OMB No 1545-0047 Form; Return of Organization Exempt From Income Tax Under section 501 527, or 4947(a)(1) of the Internal Revenue Code 2012 (except black lung benefit trust or private foundation) The organization may have to use a copy of this return to satisfy state reporting requirements 2912, and ending Open to Public - epartment 0 the Treasury Inspection Internal Revenue Service A For the 2012 calendar year, or tax year beginning Employer Identification Number 95-4756900 Telephone number 3 Check if applicable ARMS OF GRACE HUMANITARIAN SERVICES 2931 WEST FLORENCE AVE LOS ANGELES, CA 90043 Address change Name change lntlial return Terminated Amended return Gross receipts 64 3 97 . Application pending Name and address of principal officer Hta) '5 "115 <3 QTOUP return 701' yes "(bl Are all affiliates included' If No,' attach a list (see instructions) Yes Same A5 Above No No SCANNED 2 II 20113 I Tax-exempt status lg] 501(c)(3) l_l5oi(c) (insert no) U4947(a)(1) or 527 Website: H(c) Group exemption number Form of organization Corporation LI Trust Association LL other' i Year of Formation State of legal domicile lffiart I. Jsummaiy 1 Briefly describe the organization's mission or most significant activities 3 purpg se_ _is _t9_p_r9tr_i_c1e _d_r11q _a?1Cl _r_e t_1a_b_i sand _c9ui1.ce :ct_1e_ per_p9 se_ 9: _a;L c1i_n9 _i_n9i_v_i?1uai_l? _s_u;f :e_r_i r_i<1 gn_. 2 EhTacT< TrrE. Bo? 5pErEtrBn's Bfo?tiuseo of Elite r?s'ne't Es--se-Ts I I <5 3 Number of voting members of the governing body (Part VI, line 1a) 3 3 4 Number of independent voting members of the governing body (Part VI, line 1b) 4 0 5 Total number of individuals employed in calendar year 2012 (Part V, line 2a) 5 0 6 Total number of volunteers (estimate it necessary) 6 0 3 7a Total unrelated business revenue from Part column (C), line 12 7a 0 Net unrelated business taxable income from Form 990-T, line 34 7b 0 Prior Year Current Year 8 Contributions and grants (Part line 1h) 2 9 Program service revenue (Part line 2g) 481, 929 641 397 10 Investment income (Part column (A), lines 3, 4, and 7d) '1 11 Other revenue (Part column (A), lines 5, 6d, 8c, 9c, 10c, and He) 12 Total revenue -- add lines 8 through 11 (must equal Part column (A), line 12) 481, 929_ 641 397 13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) 14 Benefits paid to or for members (Part IX, column (A), line 4) an 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 32 9 769 496, 009_ 16a Professional fundraising fees (Part IX, column (A), line He) Total fundraising expenses (Part IX, column (D), line 25) ;t e' 17 Other expenses (Part IX, column (A), lines 11a-11d, '1f-2 fl@ 132 130 141 674_ 18 Total expenses Add lines 13-17 (must equal Part IX, colum ,0 461, 899 637 683 19 Revenue less expenses Subtract line 18 from line 12 20, 030 3, 714 5* IVIAY 2 3 Beginning of Current Year End of Year 20 Total assets (Part X, line 16) 5:43 52,710. 81, 019. EE 3 gotal liabilities (Part X, line 26assets or fund balances Subtract line 21 from 7 057 10 771 lfiart II Lsignature Block Under penalties of periury, I declare that I ha ined this return, lnClUdIl'lgfiCCOITlDal'lyII'Ig schedules and statements. and to the best of my knowledge and belief. it is true. correct. and complete Declaration of preparer (oth tha is based on all inf of which preparer has any knowledge ,1 I5 /23 Signature of oflfier Date I Here ALEX FERDMAN CEO Type or print name and title F'rint!T re arer's name Pre arer's si nature Dale PTIN I ypp-p 9. Sis.' Chek Paud Max Fr1d, CP Max Frld, CPA se1fernPl0l/ed P00736591 Preparer counting Solutions, Inc Use Only 8159 Santa Monica Blvd., Suite 200 rum-saw>> 95-4832024 West Hollywood, CA 90046-4912 Phoneno (323) 654-3500 May the IRS discuss this return with the preparer shown above'? (see instructions) BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEAO1I3L 6 lg Yes No Form 990 (2012) Form 990 ?2012) ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 Page 2 [Part Statement of Program Service Accomplishments . 