.OUB m,. ISGS-IWi? Undcf section SOi (c), 52T, or <494T(3i(1) of the Internal R^ventw; Code (excepi bfack lung tcriae'T'e* " Th& Di-gani?al ion ttisy have to use a c i p y of tfits raiifm to salisfy stats rgportins ("equiremanls. F o r l t e 2012 caJcnrfar year, or tax year bftginnrng Ctw* if a n^ ending C Name of orgsntselbn i 1 Address • • terras. Ihiili* D EmptoycridenSificatiorvnttfnbor CHILDKEN'S CANCER RECOVERY FOUNDATION 33-0418563 Doing Busin&ssAs Nyrnber-and street (or P.O bti; if rfiaii is noldetersd lo street adrfi^ss^ rfttam 17*1771*1- P.O. Room/suile £ Telepiione numbsr BOX 2 3 8 Cfty, town, or post oHItw. stale, and Zip' code- HERSHEY, PA a Q .17033-0238 Hia} Is fhls a proup return F Name snd address erf fjrincipa! ufilcenDOUG P.O. RUNKXE BOX 2 3 8 , HERSHEX, PA forpfMJaes? EUYes Q D NO H'(bl Araallstfitate Bttta4e«? • Yes • [ N o 17033 QnsBitM) L H 4947faift|6M_J'.527 501 (cj i f Tax^xempi status; i J U J Website: ••• WWW. CHILDREMSCANCERgECOVERy - ORG K Fotmcfprganiznton: I A J f c p r p g r a l i a i r X I j Tnjst Q 717-545-7600 17^218,643 GrE^K BKRplsS If 'No," aliacfi a tet. (EBQ irsTructiofvs} I4(i^ Grotip-tjj^fnption n^wter ^ i LYeafofituFnaliQrr 1 9 9 0 [ M SUieofisgaldomidteiCA Assoriallon Briefly tfescribe the orgsnisation-s m ^ i o n or most significant sctiviUes: T O _ A S S I S T ^ H I L M 1 M _ M ^ 5 _ ^ ^ ^ G S OF 1 8 AND THEIR JTAMILXES TOO ARE PACING THE HARDSHIPS OF A CANCER 2 Check lliis hay. ^ 3 4 KtsmtxiFof voiing members of the efnt'ertiifig body ^Paft VI, tine, la) tsSoi^ej- of independent voiins memb^s o? the governing body (Part V!, line lb) ' 1 ff tho orflani^fiticn dsconiinuediis operations or disposed of mora thara 2S%cfEt8 net assets. 3 5 Total numberoJ individuals employed in calenctor year 201?.ipsn V, line23) ... 6 Tctal number of vefunleers (estimate tf necessary) ... .... Ta Tots! ur-.reltUed business nsvenue from Part Vfli, column ( 0 , line T2 . .. _ 7a b Ksi unrstated business {a^abt&.i'ncomeJrom Form SB0-T.]iTie34 -.. ...•,.. 7b Prior Year Contnbulions and granis (Pari Vli!. line! h) ProQwrr-servir^ revunue ^Part VIII, line 2g) . .. 4 2 0 235 0. 0. 4 5 6 Current YEar 7,652,702. ,,.... Inveslmem insome (Part viii, coiumn (A), lines3,4, and ?dj Other revenue (Part VIH,cd'Jfnii{AJ. lines 5,6*18c, &c, l O c . a n d l t a ) , Totdrgyenuc-add lines 8 thfounti 1"! (must cquatPari VII!, column (A), iine ;£) . Grarite»sicisiniiiaraniDUntspaid(parttX,cokimn(A),tinesV3} ,. ,,..., ,, . ... SoneWB pajd !o orformembcts (Port IX, column {AJJine^} ....... , . , , . . „•. Salaries. otliercompensaficn.emptoyeB benerftts-(Part W, cciumn (A), lines 5-10], Professional fgndraising lees (Pan W, ceiumntAJ, line l i e ) , , Toiaf fgndraising expenses (Part IX, column (DJ, Bne 25) &*- „ 2^443f Otfier expenses (Part IX.cokimn (Al, Sines I1a-T3d, nf-24e) IB ., ,, Total expenses Add lines } 3-1 ? (must equal Part IX, column (A), line 25} Revenue lesseXoenses. Subiracl line 1S from line 1?? ., . ,. BBDlrmlMj ol Curfenl Veaf 20 Tolal assets (Pan X. line S6J 21 Tots) liabilllles (Part X. line 26) End of Year 462,480, 327,072. 135f4< . , , 22 fet assets or fund balances. Subtract line 21 from line 20 716^572. I ' S l , 576.' 534,9! Under penaiiies of perjiity, I decora ihal! have exaifiinod tltiKretuiR.tncludina sccompanying schartufes and statemfints, and tn the t)g$£ of my (cnowiedpe anti SieliBf, ft i p;epa[ar lias any ltrnwlcd.ije imatlcntd true, correct, and comriielEjJtelaration of g i e p a i ^ l h e r l h m officar) is baseri on lyiayjjie IRS discuas this telnrn with the piepartr sh&y/n.above? (ste inslructorts) S3?cn: i?.io-;s . ^.^^..-^^ LHA For Paperwork Reductson Act Notice, see the separate insfrUctions. SEE SCHEDUL! O FOR ORGANI3ATION MISSION STATEMENT COWTINUATTOW form 990(201?) Form 990 (2012) CHILDREN'S CANCER RECOVERY FOUNDATION 33-0418563 Paqe2 :ipia(ra^)|-;| Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part 111 1 [Xj Briefly describe the organization's mission: CHILDREN'S CANCER RECOVERY FOUNDATION ASSISTS CHILDREN AND THEIR FAMILIES WHO ARE FACING THE HARDSHIPS OF A CANCER DIAGNOSIS. THE FOUNDATION FOCUSES ON IMPROVING THE MENTAL, SOCIAL, FINANCIAL, EMOTIONAL AND SPIRITUAL WELL-BEING OF THESE FAMILIES. 2 3 4 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 99Q-EZ7 If "Yes," describe these new services on Schedule O. Did the organization cease conducting, or make significant changes in how it conducts, any program services? ^^^ • Y C S FXINO ^_^ I I Yes I X I No If "Yes." describe these changes on Schedule O. Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501 {c)(3) and 501 (c){4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. 4a (Code- ) (Expenses $ 1 0 , 2 9 3 , 7 9 3 . including grants of $ 1 0 , 0 5 2 , 8 0 5 . ) (Revenues ) INTERNATIONAL AID PROGRAM: THE FOUNDATION OPERATED AN EXTENSIVE INTERNATIONAL AID PROGRAM WHICH PROVIDED CANCER TREATMENT MEDICATIONS AND MEDICAL SUPPLIES TO HOSPITALS, CLINICS AND DOCTORS IN DEVELOPING AND IMPOVERISHED COUNTRIES. AID INCLUDED MEDICINES AND SUPPLIES TO ASSIST IN MANAGING POST-TREATMENT SIDE EFFECTS OF CANCER INCLUDING LYMPHEDEMA AND TREATMENT-RELATED INFECTIONS. 4b (Code: ) (Expenses S 3 , 0 0 5 , 1 6 5 . including grants of $ ) (Revenue $ COMMUNITY OUTREACH:THE FOUNDATION CONDUCTED AN EXTENSIVE EDUCATION PROGRAM FOCUSING ON CANCER PREVENTION AND RECOVERY. THE FOUNDATION'S UNIQUE WHOLE-PERSON INTEGRATED CANCER CARE MODEL IS AN AWARD-WINNING EFFORT INCORPORATING NUTRITION, EXERCISE, SOCIAL SUPPORT AND SPIRITUALITY INTO THE TRADITIONAL HEALTHCARE EQUATION. COMMUNITY OUTREACH ALSO FOCUSED ON ENVIRONMENTAL CARCINOGENS AND THEIR CONNECTION TO PEDIATRIC CANCER. THE FOUNDATION ASSERTS THAT 80.0% OF CHILDHOOD CANCERS CAN BE PREVENTED. PUBLIC EDUCATION IS AT THE HEART OF THIS EFFORT. 4c (Code- _ _ _ _ _ _ _ _ ) (Expenses $ Ly J r yQ 1 * including grants of $ ) (Revenues THE GIFTS PROGRAM: THE FOUNDATION DELIVERED GIFTS TO OVER 14,000 PEDIATIRC CANCER PATIENTS WHILE THEY WERE IN TREATMENT. THE "BEAR-ABLE GIFTS" PROGRAM INCLUDED TOYS, CRAFTS, GAMES AND THE LIKE. THE GIFTS WERE DISTRIBUTED THROUGH 260 HOSPITAL AFFILIATES THROUGHOUT THE U.S. 4d Other program services (Describe in Schedule O.) 4e Total program service expenses • (Expenses $ D 3 , J J Z • including grants of 3 } (Revenue $ ] 1 3 , 5 5 8 , 8 7 1 . Form 9 9 0 (2012) 232002 12-10-12 Form 990(2012) CHILDREN'S CANCER RECOVERY FOUNDATION 33-0418563 Paqe3 Part IV Checklist of Required Schedules Yes 1 Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A Is the organization required to complete Schedule S, Schedule of Contributor^ No X X Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I 8 Section 501 (c)(3) organizations. 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 X Is the organization a section 501(c)(4), 501(c)(5), or 501 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III X Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I X Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II X Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent 11 endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X X X X 10 as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete Schedule D, PartVI b Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII 11a X lib X 11c X 11d X X c Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total assets reported in PartX, line 16? If "Yes," complete Schedule D, Part VIII d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in PartX, line 16? ff "Yes," complete Schedule D, Part IX e Did the organization report an amount for other liabilities in PartX, line 25? If "Yes," complete Schedule D, PartX f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, PartX 12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete lie 11f X Schedule D, Parts XI and XII b Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional 13 Is the organization a school described in section 170(b}(1)(A)(ii)? If "Yes," complete ScheduleE 12a X 14a Did the organization maintain an office, employees, or agents outside of the United States? b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, 15 investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If "Yes," complete Schedule F, Parts II and IV 12b X 13 14a X 14b X 15 X 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If "Yes," complete Schedule F, Parts III and IV 16 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I 17 X 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1cand8a?