Document 6423287

Transcription

Document 6423287
Short
Fonn
Fm 990-EZ . Return of Organization Exempt From Income Tax
OMB No 1545-1150
Under(except
section
501 (c), 527, or 4847(a)(1) ofthe lntemal Revenue Code
black lung benefit tiust or pnvate foundation)
* Sponsonng organizations of donor advised funds and controlling organizations as defined in section 512(b)(13) must file Form
ma use this form
open to Pubns
Department of the Treasury
Y inspection
990 All other organizations with gross receips less than $500,000 and total assets less than $1,250,000 at the end of the year .
lntemal Revenue Service * The organization may have to use a copy of this return to satisfy state reporting requirements
A For the 2009 calendar
B Check if applicable
ear,
or tax year beginning , 2009, and ending
C
Address
change
a or FIGHTING CHANCE, INC.
Name change mn or PO BOX 1358
Initial retum 53:. SAG HARBOR, NY 11963
Termination gpeduc
D Employer ldeiitticatloii number
0 2 - 0 53 63 8 8
E Telephone number
631-725-4691
Amended return Inmlc*
tions.
Number *
F Group Exemption
Application pending
P
0 Section 50-gc? o/yanizahbns and 4.947(a%7) nonexempt chanbble b-usb G ACCOUNTING meU"l0d5
I-I Cash Accfual
H Check
* If the organization is not
mu a ch a completed Schedule (Form 9.90 or 990-Z. Other
(speci%)
l Website: * WWW. FIGHTINGCHANCE . ORG required to attach Schedule B (Form 990,
J Tu-exemtstatus(checkonlyone)- ,XI 50l(g) ( 3 ) *(insertno) I I4947(a)(l)or 1 1527 99O"EZ"0r 99O"PF)
S,
K Check * I Iif the organization is not a section 509(a)(3) supporting organization and its gross receipts are normally not more than
$25,000. A orm 990-EZ or Form 990 return is not required, but If the organization chooses to file a return, be sure to flle a complete return.
L Add lines 5b, 6b, and 7b, to llne 9 to determine gross recelptsg if $500,000 or more, flle Form 990
* 445 234.
1 397,973.
instead of Form 990-EZ
lPant
I Revenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.)
1 Contributions, gifts, grants, and similar amounts received
Program servlce revenue lncludlng government fees and contracts
2
3
4
b.p
Membership dues and assessments . .
Investment Income
5a
Gross amount from sale of assets other than Inventory 5a
Less" cost or other basis and sales ex enses E
c Gain or (loss) from sale of assets other than inventory (Subtract In 5b from ln 5a)
6 Special events and activities (complete applicable parts of Schedule G). If any amount is from gaming, check here
c
5 Ll
reported
on line 1) Ga 47 250 .
Less: dlrect expenses other than fundraising expenses E 48 339 .
a Gross revenue (not including S 127, 220 . of contributions
b
6c ,
-1 089.
c Net income or (loss) from special events and activities (Subtract Ilne 6b from line 6a) .
b Less: cost of goods soldI 7aI.
7a Gross sales of inventory, less returns and allowances
c Gross profit or (loss) from sales of Inventory (Subtract line 7b from line 7a)
8 Other revenue (describe *
9 Total revenue. Add lines 1, 2, 3, 4, Sc, 6c, 7c, and 8 .
10 Grants and similar amounts pald (attach schedule)
7c
)*89 396,895.
1o
11 Benefits paid to or for members
12 Salaries, other compensation, and employee benefits
13 Professional fees and other payments to independent contr rs 0
14 Occupancy, rent, utilities, and maintenance .
15 Printing, publications, postage, and shipping , ­
16 Other expenses (describe * SEE STATEMENT 1
17 Total expenses. Add lines 10 through 16
18 Excess or (deficit) for the year (Subtract line 17 from line 9)
19
20
21
11
12"" 176,413.
13
7,350.
14 27,583.
. 15
1 16 155,144.
e 17 366,490.
18 30, 405.
figure reported on prior year"s return) .
Other changes in net assets or fund balances (attach explanation) .
Net assets or fund balances at end of year. Combine Innes 18 through 20
.Z0-ll
. .. 19 215, 553.
Net assets or fund balances at beglnning of year (from Inne 27, column (A)) (must agree with end-of-year
. .. e 21 245,958.
il, , BRIGIICB Sheets. If Total assets on line 25, column (Q) are $1,250,000 or more file Form 990 instead of Form 990-EZ.
