ICIRR Money and Organizations

l efil e GRAPHIC p rint - DO NOT PROCESS As Fil ed Data - DLN: 93493062009154
Form 990
Return of Organization Exempt From Income Tax
OMBNo 1545- 0047
Under section 501( c) , 527, or 4947( a) ( 1) of the Internal Revenue Code ( except bl ack l ung
2012
benefit trust or private foundation)
Department of the Treasury
Internal Revenue Service
1- The organization may have to use a copy of this return to satisfy state reporting requirements
A For the 2012 cal endar y ear , or tax y ear beginning 07- 01- 2012 , 2012, and ending 06- 30- 2013
B Check if appl icabl e
C Name of organization
D Empl oy er identification number
ILLINOIS COALITION FOR IMMIGRANT
F Address change AND REFUGEE RIGHTS
36- 3783551
Doing Business As
F Name change
fl Initial return
Number and street ( or P 0 box if mail is not del ivered to street address) Room/suite
E Tel ephone number
55 E JACKSON NO 2075
p Terminated
( 312) 332- 7360
- ( Amended return City or town, state or country , and ZIP + 4
CHICAGO, IL 60603
1Appl ication pending
G Gross receipts $ 9, 748, 062
F Name and address of principal officer
H( a) Is this a group return for
LAWRENCE BENITO
affil iates? ( - Yes No
55 E JACKSON NO 2075
CHICAGO, IL 60603
H( b)
Are al l affil iates incl uded? F Yes F_ No
If "No, " attach a l ist ( see instructions)
I Tax- exempt status
F 501( c) ( 3) 1 501( c) ( ) I( insert no ) ( - 4947( a) ( 1) or F_ 527
H( c)
Group exemption number 0-
J Website :1- WWWICIRRORG
K Form of organization F Corporation 1Trust F_ Association ( - Other 0- L Year of formation 1991 MState of l egal domicil e IL
Summary
1 Briefl y describe the organization's mission or most significant activities
TO PROMOTE THE FULL AND EQUAL PARTICIPATION OF IMMIGRANTS AND REFUGEES IN THE POLITICAL, CIVIC,
CULTURAL, AND SOCIAL LIFE OF OUR DIVERSE SOCIETY
w
2 Check this box Of- if the organization discontinued its operations or disposed of more than 25% of its net assets
3 Number of voting members of the governing body ( Part VI, l ine 1a) . . . . . . . 3 21
of
:2 4 Number of independent voting members of the governing body ( Part VI, l ine 1 b) . . . . 4 21
5 Total number of individual s empl oy ed in cal endar y ear 2012 ( Part V, l ine 2a) . 5 60
6 Total number of vol unteers ( estimate if necessary ) 6 1, 500
7aTotal unrel ated business revenue from Part VIII, col umn ( C) , l ine 12 . 7a 0
b Net unrel ated business taxabl e income from Form 990- T, l ine 34 . . . . . . . 7b 0
Prior Year Current Year
8 Contributions and grants ( Part VIII, l ine 1h) . 7, 865, 952 9, 647, 061
9 Program service revenue ( Part VIII, l ine 2g) . 38, 835 24, 556
N 10 Investment income ( Part VIII, col umn ( A) , l ines 3, 4, and 7d . . . 342 4
11 Other revenue ( Part VIII, col umn ( A) , l ines 5, 6d, 8c, 9c, 10c, and 11e) - 16, 487 34, 122
12 Total revenue- add l ines 8 through 11 ( must equal Part VIII, col umn ( A) , l ine
12) . . . . . . . . . . . . . . . . . . .
7, 888, 642 9, 705, 743
13 Grants and simil ar amounts paid ( Part IX, col umn ( A ) , l ines 1- 3) . 4, 404, 744 6, 218, 040
14 Benefits paid to or for members ( Part IX, col umn ( A) , l ine 4) . 0 0
15
Sal aries, other compensation, empl oy ee benefits ( Part IX, col umn ( A) , l ines
5- 10)
1, 706, 068 1, 913, 110
16a Professional fundraising fees ( Part IX, col umn ( A) , l ine 11e) 0 0
LLJ
b Total fundraising expenses ( Part IX, col umn ( D) , l ine 25)
0- 139, 421
17 Other expenses ( Part IX, col umn ( A) , l ines 11a- 11d, 11f- 24e) . . . . 1, 137, 207 1, 389, 781
18 Total expenses Add l ines 13- 17 ( must equal Part IX, col umn ( A) , l ine 25) 7, 248, 019 9, 520, 931
19 Revenue l ess expenses Subtract l ine 18 from l ine 12 640, 623 184, 812
Beginning of Current
End of Year
Year
- A
M
20 Total assets ( Part X, l ine 16) 5, 214, 427 5, 588, 063
%TS 21 Total l iabil ities ( Part X, l ine 26) . . . . . . . . . . . . 2, 046, 268 2, 235, 092
ZLL 22 Net assets or fund bal ances Subtract l ine 21 from l ine 20 3, 168, 159 3, 352, 971
l ijaW Signature Bl ock
Under penal ties of perjury , I decl are that I have examined this return, incl udin
my knowl edge and bel ief, it is true, correct, and compl ete Decl aration of preps
preparer has any knowl edge
Sign
Signature of officer
Here
LAWRENCE BENITO EXECUTIVE DIRECTOR
Ty pe or print name and titl e
Print/Ty pe preparer's name Preparers signature
ANDREW T TWARDOWSKI CPA
Paid
Firm's name 1- SIKICH LLP
Pre pare r
Use Onl y
Firm's address 1- 1415 WDIEHL RD SUITE 400
NAPERVILLE, IL 605632349
May the IRS discuss this return with the preparer shown above? ( see instructs
For Paperwork Reduction Act Notice, see the separate instructions.
