990 For~ 0MB No 1545-0047 Return of OrganizationExempt From Income Tax ~@10 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation) Departmentof the Treasury Internal RevenueService ► The or anization ma have to use a co uirements. ,20 A For the 2010 calendar year, or tax year beginning B Check if applicable .,c_N_am_e_of_o_rg_a_n_lza_t_1o_n_C_oa_l_it_io_n_t_o_P_r_o_te_c_t_P_a_ti_e_nt_s_' _R...,ig._h_ts __________ D Address change Doing Business As Name change Number and street (or P O box 1fmail Is not delivered to street address} 0 D D D D 27-0224057 E Telephone number Room/suite 703-405-9407 City or town, state or country, and ZIP+ 4 Arlin ton Amended return Application pending Tax-exem t status Website: ► G Gross receipts $ VA 22203 F Name and address of principal officer. __j H(b) Are all affiliates included? If "No," attach a list (see Instructions) H(c) Group exemption number ► www.protectpatientsrights.org [Z)Corporation D Trust Summary 205,000 D Yes 0 No D Yes D No H(a) Isthisa groupreturnfor affiliates? __._T_h_o=m~a_s_B_a_r_k_er_-_P_._O_._B=o_x_3_1_1_4_A_r_li_n,,_gt_o_n.;.., _V_A_2_2_2_03 _________ D 501(c)(3} [Z) 501(c} ( 4 }◄ (insert no.) 0 4947(a)(1)or O 527 Form of organization 1 __. D Employer identificationnumber PO Box 3114 lmt1alreturn Terminated _______ J K Open to Public Inspection D Association D Other ► 2009 L Year of formation M State of legal domicile VA Briefly describe the organization's mission or most significant activities: _The organization was established within the---------· meaning of 501(c)(4) to educate the public and policymakers on issues related healthcare.The organization "advo~~t~s for policies that allow patients to choose and use_medical products, promote the relationship ____ : _____________ --- -------- -- -between patients and their medical care providers, and provide patients independence and autonomy. 2 3 4 5 6 7a b Check this box ► D if theorganization discontinued its operations or disposedof morethan25%of its netassets. Number of voting members of the governing body {Part VI, line 1a) . Number of independent voting members of the governing body {Part VI, line 1b) Total number of individuals employed in calendar year 2010 (Part V, line 2a) Total number of volunteers (estimate if necessary) . Total unrelated business revenue from Part VIII, column (C), line 12 Net unrelated business taxable income from Form 990-T, line 34 3 3 4 3 5 o 6 0 7a 7b o O Current Year Prior Year Contributions and grants (Part VIII, line 1h) . Program service revenue (Part VIII, line 2g) Investment income (Part VIII, column (A), lines 3, 4, and 7d) Other revenue (Part VIII, column (A), lines 5, 6d, Sc, 9c, 10c, and 11e) Total revenue-add lines 8 through 11 (must equal Part VIII, column (A), line 12) 12 Grants and similar amounts paid {Part IX, column (A), lines 1-3) . 13 14 Benefits paid to or for m ber 4) . 15 Salaries, other compensat n, ~l~~~fil!!IB!l~:fil!...!i lumn (A),lines 5-10) e) . 16a Professional fundraising _,______________________ _ b Total fundraising expens 17 Otherexpenses(PartlX, 18 19 8 ; 2 C GI 2,360,000 205,000 0 0 0 0 0 0 2,360,000 205,000 0 0 0 0 0 2,224,863 2,224,863 0 0 0 333,015 333,015 135,137 Beginningof CurrentYear -128,015 End of Year 135,137 7,122 Total assets (Part X, line 16) Total liabilities (P~rt X, line 26) Net assets or fund balances. Subtract line 21 from line 20 0 0 135,137 7,122 Signature Block Under penalties of perJury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It Is true, correct, and complete Declaration of preparer (other than officer) Is based on all 1nformat1onof which preparer has any knowledge. Sign Here ► ► Paid Preparer Use Only Date Signature of officer !En'c1-l~al,n Tre.~ s \A.~r Type or print ntme and t1tiJ / Pnnt/Type preparer's name Check [Z) If PTIN self-employed P01064967 Howard Sckolnik Firm's name ► Firm's address ► Howard Sckolnik CPA Firm'sEIN ► 602-524-0974 11646 N. 129th Way, Scottsdale, AZ 85259 May the IRS discuss this return with the preparer shown above? (see instructions) For Paperwork Reduction Act Notice, see the separate instructions. 