(See the instructions for Part ll.) (A) Beglnning of year
22 Cash, savings, and investments . .
23 Land and buildings
25 Totalassets . . .. . .
24
26 Total liabllltles (describe * SEE STATEMENT 3 ) .
Other assets (descrlbe * SEE STATEMENT 2 ) f
27 Net assets or fund balances (line 27 of column (Q) must agree with line 21)
BAA For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
1EEAo8o31. oi/so/io
(Q) End of year
136,308.
28 255
57,56of
158,596.
33,508.
222, 123.
lt
251,443.
6,570.
5,485.
215,553. 245,958.
26
Z/
Form 990-EZ (2009) FIGHTING- CHANGE, INC . 02-0536388 Paqe 2
lPal1IIl I Statement of Program Service Accomplishments (See the instructions.) EXPGHSSS
program title. for o ers.)
What is the organization"s primary exempt purpose? SEE STATEMENT 4 g3(f?g)I(r3e)dE,f,.?(g fiction
Describe what was achieved in carrying out the organization"s exempt urposes. In a clear and concise manner, or anizations and section
describe the services provided, the number of persons benefited, or other relevant information for each 49g.71Sa)(l) trusts: optional
28 .Fl QUE NG. SILULNEE .?.BQV.I1.9ES. EQU.NE ELINQ .F 913 .fLUlC.13B.Pl4l7l@il7E AND EEELR. ­
.FEMLLI ES. IEIIOQQH. IIS. EEJQSI "LE, - E052 LN.-EI AND .C.0LiPlRE1iC.E. QE.NI 1211- - - - - ­
-@@--g---@---@------*.....-.-@-1---.---­
jGrants $ ) If this amount includes foreign grants, rgiecz h-ere ------- --:VT 28a 313, 562 .
29
jGrants S ) lf this amount includes foreign gi*-antsicgriecz here ------- --:VT 29a
30
@--1--th--Q*---1--@1-1-----i------.-----.-*1.-----..--.-­
$Grants S ) lf this ann-ciun-t.in-ciidesforeign-gr-arTt5 angel. Fefe ------- --:I-I, 30a
31 Other program services (attach schedule) .
jGrants $ ) If this amount includes foreign grants, check here * I-I 31 a
32 Total rogram service expenses (add lines 28a through 31 a) * 32 313, 562 .
IPB# IV r List Of 0ffiC8l*S, Dil*8Cf0l*S, TrU$t8B$, Bhd K8y Empl0y66$. List each one even if not compensated. (See the instrs.)
(b) Title and average hours (c) Compensation (lf (d) Contributions to (e) Expense account
to position eferred compensation
(a) Name and address per week devoted not paid, enter -0-.) emtployee benefit plans and and other allowances
g-.---1-------1-.--@-1-­
SEE STATEMENT 5 0. 0. O.
--4-----.1.----@..-.--@-*-­
-@.---@...-----..-*---@.-11­
@-.---.-----.-1--1--1--@­
1-.---1---..@1---@----@-­
11..--.------@---------4-.
--4---1--.-@----@.-@---....­
-@..-1---@-11--.-----q@1­
--..--.------@-1---@@---­
1-..------@-------1-1--­
1-.--*@------.--.1------­
--,-.-*1-------.------.1-­
--..--@---...-------1--@-­
--..--11-1----.1-1---1--­
--@-@-.-@@--1--.-@1--..,..-­
@@.--@1-1----Q-...-1-@11­
.-1.,--.-1------.@-----11-­
-1.,---1-1---......-.-----1@­
,1.,--.1-----.--.---.----.-.1­
-*.,--.1--.----.--.-@-@--@1­
--..-----.1--@-.-.@1------­
--,-------11------1----.
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--..--1-..---.----11--@@--­
BAA TEE/iosizi oi/so/io Form 990-EZ (2009)
Fofmggo-5242009) FIGHTING -CHANGE INC. oz-0536388 Pages
PartV I Other Infomeation (Note the statement requirements in the instrs for Part V.)
Yes No
33 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of
each activity
34 Were any changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the changes
33 X
35 If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T,
attach a statement explaining why the organization did not report the income on Form 990-T
reporting, and proxy tax requirements? . . 35a X
a Did the organization have unrelated business gross income of $1,000 or more or was it subject to section 6033(e) notice,
b If "Yes," has it filed a tax return on Form 990-T for this year? . . . 35b
36 Did
theIforfganization
undergo
a liquidation,
year?