Form 990 (2012) Page 2
Statement of Program Service Accomplishments
Check if Schedule 0 contains a response to any question in this Part I I I .F
1 B riefly describe the organization's mission
TO PROMOTE THE FULL AND EQUAL PARTI CI PATI ON OF I MMI GRANTS AND REFUGEES I N THE POLI TI CAL, CI VI C, CULTURAL,
AND SOCI AL LI FE OF OUR DI VERSE SOCI ETY
2 Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? . . . . . . . . . . . . . . . . . . . . . . fl Yes F No
I f"Yes,"describe these new services on Schedule 0
3 Did the organization cease conducting, or make significant changes in how it conducts, any program
services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . F Yes F7 No
I f"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(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others,
the total expenses, and revenue, if any, for each program service reported
4a (Code ) (Expenses $ 2,312,296 including grants of $ 1,724,485 ) (Revenue $
THE NEW AMERI CANS I NI TI ATI VE (NAI ) I S FUNDED THROUGH THE I LLI NOI S DEPARTMENT OF HUMAN SERVI CES AND ADMI NI STERED THROUGH I LLI NOI S COALI TI ON
FOR I MMI GRANT AND REFUGEE RI GHTS (I CI RR) I N COOPERATI ON WI TH I LLI LNOI S DEPARTMENT OF HUMAN SERVI CES (DHS) THE NAI PROVI DES COMPREHENSI VE
SERVI CES TO ASSI ST I LLI NOI S' MORE THAN 325,000 LEGAL PERMANENT RESI DENTS B ECOME U S CI TI ZENS NAI PROVI DES SERVI CES RANGI NG FROM CI TI ZENSHI P
PREPARATI ON TO ASSI STANCE I N FI LLI NG OUT APPLI CATI ONS, AS WELL AS LEGAL SCREENI NG I T EMPHASI ZES REGI ONAL OUTREACH AND OFFERS CONVENI ENT
LOCATI ONS FOR CI TI ZENSHI P APPLI CATI ONS TO RECEI VE THESE SERVI CES I T ASSI STS LEGAL PERMANENT RESI DENTS I N APPLYI NG FOR U S CI TI ZENSHI P THE FY
2012 GRANT WAS $ 2,352,879 OF THAT AMOUNT, $ 1,721,684 WAS DI RECTLY SUB CONTRACTEDTO COMMUNI TY AND SOCI AL SERVI CES ORGANI ZATI ONS,
$ 369,444 WAS FOR MEDI A AND OTHER OUTREACH TO I NFORM I MMI GRANTS OF WORKSHOPSAND OTHER EVENTS
4b (Code ) (Expenses $ 1,786,101 including grants of $ 1,455,682 ) (Revenue $
THE OUTREACH AND I NTERPRETATI ON PROGRAM I S FUNDED B Y THE I LLI NOI S DEPARTMENT OF HUMAN SERVI CES I T PROVI DES GRANTS TO COMMUNI TY-B ASED
ORGANI ZATI ONS I N ORDER TO I NCREASE THE AMOUNT AND LEVEL OF SERVI CES PROVI DED TO I MMI GRANT COMMUNI TI ES THE PROGRAM ALSO PROVI DES
TRAI NI NG TO I DHS CASEWORKERS ON I MMI GRANT-RELATED I SSUES THE FY 2012 GRANT WAS $ 1,825,846 OF THAT AMOUNT, $ 1,494,277 WAS DI RECTLY
SUB CONTRACTEDTO COMMUNI TY AND SOCI AL SERVI CES ORGANI ZATI ONS OVER 70,000 I NDI VI DUALS RECEI VED ASSI STANCE I N FY 2012
4c (Code ) (Expenses $ 1,689,608 including grants of $ 1,607,044 ) (Revenue $ 15,700
REFUGEE AND I MMI GRANT CI TI ZENSHI P I NI TI ATI VE (RI CI ) WAS CREATED FOR THE PURPOSE OF I MMI GRANT I NTEGRATI ON B Y ASSI STI NG TO EXPEDI TE THE
NATURALI ZATI ON OF NON-CI TI ZENS STATEWI DE THI S I NCLUDED THE PROVI SI ON OF SERVI CES, AS WELL AS POLI CY AND PUB LI C EDUCATI ON, RI CI WASA
PROGRAM USED TO ENHANCE THE EXI STI NG RESOURCES DEVOTED TO THE NATURALI ZATI ON PROCESS, DURI NG ATI ME OF I NCREASED NEED FOR THOSE
SERVI CES THE STATE OF I LLI NOI S HAS ONE OF THE MOST DI VERSE I MMI GRANT AND REFUGEE POPULATI ONS I N THE NATI ON THE RI CI PROGRAM I NCLUDE 35
PARTNERS THROUGHOUT THE STATE, I NCLUDI NG COMMUNI TY B ASED ORGANI ZATI ONS, LEGAL SERVI CE AGENCI ES, AND EDUCATI ONAL I NSTI TUTI ONS
See Additional Data Table
4d Other program services (Describe in Schedule 0
(Expenses $ 3,329,754 including grants of $ 1,430,829 ) (Revenue $ 8,856
4e Total program service expenses1- 9,1 17,7 59
Form 990 (2012)
Form 990 (2012) Page 3
Checklist of Required Schedules
Yes No
1 Is the organization described in section 501(c)(3) or4947(a)(1) (other than a private foundation)? If "Yes," Yes
complete Schedule As . . . . . . . . . . . . . . . . . . . . . . . 1
2 Is the organization required to complete Schedule B , Schedule of Contributors (see instructions)? . 2 Yes
3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to No
candidates for public office? If "Yes,"complete Schedule C, Part Is . . . . . . . . .
