4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated
supporting organizations)? If "Yes," answer 10b below.
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to
determine whether the organization had excess business holdings.)
9c
10a
10b
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
Part IV
Page
5
Supporting Organizations (continued)
Yes No
11
a
b
c
Has the organization accepted a gift or contribution from any of the following persons?
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)
below, the governing body of a supported organization?
A family member of a person described in (a) above?
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11a
11b
11c
Section B. Type I Supporting Organizations
Yes No
1
2
Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the
tax year? If "No," describe in Part VI how the supported organization(s) effectively operated, supervised, or
controlled the organization’s activities. If the organization had more than one supported organization,
describe how the powers to appoint and/or remove directors or trustees were allocated among the supported
organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization? If "Yes," explain in Part
VI how providing such benefit carried out the purposes of the supported organization(s) that operated,
supervised, or controlled the supporting organization.
2
Section C. Type II Supporting Organizations
Yes No
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization’s supported organization(s)? If "No," describe in Part VI how control
or management of the supporting organization was vested in the same persons that controlled or managed
the supported organization(s).
1
1
Section D. All Type III Supporting Organizations
Yes No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the
organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior
tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of
the organization’s governing documents in effect on the date of notification, to the extent not previously
provided?
1
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported
organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how
the organization maintained a close and continuous working relationship with the supported organization(s).
2
3
By reason of the relationship described in (2), did the organization’s supported organizations have a
significant voice in the organization’s investment policies and in directing the use of the organization’s
income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s
supported organizations played in this regard.
3
Section E. Type III Functionally Integrated Supporting Organizations
1
a
b
c
2
a
b
3
a
b
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions).
The organization satisfied the Activities Test. Complete line 2 below.
The organization is the parent of each of its supported organizations. Complete line 3 below.
The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).
Yes No
Activities Test. Answer (a) and (b) below.
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify
those supported organizations and explain how these activities directly furthered their exempt purposes,
how the organization was responsive to those supported organizations, and how the organization determined
that these activities constituted substantially all of its activities.
2a
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more
of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the
reasons for the organization’s position that its supported organization(s) would have engaged in these
activities but for the organization’s involvement.
2b
Parent of Supported Organizations. Answer (a) and (b) below.
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or
trustees of each of the supported organizations? Provide details in Part VI.
Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each
of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3a
3b
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
Part V
Page
6
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See
instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
(B) Current Year
Section A - Adjusted Net Income
(A) Prior Year
(optional)
1 Net short-term capital gain
1
2 Recoveries of prior-year distributions
2
3 Other gross income (see instructions)
3
4 Add lines 1 through 3.
4
5 Depreciation and depletion
5
6 Portion of operating expenses paid or incurred for production or
collection of gross income or for management, conservation, or
maintenance of property held for production of income (see instructions)
7 Other expenses (see instructions)
8 Adjusted Net Income (subtract lines 5, 6, and 7 from line 4).
6
7
8
Section B - Minimum Asset Amount
(A) Prior Year
1 Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
a Average monthly value of securities
b Average monthly cash balances
c Fair market value of other non-exempt-use assets
d Total (add lines 1a, 1b, and 1c)
e Discount claimed for blockage or other
factors (explain in detail in Part VI):
2 Acquisition indebtedness applicable to non-exempt-use assets
3 Subtract line 2 from line 1d.
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,
see instructions).
5 Net value of non-exempt-use assets (subtract line 4 from line 3)
6 Multiply line 5 by .035.
7 Recoveries of prior-year distributions
8 Minimum Asset Amount (add line 7 to line 6)
(B) Current Year
(optional)
1a
1b
1c
1d
2
3
4
5
6
7
8
Current Year
Section C - Distributable Amount
Adjusted net income for prior year (from Section A, line 8, Column A)
1
Enter 85% of line 1.
2
Minimum asset amount for prior year (from Section B, line 8, Column A)
3
Enter greater of line 2 or line 3.