" es," complete
applicable
parts of dissolution,
Schedule N termination, or significant disposition of net assets during the
37a Enter amount of political expenditures, direct or indirect, as described in the instructions *I 37aI 0 .
b Did the organization file Form 1120-POL for this year? .
38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the period covered by this return?
amount involved 38b N/ A
b If "Yes," complete Schedule L, Part II and enter the total
a Initiation
and capitalorganizations.
contributions included
on line
39
Sectionfees
501(c)(7)
Enter.
­ 9 . 39a N/A
b Gross receipts, included on line 9, for public use of club facilities N/A
40a Section 501 (c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 * 0 . 5 section 4912 * 0 . 5 section 4955 * 0 .
b Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit
transaction during the year or is it aware that it engaged in an excess benefit transaction with a disqualified person in a
prior year, and 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
c Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization "
by the organization . * 0 40a X
managers or disqualified persons during the year under sections 4912, 4955, and 4958 . * 0 .
d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed
e All organizations At any time during the tax year, was the organization a party to a prohibited tax
shelter transaction? If "Yes," complete Form 8886-T
41 List the states with which a copy of this return is filed * NONE
42a The organization"s
books are in care of * QIy-LNEEl,- ------------------ - I Telephone no. * -( 63 l) 725- 4 64 6
Weleda* * .P9.13.0l4.1.3@fi-L5*1if3..P1?lRl39fll*1X ..................... -- ZIP +4 * .1-1553122222::
b At any time during the calendar year, did the organization have an interest in or a signature or other authority over a
No
financial account in a foreign country (such as a bank account, securities account, or other financial account)? . X
lf "Yes," enter the name of the foreign country: *
See the instructions for exceptions and filing requirements for Fonn TD F 90-22.1, Report of a Forelgn Bank and Flnanelal Accounts.
c At any time during the calendar year, did the organization maintain an office outside of the U.S.? . X
If "Yes," enter the name of the foreign country: *
43 Section 4947(a)(l) nonexempt charitable trusts filing Form 990-EZ in lieu of Fonn 1041 - Check here . * III N/A
and enter the amount of tax-exempt interest received or accrued during the tax year . . . *I 43 I N/A
of Form 990-EZ . .
No
I 44 Did the organization maintain any donor advised funds? If "Yes," Form 990 must be completed instead X
Form 990 must be completed instead of Form 990-EZ 45 X
BAA
reeaosizi. oi/so/io Form 990-EZ (2009)
45 ls any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? lf "Yes,"
3-9
Form 990-EZ (2009) FIGHTING -CHANCE, INC 02-0536388 Pa e 4
lPart Vl 1 Secti-on 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section
501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions
46-49b and complete the tables for lines 50 and 51.
46 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
47 Dld the organization engage In lobbying activities? ll" "Yes," complete Schedule C, Part ll .
48 ls the organization a school as described in section 170(b)(1)(A)(il)? If "Yes," complete Schedule E
49a Did the organization make any transfers to an exempt non-charitable related organization?
b If "Yes," was the related organization a section 527 organization?
50 Complete this table for the organization"s tive highest compensated employees (other than officers, directors, trustees and key
employees) who each received more than $100,000 of compensation from the organization. lf there ls none, enter "None "
(b)Title and average (c)Compensati
fi
o on nu(d)C
onstrib
to emJaloyee
(e) Expense
(I) Name
andthan
address
of eachdevoted
employee
paid hours
per week
benefit
plansother
an account
and
more
$100,000
to position
deferred
compensation
allowances
.NQNE ................... -­
f Total number of other employees paid over $100,000 *
51 Complete this table for the organlzatlon*s five highest compensated independent contractors who each received more than $100,000 of
compensation from the organization. If there is none, enter "None."