0ves0No Cat. No 11282Y Form 990 (2010) ~ rtr'r; /'cf Page2 Form 990 (2010) j@IJD 1 Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part Ill □ Briefly describe the organization's mission: _The organization was established within the meaning of 501(c)(4) to educate the_public and_pollcymakers on _issues_______________________ _ _related healthcare. The organization advocates for policies that allow patients to choose and_use medical products, _______________________ _ _promote the relationship_between patients and their medical_care providers, _and provide patients independence ___________________________ _ and autonomy. 2 3 4 4a Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? . D Yes 0 No If "Yes," describe these new services on Schedule 0. Did the organization cease conducting, or make significant changes in how it conducts, any program services? . D Yes 0 No If "Yes," describe these changes on Schedule 0. Describe the exempt purpose achievements for each of the organization's three largest program services by expenses. Section 501 (c)(3) and 501(c)(4) organizations and section 494 7(a)(1)trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, 1fany, for each program service reported. (Code: _______________ ) (Expenses $ ___________ 320,700 including grants of $ ________________________ ) (Revenue $ _______________________ _ _Program Service_Achievements _:The Coalition to Protect Patients' Rights (CPPR) spent the_past year-----------------------------------------_advocating for health system reform that places patients in control of their own medical decisions with_doctors as---------------------·-·· _their trusted advisors._Examples_include_a phone_program to recruit_members, onlme education and recruitment,---·-····-··--------··-·-·· _social media (twitter and face_book), media events,_opinion editorials, letters to the editor, TV/Radio interview and-------------······-·-·--· _other grassroots_efforts_to educate_elected_officials. ___________________________________________________________________ .... _______________________________ _ 4b (Code:---------·-····) (Expenses $ ______________________ including grants of $ ________________________ ) (Revenue $ ---··-·····-·----------- 4c (Code: _______________ ) (Expenses $ ______________________ including grants of $ ________________________ ) (Revenue $ ________________________ ) 4d Other program services. (Describe in Schedule 0.) (Expenses $ including grants of$ Total program service expenses ► 320,700 4e ) (Revenue$ Form 990 (2010) / / Page3 Form 990 (2010) •~•l'• Checklist of Required Schedules Yes 1 Is the organization described In section 501 {c)(3) or 494 7{a)(1) {other than a private foundation)? If "Yes," complete Schedule A . 2 3 Is the organization required to complete Schedule B, Schedule of Contributors? {see instructions) 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 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 . 4 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 Ill . 5 4 5 Did the organization maintain any donor advised funds or any similar funds or accounts where 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 . 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 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part Ill 9 Did the organization report an amount in Part X, line 21; 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 term, permanent, or quasiendowments? If "Yes," complete Schedule D, Part V 11 If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete Schedule D, Part VI 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 related in Part X, line 13 that Is 5% or more C Did the organization report an amount for investments-program of its total assets reported in Part X, 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 Part X, line 16? If "Yes," complete Schedule D, Part IX 6 7 8 1 2 No ✓ ✓ ✓ 3 ✓ 6 ✓ 7 ✓ 8 ✓ 9 ✓ 10 ✓ ~1ar~'.'''"Ii;• ~ 11a ✓ 11b ✓ 11c ✓ 11d 11e e Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X f Did the organization'sseparate or consolidated financial statementsfor the tax year include a footnote that addresses the organization'sliabilityfor uncertaintax posItIonsunder FIN48 (ASC740)? If "Yes," complete Schedule D, Part X 11f 12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete Schedule D, Parts XI, XII, and XIII 12a b Was the organizationincluded In consolidated,independentauditedfinancialstatementsfor the tax year? If "Yes," and if the orgamzat,onanswered "No" to line 12a, then completing ScheduleD, Parts XI, XII, and XIII is optional 12b Is the organization a school described in section 170{b)(1)(A)(ii)?If "Yes," complete Schedule E 13 13 14a 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 grantmak1ng,fundraising, business, and program service activities outside the United States? If "Yes," complete Schedule F, Parts I and IV 14b Did the organization report on Part IX, column {A), line 3, more than $5,000 of grants or assistance to any 15 organization or entity located outside the United States? If "Yes," complete Schedule F, Parts II and IV . 