4 Section 501( c)(3) organizations . Did the organization engage in lobbying activities, or have a section 501(h) Yes
election in effect during the tax year? If "Yes "complete Schedule C Part II . . . . . . . 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 HIS . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
N o
6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the
right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes,"complete
Schedule D, Part I . . . . . . . . . . . . . . . . . . . . . . 6
N o
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 IIS .
7
No
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
N o
complete Schedule D, Part 111 19 . . . . . . . . . . . . . . . . . . .
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
No
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, 10 No
permanent endowments, or quasi-endowments? 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?
Yes
If "Yes,"complete Schedule D, Part VI. . . . . . . . . . . . . . . . . . . .
lla
b Did the organization report an amount for investments-other securities in Part X , line 12 that is 5% or more of
No
its total assets reported in Part X , line 16? If "Yes, "complete Schedule D, Part VIIS . . . . . .
llb
c Did the organization report an amount for investments-program related in Part X , line 13 that is 5% or more of
No
its total assets reported in Part X , line 16? If "Yes, "complete Schedule D, Part VIII . . . . . .
llc
d Did the organization report an amount for other assets in Part X , line 15 that is 5% or more of its total assets
Yes
reported in Part X , line 16? If "Yes," complete Schedule D, Part IX ' . . . . . . . . . . . .
lld
e Did the organization report an amount for other liabilities in Part X , line 25? If "Yes," complete Schedule D, Part X
Ile I I No
f Did the organization's separate or consolidated financial statements for the tax year include a footnote that
llf Y
addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes,"complete
es
Schedule D, Part X . . . . . . . . . . . . . . . . . . . . . . . . . .
12a Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes,"complete Schedule D, Parts X I and X II . . . . . . . . . . . . . . . . .
12a N o
b Was the organization included in consolidated, independent audited financial statements for the tax year? If
12b Yes
"Yes,"and if the organization answered "No" to line 12a, then completing Schedule D, Parts X I and X II is optional
13 Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes, "complete Schedule E . .
13 No
14a Did the organization maintain an office, employees, or agents outside of the United States? . 14a No
b 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? If "Yes, "complete Schedule F, Parts I and IV . . . . . . . .
14b No
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? If "Yes," complete Schedule F, Parts II and IV
15
No
16 Did the organization report on Part IX , column (A), line 3, more than $5,000 of aggregate grants or assistance to
individuals located outside the United States? If "Yes," complete Schedule F, Parts III and IV . .
16
No
17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part 17 No
IX , column (A), lines 6 and 11 e? If "Yes," complete Schedule G , Part I (see instructions) . . . . IN
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part
VIII, lines 1c and 8a? If "Yes, "complete Schedule G , Part II . . . . . . . . . . .
cS 18
Yes
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If
I
19 No
"Yes,"complete Schedule G , Part III . . . . . . . . . . . . . . . . . . . IN
20a Did the organization operate one or more hospital facilities? If "Yes,"completeSchedu leH . .
1 20a I
I
No
b If"Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Form 990 (2012)
Form 990 ( 2012) Page 4
Checklist of Required Schedules ( continued)
21 Did the organization report more than $5,000 of grants and other assistance to any government or organization in 21 Yes
the United States on Part IX, column ( A), line 1? If "Yes ," comp l ete Schedul e I, Parts I and II . . .
22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United States
22
on Part IX, column ( A), line 2? If "Yes , " comp lete Schedule I, Parts I and III . . . . . . . .
'S
1
No
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," 23
No
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 lines 24b through 24d
and complete Schedule K. If "No," go to line 25 . . . . . . . . . . . . . . . 24a
N o
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
24b
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?
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 No
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 25b No
"Yes,"complete Schedule L , Part I . . . . . . . . . . . . . . . . . . .
26 Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, o
disqualified person outstanding as of the end of the organization's tax year? If "Yes," complete Schedule L , 26
No
Part II . . . . . . . . . . . . . . . . . . . . . . . . . .
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 27 No
member of any of these persons? If "Yes,"complete Schedule L , Part III . . . . . . . . .
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)
a A current or former officer, director, trustee, or key employee? If "Yes,"complete Schedule L , Part
IV . . . . . . . . . . . . . . . . . . . . . . . . . .
28a No
b A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L , Part IV . . . . . . . . . . . . . . . . . . . .
28b
N o
c A n 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
No
29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes,"completeScheduleM 29
No
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified
conservation contributions? If "Yes, "complete Schedule M . . . . . . . . . . . .
30
No
31 Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I . . . . . . . . . . . . . . . . . . . . . . . . . . 31
N o
32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes, " complete
Schedule N, Part II . . . . . . . . . . . . . . . . . . . . .
32
N o
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? If "Yes,"complete Schedule R, PartI . . . . . . . .
33
No
34 Was the organization related to any tax-exempt or taxable entity? If "Yes,"complete Schedule R, Part II, III, orIV,
and Part V, line l . . . . . . . . . . . . . . . . . . . . . . .
34
Yes
35a Did the organization have a controlled entity within the meaning of section 512( b)( 13)7
35a Yes
b If'Yes'to line 35a, did the organization receive any payment from or engage in any transaction with a controlled
35b No
entity within the meaning of section 512 ( b)( 13 )? If "Yes, "complete Schedule R, Part V, line 2 . . .