(I) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
Sign
.................... -- -1-- x-------------­
dTotal number of other independent contr ctors a releivlng over $100,000 . . * Y
i
I
, ldgder
e, corr/,
penaltles
ec, an comp
gf periuiry,
I geclare
l h ve
d thi relum,
including
and statements,
e e eclaratlon
ofthat
eparer
o erexa
th in
n officer)
is based
on allaccompanying
information ofschedules
which preparer
has any and
wle to
geest y knowledge and belief, it is
/
Hero
nature
of
officer
V
Date
, DUNCAN DARROW PRESIDENT & CEO
Type or pnnt name and title
* Pre arer"s Date check If I(,gggaihesrtrI1t:ctieTiis,)yIng Number
5:16#-Iirm"s
s.g3am,.name
* Sting- or
1 wh &
I 3/09/1o Zfllsioyed -VltPoo174355
02265
23,:p"T.,$,Z3*f2( v Po Box 1307 ( 1 Em - 11-2883699
Only %p"3i?"*"" SOUTHAMPTON, NY 11969-1307 Pima - (631) 283-2370
BAA Form 990-EZ (2009)
May the IRS discuss this return with the preparer shown above? See instructions *txt Yes t t No
TEEAOsi2L oirso/io
OMB No 1545-0047
SCHEDULE A
(F emi 990 or 990-EZ)
2009
I " Public Charity Status and Public Support
Complete if the organization Is
a sectlon 501(c)(3)
or a section 4947(a)(1)
nonexempt
charitab eorganlzatlon
trust.
Department of the Treasury
Intemal Revenue Service
* Attach to Form 990 or Fonn 990-EZ. * See separate Instructions.
Name of the organization
toPdm
oizmumonc
Employer lileiitltlcatleii number
FIGHTING CHANCE, INC. IOZ-0536388
IPartl #Reason for Public Chanty Status (All organizations must complete this part.) See instructions
The o@nization is not a private foundation because it is: (For lines 1 through I I, check only one box.)
1
A church, convention of churches or association of churches described in sectlon170(bX1XAXl).
2
A school described in sectlon170(bX1)(AXll). (Attach Schedule E.)
A hospital or cooperative hospital service organization described in section 170(bX1XA)(lil).
A medical research organization operated in conjunction with a hospital described in sectlon170(bX1)(AXlii). Enter the hospital"s
name, city, and state: ------------------------------------------------- -­
5
6
7
X
B
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section
170(bX1XAXiv). (Complete Part ll.)
A federal, state, or local government or governmental unit described in section 170(bX1XAXv).
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described
in section 170(bX1XA)(vi). (Complete Part ll.)
A community trust described in sectIon170(b)(1XAXvi). (Complete Part ll.)
9
An
organization
that normally
receives:
(1) more
than 33-1/3
% ofexceptions,
its support and
from(2)
contributions,
and gross
receipts
from
activities related
to its exempt
functions
- subject
to certain
no more thanmembershya
33-1/3 "0 offees,
its support
from
gross
investment income and unrelated business taxable income (less section 51 1 tax) from businesses acquired by the organization after
June 30, 1975. See sectlon 509(a)(2). (Complete Part Ill.)
An organization organized and operated exclusively to test for public safety. See section 509(a)(4).
10
11
An
organization
organizedorganizations
and operated exclusively
the benefit
of, toorperform
functionsSee
of, section
or cag-,rg
out theCheck
purposes
one
or
more
publicly supported
described infor
section
509(a)(l)
sectionthe
509(a)(2).
9(aX3).
the of
box
that
describes the type of supporting organization and complete lines lle through 11h.
a IjType I b IjType ll c EI Type Ill - Functionally integrated d D Type Ill- Other
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified ersons other
check this box . .
a.
gfbagiarz f)o(g?dation managers and other than one or more publicly supported organizations described in section 509(a)(1g)or section
f
If the organization received a written determination from the IRS that is a Type I, Type II or Type III supporting organization, lj
I
9
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii)
No
below, the governing body of the supported organization? . :
(Ill) a 35% controlled entity of a person described in (I) or (ii) above?
(ll) a family member of a person described in (i) above?
h
Provide the following information about the supported organizations.
Ili.
(I) Name of Supported (ll) EIN (ll1)Type ol organization (ht) ls the (ll) Did you notify (VI) Is the (Vll)Amount of Support
Organization (descnbed on lines 1-9 or anization in col the organization in organization in col
above or IRC section 5 listed in your col U) of G) organized in the
(see lneUlldl0lio)) iovemintg,
ocumen
your support? U S 7
Yes No Yes No Yes No
I
I
I
Total
BAA For Privacy Act and Paperwoit Reductlon Act Notice, see the Instructions for Fonn 990 or 990-EL Schedule A (Form 990 or 990-EZ) 2009
TEEA040lL 02/05/10
Schedule A (Form 990 or 990-EZ) 2009 FIGHTING CHANCE, INC . O2-0536388 Page 2
I art tl 1Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part 1.)