//"Y'es,"compfeteSc/jec/u/eG, Part// 18 X X 19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes," complete Schedule G, Part III 20a Did the organization operate one or more hospital facilities'' If "Yes," complete Schedule H b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? 19 20a 20b X X Form 9 9 0 (2012) 232003 12-10-12 C H I L D R E N ' S CANCER Form 990 (2012) P a p & M i C h e c k l i s t of R e q u i r e d S c h e d u l e s (continued) RECOVERY FOUNDATION 33-0418563 Paqe4 Yes 21 22 23 United States on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I andII 21 X Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and III 22 X Did the organization answer "Yes" to Part VII, Section A, fine 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Scheduled 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31,2002? If "Yes," answer lines 24b through 24d and complete Schedule K. If "No", go to line 25 b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? 25a Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and 26 27 28 31 32 33 34 24c 24d X 25a 26 x of any of these persons? If "Yes," complete Schedule L, Part III Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV 27 x 28a x x A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete ScheduleL, Part IV 2Bb Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete ScheduleM Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation 29 contributions? tf "Ves," complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete ScheduleN, Parti Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?If "Yes," complete ScheduleN, PartII 30 x 31 x 32 x 33 X Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?/f "Yes," complete Schedule R, Parti Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and b If "Yes" to line 35a, 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," complete Schedule R, Part V, Iine2 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? 38 24a 24b person outstanding as of the end of the organization's tax year? If "Yes," complete Schedule L, Part II Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member PartV,line1 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 37 23 that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I 25b Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified instructions for applicable filing thresholds, conditions, and exceptions): A current or former off leer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV 29 30 No Did the organization report more than $5,000 of grants and other assistance to any government or organization in the x 28c 34 35a X X X 35b If "Yes," complete Schedule R, PartV,line2 Did the organization conduct more than 5% of its activities through an entity that is not a related organization 36 and that is treated as a partnership for federatincome tax purposes? If "Yes," complete Schedule R, Part VI Did the organization complete Schedule O and provide explanations in Schedule Ofor Part VI, lines l i b and 19? Note. All Form 990 filers are required to complete Schedule O 37 38 Form 9 9 0 (2012) 232004 12-10-12 C H I L D R E N ' S CANCER RECOVERY FOUNDATION iPgrt-.y';! Statements Regarding Other IRS Filings and Tax Compliance 33-0418563 Form 990 (2012) PageS Check if Schedule O contains a response to any question in this Part V • Yes 1 a Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable 1a b Enter the number of Forms W-2G included in line 1 a. Enter -O- if not applicable 1b c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? No 5 0 1c 2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return 2a b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? 0 2b Note. If the sum of lines 1 a and 2a is greater than 250, you may be required to e-file (see instructions) 3a Did the organization have unrelated business gross income of $1,000 or more during the year? b If "Yes," has it filed a Form 990-T for this year? If "No," provide an explanation in Schedule O 3a 3b 4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? 4a b If "Yes," enter the name of the foreign country: • See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts. 5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? c If "Yes," to line 5a or 5b, did the organization file Form 8886-T? 6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible9 7 Organizations that may receive deductible contributions under section 170(c). X X : : :>: A; ; X , 5a 5b 5c ; X X 6a 6b X a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? 7a b If "Yes," did the organization notify the donor of the value of the goods or services provided 9 7b c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? d If "Yes," indicate the number of Forms 8282 filed during the year 7d e Did the organization receive any funds, directty or indirectfy, to pay premiums on a personal benefit con tract? f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? 8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? 9 Sponsoring organizations maintaining donor advised funds. a Did the organization make any taxable distributions under section 4966? b Did the organization make a distribution to a donor, donor advisor, or related person? 10 Section 501 (c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line 12 b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities 11 Section 501 (c)(12) organizations. Enter: a Gross income from members or shareholders b Gross income from other sources (Do not net amounts due or paid to other sources against 7e 7f X X 7q 7h 8 10a 10b i 11a 12a . •> : 13a * ! * 13b 13c 14a Did the organization receive any payments for indoor tanning services during the tax year"? b If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedul 3 0 232005 12-10-12 X 9a 9b amounts due or received from them) 11b 12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? b If "Yes," enter the amount of tax-exempt interest received or accrued during the year 12b 13 Section 501 (c)(29) qualified nonprofit health insurance issuers. a Is the organization licensed to issue qualified health plans in more than one state? Note. See the instructions for additional information the organization must report on Schedule O b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans c Enter the amount of reserves on hand 7c X 14a 14b Form 9 9 0 (2012) C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 Page6 Form 990 (2012) ;Pa'rt.;\f| :i j G o v e r n a n c e , M a n a g e m e n t , a n d D i s c l o s u r e For eacrt "Ves" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instnictions. Check if Schedule O contains a response to any question in this Part VI ^^_^^ . I X1 Section A. Governing Body and Management Yes 1 a Enter the number of voting members of the governing body at the end of the tax year If there are material differences m voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule 0 1a b Enter the number of voting members included in line 1 a, above, who are independent 1b 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision 4 5 of officers, directors, or trustees, or key employees to a management company or other person? , Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? Did the organization become aware during the year of a significant diversion of the organization's assets? 6 Did the organization have members or stockholders? 7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? , b Are any governance decisions of the organization reserved to {or subject to approval by) members, stockholders, or persons other than the governing body? 8 • " ' - 2 2 X 3 4 6 X X X X 7a X 7b X 5 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following a The governing body? b Each committee with authority to act on behalf of the governing body? 8a 8b Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the orqamzation's mailing address? If "Yes," provide the names and addresses in Schedule 0 9 9 No 4 X X X S e c t i o n B. P o l i c i e s (This Section B requests information about policies not required by the Internal Revenue Code.) Yes 10a Did the organization have local chapters, branches, or affiliates? b If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? 11a Has the organization provided a compfete copy of this Form 990 to alt members of its governing body before filing the form? b Describe in Schedule O the process, if any, used by the organization to review this Form 990. 10b ITa X 12a Did the orgamzatton have a written conflict of interest policy? If "No," go to line 13 12a b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Ves," describe in Schedule O how this was done 13 Did the organization have a written whistleblower policy? 