15 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 Ill and IV 16 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on 17 Part IX, column {A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) 17 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and Ba? If "Yes," complete Schedule G, Part II . 18 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 Ill 19 20a Did the organization operate one or more hospitals? If "Yes," complete Schedule H 20a b If "Yes" to line 20a, did the organization attach its audited financial statements to this return? Note. Some Form 990 filers that operate one or more hospitals must attach audited financial statements {see instructions) 20b ✓ Form ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 990 (2010) Page 4 Form 990 (2010) Checklist of Required Schedules (continued) Yes Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I and II Did the organization report more than $5,000 of grants and other assistance to ind1v1dualsin the United States on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and Ill . 21 22 23 Did the organization answer "Yes" to Part VII, Section A, line 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 Schedule J . . . . . . . . . . . . . . . . . . . 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 Imes 24b 21 t---t----1-- No ✓ -----22 ✓ 23 ✓ t---t----t-- through 24d and complete Schedule K. If "No," go to line 25 . . . . . . . . . . . . . 24a ✓ 1----11----1-b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? . . ,_2_4_b ______ _ 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? . . . . . . . . . . . . . . . . . . . . . . . . 24c -----_____ d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? . . 1--2_4d--+--+--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 . . . . 25a ✓ 1----,1----+-- b Is the organization 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 . . . . . . . . . . . . . . . . . . 26 Was a loan to or by a current or former officer, director, trustee, key employee,highly compensatedemployee,or d1squallf1ed personoutstandingas of the end of the organization'stax year?If "Yes," complete Schedule L, Part II 27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If "Yes," complete Schedule L, Part Ill . . . . . . . . . . . . . . . . 25b ,__ ✓ 26 ✓ 27 ✓ t----+--+--- Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): 28 A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV b A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete a 1--2_8_a-+--+-'-✓- . . . . . . . . . . . . . . . . . . . . . . . . 28b ✓ 1---1----,f--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 1nd1rectowner? If "Yes," complete Schedule L, Part IV . . 28c ✓ 1---1----,f--Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M ,__2_9 ____ ✓ __ Did the organization receive contributions of art, historical treasures, or other s1m1larassets, or qualified conservation contributions? If "Yes," complete Schedule M . . . . . . . 30 ✓ ,___,____, Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I . . . . . . . . . . . . . 31 ✓ t---t----,f--Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II . . . . . . . . . . . . . . 32 ✓ ,___,___,___ Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I . . . . . . 33 ,___,____, ✓ Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Parts II, Ill, IV, and V, line 1 . . . . . . . . . . . . . . . . . . . . . 34 ✓ ,___,____, Schedule L, Part IV c 29 30 __ 31 32 __ 33 34 __ 35 a Is any related organization a controlled entity within the meaning of section 512(b)(13)? . 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, 1---35-+--+-...;.. ✓_ . . . . . . . . . . . . . . . . . . . . . . . □ Yes 0 No Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, /me 2 . . . . 