4
Income tax imposed in prior year
5
6 Distributable Amount. Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions).
6
7
Check here if the current year is the organization’s first as a non-functionally integrated Type III supporting organization (see
instructions).
1
2
3
4
5
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
Part V
Page
7
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported
organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions.
7 Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive
(provide details in Part VI). See instructions.
9 Distributable amount for 2016 from Section C, line 6
10 Line 8 amount divided by Line 9 amount
(i)
Excess Distributions
Section E - Distribution Allocations (see instructions)
Current Year
(ii)
Underdistributions
Pre-2016
(iii)
Distributable
Amount for 2016
Distributable amount for 2016 from Section C, line 6
Underdistributions, if any, for years prior to 2016
(reasonable cause required-explain in Part VI). See
instructions.
Excess distributions carryover, if any, to 2016:
1
2
3
a
b
c
d
e
f
g
h
i
j
4
a
b
c
5
6
7
8
a
b
c
d
e
mmmmmmmm
mmmmmmmm
mmmmmmmm
From 2013
From 2014
From 2015
Total of lines 3a through e
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Carryover from 2011 not applied (see instructions)
Remainder. Subtract lines 3g, 3h, and 3i from 3f.
Distributions for 2016 from
Section D, line 7:
$
Applied to underdistributions of prior years
Applied to 2016 distributable amount
Remainder. Subtract lines 4a and 4b from 4.
Remaining underdistributions for years prior to 2016, if
any. Subtract lines 3g and 4a from line 2. For result
greater than zero, explain in Part VI. See instructions.
Remaining underdistributions for 2016. Subtract lines 3h
and 4b from line 1. For result greater than zero, explain in
Part VI. See instructions.
Excess distributions carryover to 2017. Add lines 3j
and 4c.
Breakdown of line 7:
Excess
Excess
Excess
Excess
from
from
from
from
2013
2014
2015
2016
mmmm
mmmm
mmmm
mmmm
Schedule A (Form 990 or 990-EZ) 2016
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Schedule A (Form 990 or 990-EZ) 2016
Part VI
Page
8
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part
III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section
B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b,
3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E,
lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.)
ATTACHMENT 1
SCHEDULE A, PART III - OTHER INCOME
DESCRIPTION
2012
2013
2014
2015
2016
TOTAL
MISCELLANEOUS
1,520.
5,529.
7,049.
TOTALS
1,520.
5,529.
7,049.
Schedule A (Form 990 or 990-EZ) 2016
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Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
OMB No. 1545-0047
Schedule of Contributors
I
I
Attach to Form 990, Form 990-EZ, or Form 990-PF.
Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
Name of the organization
À¾µº
Employer identification number
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
74-2095442
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ
X
501(c)( 3
) (enter number) organization
4947(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
Form 990-PF
501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See
instructions.
General Rule
X
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000
or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a
contributor's total contributions.
Special Rules
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3 % support test of the
regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line
13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1)
$5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific,
literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one
contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such
contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received
during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the
General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions
$
totaling $5,000 or more during the year
mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm I
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its
Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
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Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Name of organization
Part I
(a)
No.
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Employer identification number
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
1
$
120,000.
(d)
Type of contribution
Person
Payroll
Noncash
X
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
2
$
29,861.
(d)
Type of contribution
Person
Payroll
Noncash
X
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
$
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
$
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
$
(Complete Part II for
noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
$
(Complete Part II for
noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
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Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Name of organization
Part II
(a) No.
from
Part I
Page
3
Employer identification number
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
(a) No.
from
Part I
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
(a) No.
from
Part I
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
(a) No.
from
Part I
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
(a) No.
from
Part I
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
(a) No.
from
Part I
(c)
FMV (or estimate)
(b)
Description of noncash property given
(See instructions)
(d)
Date received
$
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
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Page 4
Employer identification number
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or
(10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and
the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $
Use duplicate copies of Part III if additional space is needed.