Section A. Public Support
Calend-ar year (or fiscal year
beglnning ln) *
Gifts, grants, contributions and
membership fees received. Do
not include "unusual grants)
Tax revenues levied for the
(a) 2005
(b) 2006 (c) 2007
(d) 2008
269,111
356,283. 370,164.
397,973.
(e) 2009 (f) Total
1,393,531.
organizations
and
ei
er paid to itbenefit
or expended
on its behalf .
0.
The
valuefurnished
of services
or
acilities
to the
orgtanifgatiop
a gogernmtental
uni
wi ou c by
arge.
o no
include the value of services or
facilities
furnished to
the
publicgenerally
withou charge
Total. Add lines 1-through 3
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 (0
269,111
356,283.
370,164.
.....................
.
0.
397, 973
o. 1,393,531.
837,237.
Public support. Subtract line 5
from line 4 .
556,294.
1
Section B. Total Support
Calendar year (or fiscal year
beginning in) *
Amounts from line 4
Gross income from interest,
dividends, payments received
on securities loans, rents,
royalties and income form
similar sources
Net income from unrelated
business activities, whether or
not the business is regularly
carried on .
Other income Do not include
gain or loss from the sale of
capital assets (Explain in
Part IV.) . .
through 10 .
Total support. Add lines 7
(e) 2009 (f) Total
(a) 2oo5
(b) 2006 (c) 2007
(d) 2008
269,111
356,283. 370,164
397,973
o. 1,393,531.
225
873. 711
11
1,920.
0.
1ll
Gross receipts from related activities, etc. (see instructions)
0.
I12 0.
. 1,395,351.
organization, check this box and stop here * II(-L
First five years. lf the Form 990 is for the organization"s first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
Section C. Computation of Public Support Percentage
14 Public support percentage for 2009 (line 6, column (f) divided by line 11, column (f) 14 %
15 Public support percentage from 2008 Schedule A, Part ll, line 14 . . . %
.. -Q
16a 33-1I3support test - 2009. lf the organization did not check the box on line 13, and the line 14 is 33-1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization
. rifj
b 33-1/3 support test - 2008. 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-clrcumstances test - 2009 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. * EI
b 10%-factsfand-clrcumstances test - 2008. 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
AA Schedule A (Form 990 or 990-EZ) 2009
18 Private
foundation.
lf the
did not check a box
line,organization
13, 16a, 16b,qualifies
17a, or 17b,
this box
and seeorganization.
instructions * * H
organization
meets
theorganization
"facts-and-circumstances*
test.onThe
as acheck
publicly
supported
TEEA0402L l0KJ8l09
Schedule A Form 990 or 990-EZ) 2009 FIGHTING CHANCE) INC . 02-0536388 Page 3
art Ill Support Schedule for Organizations Descn bed in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I.)
Section A. Public Support
Calendar year (or fiscal yr lieglnnlng In) * (g) 2005 (E) 2006 (5) 2007 (Q 2008 (g) 2009 (9 Total
1 Gifts, grants, contributions and
membership
not
include "unusual
fees received.
grants."S00
2 Gross receipts from
admissions, merchandise sold
or services performed, or
facilities furnished in a activity
that is related to the
organization*s tax-exempt
purpose . . .
3 Gross receipts from activities that are
not an unrelated trade or business
under section 513
4 Tax revenues levied for the
organization"s benefit and
either paid to or expended on
its behalf
5 The value of services or
facilities furnished by a
governmental unit to the
organization without charge
6 Total. Add lines l through 5
7a Amounts included on lines l,
2, 3 received from disqualified
persons
b Amounts included on lines 2
and 3 received from other than
disqualified persons that
exceed the greater of 1% of
the amount on line I3 for the
year . .
7c from line 6.) E
8 Publlc support (Subtract line .
c Add lines 7a and 7b .
Section B. Total Sup-port
Calendar year(or fiscal yr beginning in) *
9 Amounts from line 6
10a Gross income from interest,
dividends, payments received
on securities loans, rents,
royalties and income form
similar sources
b Unrelated business taxable
income (less section 51 l
taxes) from businesses
acquired after June 30, 1975
c Add lines l0a and l0b
Q) 2005 (I3) 2006 (Q 2007 (Q 2008 (2) 2009 (9 Total
11 Net income from unrelated business
activities not included inline l0b,
whether or not the business is
regularly carried on
12 Other income. Do not include
gain or loss from the sale of
capital assets (Explain in
Part IV.)