12b X X 14 15 Did the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official b Other officers or key employees of the organization If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions). X X X 12c 13 14 X 15a 15b 16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? No X 10a X i: X 16a b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's '• : :.- 16b exempt status with respect to such arranqements? Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed • A L , A K , A Z , A R , C A , C T , DC , G A , 18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501 (c)(3)s only) available for public inspection Indicate how you made these available. Check all that apply 1 X I Own website I X I Another's website 1 X 1 Upon request I I Other (explain in Schedule O) Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year 19 20 IL,KS,KY ,LA State the name, physical address, and telephone number of the person who possesses the books and records of the organization. • DOUG RUNKLE - 717-545-7600 6380 FLANK DRIVE SUITE 400, HARRISBURG, PA 232555 12-10-12 SEE SCHEDULE O FOR FULL L I S T OF 6 17112 STATES Form 9 9 0 (2012) 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION ;P^rfe-:VH;| Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Form 990 (2012) Check if Schedule O contains a response to any question in this Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. Page? • • List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of "key employee." • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. • List alt of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List ail of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. I l Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (A) Name and Title (C) (BJ Position Average (Qo not check more tnan one hours per box, unless peraon Is both an officer and a director/lfustee) week o (list any •a hours for a related 1 organizations o below a 8 1 o line) 1 i (1) DOUG RUNKLE PRESIDENT (2) T I M GRUNSTRA 20.00 20.00 0.50 TREASURER (3) ART GRANITO JESSICA TRUSTEE 232007 12-10-12 SCHAEFER IE) Reportable compensation from related organizations (W-2/1099-M1SC) (F) Estimated amount of compensation from the organization and related organizations X x 0. 121,000. 9,753. X X 0. 0. 0. x X 0. 0. 0. 0. 0. 0. 0.50 SECRETARY (4) (D) Reportable compensation from the organization (W-2/1099-MISC) 0.50 X Form 9 9 0 (2012) C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 PageS Form 990 (2012) P^ffi'tyfE Section A, Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (B) (C) (A) (D) (E) (F) Position Average Reportable Reportable Name and title Estimated [do not check more than one hours per box, unless person is both an compensation compensation amount of officer and a direclor/trustee) week from from related other (list any the organizations compensation hours for organization (W-2/1099-MISC) from the related (W-2/1099-MISC) organization organizations and related below organizations line) 1b Sub-total 121,000 • c Total from continuation sheets to Part VII, Section A 0 0 • d Total (add lines l b and 1c) 121,000 0 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization • 9,753 0 9,753 Yes No Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on X line la? If "Yes," complete Schedule J for such individual For any individual listed on line l a , is the sum of reportable compensation and other compensation from the organization and related organizations greater than $1SCOOO9 If "Yes," complete Schedule J for such individual Did any person listed on line 1 a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? // "Ves," complete Schedule J for such person Section B. Independent Contractors 1 . .. . Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization Report compensation for the calendar year ending with or within the organization's tax year. (B) (A) Description of services Name and business address ASSOCIATED COMMUNITY S E R V I C E S , 2 9 7 7 7 COMMUNITY OUTREACH TELEGRAPH A V E . STE 3 0 0 0 , SOUTHFIELD, M I CONTRACT COMMUNICATIONS 3 6 3 0 S PLAZA T R L , V I R G I N I A BEACH, VA 2 3 4 5 2 COMMUNITY OUTREACH B R I C K M I L L MARKETING SERVICES COMMUNITY OUTREACH 24 M I L L BROOK ROAD, W I L T O N , NH 0 3 0 8 6 2 X ^^^__ (C) Compensation 3,066,031. 609,941. 359,373. Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization • 3 Form 9 9 0 (2012) 232008 12-10-12 CHILDREN'S CANCER RECOVERY FOUNDATION Form 990 (2012) * H n 5 1 a gjt Check if Schedule 0 contains a response :o any question n this Part VIII (A) A " x * Total revenue Federated campaigns la b Membership dues lb c Fundraising events 1c d Related organizations 1d e Government grants (contributions) 1e f All other contributions, gifts, grants, and g O c 17 1f 10,310,562. Noncash coninbutlons Included in lines la-lf-$ • 17,130,106. : : •> <: v. Business Code ••'• , ..>• -: ' 2 a "S* «^ b n v d (D) Revenue excluded from tax under sections 512, 513, or 514 :>:'" 130,106. h Total. A d d lines l a - l f a> • (C) Unrelated business revenue (B) Related or exempt function revenue PageQ ;• similar amounts not included above fli : 0 33-0418563 c """ e Q. f All other program service revenue . q Total. A d d lines 2a-2f 3 • : ' • > • • ' ,:" Investment income (including dividends, interest, a n d other similar amounts) •" 4 Income from investment of tax-exempt bond proceeds •• 5 Royalties • 340. 340. /, (i) Real 6 a (ii) Personal Gross rents b Less: rental expenses c Rental income or (loss) d Wet rental income or (loss) - • 7 a Gross amount from sales of : ' '• • (i) Securities (ii) Other assets other than inventory b V :•• • : Less, cost or other basis and sales expenses c Gain or (loss) d Net gam or (loss) 8 a 3 C including $ > • Gross income from fundraising events (not of K contributions reported on line 1c). See tr 5 PartIV, line 18 a 24,099. b Less: direct expenses b 9,894. c Net income or (loss) from fundraising events 9 a b c 10 a • ; 14,205. ,: Gross income from gaming activities. See PartIV, line 19 a Less: direct expenses b 14,205. ] ••.; : : 'V. : *• • Net income or (loss) from gaming activities Gross sales of inventory, Jess returns r and allowances a b Less: cost of goods sold b c Net income or (loss) from sales of inventory Miscellaneous Revenue 11 a MANAGEMENT SERVICES TO A F F I L I A T E S b y L I S T RENTAL ROYALTIES .. . ' ,--,v i, • .;. Business Code 900099 62,331. 900099 1,767. 62,331. 1,767. C 12 232009 12-10-12 d All other revenue e T o t a l . A d d lines 11 a-11 d Total revenue See instructions • • 64,098. 17,208,749. — • •'••• ."-••-" 62.331. 0. 16,312. Form 9 9 0 (2012) CHILDREN'S CANCER RECOVERY FOUNDATION Form 990 (2012) 33-0418563 PagelO ip^l^fciX; Statement of Functional Expenses Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). IXI Check if Schedule 0 contains a response to any question in this Part IX (A) (B) Do not include amounts reported on lines 6b, Total expenses Program service 7b, 8b, 9b, and 10b of Pari Vltt. expenses 1 Grants and other assistance to governments and (C) Management and general expenses (D) Fundraising expenses : * ••: : , organizations in the United States See Part IV, line 21 2 Grants and other assistance to individuals in the United States. See Part IV, line 22 Grants and other assistance to governments, 3 % ' * • # & > organizations, and individuals outside the United States. See Part IV, lines 15 and 16 Benefits paid to or for members 4 5 Compensation of current officers, directors, trustees, and key employees Compensation not included above, to disqualified persons (as defined under section 4958(f}(l)) and persons described in section 4958(c)(3)(B) 6 7 8 9 10 11 : " " i i : "-.y ,' 81,074. 23,532. 26,147. Other salaries and wages Pension plan accruals and contributions (include section 401 (k) and 403(b) employer contributions) 26,709. 16,552. 4,811. 5,346. Other employee benefits Payroll taxes Fees for services (n on-employees): 10,551. 11,926. 6,657. 7,395. 1,933. 2,146. 1,961. 2,385. d Lobbying e Professional fundraising services See Part IV, line 17 f Investment management fees g Other. (If fine 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Sch 0.) 12 13 14 15 Advertising and promotion Office expenses Information technology Royalties 16 17 Occupancy Travel 18 Payments of travel or entertainment expenses 19 20 for any federal, state, or local public officials Conferences, conventions, and meetings Interest a b c d 10,052,805. 