36 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, line 2 . . . . . . . . . . . . .
IS 1
36
No
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? If "Yes, " complete Schedule R, Part VI
37
No
38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 1 lb and 19?
Note . All Form 990 filers are required to complete Schedule 0 . . . . . . . . . . . 38
Yes
Form 990 ( 2012)
Form 990 (2012) Page 5
MEW-
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule 0 contains a response to any q uestion in this Part V (-
Yes No
la Enter the number reported in Box 3 of Form 1096 Enter -0-if not applicable . la 3 3
b Enter the number of Forms W-2G included in line la Enter-0-if not applicable lb 0
c Did the organization comply with backup withholding rules f or reportable pay ments to vendors and reportable
gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . . 1c Yes
2a Enter the number of employ ees reported on Form W-3 , Transmittal of Wage and
Tax Statements, f iled f or the calendar y ear ending with or within the y ear covered
by this return . . . . . . . . . . . . . . . . . 2a 60
b If at least one is reported on line 2a, did the organization f ile all req uired f ederal employ ment tax returns?
2b Yes
Note. If the sum of lines la and 2a is greater than 250, y ou may be req uired to e-f ile (see instructions)
3 a Did the organization have unrelated business gross income of $1,000 or more during the y ear? . . 3 a No
b If "Yes," has it f iled a Form 990-T f or this y ear? If "No,"provide an explanation in Schedule O . . . . 3 b
4a At any time during the calendar y ear, did the organization have an interest in, or a signature or other authority
over, a f inancial account in a f oreign country (such as a bank account, securities account, or other f inancial
account)? . . . . . . . . . . . . . . . . . . . . . . . . . .
4a
No
b If "Yes," enter the name of the f oreign country 0-
See instructions f or f iling req uirements f or Form TD F 90-22 1, Report of Foreign Bank and Financial Accounts
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax y ear? . .
b Did any taxable party notif y the organization that it was or is a party to a prohibited tax shelter transaction?
c If "Yes,"to line 5a or 5b, did the organization f ile Form 8886-T?
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions? . .
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gif ts
were not tax deductible? .
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a pay ment in excess of $75 made partly as a contribution and partly f or goods and
services provided to the pay or? .
b If "Yes," did the organization notif y the donor of the value of the goods or services provided? . .
c Did the organization sell, exchange, or otherwise dispose of tangible personal property f or which it was req uired to
f ile Form 82827 .
d If "Yes," indicate the number of Forms 8282 f iled during the y ear 7d
e Did the organization receive any f unds, directly or indirectly , to pay premiums on a personal benef it
contract? .
f Did the organization, during the y ear, pay premiums, directly or indirectly , on a personal benef it contract?
g If the organization received a contribution of q ualif ied intellectual property , did the organization f ile Form 8899 as
req uired? .
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization f ile a
Form 1098-C? .
8 Sponsoring organizations maintaining donor advised f unds and section 509(a )( 3 ) supporting organizations. Did
the supporting organization, or a donor advised f und maintained by a sponsoring organization, have excess
business holdings at any time during the y ear? .
9 Sponsoring organizations maintaining donor advised f unds.
a Did the organization make any taxable distributions under section 4966? . .
b Did the organization make a distribution to a donor, donor advisor, or related person? . .
10 Section 501(c)( 7) organizations. Enter
a Initiation f ees and capital contributions included on Part VIII, line 12 . 10a
b Gross receipts, included on Form 990, Part VIII, line 12, f or public use of club 10b
f acilities
11 Section 501(c)( 12) organizations. Enter
a Gross income f rom members or shareholders . . . . . . . . 11a
b Gross income f rom other sources (Do not net amounts due or paid to other sources
against amounts due or received f rom them ) . . . . . . . . . 11b
12a Section 4947( a)(1) non-exempt charitable trusts. Is the organization f iling Form 990 in lieu of Form 1041?
b If "Yes," enter the amount of tax-exempt interest received or accrued during the
y ear . . . . . . . . . . . . . . . . . . .
12b
13 Section 501(c)( 29) q ualif ied nonprof it health insurance issuers.
a Is the organization licensed to issue q ualif ied health plans in more than one state?
Note. See the instructions f or additional inf ormation the organization must report on Schedule 0
b Enter the amount of reserves the organization is req uired to maintain by the states
in which the organization is licensed to issue q ualif ied health plans
13 b
c Enter the amount of reserves on hand
13 c
5a N o
5b
N o
5c
6a N o
6b
7a N o
7b
7c N o
7e N o
7f N o
7g
7h
8
9a
9b
12a
13 a
14a Did the organization receive any pay ments f or indoor tanning services during the tax y ear? . . . 14a No
b If "Yes," has it f iled a Form 720 to report these pay ments? If "No,"provide an explanation in Schedule 0 . 14b
Form 990 (2012)
Form 990 ( 2012) Page 6
Lam
Governance, Management, and Disclosure For each "Yes"response to lines 2 through 7b below, and for a
"No" response to lines 8a, 8b, or 10b 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 .F
Section A. Governing Body and Management
la Enter the number of voting members of the governing body at the end of the tax
la 21
year
If there are material differences in voting rights among members of the governing
body, or if the governing body delegated broad authority to an executive committee
or similar committee, explain in Schedule 0
b Enter the number of voting members included in line la, above, who are
independent . . . . . . . . . . . . . . . . . lb 21
2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any
other officer, director, trustee, or key employee?