36 ,___,____, Did the organization conduct more than 5% of its activities through an entity that Is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI . . . . . . . . . . . . . . . . . . . . . . 37 1---1----t-Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O . . . . . . . . . . 38 Part V, line 2 . 36 37 38 __ ✓ ✓ Form 990 (2010) Page5 Form 990 (2010) ■ :jfflJ!j Statements Regarding Other IRS Filings and Tax Compliance -0 Check if Schedule O contains a response to any question in this Part V Yes 1a b c 2a b 3a b 4a b Sa b c 6a b 7 a b c d e f g h 8 9 a b 10 a b I I I 8:~- ~i;J 1 l~7_d_l~---- _-:___ reportable gaming (gambling) winnings to prize winners? 1c Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax 1----t,----1----, Statements, filed for the calendar year ending with or within the year covered by this return .....__2_a_._ ____ o-1--'----+---1--~ If at least one is reported on line 2a, did the organization file all required federal employment tax returns? 2b ,__ _:_J Note. If the sum of lines 1a and 2a Is greater than 250, you may be required to e-ftle. (see instructions) Did the organization have unrelated business gross income of $1,000 or more during the year? 3a ✓ If "Yes," has it filed a Form 990-T for this year? If "No," provide an explanation ,n Schedule 0 3b At any time during the calendar year, did the organization have an interest m, 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 ✓ 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. Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? Sa ✓ Did any taxable party notify the organization that It was or Is a party to a prohibited tax shelter transaction? Sb ✓ If "Yes" to line Sa or Sb, did the organization file Form 8886-T? Sc 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? . 6a ✓ If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 6b ✓ Organizations that may receive deductible contributions under section 170(c). 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 If "Yes," did the organization notify the donor of the value of the goods or services provided? 7b Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? 7c If "Yes," indicate the number of Forms 8282 filed during the year _~;=. -1~..,.::_-, ---i_ ,_::--_j--, Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . 7f If the organizationreceiveda contributionof qualifiedintellectualproperty,did the organizationfile Form 8899 as required? 7g If the organizationreceiveda contnbut1onof cars, boats,airplanes,or other vehicles,did the organizationfile a Form1098-C? 7h 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? Sponsoring organizations maintaining donor advised funds. Did the organization make any taxable distributions under section 4966? . Did the organization make a distribution to a donor, donor advisor, or related person? 9b Section 501 (c)(7) organizations. Enter: Initiation fees and capital contributions included on Part VIII, line 12 1oa ' ,- r t----tf-------1 Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities 10b ~~~----i .,_~ ;- _,,_ Section 501 (c)(12) organizations. Enter: : , Gross income from members or shareholders . 11 a ,.. Gross income from other sources (Do not net amounts due or paid to other sources t----tt------i ,, ' against amounts due or received from them.) 11 b ~-~------i---1--~ Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? 12a If "Yes," enter the amount of tax-exempt interest received or accrued during the year. . 12b ~-~-----< Section 501 (c)(29) qualified nonprofit health insurance issuers. 13a 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 0. 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 13b I - • I \i:-" I i----t-----1 I Enter the amount of reserves on hand 13c Did the organization receive any payments for indoor tanning services during the tax year? If "Yes," has It filed a Form 720 to report these payments? If "No," provide an explanation ,n Schedule 0 ·:~: ;;, .:;: .