1 Check if Schedule 0 contains a response to any question in this Part Ill 1 Briefly describe the organization's mission . p1;i_m_ie_tI;v_ ex_e212t_ 991139 1:9 _p_r9\1i_d? _d_rJ3q _a11t1 _a.l 9099; - i_l_i:c r=_It_i9I1 .83 :v_i9_e:s_ ?T_1d_ 99u_n9 el_i11g _f9? jabs pyzeoee _0_f -a_is'1i_ry. _suf_fe?i_n9_?r9n_1 _dl3E9_ ?r_1d_ 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-E27 Yes No If 'Yes,' describe these new services on Schedule 0 3 Did the organization cease conducting. or make significant changes in how it conducts, any program SEFVICES7 Yes No If 'Yes,' describe these changes on Schedule 0 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses Section 501 and 501(c)(4) organizations and section 4947(a)(l) trusts 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 588 916 including grants of (Revenue 913.1119 Lille y_e _t1;e_ $9 .1112 4d Other program services (Describe in Schedule 0) (Expenses including grants of (Revenue 4e Total program service expenses 588 916 BAA TEEA0102L 03/03112 FOTFFI 990 (2012) Form 990 (2012) ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 Page 3 [Part IV Checklist of Required Schedules . Yes No 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If 'Yes, complete Schedule A 1 is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? 2 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? li' 'Yes,' complete Schedule C, Part I 3 4 Section 501(c)(3) organizations Did the organization engage in Iobb ing activities, or have a section 501 election in effect during the tax year? lf 'Yes, complete Schedule C, Part 4 5 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 5 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right tg provide advice on the distribution or investment of amounts in such funds or accounts? If 'Yes,' complete Schedule D, art I 6 7 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 ll 7 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,' complete Schedule D, Part 8 9 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 9 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If 'Yes, complete Schedule D, Part 11 If the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts Vl, Vll, lX, or as applicable a gidFt>he organization report an amount for land, buildings and equipment in Part X, line 10? If 'Yes, complete Schedule art VI .. 'eiitfigt ii -: 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? lf 'Yes,' complete Schedule D, Part 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 Part X, line 16? ll' 'Yes, complete Schedule D, Part Did the organization report an amount for other assets in Part X, line 15 that 1S 5% or more of its total assets reported in Part X, line 16? If 'Yes,' complete Schedule D, Part IX Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes, complete Schedule D, Part 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, Part 12a Did the organization obtain separate, independent audited financial statements for the tax year? lf 'Yes, complete Schedule D, Parts Xl, and Was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes,'and if the organization answered 'No' to line l2a, then completing Schedule D, Parts XI and is optional 13 is the organization a school described in section If 'Yes, complete Schedule 14a Did the organization maintain an office, employees, or agents outside of the United States? Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? lf 'Yes, complete Schedule F, Parts and IV 15 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? lf 'Yes, complete Schedule F, Parts ll and IV 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 and IV 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, Partl (see instructions) 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part lines 1c and 8a? If 'Yes, complete Schedule G, Part ll 19 Did the organization report more than $15,000 of gross income from gaming activities on Part line 9a? If 'Yes,' complete Schedule G, Part 20 aDid the organization operate one or more hospital facilities? If 'Yes,' complete Schedule If 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return20b BAA TEEAO103L 12/13/12 Form 990 (2012) Form 99062012) ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 P3094 [Part IV |'Checklist of Required Schedules (continued) . Yes No 21 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 l, Parts land ll 21 22 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 land Ill 22 23 Did the organization answer 'Yes' to Part Vll, Section A, line 3, 4, or 5 about compensation of the organization's current 'ash?' former officers, directors, trustees, key employees, and highest compensated employees? If 'Yes.'complete edule 23 24a Did the organization have a tax-exempt bond issue with an outstanding principal am0U|'l't 01 m0le than $100,000 as of the last day of the year, and that was issued after December 31, 2002? If 'Yes,' answer lines 24b through 24d and complete Schedule lf 'No, 'go to line 25 24a Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? 