130,753. a Management b Legal c Accounting 21 22 23 24 10,052,805. Payments to affiliates Depreciation, depletion, and amortization Insurance Other expenses Itemize expenses not covered above (List miscellaneous expenses in line 24e If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schsdule 0 ) G I F T PROGRAM POSTAGE AND DELIVERY BANK SERVICE CHARGES EMERGENCY F I N A N C I A L ASS e All other expenses 25 Total iunctional expenses. Add lines 1 thiouqh 24e 26 Joint costs Complete this line only if the organization 11,718. 23,000. 11,718. 23,000. 2,387,706. 2,387,706. 3,553,235. 24,920. 2,960,362. 24,920. 592,873. 70,590. 19,898. 43,766. 13,551. 12,706. 3,934. 496. 14,118. 2,413. 496. 783. 4,652. 485. 141. 4,652. •1 171,206. 102,873. ..• • *. 157. "' 171,206. 109,812. 76,467. 59,922. 62,012. 16,809,161. 59,922. 17,303^ 13,558,871. 41,305. 806,653. 3,404. 2,443,637. 5,756,220. 2,817,265. 568,748. 2,370,207. 6,939. 76,467. reported in column (B) joint costs from a combined educational campaign and fundraising solicitation Ctieck here • " | X I if fcllowina SOP 9B-2 [ASC 953-720) Form 9 9 0 (2012) 232010 12-10-12 10 Form 990 (5012) P&ft:X ; Balance Sheet CHILDREN'S CANCER RECOVERY FOUNDATION 33-0418563 Page 11 1 | Check if Schedule 0 contains a response to any question in this Part X (A) Beginning of year 221,084. 49,658. 45,097. 5,000. 1 2 Cash - non-interest-bearing Savings and temporary cash investments 3 4 Pledges and grants receivable, net Accounts receivable, net 5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete 6 01 7 8 9 10a Notes and loans receivable, net Inventories for sale or use Prepaid expenses and deferred charges Land, buildings, and equipment, cost or other basis. Complete Part VI of Schedule D b Less: accumulated depreciation 11 Investments - publicly traded securities ID * * * * 'y 6 7 8 120,341. 6,265. 84,831. 77,430. •'• 8,184. 10c 11 Accounts payable and accrued expenses Grants payable Deferred revenue 20 21 22 Tax-exempt bond liabilities Escrow or custodial account liability. Complete Part IV of Schedule D Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L 22 23 24 25 Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of 23 24 13 14 6,851. 462,480. 252,072. Schedule D Total liabilities. Add lines 17 through 25 27 28 Unrestricted net assets Temporarily restricted net assets •o 29 Permanently restricted net assets Organizations that do not follow SFAS 117 (ASC 958), check here • 1 and complete lines 30 through 34. o 15 16 17 11,937. 716,572. 181,576. 18 19 20 21 : 75,000. 327,072. 25 26 0. 181,576. 90,311. 45,097. 27 489,899. 45,097. 1 X | and u c to 3 LL 7,401. 12 17 18 19 Organizations that follow SFAS 117 (ASC 958), check here • complete lines 27 through 29, and lines 33 and 34. •' * : Other assets. See Part IV, line 11 Total assets. Add lines 1 throuqh 15 (must equal line 34) in V 207,707. 6,298. 9 ;••'• 10a 10b :o 5 15 16 26 Z :>. t < Investments - other securities. See Part fV, line 11 Investments - program-related. See Part IV, line 11 Intangible assets (0 in in 3 4 12 13 14 '3 in ': 70,180. 367,952. 45,097. 0. 1 2 Part 11 of Schedule L Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(8), and contributing employers and sponsoring organizations of section 501 (c)(9) voluntary employees' beneficiary organizations (see instr). Complete Part II of Sch L « (B) End of year 30 31 32 Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds 33 34 Total net assets or fund balances Total liabilities and net assets/fund balances 28 29 ••' 30 31 32 135,408. 462,480. 33 34 534,996. 716,572. Form 9 9 0 (2012) 232011 12-10-12 11 CHILDREN'S CANCER RECOVERY FOUNDATION ;Psgrt-Xl:;] Reconciliation of Net Assets Form 990 (2012) 33-0418563 PaQe12 • Check if Schedule O contains a response to any question in this Part XI 1 Total revenue (must equal Part VIII, column (A), line 12) i 2 3 Total expenses (must equal Part IX, column (A), line 25) Revenue less expenses. Subtract line 2 from line 1 2 4 5 6 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) Net unrealized gains (losses) on investments Donated services and use of facilities 7 8 Investment expenses Prior period adjustments 9 10 Other changes in net assets or fund balances (explain in Schedule 0) Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, 3 4 5 6 7 8 9 10 column (B)) 17 , 2 0 8 , 7 4 9 . 16 , 8 0 9 , 1 6 1 . 399,588. 135,408. 0. 534,996. Part XII Financial Statements and Reoorting Check if Schedule O contains a response to any question in this Part XII Yes Accounting method used to prepare the Form 990: I I Cash ULl Accrual I I Other If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O. 2a Were the organization's financial statements compiled or reviewed by an independent accountanf? • No 1 X 2a If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: I I Separate basis I I Consolidated basis I I Both consolidated and separate basis b Were the organization's financial statements audited by an independent accountant? If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both. c 2b I X I Separate basis 1 J Consolidated basis I I Both consolidated and separate basis If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits . . .. 2c X 3a 3b Form 9 9 0 (2012) 232012 12-10-12 12 SCHEDULE A (Form990or990-EZ) Deparimerit of the Treasury Internal Revenue Service OMB No 15.15-0047 Public Charity Status and Public Support 2012 Comptete 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. Name of the organization Jnsfe£ei;i:6.rv Employer identification number 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION :(?art;:fi/ R e a s o n for P u b l i c C h a r i t y S t a t u s (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.) 1 2 3 4 I EH I I | I A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i). A school described in section 170(b)(1KA)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization described in section •J70(b)(1)(A)(iii). A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(rii). Enter the hospital's name, 5 I city, and state: I An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(AKiv). (Complete Part II.) 6 I 1 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 I X I An organization that normally receives a substantial part of its support from a governmental unit or from the genera! public described in section 170(b)(1)(A)(vi). (Complete Part II.) 8 I I A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 I 10 I 11 I I 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.) i An organization organized and operated exclusively to test for public safety. See section 509(a)(4). I 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. aI I Type I b I I Type II c I 1 Type III - Functionally integrated eI f g dI I Type 111 - Non-functionally integrated I By checking this box, 1 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? A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below, the governing body of the supported organization? (ii) A family member of a person described tn (i) above? (iii) A 35% controlled entity of a person described in (i) or (ii) above? • Yes (i) h No 11q(i) 11g(ii) iintiii) Provide the following information about the supported organizationfs). (i) Name of supported organization (il)EIN (vi) Is the (iii) Type of organization ;iv) Is the organization (v) Did you notify the (vii) Amount of monetary (described on lines 1-9 n col (i) listed in your organization in col. organization in col. support 9 above or IRC section governing document (i) of your support? (i) organized in the U.S.? (see instructions)) Yes No Yes No No Yes Total LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. •s Schedule A (Form 990 or 990-EZ) 2012 232021 12-04-13 13 Schedule A (Form 990 or 990-EZ) 2012 C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 •Partiillj Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) 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.") (b) 2009 fa) 2008 (CJ2010 fd) 2011 (e) 2012 ff) Total 9790400. 4471208. 8965566. 7652702. 17130106. 48009982. 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) 9790400. 4471208. ?. "•'• y ":-. :V. '^ : : Public Support. Subtraci line 5fromline 4. •" |^:. ;:...' '..' 6 8965566. 7652702. 17130106. 48009982. y/' 48009982. '•..;,;: Section B. Total Support Calendar year (or fiscal year beginning in) • 7 Amounts from line 4 8 (b) 2009 (c) 2010 (d)2011 (e)2012 (f) Total Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources 9 (a) 2008 9790400. 4471208. 8965566. 7652702. 17130106. 48009982. 31,147. 14,678. 10,485. 8,401. 2,107. 66,818. 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 'f i- ";:" 225,853. i*" y.: 14,205. 240,058. 48316858. 12 864,190. 