~ .. ·- ·, ,1' 14a 14b Form ✓ 990 (2010) Page 6 and Disclosure For each "Yes" response to lines 2 through lb below, and for a "No" response to line Ba, Bb, or 10b below, descnbe the c,rcumstances, processes, or changes in Schedule 0. See instructions. Form' 990 (2010) httt411i Governance, Management, Check if Schedule O contains a response to any question in this Part VI Section A. Governing Body and Management 1a b 2 3 4 5 6 7a b 8 Enter the number of voting members of the governing body at the end of the tax year. i---.:.1..:.;a _____ E. 1 Enter the number of voting members included in line 1a, above, who are independent 1b 3 Did any officer, director, trustee, or key employee have a family relationship or a business relat1onsh1pwith any other officer, director, trustee, or key employee? . . . . . . . . . . . . . . . 2 1----,1----1-'-Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? . 3 ✓ Did the organizationmake any significant changes to its governingdocuments since the prior Form 990 was flied? 4 ✓ 1----,1----;-Did the organization become aware during the year of a significant diversion of the organization's assets? . 1--6__,1----1-✓'--Does the organization have members or stockholders? . . . . . . . . . . . . . . . 6 ✓ 1----,1----;-Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? . . . . . . . . . . . . . . . . . . . . 7a ✓ Are any decisions of the governing body subJect to approval by members, stockholders, or other persons? Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: a The governing body? . . b 9 ✓ . . . . Each committee with authority to act on behalf of the governing body? Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes," provide the names and addresses m Schedule O . . . . . 1---1----,1--- 7b ✓ -,-f,==7±,,,-,,----, Ba 8b ✓ ✓ ✓ 9 Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.) Yes 10a b 11a b 12a b c 13 14 15 Does the organization have local chapters, branches, or affiliates? . . . . . . . . . . If "Yes," does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? . Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form? . . . . ....... . Describe in Schedule O the process, if any, used by the organization to review this Form 990. Does the organization have a written conflict of interest policy? If "No," go to line 13 . Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? . . . . . . . . . . . . . . . . . . . Does the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," descnbe in Schedule O how this is done . . . . . . . . . . . . Does the organization have a written whistleblower policy? . . . . Does 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 substant1at1onof the del1berat1onand decision? No ✓ 10a 10b 11a ✓ 12a ✓ 12b ✓ 12c 13 14 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 0. (See instructions.). 16a Did the organization invest in, contribute assets to, or part1c1patein a Joint venture or similar arrangement with a taxable entity during the year? . . . . . . . . . . . . . . . . . . . b If "Yes," has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization's exempt status with respect to such arrangements? . . . . . . . . . Section C. Disclosure 17 18 19 20 List the states with which a copy of this Form 990 is required to be filed ► None Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)sonly) available for public inspection. Indicate how you make these available. Check all that apply. D Own website D Another's website 0 Upon request Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public. State the name, physical address, and telephone number of the person who possesses the books and records of the organization: ► _Star_Eitmg20118 N_67th_Ave Ste 300-615Glendale,_Anzona,USA 85308602-989-9993 _________________________________ _ Form 990 (2010) Forni 990 (2010) Page 7 ■ @191 ■ Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Check If Schedule O contains a response to any question In this Part VII . . D 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. • 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, 1fany. See instructions for def1nit1onof "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 all 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 all 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; instItut1onal trustees; officers; key employees; highest compensated employees; and former such persons. D Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. (A) (Bl (Cl Name and TIiie Average hours per Position (check all that apply) week (describe hours for related organizations 1nSchedule 0) _ (1) __Thomas Richard_Barker (Dir._& President) ___ _ (2)_Eric David Hargan (Director &_Treasurer)______ _ _ (3) __Lawrence Wiley_(Director_& Secretary) _______ _ 0.5 0.5 0.5 o, ::, c.9::; (1) nc :::: C. 0~ ,_ 2 * 5" !i "" s 0 ::, !!!. 