24b 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 Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year? 24d 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 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 lf 'Yes,' complete Schedule L, Part I 25b 26 Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization's tax year? If 'Yes,' complete Schedule L, Part ll 26 27 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 of any of these persons? If 'Yes, complete Schedule L, Part Ill 27 28 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) ,3 a A current or former officer, director, trustee, or key employee? lf 'Yes, complete Schedule L, Part IV 28a A family member of a current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV 28b 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 Schedule L, Part IV 28c 29 Did the organization receive more than $25,000 in non-cash contributions? If 'Yes,' complete Schedule 29 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If 'Yes,' complete Schedule 30 31 Did the organization liquidate, terminate, or dissolve and cease operations? If 'Yes,' complete Schedule N, Part I 31 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If 'Yes,'complete Schedule N. Part ll 32 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301 7701-2 and 301 7701-3? 'Yes,' complete Schedule Fr', Partl 33 34 Was the organization related to any tax-exempt or taxable entity? lf 'Yes, complete Schedule R, Parts ll, IV, and V, line 1 34 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? 35a 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)? lf 'Yes, complete Schedule Fi', Part V, line 2 35b 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization lf 'Yes, complete Schedule Part V, line 2 36 37 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? lf 'Yes, complete Schedule R, Part VI 37 38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part Vl, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule 0 38 BAA Form 990 (2012) TEEAO104L 08i'O3l1 2 BAA TEEA0105L 08/0811 2 Form 990 (2012) ARMS OF GRACE HUMANITARIAN SERVICES 95--4756900 Page 5 IPart'V, I Statements Regarding Other IRS Filings and Tax Compliance . . Check if Schedule 0 contains a response to any question in this Part CI Yes No 1 a Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable 1 a 0 . Enter the number of Forms W-2G included in line 1a Enter -0- if not applicable 1 0 'f I Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming 5 (gambling) winnings to prize winners? 1 2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State- ments, filed for the calendar year ending with or within the year covered by this return 2a 0 5 If at least one is reported on line 2a, did the organization file all required federal employment tax returns? 2b Note. If the sum of lines Ia 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? 3a If 'Yes' has It filed a Form 990-T for this year? If 'No, provide an explanation in Schedule 0 3 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 If 'Yes,' enter the name of the foreign country 'fg 2 See Instructions for filing requirements for Form TD 90-22 I, Report of Foreign Bank and Financial Accounts 5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? 5a Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? 5b If 'Yes,' to line 5a or 513, did the organization file Form 5c 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? 6a If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? 6b 7 Organizations that may receive deductible contributions under section 170(c). sf? a Dad the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and I <5 5 at services provided to the payor? 7a I 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? 7 If 'Yes,' indicate the number of Forms 8282 filed during the year I 7dI Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e I Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? 7f If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? 7 If the organization received a of cars, boats, airplanes, or other vehicles, did the organization file a I Form 7 I 8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the I supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? 8 I 9 Sponsoring organizations maintaining donor advised funds. I a Did the organization make any taxable distributions under section 4966? 9a I Did the organization make a distribution to a donor, donor advisor, or related person? 9b 10 Section 501(c)(7) organizations. Enter 3 . a Initiation fees and capital contributions included on Part line 12 10a fig I Gross receipts, included on Form 990, Part line 12, for public use of club facilities 3 ?gg 11 Section 501(c)(12) organizations. Enter ftfi' a Gross income from members or shareholders 11 a 5: Gross income from other sources (Do not net amounts due or paid to other sources I against amounts due or received from them 11 5 I 12a 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 I 12bI ya . 