12 Gross receipts from related activities etc. (see mstructi ans) 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 99.36 14 Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) 14 99.33 15 Public support percentage from 2011 Schedule A, Part 11, 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 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 • I I organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization • 1 I 18 Private foundation. If the organization did not checks box on line 13,16a, 16b, 17a, or 17b, check this box and see instructions •• I 1 Schedule A (Form 990 or 990-EZ) 2012 232022 12-01-12 14 Page 3 Schedule A (Form 990 or 990-EZ) 2012 iiKartftHij 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) • 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") (a) 2 D D 8 (c)2010 (b) 2009 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 (dj 2011 (e)2012 {f) Tota! (e)2012 (0 Total * 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 6 Total. Add lines 1 through 5 7a Amounts included on lines 1,2, and 3 received from disqualified persons b Amounts included on lines 2 and 3 received from older ifian disqualified persons that exceed ttie greater of $5,000 or 1 % of the amount on [Ine 13 for the year c Add lines 7a and 7b 8 P u b l i c s u p p o r t (Subtract line 7c from lire 6.) '•ly'ii-::- W^^MM^ ••••:.':'.^!,::''!'i:,:",:.": Section B. Total Support Calendar year (or fiscal year beginning in} • (a) 2008 (c»2010 (b) 2009 <dj 2011 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 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 toss from the sale of capital 13 Total SUppOlt. (Addllnes9. 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 tine 13, column (f)) 16 Public support percentaqe from 2011 Schedule A, Part III, line 15 % % 15 16 Section P. Computation of Investment Income Percentage 17 17 Investment income percentage for 2012 (line 10c. column (f) divided by line 13, column (f)} 18 18 Investment income percentage from 2011 Schedule A, Part 111, line 17 19a 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 % % • 1 I 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 • I I 20 Private foundation. If the organization did not check a box on line 14,19a, or 19b, check this box and see instructions • i I Schedule A (Form 990 or 990-EZ) 2012 232023 12-04-12 15 Schedule B Schedule of Contributors (Form 990, 990-EZ, or 990-PF) • OMB No. 1545-0047 Attach to Form 990, Form 990-EZ, or Form 990-PF. 2012 Department of Die Treasuiy internal Revenue Service Name of the organization Employer identification number C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 Organization type (check one): Filers of: Section: Form 990 or 990-EZ I X I 501 (c)( Form 990-PF 3 ) (enter number) organization I I 4947(a)(1) nonexempt charitable trust not treated as a private foundation I 1 527 political organization I I 501(c)(3) exempt private foundation I 1 4947(a)(1) nonexempt charitable trust treated as a private foundation I I 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 I I For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. Special Rules I X I For a section 501 (c)(3} organization 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)(vt) and received from any one contributor, during the year, a contribution 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 land II. I I For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and III. I I For a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not total to more than $1,000. [f this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more during the year • $ Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 99D-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 Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF). LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. 223451 12-21-12 Schedule B (Form 990, 99D-EZ, or 990-PF) (2012) Page 3 Employer identification number Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Name ol organization 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION Part II N o n c a s h P r o p e r t y (see instructions). Use duplicate copies of Part 11 if additional space is needed. (a) No. from Parti (c) FMV (or estimate) (see instructions) (b) Description of noncash property given MEDICINE / (d) Date received VACCINES 1 $ (a) No. from Parti 3,120,125. (c) FMV (or estimate) (see instructions) (b) Description of noncash property given 04/30/12 (d) Date received MEDICINES 2 $ (a) No. from Parti lb) Description of noncash property given 6,929,162. 12/13/12 (c) FMV (or estimate) (see instructions) <d) Date received (c) FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Parti (b) Description of noncash property given $ (a) No. from Parti (b) Description of noncash property given FMV (or estimate) (see instructions) (d) Date received $ (a) No. from Parti (c) FMV (or estimate) {see instructions) Description of noncash property given (d) Date received $ 223153 12-21-12 Schedule B (Form 99D, 990-EZ, or 990-PF) (2012) Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Name o! organization Page 4 Employer identitication number 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION mmm (a) No. from Parti Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations thai total more than $1,000 (or the year. Complete columns (a) through (e) and the following line entry. For organizations completing Part 111, enter the total of exc/us/ve/y religious, charitable, etc., contributions of $1,000 or less for the year (Enterthis intormasm once) ^ * Use duplicate copies of Part 111 if additional space is needed. (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 (a) No. from Parti (b) Purpose of gift Relationship of transferor to transferee (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 (a) No. from Parti (b) Purpose of gift Relationship of transferor to transferee (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 (a) No. from Parti (b) Purpose of gift Relationship of transferor to transferee (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee Schettule B (Form 990. 990-EZ, or 990-PF) (2012) 223454 12-21-12 19 OMBNo, 1515-0017 Supplemental Financial Statements SCHEDULE D (Form 990) 2012 • Complete if the organization answered "Yes," to Form 990, Part IV, line 6, 7, 8, 9,10,11a, 11b, 11c, 11d, l i e , 11f, 12a, or 12b. • Attach to Form 990. • See separate instructions. Department of the Treasury Inlemal Revenue Service Name of the organization :-lrisp£Q$iipn::; Employer identification number CHILDREN'S CANCER RECOVERY FOUNDATION Parti 33-0418563 Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "YesB to Form 990, Part IV, line 6. (a) Donor advised funds (b) Funds and other accounts 1 2 Total number at end of year Aggregate contributions to (during year) 3 4 Aggregate grants from (during year) Aggregate value at end of year 5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control? 6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? Jg&mWM C o n s e r v a t i o n E a s e m e n t s . Complete if the organization answered "Yes" to Form 990, Part IV, line 7. • Yes I I Yes • No LJ No Purpose(s) of conservation easements held by the organization (check all that apply). 1 I I 1 Preservation of land for public use (e.g., recreation or education) Protection of natural habitat I Preservation of open space 1 I I Preservation of an historically important land area I Preservation of a certified historic structure Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. Held atthe End of the Tax Year Total number of conservation easements 2a Total acreage restricted by conservation easements Number of conservation easements on a certified historic structure included in (a) Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure 2b 2c listed in the National Register 2d Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year • " 3 4 5 6 7 Number of states where property subject to conservation easement is located • Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year • Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year • $ I 1 Yes • No • Yes • No 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? 9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservation easements. liPatrt-lHyl Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 8. la ^ ^ If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items. b Jf the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items: (i) Revenues included in Form 990, Part VIII, line 1 (ii) Assets included in Form 990, Part X 2 • • $ $ If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items: a Revenues included in Form 990, Part V!U, line 1 b Assets included in Form 990, Part X • • LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. 