3 Did the organization delegate control over management duties customarily performed by or under the direct
supervision of officers, directors or trustees, or key employees to a management company or other person?
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was
filed?
5 Did the organization become aware during the year of a significant diversion of the organization's assets?
6 Did the organization have members or stockholders?
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or
more members of the governing body? . .
b Are any governance decisions of the organization reserved to ( or subject to approval by) members, stockholders,
or persons other than the governing body?
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the
year by the following
a The governing body?
b Each committee with authority to act on behalf of the governing body?
9 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 in Schedule 0 . . . . . . .
Yes I No
2 No
3 No
4 No
5 No
6 No
7a N o
7b No
8a Yes
8b Yes
9 1 1 No
Section B. Policies ( This Section B req uests information aboutp olicies notreq uired b y the Internal Revenue Code.)
Yes No
10a Did the organization have local chapters, branches, or affiliates? 10a No
b If"Yes, " did the organization have written policies and procedures governing the activities of such chapters,
affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing
the form? . . . . . . . . . . . . . . . . . . . . . . . . . . . 11a Yes
b Describe in Schedule 0 the process, if any, used by the organization to review this Form 990
12a Did the organization have a written conflict of interest policy? If "No, "go to line 13 . 12a Yes
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give
rise to conflicts? . . . . . . . . . . . . . . . . . . . . . . . . . 12b Yes
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes, "describe
in Schedule 0 how this was done . 12c Yes
13 Did the organization have a written whistleblower policy? 13 Yes
14 Did the organization have a written document retention and destruction policy? . 14 Yes
15 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 15a Yes
b Other officers or key employees of the organization 15b Yes
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 participate in a joint venture or similar arrangement with a
taxable entity during the year? . . . . . . . . . . . . . . . . . . . . . 16a No
b If "Yes, " did the organization follow a written policy or procedure requiring the organization to evaluate its
participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the
organization's exempt status with respect to such arrangements? . . . . . . . . . .
16b
Section C. Disclosure
17 List the States with which a copy of this Form 990 is required to be filed- IL
18 Section 6104 requires an organization to make its Form 1023 ( or 1024 if applicable), 990, and 990-T ( 501( c)
( 3)s only) available for public inspection Indicate how you made these available Check all that apply
fl Own website fl Another's website 17 Upon request fl Other ( explain in Schedule O)
19 Describe in Schedule 0 whether ( and if so, how), the organization made its governing documents, conflict of
interest policy, and financial statements available to the public during the tax year
20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization
-KIM SUH 55 E JACKSON - SUITE 2075 CHICAGO, IL ( 312) 332-7360
Form 990 ( 2012)
Form 990 (2012) Page 7
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
Check if Schedule 0 contains a response to any question in this Part VII . (-
Section A. Officers, Directors, Trustees, Kev Employees, and Highest Compensated Employees
la 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
* L ist 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
* L ist all of the organization' s current key employees, if any See instructions for definition of "key employee "
* L ist 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
* L ist all of the organization' s former officers, key employees, or highest compensated employees who received more than $100, 000
of reportable compensation from the organization and any related organizations
* L ist 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
L ist persons in the following order individual trustees or directors, institutional trustees, officers, key employees, highest
compensated employees, and former such persons
1 Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee
(A) (B) (C) (D) (E) (F)
Name and Title Average Position (do not check Reportable Reportable Estimated
hours per more than one box, unless compensation compensation amount of
week (list person is both an officer from the from related other
any hours and a director / trustee ) organization organizations compensation
for related 5 0 = T (W- 2/1099- (W- 2/1099- from the
organizations CL
: 1 2 fD
ado a MISC) MISC) organization
below m (D art,
and related
dotted line ) u S
_
- - organizations
(1) AL JE KABBA 2 00
X X 0 0 0
PRESIDENT, BOARD OF DIRECTORS
(2) TUYET L E 2 00
X X 0 0 0
VICE PRESIDENT
(3 ) MARIA PESQUEIRA 2 00
X X 0 0 0
VICE PRESIDENT
(4 ) ROSA CARRASCO 2 00
X X 0 0 0
SECRETARY
(5 ) RAUL RAYMUNDO 2 00
X X 0 0 0
TREASURER
(6 ) GONZAL O ARROYO 2 00
X 0 0 0
DIRECTOR
(7) GRACIEL A CONTERAS 2 00
X 0 0 0
DIRECTOR
(8 ) DAYSI FUNES 2 00
X 0 0 0
EXEC COMM MEMBER AT L ARGE
(9) L AURA GARZA 2 00
X 0 0 0
DIRECTOR
(10) JOSE L UIS GUTIERREZ 2 00
X 0 0 0
DIRECTOR
(11) JEFF BARTOW 2 00
X 0 0 0
DIRECTOR
(12) BIL L Y L AWL ESS 2 00
X 0 0 0
DIRECTOR
(13 ) RUDY L OPEZ 2 00
X 0 0 0
DIRECTOR
(14 ) SIK SON 2 00
X 0 0 0
DIRECTOR
(15 ) JUAN SAL GADO 2 00
X 0 0 0
DIRECTOR
(16 ) JANE RAMSEY 2 00
X 0 0 0
DIRECTOR
(17) AHMEN REHAB 2 00
X 0 0 0
DIRECTOR
Form 990 (2012)
Form 990 (2012) Page 8
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A) (B) (C) (D) (E) (F)
Name and Title Average Position (do not check Reportable Reportable Estimated
hours per more than one box, unless compensation compensation amount of other
week (list person is both an officer from the from related compensation
any hours and a director/trustee) organization organizations from the
for related 0 - 5 0 = T (W- 2/1099- (W- 2/1099- organization
organizations - c
fD
ado a MISC) MISC) and related
below
Q - 5
m
(D
U_
art,
organizations
dotted line) u Q a,
4rD 0
(18) DR ZAHER SAHLOUL 2 00
X 0 0 0
DIRECTOR
(19) YESENIA SANCHEZ 2 00
X 0 0 0
DIRECTOR
(20) BERNARDA WONG 2 00
X 0 0 0
DIRECTOR
(21) LAWRENCE BENITO 40 00
X 114, 033 0 5, 200
EXECUTIVE DIRECTOR
(22) JOSHUA W HOYT 40 00
X 82, 399 0 25, 506
STRATEGY EXECUTIVE DIRECTOR
(23) MAUREEN METER 40 00
X 72, 535 0 9, 925
DIRECTOR OF FINANCE/ADMIN
lb Sub -Total . . . . . . . . . . . . . . . .