13 Section 501(c)(29) qualified nonprofit health insurance issuers. if a Is the organization licensed to issue qualified health plans in more than one state? 13a I Note. See the instructions for additional information the organization must report on Schedule 0 ;e 3 Enter the amount of reserves the organization is required to maintain by the states in 3; which the organization is licensed to issue qualified health plans 13b A: I Enter the amount of reserves on hand 13c .25 14a Did the organization receive any payments for indoor tanning services during the tax year? 14a If 'Yes,' has it filed a Form 720 to report these payments? If 'No, provide an explanatron in Schedule 0 14b Form 990 (2012) Form 990 (2012) ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 Page6 |Part VI II Governance, Management and Disclosure For each 'Yes' response to lines 2 through 7b below, and for - a 'No' response to line 8a, 8b, or l0b below, describe the circumstances, processes, or changes in Schedule 0. See instructions. Check if Schedule 0 contains a response to any question in this Part VI Section A. Governing Body and Management 1 a Enter the number of voting members of the governing body at the end of the tax year there are material differences in voting rights among members ti" of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule Enter the number of voting members included in line 1a, above, who are independent 1 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? -A . 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 organization make any significant changes to its governing documents since the prior Form 990 was filed? 4 Did the organization become aware during the year of a significant diversion of the organization's assets? Did the organization have members or stockholders? 6 a 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? 7a U1 Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or other persons other than the governing body? 7b Did the organization contemporaneously document the meetings held or written actions undertaken during the year by 'i the following 5 a The governing body? 8a Each committee with authority to act on behalf of the governing body? 8b is there any officer, director or trustee. or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? lf 'Yes, 'provide the names and addresses in Schedule 0 9 Section B. Policies (This Section requests information about policies not required by the Internal Revenue CodeDid the organization have local chapters, branches, or affiliates? 10a lt '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? 10b a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11 a Describe in Schedule 0 the process, if any, used by the organization to review this Form 990 See Schedule 0 $2 a Did the organization have a written conflict of interest policy? If go to line 13 12a Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? 12b Did the organization regularly and consistently monitor and enforce compliance with the policy? if 'Yes,' describe in Schedule 0 how this is done 12c Did the organization have a written whistleblower policy? 13 Did the organization have a written document retention and destruction policy' 14 49 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 Other officers of key employees of the organization If 'Yes' to line 15a or 15b, describe the process in Schedule 0 (See instructions) tin) ta'! 'Pp . 5 U1 cr 'Vim-'gr' U1 9) yaw a Did the organization invest in, contribute assets to, or participate in a Joint venture or similar arrangement with a taxable entity during the year? 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 taken steps to safeguard the organization's exempt status with respect to such arrangements? _i 01 0' Section C. Disclosure 17 18 19 20 BAA List the states with which a copy of this Form 990 is required to be filed Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection indicate how you make these available Check all that apply Own website Another's website El Upon request Other (explain in Schedule 0) Describe in Schedule 0 whether (and if so, how) the organization makes its governing documents, conflict of interest policy, and financial statements available to the public during the tax year see Schedule 0 State the name, physical address, and telephone number of the person who possesses the books and records of the organization _5_0lJlT_19 115. l5_9_ _M91flI_C?i _2_09 flQL_L_?il0_0P 20.011 .6 .33 TEEAO106L 03/03/12 Form 990 (2012) Form 990 (2012) ARMS OF