232051 12-10-12 20 $ $ Schedule D (Form 990) 2012 Schedule D (Form 990) 2012 33-0418563 Paqe2 CHILDREN'S CANCER RECOVERY FOUNDATION illn Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assetsfconf/nuedj Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): I I Public exhibition 1 I I Scholarly research 1 Preservation for future generations d I I Loan or exchange programs e I ) Other Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as part of the organization's collection? I I Yes P a r t IV E s c r o w a n d C u s t o d i a l A r r a n g e m e n t s . Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. 1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X? • Yes I 1 No • No • No If "Yes," explain the arrangement in Part XIII and complete the following table: Amount Beginning balance Additions during the year 1c 1d Distributions during the year Ending balance 2a Did the organization include an amount on Form 990, Part X, line 21 ? b If "Yes," explain the arranqement in Part XIII Check here if the explanation has been provided in Part XIII Part V E n d o w m e n t F u n d s . Complete if the organization answered "Yes" to Form 990, Part IV, line 10. (a) Current year (b) Prior year (c) Two years back 1e If • Yes • (d) Three years back (e) Four years back 1a Beginningof year balance b Contributions c Net investment earnings, gains, and losses d Grants or scholarships e Other expenditures for facilities and programs f Administrative expenses g Endof year balance Provide the estimated percentage of the current year end balance (line 1 g, column (a)) held as: Board designated or quasi-endowment • _% Permanent endowment • • Temporarily restricted endowment • • % % The percentages in lines 2a, 2b, and 2c should equal 100%. 3a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: (i) unrelated organizations (ii) related organizations b If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? Describe in Part Xlll the intended uses of the organization's endowment funds. Part VI Yes No 3a{i) 3a(ii) 3b Land, Buildings, and Equipment. See Form 990, Part x, line ID. Description of property (a) Cost or other basis (investment) (b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value 1 a Land b Buildings c Leasehold improvements d Equipment 84,831. 77,430. 7,401. i e Other Total. Add lines l a through 1e. (Column (d) must equal Form 990, Pari X, column (B), line 10(c).) • 7,401. Schedule D (Form 990) 2012 232053 12-10-12 21 33 - 0 4 1 8 5 6 3 Paqe3 Schedule D (Form 990) 2012 C H I L D R E N ' S CANCER RECOVERY FOUNDATION I ' ^ a t f c l d l I n v e s t m e n t s - O t h e r S e c u r i t i e s . See Form 990, Part X, line 12. (a) Description Of Security Or Category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value (1) Financial derivatives (2) Closely-held equity interests (3) Other (A) (B) (C) (D) (E) (F) (G) (H) (1) Total.(Col (b) must equal Form 990, Part X, col (B}line12)^ P K V i i l I n v e s t m e n t s - P r o g r a m R e l a t e d . See Form 990, Part x, line 13. (b) Book value (a) Description of investment type (c) Method of valuation: Cost or end-of-year market value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Col. lb) must equal Form 990, Part X. col (Bllme 13 ) • : :I*pt-.JIX!: O t h e r A s s e t s . See Form 990, Part X, line 15. (a) Description (b) Book value (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Total. (Column (b) must epual Form 990, Part X, col. (B) line 15.) i^tftM'}. O t h e r Liabilities. See Form 990, Part X, line 25. 1. (a) Description of liability • (b) Book value ';: (1) Federal income taxes (2) (3) (4) (5) (6) (7) -M (8) (9) 00) :>• •;,: 01) Total. (Column (b) must equal Form 990, Part X, col. (B) line 25.) • 2. FIN 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII IX I Schedule D (Form 990) 2012 232053 12-10-12 22 C H I L D R E N ' S CANCER RECOVERY FOUNDATION 3 3 - 0 4 1 8 5 6 3 Paqe4 lEarfciXI : Reconciliation of Revenue per Audited Financial Statements With Revenue per Return 17,218,643. 1 Total revenue, gams, and other support per audited financial statements 1 ScheduleD(Form990)2012 2 Amounts included on line 1 but not on Form 990, Part VIII, line 12 a Net unrealized gains on investments b Donated services and use of facilities c Recoveries of prior year grants 2a d Other (Describe in Part XIII.) 2d 2b 2c 9,894. e Add lines 2a through 2d 3 Subtract line 2e from line 1 4 2e 3 Amounts included on Form 990, Part VIII, line 12, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b b Other (Describe in Part XIII.) c Add lines 4a and 4b 5 Total revenue. Add lines 3 and 4c. (This must equal Form 990. Part 1, line 12.) 9,894. 17,208,749. 4a 4b 0. 17,208,749. Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return 16,819,055. 1 Total expenses and losses per audited financial statements 1 2 Amounts included on line 1 but not on Form 990, Part IX, line 25: a Donated services and use of facilities 4c 5 2a 2b b Prior year adjustments c Other losses d Other {Describe in Part XIII.) 2c 2d e Add lines 2a through 2d 3 Subtract line 2e from line 1 4 Amounts included on Form 990, Part IX, line 25, but not on line 1: a investment expenses not included on Form 990, Part Vl|l, line 7b b Other (Describe in Part XIII.) c Add lines 4a and 4b 5 9,894. 2e 3 9,894. 16,809,161. 4c 0. 16,809,161. 4a 4b Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) 5 Part XIII Supplemental Information Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part IN, lines 1a and 4, Part IV, lines l b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part Xlf, lines 2d and 4b. Also complete this part to provide any additionaf information. PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ON ACTIVITIES RELATED TO THE FOUNDATIONS EXEMPT PURPOSE. THE FOUNDATION ADHERES TO THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) CODIFICATION 740, INCOME TAXES (ASC 740). ASC 740 PRESCRIBES A COMPREHENSIVE MODEL FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF UNCERTAIN TAX POSITIONS. THE FOUNDATION Schedule D (Form 990) 2012 23205-1 12-10-12 23 Schedule D (Form 990) 2012 C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 Pages •Ifeiart;ffiltj Supplemental Information (continued) HAS CONCLUDED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENTS EXPENSES DEDUCTED FROM REVENUE 9,894 PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENTS EXPENSES DEDUCTED FROM REVENUE 9,894 Schedule D (Form 990) 2012 2320S5 12-10-13 24 Scheduler (Form 990) 2012 CHILDREN'S CANCER RECOVERY FOUNDATION 33-0418563 IJ^ft-W' Grants and Other Assistance to Individuals Outside the United States. Compiete if the organization answered "Yes" to Form 990, Part IV, line 16. Part III can be duplicated if additional space is needed. (c) Number of (d) Amount of (e) Manner of (f) Amount of (g) Description of (a) Type of grant or assistance (b) Region recipients cash grant cash disbursement non-cash non-cash assistance assistance Page 3 (h) Method of valuation (book, FMV, appraisal, other) Schedule F (Form 990) 2012 232073 12-10-12 27 Schedule F (Form 990) 2012 CHILDREN'S CANCER RECOVERY FOUNDATION 33-0418563 page4 ifiariW: Foreign Forms 1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U. S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926) 2 L_J Yes ^_^ I X I No L U Yes QT] No ^_^ I Yes I X | No E H Yes [ X ] No I I Yes I X I No • Yes QT] No Did the organization have an interest in a foreign trust during the tax year? If "Ves," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A) 3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons With Respect To Certain Foreign Corporations, (see Instructions for Form 5471) 4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. • (see Instmctions for Form 8621) 5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons With Respect To Certain Foreign Partnerships, (see Instructions for Form 8865) 6 I Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report, (see Instructions forForm5713) Schedule F (Form 990) 2012 232074 12-10-12 Supplemental Information Regarding Fundraising or Gaming Activities SCHEDULEG (Form 990 or 990-EZ) OMBNo. 