c Total from continuation sheets to Part VII, Section A . . . .
d Total ( add lines lb and 1c) . . . . . . . . . . . .
10- 268, 967 0 40, 631
Total number of individuals (including but not limited to those listed above) who received more than
$100, 000 of reportable compensation from the organization-1
No
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee
on line la? If "Yes, " complete Schedule Jfor such individual . . . . . . . . . . . . .
3 No
4 For any individual listed on line la, is the sum of reportable compensation and other compensation from the
organization and related organizations greater than $150, 0007 If "Yes, " complete Schedule -7 for such
individual . . . . . . . . . . . . . . . . . . . . . . . . . .
4 N o
Did any person listed on line la receive or accrue compensation from any unrelated organization or individual for
services rendered to the organization? If "Yes, "complete Schedule J for such person . . . . . . .
5 No
Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100, 000 of
compensation from the organization Report compensation for the calendar year ending with or within the organization's tax year
(A) (B) (C)
Name and business address DescriDtion of services Compensation
2 Total number of independent contractors (including but not limited to those listed above) who received more than
$100, 000 of compensation from the organization 0-0
Form 990 (2012)
Form 990 (2012) Page 9
Statement of Revenue
Check i f Schedule 0 contai ns a response to any questi on i n thi s Part VIII F
(A) (B) (C) (D)
Total revenue Related or Unrelated Revenue
exempt busi ness excluded from
functi on revenue tax under
revenue secti ons
512, 513, or
514
la Federated campai gns . la Z
b Membershi p dues . . . . lb
37,553
6 - O
0 E c Fundrai si ng events . . . . 1c
105,6 50
d Related organi zati ons . ld
tJ '
E e Government grants (contri buti ons)
le
7,6 00,023
V
f All other contri buti ons, gi fts, grants, and
i f
1,903,835
^ si mi lar amounts not i ncluded above
g Noncash contri buti ons i ncluded i n li nes
la- If $
h Total . Add li nes la- 1f .
9,6 47,06 1
Busi ness Code
2a PROGRAM FEE INCOME 900099 24,556 24,556
b
c
d
e
f All other program servi ce revenue
g Total . Add li nes 2a- 2f . . . . . . . . 0- 24,556
3 Investment i ncome (i ncludi ng di vi dends, i nterest,
10-
and other si mi lar amounts) . .
4 4
4
Income from i nvestment of tax- exempt bond proceeds , . 0-
5 Royalti es . . . . . . . . . . .
0-
(i ) Real (i i ) Personal
6 a Gross rents
b Less rental
expenses
c Rental i ncome
or (loss)
d Net rental i nco me or (loss) . . li m-
(i ) Securi ti es (i i ) Other
7a Gross amount
from sales of
assets other
than i nventory
b Less cost or
other basi s and
sales expenses
c Gai n or (loss)
d Net gai n or (loss) . .
8a Gross i ncome from fundrai si ng
W events (not i ncludi ng
$ 105,6 50
of contri buti ons reported on li ne 1c)
W See Part IV, li ne 18
L a 7,100
s b Less di rect expenses . b 42,319
c Net i ncome or (loss) from fundrai si ng events .
0-
- 35,219 - 35,219
9a Gross i ncome from gami ng acti vi ti es
See Part IV, li ne 19 . .
a
b Less di rect expenses . b
c Net i ncome or (loss) from gami ng acti vi ti es . .
. 0-
10a Gross sales of i nventory, less
returns and allowances .
a
b Less cost of goods sold . b
c Net i ncome or (loss) from sales of i nventory . li m-
Mi scellaneous Revenue Busi ness Code
11a
MISCELLANEOUS INCOME
900099 6 9,341 6 9,341
b
C
d All other revenue . .
e Total . Add li nes 11a- 11d . 0-
6 9,341
12 Total revenue. See Instructi ons
9,705,743 24,556 0 34,126
Form 990 (2012)
Form 990 (2012) Page 10
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns A ll other organizations must complete column (A )
Check if Schedule 0 contains a response to any auestion in this Part IX . . . . . . . . . . . . . .
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII .
(A )
Total expenses
(B)
Program serv ice
expenses
(C)
Management and
general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to gov ernments and organizations
in the United States See Part IV, line 21
6,218,040 6,218,040
2 Grants and other assistance to indiv iduals in the
United States See Part IV, line 22
3 Grants and other assistance to gov ernments,
organizations, and indiv iduals outside the United
States See Part IV, lines 15 and 16
4 Benefits paid to or for members
5 Compensation of current officers, directors, trustees, and
key employees 360,631 209,634 101,414 49,583
6 Compensation not included abov e, to disqualified persons
(as defined under section 4958(f)(1)) and persons
described in section 4958 (c)(3)(B)
7 Other salaries and wages 1,193,677 1,157,971 2,065 33,641
8 Pension plan accruals and contributions ( include section 401(k)
and 403(b) employer contributions) .