GRACE HUMANITARIAL1 SERVICES 95-4756900 Page 7 |Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and lndependentconhackns Check if Schedule 0 contains a response to any question in this Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1 a 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 0 List all of the org) nization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation Enter - - in columns (D), (E), and (F) if no compensation was paid 0 List all of the organization's current key employees, if any See instructions for definition of 'key employee 0 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 0 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 0 List all of the or anization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more an $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 Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee (C) (A) (3) Position (do not check more than (D) (E) (F) a One 995lfofisaggr omcer and a compgregatfonefrom compgregatfonefrom father week (1151 (D the organization related organizations compensation any hours 9 3 5; C22 5 3 <>, 8 $3 (Subtract me <> Description of security or category (including name of security) Book value Method of valuation Cost or end-of-year market value (1) Financial derivatives (2) Closely-held equity interests (3) Other Total (Column (12) must equal Form 990, Part)(, column (8) line Fo rm 990, Part X, line 13. [Part [Investments -- Program Related. See Description of investment type Book value Method of valuation Cost or end-of-year market value (1) (2) (3) (4) (5) (5) (7) (8) (9) (10) Total (Column must equal Form 990, Pan'X, column (8) line 73 [Part ix [Other Assets. See Form 990, Part x, line 15. Description (Total. (Column must equal Form 990, Part X. column (8), line 15 lPartX [Other Liabilities. See Form 990. Part X. line 25. Book value Description of liability Book value (1) Federal income taxes (2) GARNISHMENT PAYABLE 1,425. (3) MEDICAL INSURANCE PAYABLE 113. (4) PAYROLL LIABILITIES 25,796. (5) (6) (7) (8) (9) (10) (11) Total. (Column must equal Form 990, Part )6 column (B) line 25 F- 27,334. 2. FIN 48 (ASC 740) Footnote In Part 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 BAA TEEA3303L 'l2i'23l12 Schedule (Form 990) 2012 Schedule D-(Form 990) 2012 ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 Page 4 [Bart XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return A 1' Total revenue, gains, and other support per audited financial statements 1 2 Amounts included on line I but not on Form 990, Part line 12 a Net unrealized gains on investments 2a Donated services and use of facilities 2 Recoveries of prior year grants 2c Other (Describe in Part 2d Add lines 2a through 2d 2e 3 Subtract line 2e from line 1 3 4 Amounts included on Form 990, Part line I2, but not on line 1 a Investment expenses not included on Form 990, Part line 7b 4a Other (Describe in Part 4b fl . Add lines 4a and 4b . 4c 5 Total revenue Add lines 3 and 4c. (This must equal Form 990, Part I, line I2) 5 Part XII of Expenses per Audited Financial Statements With Expenses per Return 1 Total expenses and losses per audited financial statements 1 2 Amounts included on line I but not on Form 990, Part IX, line 25 a Donated services and use of facilities 2a f; Prior year adjustments 2 Other losses 2c Other (Describe in Part 2d Add lines 2a through 2d 2e 3 Subtract line Ze from line 1 3 4 Amounts included on Form 990, Part IX, line 25, but not on line 1: I $3 a Investment expenses not included on Form 990, Part line 7b 4a ff Other (Describe In Part 4b ,3 Add lines 4a and 4b 216 5 Total expenses Add lines 3 and 4c. (This must equaI Form 990, Part I, Ime I8) 5 |F'Jart XI|l,l Supplemental Information Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9, Part lines Ia and 4, Part IV, lines Ib and 2b, Part V, line 4, Part X, line 2, Part XI, lines 2d and 4b, and Part XII, lines 2d and 4b Also complete this part to provide any additional information BAA Schedule (Form 990) 2012 TEEA3304L OMB No -0047 Complete to rovide iniormation for responses_to specific questions on 2 Form 0 or 990-EZ or to provide any additional information. Open to Public rt . Attach to Form 990 or 990-E2. Inspection SCHEDULE 0 Supplemental Information to Form 990 or 990-EZ (Form 990 or 990-EZ) Name of the organization Employer identification number ARMS OF GRACE HUMANITARIAN SERVICES 95-4756900 _F_0?m Ea_rt_V_L_L1n_e_1 v_ve;s_ 93; _w_i l_l_ 12: _c9 I1d_u9 -.-- 29_0,_ Ea_rt_V_L_Lin_eJ 2 ?116. BAA For Paperwork Reduction Act Notice, see the Instructions for Fomi 990 or 990-E2 TEEA4901L 1218112 Schedule 0 990 OF 990-52) 2012