13F Total
support. (iii im, ior, ii,miiiz) my g 1 f H , , 1
rst t1ve yea . e 9 0
organization, check this box and stop here . I-L
14 I rs If th Form 9 is for the organization"s first, second, third, fourth, or fifth tax year as a section 50l(c)(3) ,
Section C. Computation of Public Support Percentage
15 Public support percentage for 2009 (line 8, column (f) divided by line 13, column (f))
16 Public support percentage from 2008 Schedule A, Part Ill, line I5
Section D. Computation of Investment Income Percentage
17 Investment income percentage for 2009 (line l0c, column (f) divided by line I3, column (f))
18 Investment income percentage from 2008 Schedule A, Part Ill, line I7 . .
15
%
16 *A
17
%
III %
19a 33-113 support tests - 2009. lf the organization did not check the box on line I4, and line I5 is more than 33-I/3%, and line I7 is not
more than 33-I/3%, check this box and stop here. The organization qualifies as a publicly supported organization . *
b 33-1/3 support tests - 2008. If the organization did not check a box on line I4 or l9a, and line I6 is more than 33-I/3%, and line I8
is not more than 33-I/3%, check this box and stop here. The organization qualifies as a publicly supported organization . *
20 Private foundation. If the organization did not check a box on line 14, l9a, or l9b, check this box and see instructions * III.
BAA has/io4oaL oz/is/io Schedule A (Form 990 or 990-EZ) 2009
Schedule A orm 990 or 990 EZ) 2009 FIGHTING CHANCE, INC 02-053 6388 Page4
IParttV CISupplamentaI Infomation. Complete this part to provide the explanations required by Part ll, line 101
Part II, line 17a or l7b: and Part Ill, line 12. Provide any other additional information. See instructions.
-*@11--@1-1--------QA-@.-1---1.-1-----.-@---,---.,@-------1--1-@*--.--@-­
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--1-----@11---Q-1--.1-@.-1-Q.-@--.--Q--@------i--.--.--.-..--.....----------....---­
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----.1---11----1--@11--tg-*-1----*Q1--*Q----13-.---@----1-.----.-@1---­
---@1-Q..--...---.@---@--------1-------1-*@1---1------..-----@----.----*.--­
--.11*1-...-1--@----11*-.1------.-@-----*@--.-@-----1-.-@1i-1--@--@@---*@.--­
-----.@-..----..----.--.-----@---.1--..-----1-*..-1-@11-*@-g--1--.-1-@.----@1.--­
---..1-...-.--.1--11---1--...-------*.--@-1-Q-.-----@.-----.1---...1--.-1-----1--.­
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.---1-----.1--.---.-@1----*@-Q*-1---Q*----------..------.@---.-@-.-@11-1---@­
BAA 1EEAo4o4L 02/os/io Schedule A (Form 990 or 990-EZ) 2009
OMB No I545-0047
HE
29.... 990".5595*.Ez,
"Su lemental Infonnation Re arding
Fqieidraising or Gaming Acta/ities
Complete If the organization answered"Yes" to Form 990, Part N, lines 17, 18,
Department of the Treasury
Intemal Revenue Service
or 19,*or
If the organization
more 990-EZ
than $15,000
on separate
Form 990-EZ,
line Ga. Oggtn
Pubilc
Attach
to Fonn990entered
or F orm
* See
Instructions.
petition
Name of the organization
Employer ldeiitfilcaflon nilniber
FIGHTING CHANCE, INC. N02-0536388
i P8111
Fundraising
Activities.
if the organization
answered
Form 990EZ
filersComplete
are not required
to complete this
part. Yes" to Form 990, Part IV, line I7.
1 Indicate whether the organization raised funds through any of the following activities. Check all that apply.
Mail solicitations Solicitation of non-government grants
Internet and email solicitations Solicitation of government grants
Phone solicitations Special fundraising events
ln-person solicitations
2a Did the organization have 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? . I:-IYes UN
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.
(v Amount paid to
(I) Name df individual (il) Activity (III) Did fundraiser (lv) Gross receipts (or retained by) (vi) Amount paid to
or entity (fundraiser) have custody or control from activity fundraiser listed in (or retained by)
of contributions? col.(i) organization
Yes
No
I
P
Total
3 List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registratlon
or licensing.