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
Name of organization
Part III
I
(a) No.
from
Part I
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(a) No.
from
Part I
(b) Purpose of gift
Relationship of transferor to transferee
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(a) No.
from
Part I
(b) Purpose of gift
Relationship of transferor to transferee
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
(a) No.
from
Part I
(b) Purpose of gift
Relationship of transferor to transferee
(c) Use of gift
(d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2016)
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SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Name of the organization
Supplemental Information to Form 990 or 990-EZ
OMB No. 1545-0047
À¾µº
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.
I
I
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
Open to Public
Inspection
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
Employer identification number
WITH VISUAL IMPAIRMENTS, INC.
74-2095442
FORM 990-EZ LINE 34, CHANGES TO GOVERNING DOCUMENTS
DURING 2016, THE BY-LAWS WERE AMENDED AND RESTATED SO THAT OFFICERS OF
LIGHTHOUSE GUILD INTERNATIONAL, INC., A RELATED ORGANIZATION, BECAME THE
BOARD MEMBERS OF NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC. FURTHER, THE PREVIOUS DIRECTORS WERE
REMOVED. THE CHANGES TO THE BOARD LISTING CAN BE NOTED VIA PART IV.
ATTACHMENT 1
FORM 990EZ, PART I - OTHER REVENUE
ROYALTIES
42.
TOTALS
42.
ATTACHMENT 2
FORM 990EZ, PART I - OTHER EXPENSES
SUPPLIES
TRAVEL
CONFERENCES, CONVENTIONS
DEPRECIATION
FEES FOR SERVICE
ADVERTISING AND PROMOTION
INFORMATION TECHNOLOGY
INSURANCE
24,775.
928.
3,418.
386.
5,775.
1,020.
12,271.
807.
TOTAL
49,380.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Schedule O (Form 990 or 990-EZ) (2016)
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Schedule O (Form 990 or 990-EZ) 2016
Page
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Name of the organization
2
Employer identification number
74-2095442
ATTACHMENT 3
FORM 990EZ, PART II - CASH, SAVINGS AND INVESTMENTS
BEGINNING
OF YEAR
DESCRIPTION
END
OF YEAR
CASH
32,246.
66,215.
TOTALS
32,246.
66,215.
ATTACHMENT 4
FORM 990EZ, PART II - OTHER ASSETS
DESCRIPTION
DUE FROM AFFILIATES
TOTALS
BEGINNING
OF YEAR
29,183.
END
OF YEAR
62,785.
29,183.
62,785.
ATTACHMENT 5
FORM 990EZ, PART II - TOTAL LIABILITIES
BEGINNING
OF YEAR
DESCRIPTION
END
OF YEAR
ACCOUNTS PAYABLE
SUPPORT AND REVENUE FOR FUTURE PERIODS
DUE TO AFFILIATES
6,149.
500.
1,134,586.
1,405,184.
TOTALS
1,141,235.
1,405,184.
ATTACHMENT 6
FORM 990EZ, PART III - ORGANIZATION'S PRIMARY EXEMPT PURPOSE
TO PROVIDE EDUCATION, TRAINING AND SUPPORT TO PARENTS AND FAMILIES OF
VISUALLY IMPAIRED CHILDREN NATIONWIDE TO HELP THEM LIVE PRODUCTIVE,
DIGNIFIED AND FULFILLING LIVES.
ATTACHMENT 7
FORM 990EZ, PART III - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS
PROGRAM SERVICE ACCOMPLISHMENT 1
PARENTS OF VISUALLY IMPAIRED CHILDREN FACE ADDITIONAL CHALLENGES.
Schedule O (Form 990 or 990-EZ) 2016
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Schedule O (Form 990 or 990-EZ) 2016
Page
NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC.