9 Other employee benefits 222,569 176,102 30,888 15,579
10 Payroll taxes 136,233 118,887 9,588 7,758
11 Fees for serv ices (non-employees)
a Management . .
b Legal 7,928 5,999 1,929
c A ccounting 32,025 27,794 4,200 31
d Lobbying . .
e Professional fundraising serv ices See Part IV, line 17
f Inv estment management fees . .
g Other ( If line 11g amount exceeds 10 %of line 25,
column ( A ) amount, list line 11g expenses on
Schedule 0
601,783 547,616 43,363 10,804
12 A dv ertising and promotion .
13 Office expenses 93,172 81,993 7,286 3,893
14 Information technology 22,708 16,713 4,712 1,283
15 Royalties
16 Occupancy 173,800 138,653 23,485 11,662
17 Trav el . . . . . . . . . . . 145,717 138,626 6,042 1,049
18 Payments of trav el or entertainment expenses for any federal,
state, or local public officials
19 Conferences, conv entions, and meetings 63,963 59,348 4,615
20 Interest . .
21 Payments to affiliates
22 Depreciation, depletion, and amortization 8,461 3,695 4,237 529
23 Insurance . . . . . . . . . . . . . 16,332 15,391 941
24 Other expenses Itemize expenses not cov ered abov e (List
miscellaneous expenses in line 24e If line 24e amount exceeds 10%
of line 25, column ( A ) amount, list line 24e expenses on Schedule 0
a OTHER EVENTS 170,086 166,927 3,159
b EQUIPMENT RENTA L A ND MA 28,856 23,655 3,875 1,326
c OTHER EXPENSES 14,903 3,699 8,963 2,241
d DUES A ND SUBSCRIPTIONS 7,946 5,365 2,581
e A ll other expenses 2,101 1,651 408 42
25 Total functional expenses. A dd lines 1 through 24e 9,520,931 9,117,759 263,751 139,421
26 Joint costs. Complete this line only if the organization
reported in column ( B) j oint costs from a combined
educational campaign and fundraising solicitation Check
here - fl if following SOP 98-2 (A SC 958-720)
Form 990 (2012)
Form 990 (2012 ) Page 11
Balance Sheet
Check i f Schedule 0 contai ns a response to any questi on i n thi s Part X F
(A) (B)
Begi nni ng of year End of year
1 Cash-non-i nterest-beari ng 938,378 1 30,694
2 Savi ngs and temporary cash i nvestments . 56,115 2 2,094,098
3 Pledges and grants recei vable, net 3,984,897 3 3,080,760
4 Accounts recei vable, net . . . . . . . . . . . . 67,048 4 26,234
5 Loans and other recei vables f rom current and f ormer of f i cers, di rectors, trustees, key
employees, and hi ghest compensated employees Complete Part I I of
Schedule L . .
5
6 Loans and other recei vables f rom other di squali f i ed persons (as def i ned under secti on
4958(f ) (1) ) , persons descri bed i n secti on 4958(c) (3) (B) , and contri buti ng employers
and sponsori ng organi zati ons of secti on 501(c) (9) voluntary employees' benef i ci ary
organi zati ons (see i nstructi ons) Complete Part I I of Schedule L
6
7 Notes and loans recei vable, net 7
8 I nventori es f or sale or use 8
9 Prepai d expenses and def erred charges . 75,060 9 52,373
10a Land, bui ldi ngs, and equi pment cost or other basi s Complete
Part VI of Schedule D 10a
132,851
b Less accumulated depreci ati on . 10b 113,591 27,721 10c 19,260
11 I nvestments-publi cly traded securi ti es . 11
12 I nvestments-other securi ti es See Part I V, li ne 11 12
13 I nvestments-program-related See Part I V, li ne 11 13
14 I ntangi ble assets . . . . . . . . . . . . . . 14
15 Other assets See Part I V, li ne 11 65,208 15 284,644
16 Total assets . Add li nes 1 through 15 (must equal li ne 34) . 5,214,427 16 5,588,063
17 Accounts payable and accrued expenses 186,417 17 153,892
18 Grants payable 1,832,351 18 1,958,207
19 Def erred revenue . . . . . . . . . . . . . . . 27,500 19 122,993
20 Tax-exempt bond li abi li ti es . . . . . . . . . . . . 20
21 Escrow or custodi al account li abi li ty Complete Part I V of Schedule D 21
22 Loans and other payables to current and f ormer of f i cers, di rectors, trustees,
key employees, hi ghest compensated employees, and di squali f i ed
persons Complete Part I I of Schedule L . 22
23 Secured mortgages and notes payable to unrelated thi rd parti es 23
24 Unsecured notes and loans payable to unrelated thi rd parti es 24
25 Other li abi li ti es (i ncludi ng f ederal i ncome tax, payables to related thi rd parti es,
and other li abi li ti es not i ncluded on li nes 17-24) Complete Part X of Schedule
D . 25
26 Total li abi li ti es . Add li nes 17 through 25 . 2,046,268 26 2,235,092
Organi zati ons that f ollow SFAS 117 ( ASC 958 ) , check here 1- F and complete
li nes 27 through 29, and li nes 33 and 34.