BAA For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule G (Form 990 or 990-EZ) 2009
TEEA370IL 02/05/10
Schedule G (Form 990 or 990-EZ) 2009 FIGHTING CHANCE, INC . 02-0536388 Page 2
IPMUI I Fundraising Events. Complete :fthe orgamzatlon answered Yes to Form 990, Part IV, lnne 18, or
reported more than $15,000 on Form 990-EZ, lane 6a. Lust events with gross receipts greater than $5,000.
(a) Event #1 (b) Event #2 (c) Other Events (d) Total Events
SUMMER
1 (Add number)
egg-,(Qg)*g"f0UQ"
(eventGALA
type)001.1*
(event0U"r1NG
type) (total
l
1 Gross receipts . 99, 760.
61, 935.
2 Less: Charltable contributlons 88 , 510 .
25,935
12,775. 174,470.
12,775. 127,220.
3 Gross income (Ilne 1 mlnus line 2) ll, 250 .
36,000
47,250.
10,621
34,729.
4 Cash prizes
5 Noncash prizes
6 Rent/facility costs 24 , 108 .
7 Food and beverages
B Entertainment . 1, 500.
1,500.
9 Other direct expenses 12, 110 .
12,110.
** 48,339.
1 089
-(L
10 Direct expense summary. Add lines 4 through 9 In column (d).
11
Net Income summary. Combine lines 3, column (Q and line 10 .
IParlIIIl Gaming. Complete If the organizatlon answered "Yes" to Form 990, Part lV, lane 19, or reported more than
$15,000 on Form 990-EZ, llne 6a.
(a) Bingo (b) Pull tabs/Instant (c) Other gaming (d) Total aming
Eingo col. (c))
bingo/ rogresslve (Add col. (ag through
1 Gross revenue
2 Cash prizes
3 Non-cash prlzes
4 Rent/facillty costs
5 Other dlrect expenses
6 Volunteer labor
Yes
Yes No
% Yes %
No96No
P
7 Direct expense summary. Add lines 2 through 5 in column (d)
P
8 Net gaming income summary. Combine llnes 1, column (Q) and llne 7
.a
YES NO
9 Enter the state(s) in which the organization operates gaming activities:
a ls the organization licensed to operate gaming activities In each of these states?
,.21-...-.
b lf "No,* explain:
--Q-QQ----.11--1---1
10a Were any of the organization*s gamlng licenses revoked, suspended or terminated during the tax year? . 10a
b lf "Yes," explaln:
11 Does the organization operate gamlng activities with nonmembers?
---.-.-----*Q
--..--1--1*----1---1
1
12 lsadminister
the organization
grantor, beneficlary or trustee of a trust or a member of a partnership or other entlty formed
to 2 I
1
charitable agaming?
BAA TEE/t3702L 02/05/to Schedule G (Form 990 or 990-EZ) 2009
* " * YES N0
Schedule G (Form 990 or 990-EZ) 2009 FIGHTING CHANCE, INC . 02-0536388 Page 3
abAnThe
organization*s facility 13a
outside facility .
13 Indicate the percentage of gaming activity operated in:
14 Enter the name and address of the person who prepares the organization*s gaming/special events books and records:
Name: * -------------------------------------------------- -.­
Address: : - - - - - - - - - - * - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- ­
15a Does the organization have a contact with a third party from whom the organization receives gaming revenue? 15a
b If "Yes," enter the amount of gaming revenue received by the organization $ and the amount X
of gaming revenue retained by the third party $ .
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: * ------------------------------------- - ­
EI Director/officer EI Employee EI Independent contractor
17 Mandatory distributions
state gaming license? . 17a
a Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the
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: * $
BAA TEEA37o3L oz/os/io Schedule G (Form 990 or 990-EZ) 2009
2009 FEDERAL STATEMENTS
PAGE 1
02-0536388
FIGHTING CHANCE, INC.
3/09/10
09:41AM
$.
STATEMENT 1
FORM 990-EZ, PART I, LINE 16
OTHER EXPENSES
MARKETING
33,397
12,164
3,024
1,173.
5,427
5,750
PROGRAM SERVICE
TELEPHONE
TRAVEL
20,690
70,582
2,369
233.
ADVERTISING AND PROMOTION,
BOOKKEEPING
DEPRECIATION
DUES & SUBSCRIPTIONS
INSURANCE .