Name of the organization
2
Employer identification number
74-2095442
ATTACHMENT 7 (CONT'D)
FORM 990EZ, PART III - STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS
TO EASE THEIR JOURNEY, NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
WITH VISUAL IMPAIRMENTS, INC. (NAPVI) PROVIDES EDUCATION,
TRAINING, AND SUPPORT FOR PARENTS OF CHILDREN WHO ARE BLIND OR
VISUALLY IMPAIRED. LANGUAGE AND CULTURAL BARRIERS, AND LACK OF
RESOURCES CAN IMPEDE ACCESS TO THE SERVICES THEY NEED. NAPVI HOSTS
OUTREACH PROGRAMS, CREATES NETWORKING OPPORTUNITIES, AND ADVOCATES
FOR THE EDUCATIONAL NEEDS AND WELFARE OF VISUALLY IMPAIRED
CHILDREN LOCALLY, AT THE STATE LEVEL, AND NATIONALLY. PARENTS ARE
ABLE TO INTERACT WITH OTHER PARENTS FACING SIMILAR CHALLENGES TO
SHARE EXPERIENCES AND MUTUAL SUPPORT. NAPVI ALSO SERVES AS A
RESOURCE FOR VISION PROFESSIONALS, TEACHERS, AND HEALTHCARE AND
COMMUNITY ORGANIZATIONS. NAPVI HAS SUPPORTED AND CONNECTED MANY
THOUSANDS OF PARENTS THROUGH MAILINGS, NEWSLETTERS, TELEPHONE,
WORKSHOPS, AND CONFERENCES.
Schedule O (Form 990 or 990-EZ) 2016
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NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
74-2095442
ATTACHMENT 8
FORM 990EZ, PART IV - LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES
AVERAGE HOURS
PER WEEK DEVOTED
TO POSITION
NAME AND TITLE
ALAN R. MORSE
PRESIDENT & CEO
REPORTABLE
COMPENSATION
(FORM W-2/
1099-MISC)
HEALTH BENEFITS,
CONTRIBUTION TO EMPLOYEE
BENEFIT PLANS AND
DEFFERED COMPENSATION
ESTIMATED
AMOUNT OF
OTHER
COMPENSATION
0.
0.
0.
0.
JULIE URBAN - END 10/19/16
CHAIRMAN
.10
0.
0.
0.
VENETIA HAYDEN - END 10/19/16
VICE CHAIRMAN
.10
0.
0.
0.
0.
0.
0.
0.
KIM ALFONSO - END 10/19/16
TREASURER
.10
0.
0.
0.
KELLYANNE CAIVANO
ASSISTANT TREASURER
.10
808.
69.
37.
SARAH SPICEHANDLER
ASSISTANT SECRETARY
.35
876.
36.
324.
27.30
132,454.
5,475.
20,058.
RANDI SHER - END 10/19/16
SECRETARY
SUSAN LAVENTURE - END 10/19/16
EXECUTIVE DIRECTOR
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NATIONAL ASSOCIATION OF PARENTS OF CHILDREN
74-2095442
ATTACHMENT 8 (CONT'D)
FORM 990EZ, PART IV - LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES
AVERAGE HOURS
PER WEEK DEVOTED
TO POSITION
NAME AND TITLE
HEALTH BENEFITS,
CONTRIBUTION TO EMPLOYEE
BENEFIT PLANS AND
DEFFERED COMPENSATION
COMPENSATION
(FORM W-2/
ESTIMATED
AMOUNT OF
OTHER
COMPENSATION
PATRICIA COX - END 10/19/16
DIRECTOR
.10
0.
0.
0.
JAMES M. DUBIN
DIRECTOR/CHAIRMAN
.10
0.
0.
0.
1.50
22,390.
1,172.
1,408.
CHRISTINA WONG - START 10/19/16
TREASURER & CFO
.10
1,134.
39.
64.
MAURA SWEENEY - START 10/19/16
SR. V.P. FOR OPERATIONS
.75
7,457.
652.
269.
CHARLES F. BLUM - START 10/19/16
GENERAL COUNSEL
.10
0.
0.
0.
BRUCE MASTALINSKI - START 10/19/16
CHIEF COMPLIACE OFFICER
.10
895.
71.
35.
1.05
2,354.
103.
547.
168,368.
7,617.
22,742.
MARK G. ACKERMANN - START 10/19/16
SECRETARY
IRMA EVANS
ASSITANT SECRETARY
GRAND TOTALS
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