1545-0047 2012 Complete if the organization answered "Yes" to Form 990, Part IV, lines 17,18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. • Attach to Form 990 or Form 990-EZ. • See separate instructions. Employer identification number Department of the Treasury Internal Revenue Service Name of the organization 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION F u n d r a i s i n g A c t i v i t i e s . Complete if the organization answered "Yes" to Form 990, Part IV, line 17. Form 990-EZ filers are not required to complete this part. 1 Indicate whether the organization raised funds through any of the following activities. Check all that apply. a I X I Mail solicitations e I X I Solicitation of non-government grants b I X I Internet and email solicitations f I I Solicitation of government grants g I X I Special fundraising events c I X I Phone solicitations d I X I ln-person solicitations 2 a Did the organization have a written or oral agreement with any individual (including officers, directors, trustees or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? L.X 1 Yes ^__^ I 1 No b If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization. (i) Name and address of individual or entity (fundraiser) (ii) Activity Yes ASSOCIATED COMMUNITY SERVICES - 2 9 7 7 7 TELEGRAPH AVE, SUITE CONTRACT COMMUNICATIONS 3630 S. PLAZA T R A I L , BRICKMILL MARKETING - No IMMUNITY OUTREACH X 5,583,686. 3,066,031. 2,517,655. VIRGINIA ZOMMUNITY OUTREACH X 746,675. 609,941. 136,734. COMMUNITY OUTREACH X 360,534. 359,373. 1,261. COMMUNITY OUTREACH X 2,594. 8,600. 0. 6,693,589. 4,043,945. 2,655,650. SERVICES 4 SPURWOOD COURT, THE WOODLANDS, TX Total 3 (v) Amount paid (iv) Gross receipts to (or retained by) (vi) Amount paid to (or retained by) from activity fundraiser organization listed in col. (i) - 2 4 MILL BROOK ROAD, WILTON, BETHANY BRECHLER - (iii) Did fundraiser have custodv or control of contributions'? • List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing. M,rAKrAZtI^fCArCOrCT:rDEfFhfGAfliIfID/J'LrINrIArKSfKYf-LArnEfnDfMArHIrmirMSfnO MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VT,VA,WA,WV,WI,Vre DC LHA Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. SEE PART IV FOR CONTINUATIONS 232081 01-07-13 30 Schedule G (Form 990 or 9gO-EZ) 2012 ScheduleG(Form990or990-EZ)2012 C H I L D R E N ' S :.P,&rt;M: CANCER RECOVERY FOUNDATION 33-0418563 Pa q e2 F u n d r a i s i n g E v e n t s . Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000. (c) Other events (a) Event #1 (b) Event #2 (d) Total events NONE 30LF (add col (a) through lOURNAMENT I R A I L RIDE col. (c)) {event type) (event type} (total number) c > ID 10,670. 13,429. 24,099. 10,670. 13,429. 24,099. 528. 768. 1,296. 3,331. 100. 3,431. Food and beverages 250. 771. 1,021. Entertainment Other direct expenses 511. 325. 3,310. 325. 3,821. 9,894^ 14,205. 1 Gross receipts 2 Less: Contributions 3 Gross income {line 1 minus line 2) 4 Cash prizes 5 Noncash prizes 6 Rent/facility costs 7 8 9 ID 0) m c 01 b 10 Direct expense summary. Add lines 4 througi 9 in column (d) 11 Net income summary- Combine line 3, column (d), and line 10 P a r t HI G a m i n g . Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or eported more than • • ( $15,000 on Form 990-EZ, line 6a. (a) Bingo (b) Pull tabs/instant bingo/progressive bingo (d) Total gaming (add col. (a) through col. (c)) (c) Other gaming > en 1 Gross revenue 2 Cash prizes 3 Noncash prizes 4 Rent/facility costs 5 Other direct expenses 6 Volunteer labor 7 Direct expense summary. Add lines 2 through 5 in column (d) •• 8 Net qaminq income summary. Combine line 1 , column d. and line 7 • c <D Q. Q 9 1 1 1 1 Nn YP* %[ 1 1 Ye.; iNo % l _ l Yes 1 1 No % '" ( ) Enter the state(s) in which the organization operates gaming activities: a Is the organization licensed to operate gaming activities in each of these states? • Yes • No P I Yes • No b If "No," explain- 10a Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year9 b If "Yes," explain: Schedule G (Form 990 or 990-EZ) 2012 232082 01-07-13 31 Schedule G (Form 990 or 990-EZ) 2012 C H I L D R E N ' S 11 12 CANCER RECOVERY FOUNDATION 33-0418563 Does the organization operate gaming activities with nonmembers? Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity formed to administer charitable gaming? 13 Indicate the percentage of gaming activity operated in: a The organization's facility I Yes L_J Yes Page3 I J No I I No % % 13a b An outside facility 14 Enter the name and address of the person who prepares the organization's gaming/special events books and records: Name I 13b • Address • 15a Does the organization have a contract with a third party from whom the organization receives gaming revenue? b If "Yes," enter the amount of gaming revenue received by the organization • of gaming revenue retained by the third party • • $ . $ I 1 Yes I 1 No and the amount c If "Yes," enter name and address of the third party: Name • Address 16 • Gaming manager information: Name • Gaming manager compensation • • $ Description of services provided • " I 17 I Director/officer I J Employee I I Independent contractor Mandatory distributions: a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license? b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the organization's own exempt activities during the tax year • $ iPafefcly;] I—I Yes I 1 No Supplemental Information. Complete this part to provide the explanations required by Part 1, line 2b, columns (iii) and {v), and Part II lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions). SCHEDULE G, PART I, LINE 2B, LIST OF TEN HIGHEST PAID FUNDRAISERS: (I) NAME OF FUNDRAISER: ASSOCIATED COMMUNITY SERVICES (I) ADDRESS OF FUNDRAISER: 29777 TELEGRAPH AVE, SUITE 3000, SOUTHFIELD, MI 48034 (I) NAME OF FUNDRAISER: CONTRACT COMMUNICATIONS (I) ADDRESS OF FUNDRAISER: 3630 S. PLAZA TRAIL, VIRGINIA BEACH, VA 232083 01-07-13 23452 Schedule G (Form 990 or990-EZ) 2012 32 Schedule G (Form 990 or 990-EZ) 2012 C H I L D R E N ' S C A N C E R pgjrfrp; Supplemental Information (continued) RECOVERY FOUNDATION 33-0418563 Page* (I) NAME OF FUNDRAISER: BRICKMILL MARKETING SERVICES (I) ADDRESS OF FUNDRAISER: 24 MILL BROOK ROAD, WILTON, NH 03086 (I) NAME OF FUNDRAISER: BETHANY BRECHLER (I) ADDRESS OF FUNDRAISER: 4 SPURWOOD COURT, THE WOODLANDS, TX 77381 Schedule G (Form 990 or 990-EZ) 2012 232081 05-01-12 33 Noncash Contributions SCHEDULE M {Form 990) • Department of the Treasury Internal Revenue Service OMBNo 1545-004? 2012 Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30. • Attach to Form 990. Name of the organization Employer identification number 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION Part I Types of Property (a) Check if applicable (c) (b) Noncash contribution Number of amounts reported on contributions or items contributed Form 990. Part VIII. line l a (d) Method of determining noncash contribution amounts 1 Art - Works of art 2 Art - Historical treasures 3 Art - Fractional interests 4 Books and publications 5 Clothing and household goods 6 Cars and other vehicles 7 Boats and planes 6 Intellectual property 9 Securities - Publicly traded 10 Securities - Closely held stock 11 Securities - Partnership, LLC, or 12 13 trust interests Securities - Miscellaneous Qualified conservation contribution Historic structures Qualified conservation contribution - Other 14 15 Real estate - Residential 16 Real estate - Commercial 17 Real estate - Other 18 Collectibles 19 Food inventory 20 Drugs and medical supplies 21 Taxidermy 22 Historical artifacts 23 Scientific specimens 24 Archeological artifacts ( TOYS AND SMAL ) 25 Other • 26 Other • ( } 27 Other • { 28 Other • _L 29 X 520,819 X 40,879 10,049,287. 255,163 FMV, DONOR VALUATION FMV, DONOR VALUATION Number of Forms 8283 received by the organization during the tax year for contributions for which the organization completed Form 8283, Part IV, Donee Acknowledgement 29 Yes No 30a During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period 9 b If "Yes," describe the arrangement in Part 11 31 Does the organization have a gift acceptance policy that requires the review of any non-standard contributions'? 30a X 31 32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash 32a X contributions? b If "Yes," describe in Part II. 33 |f the organization did not report an amount in column {c) for a type of property for which column (a) is checked, describe in Part II. LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule M (Form 990) (2012) 232141 13-20-12 34 SCHEDULE 0 OMBNo. 