0 =I: 0 9l (D) ;,; (1) '< (1) 3 1J 0 '< (1) 2 (1) !i (1) "T1 "'I -5'§.3 0 ~m. 9l mg 3 (El (F} Reportable Reportable compensation compensation from from related the organizations organization (;,N-2/1099-MISC) r,N-2/1099-MISC) 1J (1) ::, (/J Estimated amount of other compensation from the organization and related organizations !!!. ~ (1) ✓ ✓ ✓ ✓ ✓ ✓ 0 0 0 0 0 0 0 0 0 - (4) _--- ------------------ ------------------------- ------------ (5) ________________ ----------- --------------------- ------ ----- (6) ___________________________ ------- ------------------------- (7) _____________________________ ---- -------------------------- (8) _---------------------------------------------------- ------ (9) _--------------------- --------------- ---------------------- (10)___ --____ ---____ -------_---_______________________________ _ (11)______________________________________ --------------------- (12)______ ----_--_--_______ --_____ --____ ----_________________ -(13)________ --_--_--- ----_-- ____________ --_----_--__-- _--_____ _ (14)_______________ --__--__________ --____________ --___________ _ (15)_-- __----______ --____________________________ --___________ _ (16)__-- _----_--______ --_________ --________ --____ --- _______ --__ Form 990 (2010) - ---- - --------------------------- Page 8 Form 990 (2010) • .r.ila•jl ■ ·section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (A) (B) (C) Name and title Average Pos1t1on(check all that apply) hours per o~::, week a. Q. :::; :s (describe CD a. nc hours for 0~ related 2 organizations ~ ~- in Schedule 0) CD (I) (D) 5" 0 :,; s: fj '< ~ 6 ::, !!!. 2 ~ (I) (I) ::i: ~ CD CD 3 "C 0 '< m 3'§- mg 3 (F) Estimated amount of other compensation from the orgarnzatIon and related organizations .,, m:i: "C ~~ (E) Reportable Reportable compensation compensation from 0 from related 3 the orgarnzatIons ~ organization f:N-2/1099-MISC) r,N-2/1099-MISC) "C CD ::, "' !!l. ~ (17)_-----. -. -------------------------------------------------(18)_--___. __________________________ --________ ----___________ _ (19) ------------------------ _---------------- ----------------(20)__--_--_---____ ---_----__----_________ --__---_--____ --____ _ (21) ______ . _____ --_--__--_____ --- --_---- ______________________ _ (22)__----. ---------------------------------------------------(23)______ . --_----____ --______ --________ --_______________ --_--_ (24)____ --·-_____ --_----_________ . _----____ --____________ --__-(25)__--_--____________ ----________________ --------_--_______ -(26)_______ ---_---_____ --______ --. ________________ --__----____ _ (27)_------------------------------------- --------------------- (28)____________________ --______ -· --__________________ --______ _ 1b c d 2 0 Sub-total . 0 ► Total from continuation sheets to Part VII, Section A ► Total (add lines 1b and 1c) . ► Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organization ► o 3 Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual 4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual . Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person 0 Yes No 5 5 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. (A) Name and business address DCI Group LLC 1828 L Street NW, Suite 400 Washington DC 20036 2 (B) (C) Descnpt1on of services Compensation 233,450 Strategy & consulting Total number of independent contractors (1ncludIng but not l1m1tedto those listed above) who received more than $100,000 In compensation from the organization ► 1 C _- : "~ ; ·~" • ~ ). •" t..:? Form 990 (2010) Form 990 (2010) Page9 ---""."':,5::".t:--a-:-te_m_e_n-:-t-0-=f-=R=-e-v_e_n_u_e _______________________________ _ (A) Total revenue .... 111 1a C: C: m ::::i b Ill Federated campaigns 1--1_a ______ o-1 Membership dues 1--1_b-+_____ o--1 1--1_c ______ o-1 C Fundraising events 1--1_d ______ o-1 d Related organizations e Governmentgrants(contributions) i---1_e---+-_____ o... gifts, grants, f All other contributions, ands1m1lar amounts notincludedabove 1f 2os,ooo ~--------1 contnbut1ons included mImes1a-11$ o g Noncash ---------------------➔ -------1 205,000 h Total. Add lines 1a-1f ► ... 