MEALS
.
OFFICE EXPENSES .
335
TOTAL
S 155,144.
STATEMENT 2
FORM 990-EZ, PART II, LINE 24
OTHER ASSETS
BEGINNING
FURNITURE AND FIXTURES
INTANGIBLE ASSETS
ENDING
$ 3,886.
$ 3,276
39,972
39,973
MACHINERY
AND EQUIPMENT 6,376
PREPAID EXPENSES AND DEFERRED CHARGES 3,725
7,633
3,638
4 210
SECURITY DEPOSITS .. . . 4 210
3 SE 339
TQTAL 3 5*7"""55, o
STATEMENT 3
FORM 990-EZ, PART II, LINE 26
TOTAL LIABILITIES
BEGINNING
ACCOUNTS PAYABLE AND ACCRUED EXPENSES $ 6,570
ENDING
. 35,485.
5,485.
TOTAL "$ 6, 570 .
S
STATEMENT 4
FORM 990-EZ, PART III
ORGANIZATION"S PRIMARY EXEMPT PURPOSE
FIGHTING CHANCE IS A HOT LINE-TYPE COUNSELING CENTER, FOR THE NON-MEDICAL
LIFESTYLE ISSUES ASSOCIATED WITH CANCER, AS WELL AS AN INFORMATION CLEARINGHOUSE
AND RESOURCE CENTER. THE CENTER IS LOCATED IN SAG HARBOR, NY, AND PROVIDES
SERVICES TO CANCER PATIENTS, AND THOSE THAT CARE FOR THEM, IN SUFFOLK COUNTY, NEW
YORK.
2009 FEDERAL STATEMENTS PAGE 2
3/09/10 09.41/uv:
FIGHTING CHANCE, INC. 02-0536388
STATEMENT 5
FORM 990-EZ, PART IV
LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES
TITLE AND CONTRI- EXPENSE
AVERAGE HOURS COMPEN- BUTION TO ACCOUNT/
@. ADDRESS# PER WEEK DEVOTED SAIIQN .EBP & DC OTHEB
DUNCAN
DARROW PRESIDENT
& CEO $ 0. $ 0. $ 0.
PO BOX 1358
10.00
SAG HARBOR, NY 11963
BETSY BATTLE
12 EAST 86TH ST
DIRECTOR
1.00
NEW YORK, NY 10028
ANTHONY BRANDT
54 HIGH ST
DIRECTOR
1.00
SAG HARBOR, NY 11963
LISA MATLIN
DIRECTOR
SUE DAVIES
97 MIDDLE LN
EASTHAMPTON, NY 11937
DIRECTOR
BARBARA MLAUGHLIN
DIRECTOR
PO BOX 1358
SAG HARBOR, NY 11963
PO BOX 1358
SAG HARBOR, NY 11963
BEN GILLIKIN
415 EAST 54TH ST
1.00
1.00
1.00
DIRECTOR
1.00
NEW YORK, NY 10022
CATHY PEACOCK
PO BOX 1358
SAG HARBOR, NY 11963
RICHARD PERLMAN
PO BOX 1358
SAG HARBOR, NY 11963
DR PETER BACH
PO BOX 58
SAG HARBOR, NY 11963
EDWARD TIRRELL
39 WEST 67TH ST APT - 1204
DIRECTOR
1.00
DIRECTOR
1.00
DIRECTOR
1.00
DIRECTOR
1.00
NEW YORK, NY 10023
DR. MARTIN KARPEH
PO BOX 1358
SAG HARBOR, NY 11963
DIRECTOR
1.00
0. O.
0. 0.
0. O.
O. 0.
0. 0.
0. 0.
0. O.
0. 0.
0. 0.
O. 0.
0. 0.
2009 FEDERAL STATEMENTS PAGE 3
3/09/10 09-41AM
FIGHTING CHANCE, INC. 02-0536388
STATEMENT 5 (CONTINUED)
FORM 990-EZ, PART IV
LIST OF OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES
TITLE AND CONTRI- EXPENSE
AVERAGE HOURS COMPEN- BUTION TO ACCOUNT/
W .BE.B.WEE1K..I2EYOTED SAILIQN A .EBP 5: DC OTEIEB.
DR.
DIRECTOR $ 0. $ 0. $ 0.
PORENU
BOXHAUSEN
1358 1.00
SAG HARBOR, NY 11963
TOTALE o. 3 o. 3 o.