1515-0047 Supplemental Information to Form 990 or 990-EZ (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. Departrnent of the Treasury Internal Revenue Service 2012 ^^•S^ftSiSectiqn'i-^'ii-i-V^::!: Employer identification number Name of the organization C H I L D R E N ' S CANCER RECOVERY 33-0418563 FOUNDATION FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: DIAGNOSIS. FORM 990, PART III, LINE 4D, OTHER PROGRAM SERVICES: THE HELPING HANDS FUND PROGRAM: THE FOUNDATION PROVIDED EMERGENCY FINANCIAL ASSISTANCE TO THE FAMILIES OF PEDIATRIC CANCER PATIENTS. BECAUSE OF THE HIGH DEMAND, FUNDING WAS LIMITED TO PAYMENT OF PAST-DUE UTILITY BILLS, RENT EVICTION NOTICES AND CHILDHOOD SCHOLARSHIPS. EXPENSES $ 65,932. INCLUDING GRANTS OF $ 0. REVENUE $ 0. FORM 990, PART VI, SECTION B, LINE 11: A COPY OF THE FORM 990 HAS BEEN PROVIDED TO THE BOARD OF TRUSTEES AND IS REVIEWED BY THEM. THE PRESIDENT ALSO MEETS WITH A REPRESENTATIVE OF THE ACCOUNTING FIRM THAT PREPARED THE FORM 990 AND RELATED SCHEDULES TO DISCUSS THE CONTENT AND ANSWER ANY QUESTIONS OF THE BOARD OF TRUSTEES. FINAL CHANGES, IF ANY, ARE THEN MADE TO THE FORM 990 AND RELATED SCHEDULES. THE FINAL COPY OF THE FORM 990 AND RELATED SCHEDULES IS THEN PROVIDED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C: THE QUESTION IS RAISED AND APPROPRIATE DISCLOSURES ARE MADE AT THE FIRST BOARD MEETING OF EACH CALENDAR YEAR. FORM 990, PART VI, SECTION B, LINE 15A: THE BOARD OF TRUSTEES AND OFFICERS SERVE WITHOUT COMPENSATION FROM CCRF. THE NON-INDEPENDENT OFFICERS COMPENSATION (IF ANY) ARE PAID THROUGH CANCER RECOVERY FOUNDATION INTERNATIONAL, THE COMMON PAYER FOR THE CRFI GROUP OF CHARITIES IN THE LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. 232211 O1-Od-13 35 Schedule O (Form 990 or 990-EZ) (2012) Page 2 Schedule O (Form 990 or 990-EZ) (2012) Name of the organization Employer identification number 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION UNITED STATES. COMPENSATION IS DETERMINED BY THE CEO OF CRFI, WHO USES A COMBINATION OF FORM 990S FROM OTHER ORGANIZATIONS, COMPENSATION STUDIES, AND A DISCUSSION WITH THE INDEPENDENT BOARD MEMBERS. FORM 990, PART VI, LINE 17, LIST OF STATES RECEIVING COPY OF FORM 990: AL,AK,AZ,AR,CA,CT,DC,GA,IL,KS,KY,LA,ME,MP,MA,MI,MN,MS,MO,NH,NJ,NM,NY,NC,ND OH,OR,PA,RI,SC,TN,UT,VA,WA,WV,WI,CO,FL,OK FORM 990, PART VI, SECTION C, LINE 19: ANY DISCLOSURES REQUIRED BY FEDERAL AND STATE LAW ARE INCLUDED IN OUR DIRECT RESPONSE AND FULFILLMENT PIECES. OUR WEBSITE IS UTILIZED WHERE APPROPRIATE. WE FULLY COMPLY WITH ALL CORPORATE AND NON-PROFIT REGISTRATION REQUIREMENTS IN ALL 50 STATES AS APPLICABLE. THE DOCUMENTS ARE AVAILABLE FOR INSPECTION AT OUR SITE DURING NORMAL BUSINESS HOURS. FORM 990, PART IX, LINE 11G, OTHER FEES COMMUNITY OUTREACH SERVICES: 2,817,265 PROGRAM SERVICE EXPENSES 568,748 MANAGEMENT AND GENERAL EXPENSES FUNDRAISING EXPENSES 3,386,013 TOTAL EXPENSES CONTRACT LABOR 143,097 PROGRAM SERVICE EXPENSES 24,125 MANAGEMENT AND GENERAL EXPENSES FUNDRAISING EXPENSES 167,222. TOTAL EXPENSES TOTAL OTHER FEES ON FORM 990, PART IX, LINE 11G, COL A 232212 01-04-13 3,553,235. Schedule O (Form 990 or 990-EZ) (2012) 36 OMB No. 1545-0047 Related Organizations and Unrelated Partnerships SCHEDULER (Form 990) • Department of the Treasury Internal Revenue Servrce 2012 Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37. • Attach to Form 990. • See separate instructions. i^QjP'en: :ta:Pu.bJicr:> Employer identification number Name of the organization 33-0418563 CHILDREN'S CANCER RECOVERY FOUNDATION : ^'F£|>;-: Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.} (a) Name, address, and EIN (if applicable) of disregarded entity tfSrtft? (b) Primary activity (c) Legal domicile (state or foreign country) (e) End-of-year assets (f) Direct controlling entity Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.) (a) Name, address, and EIN of related organization (b) Primary activity CANCER RECOVERY FOUNDATION INTERNATIONAL TO PROVIDE EDUCATIONi INC. - 2 0 - 8 2 4 0 2 4 1 , 6380 FLANK DRIVE, HARRISBURG, PA 17112 TRAINING, AND SUPPORT TO AFFILIATED ENTITIES. (c) Legal domicile (state or foreign country) PENNSYLVANIA LHA (d) Exempt Code section 501(C)(6) <e) Public charity status (if section 501 (c)(3)) (0 (9) Direct controlling entity Section 512(bX13) controlled entity? Yes tf/A No X Schedule R (Form 990) 2012 For Paperwork Reduction Act Notice, see the Instructions for Form 990. 232161 12-10-12 (d) Total income 37 ScheduleR(Form990)2012 : ;i?art :l& CHILDREN'S CANCER RECOVERY 33-0418563 FOUNDATION paQe2 Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part iV, line 34 because it had one or more related organizalhns treated as a partnership during the tax year.) (a) Name, address, and E1N of related organization (c) Primary activity Legal domicile (state or foreign country) (d) Direct controlling entity (e) Predominant income (related, unrelated, excluded from tax under sections 512-514) ffl Share of total income (g) Share of end-of-year assets (h) Disproportionate allocations? Yes No (k) (i) 0) General or Percentage CodeV-UBI ownership amount in box managing partner? 20 of Schedule Yes No K-1 (Form 1065) ';Ra'rt-:iV: ! c ' e n t ' f ' c a t ' o n ^ Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part iV, line 34 because it had one or more related ..; organizations treated as a corporation or trust during the tax year.) (a) Name, address, and BIN of related organization 232162 12-10-12 (bj Primary activity (c) (d) Legal domicile [stale or foreign country) Direct controlling entity 38 (e) Type of entity (C corp, S corp, or trust) (f) Share of total income (g) Share of end-of-year assets (h) Percentage ownership (i) Section 512(b}(13) controlled entity? Yes No Schedule R {Form 990) 2012 Schedule R {Form 990) 2012 FattV' C H I L D R E N ' S CANCER RECOVERY FOUNDATION 33-0418563 Paqe3 Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34,35b. or 36.) Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule. Yes 1 Dunng the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts ll-IV? a Receipt of (ij interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity b Gift, grant, or capital contribution to related organization{s) 1d 1e X X X X X 1a 1b c Gift, grant, or capital contribution from related organization^) d Loans or loan guarantees to or for related organ)zatlon(s) e Loans or loan guarantees by related organtzation(s) 1c f Dividends from related organization(s) g Sale of assets to related organ izat ion (s) h Purchase of assets from related organ izat ion (s) No If X ig 1h 1i A i Exchange of assets with related organization(s) j Lease of facilities, equipment, or other assets to related organization{s) JI X k Lease of facilities, equipment, or other assets from related organ izat ion (s) 1k 11 X X X I Performance of services or membership or fundraising solicitations for related organ izat ion (s) m Performance of services or membership or fundraising solicitations by related organ izat ion (s) n Sharing of facilities, equipment, mailing lists, or other assets with related organ izat ion (s) o Sharing of paid employees with related organization{s) 1m In 1o X X p Reimbursement paid to related organ izat ion (s) for expenses q Reimbursement paid by related organ izat ion (s) for expenses JJL JlSL X X r Other transfer of cash or property to related organ izat ion (s) s Other transfer of cash or property from related organization(s) . . . . _. . . 2 If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds. (b) Transaction type (a-s) (a) Name of other organization CANCER RECOVERY FOUNDATION (1) I N C . Amount involved 1r Is X (d) Method of determining amount involved INTERNATIONAL, 0 1 8 0 , 1 2 5 . ACTUAL EXPENSES INCURRED (2) (3) (4) (5) (6) 232163 12-10-12 39 Schedule R (Form 990) 2012 Schedule R (Form 990) 2012 ::: :::iRart-V!: CHILDREN'S CANCER RECOVERY 33-0418563 FOUNDATION Page4 u Unrelated Organizations Taxable as a Partnership (Complete if the organization answered °Yes to Form 990, Part IV, line 37.) Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships. (a) Name, address, and EIN of entity (b) Primary activity (c) Legal domicile (state or foreign country) (e) Predominant income (related, unrelated, excluded from tax under section 512-514) Are all partneis sec. 501(c)(3) Oiqs.? Yes N o (t) Share of total income (g) Share of end-of-year assets (h) Disproportionate ailocatiCHis? Yes N o (i) CodeV-UBI amount in box 20 of Schedule K-l (Form 1065) (J) Seneral or rnanaging partner? (k) Percentage ownership Yes N o Schedule R (Form 990) 2012 232164 12-10-12 40 Schedule R (Form 990) 2012 C H I L D R E N ' S CANCER RECOVERY FOUNDATION i;ffft&yU;:j Supplemental Information 33-0418563 Page 5 Complete this part to provide additional information for responses to questions on Schedule R (see instructions). 232165 12-10-12 Schedule R (Form 990) 2012 41
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