0 ~E ~~ Cl Ill ui ·e C: ·- 0 Ill ·... ., GI .E.c :s0 C: "C 0 C: om a, ::I C: a, > a, a: a, u 'fa, en E [!! Cl ... 0 a. 1--------~-----"-----f-------1-------1-------- Incomefrom investmentof tax-exemptbond proceeds ► Royalties ► 6a b C d 7a (11)Personal Sa Cl) ~ a: ... Cl) 0 ., ,, 0 0 0 0 0 0 0 0 0 0 0 0 . ' ,- l ·" l 0 Gross Rents ·•t+!··f ' Gross income from fundraising events(not 1nclud1ng $ of contributions reported on line 1c). See Part IV, line 18 a _,_ ~. :ft ¥" .i_-~"~' 0 ::--_ -;-;,;-:-;..or-;,"I:--,--:-,_-,_:::-,,---= -.:f:--,. ,,_-::.-._'. t 71) assets otherthaninventory b Less·costorotherbasis andsalesexpenses 1-------+--------l-£ C Gain or (loss) d Net gain or (loss) .c (D) Revenue excluded from tax under sections 512,513, or 514 1 2a ------------------------------------------------- 1-------+-------+-------t-------+------b ------------------------------------------------- 1-------+-------+-------t-------+------C ------------------------------------------------- 1-------+-------+-------t-------+------d ------------------------------------------------- 1-------+-------+-------t-------+------e ------------------------------------------------- 1-------+-------+-------t-------+------0 0 f All other program service revenue . g Total. Add lines 2a-2f ► Investment income (including dividends, interest, 3 and other s1m1laramounts) ► 0 (1)Real ::I C: (C) Unrelated business revenue Business Code 4 5 Cl> (B) Related or exempt function revenue ·1,1,,;:'S:-: ,,: ,.;'0/ -~.:!ii,~:.:::-~?:1'-, )::.:. -~ ► -' .,.':;.;i,·f>':-;~~: 0 > Bf}'?' • -a -~·> 0 0 0 ' ,, .,,ir, .\ ,. 1--------1 j ,')i ·.-,,:\ ' • ; Less: direct expenses b '-------+---------1 0 '"' Net income or (loss) from fundraising ,....e_ve_n_t_s ___ ► -+-------+------"'----··1-------0+______ 9a Gross income from gaming act1vit1es. (! y,,, See Part IV, line 19 = a 1--------1 b Less: direct expenses b _____ __._______ _____________________----------~_____ _ 0 C Net income or (loss) from gaming act1v1ties 0 0 ► r-------+-------+-------t-------1-----10a Gro ss sales of inventory, less ,, ,, returns and allowances a if¥ i\ b c 0 ~ _1 0 ,, 1---------< b c Less: cost of goods sold b ~------------1-----Net income or (loss) from sales of inventory . ► Miscellaneous Revenue -- 0 0 Business Code !------------------+-------~---------------11a 0 0 -- b C d All other revenue e Total. Add Imes 11a-11 d 12 Total revenue. See instructions. ► ► 0 205,000 -,_. ,;; '" 0 ·i, ., ! ?? j ~"i 0 -~ 0 Form 990 (201 0) . Fonn 990 (2010) Page 10 ■ :iMif:j ·statement of Functional Expenses I Section 501(c)(3J and 501(c)(4J organizations must complete all columns. All other organizations must complete column (AJbut are not reqwred to complete columns (BJ, (CJ, and (DJ. Do not include amounts reported on lines 6b, 7b, Bb, 9b, and 10b of Part VIII. 1 Grants and other assistance to governments and organizations in the U.S See Part IV, line 21 2 Grants and other assistance to individuals :n the U.S. See Part IV, line 22 . 3 (A) (B) (C) Total expenses Program service expenses Management and general expenses Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0 0 . ,. 0 0 .. (D) Fundra1s1ng expenses ,,;;{. ' . . . •. .. .. .--;- ~--: 0 0 0 0 0 0 0 0 ">~--- "· w 4 5 Benefits paid to or for members Compensation of current officers, directors, trustees, and key employees 6 Compensation not included above, to d1squal1fied persons (as defined under section 4958(ij(1)) and persons described in section 4958(c)(3)(B) 0 0 0 0 7 Other salaries and wages Pension plan contribut1ons(include section 401(k) and section 403(b) employer contribut1ons) 0 0 0 0 0 0 0 0 Other employee benefits . Payroll taxes . Fees for services (non-employees): Management Legal Accounting Lobbying Professionalfundra1s1ng services.See Part IV, line 17 Investment management fees Other Advertising and promotion Office expenses Information technology Royalties Occupancy Travel Payments of travel or entertainment expenses for any federal, state, or local public officials 0 0 0 0 0 0 0 0 0 8 9 10 11 a b C d e f g 12 13 14 15 16 17 18 19 20 21 22 23 24 a b Conferences, conventions, and meetings Interest Payments to affiliates Depreciation, depletion, and amortization Insurance . 3,264 0 3,264 6,000 0 6,000 0 0 0 0 0 0~ '