C5
27 Unrestri cted net assets 1,891,630 27 1,875,471
M
ca
28 Temporari ly restri cted net assets 1,276,529 28 1,477,500
r
29 Permanently restri cted net assets 29
_
Organi zati ons that do not f ollow SFAS 117 (ASC 958 ) , check here 1 and
F W _
complete li nes 30 through 34.
30 Capi tal stock or trust pri nci pal, or current f unds 30
31 Pai d-i n or capi tal surplus, or land, bui ldi ng or equi pment f und 31
4T
32 Retai ned earni ngs, endowment, accumulated i ncome, or other f unds 32
33 Total net assets or f und balances 3,168,159 33 3,352,971
z
34 Total li abi li ti es and net assets/f und balances 5,214,427 34 5,588,063
Form 990 (2012)
Form 990 (2012) Page 12
Reconcilliation of Net Assets
('hark if crhariiila () rnntainc a rocnnnca to anv niiactinn in Chic Part YT
1 Total revenue (must equal Part VIII, column (A), line 12) . .
2 Total expenses (must equal Part IX, column (A), line 25) . .
3 Revenue less expenses Subtract line 2 from line 1
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
5 Net unrealized gains (losses) on investments
6 Donated services and use of facilities
7 Investment expenses . .
8 Prior period adjustments . .
9 Other changes in net assets or fund balances (explain in Schedule 0)
10 Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line 33,
column (B ))
1 9,705,743
2 9,520,931
3 184,812
4 3,168,159
5
6
7
8
9 0
10 3,352,971
Financial Statements and Reporting
Check if Schedule 0 contains a response to any question in this Part XII (-
Yes No
1 Accounting method used to prepare the Form 990 fl Cash 17 Accrual (Other
If the organization changed its method of accounting from a prior year or checked " Other," explain in
Schedule 0
2a Were the organization 's financial statements compiled or reviewed by an independent accountant? 2a No
If'Yes,'check a box below to indicate whether the financial statements for the year were compiled or reviewed on
a separate basis, consolidated basis, or both
fl Separate basis fl Consolidated basis fl B oth consolidated and separate basis
b Were the organization 's financial statements audited by an independent accountant? 2b Yes
If'Yes,'check a box below to indicate whether the financial statements for the year were audited on a separate
basis, consolidated basis, or both
fl Separate basis F Consolidated basis fl B oth consolidated and separate basis
c If" Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the
audit, review , or compilation of its financial statements and selection of an independent accountant? 2c Yes
If the organization changed either its oversight process or selection process during the tax year, explain in
Schedule 0
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the
Single Audit Act and 0 MB Circular A-1 33? 3a Yes
b If" Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required 3b Yes
audit or audits , explain why in Schedule 0 and describe any steps taken to undergo such audits
Form 990 (2012)
Additional Data
Software ID:
Software Version:
EIN: 36 -3783551
Name: ILLINOIS COALITION FOR IMMIGRANT
AND REFUGEE RIGHTS
Form 990, Part III - 4 Program Service Accomplishments (See the Instructions)
Describe the exempt purpose achievements for each of the organization's three largest programservices by expenses.
Section 501( c)(3) and ( 4) organizations and 4947( a)(1) trusts are required to report the amount of grants and allocations to
others, the total expenses, and revenue, if any, for each programservice reported.
(Code ) (Expenses $ 445,906 including grants of $ 367,877 ) (Revenue $
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM HAS BEEN SUCCESSFUL IN THE REACHING AND ASSISTING LIMITED
ENGLISH PROFICIENT FAMILIES TO APPLY FOR SNAP BENEFIT FOR 3 YEARS ICIRR'S SNAP PARTNERS HAVE AND WILL
CONTINUE TO USE A STRATEGY CENTERED ON ETHNIC, COMMUNITY-BASED ORGANIZATIONS COUPLED WITH ETHNIC MEDIA
TO REACH LOW-INCOME IMMIGRANT COMMUNITIES THE FY 2012 GRANT WAS $441,764 OF THAT AMOUNT, $376,423 WAS
DIRECTLY SUBCONTRACTED TO COMMUNITY AND SOCIAL SERVICE ORGANIZATIONS
(Code ) (Expenses $ 509,866 including grants of $ ) (Revenue $ 3,206
ORGANIZING AND LEADERSHIP DEVELOPMENT
Describe the exempt purpose achievements for each of the organization's three largest program services by expenses.
Section 501(c)(3) and (4) organizations and 4947(a)(1) 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.
(Code ) (Expenses $ 165,099 including grants of $ ) (Revenue $
WE WANTTO LEARN ENGLISH/LITERACY
(Code ) (Expenses $ 351,032 including grants of $ ) (Revenue $ 5,000 )
INEWAMERICAN DEMOCRACY PROJECT
(Code ) ( Expenses $ 199,760 including grants of $ 175,260 ) ( Revenue $
WOMEN, INFANTS, AND CHILDREN
(Code ) (Expenses $ 30,879 including grants of $ )(Revenue $
RAINING AND MEMBER SERVICES
(Code ) ( Expenses $ 22,130 including grants of$ ) (Revenue $ 650
POLICY AND RESEARCH
NATIONAL PARTNERSHIP FOR NEWAMERICANS IS A CONSORTIUM OF 12 NATIONAL PARTNERS WHO RECEIVED PRIVATE
FUNDING FOR CITIZENSHIP WORK, CAPACITY BUILDING, AND IMMIGRANT INTEGRATION ACROSS THE COUNTRY ICIRR
SERVES AS THE FISCAL AGENT OF THE $ 820,000 TOTAL GRANTS, ICIRR RETAINED $ 200,000 AS ITS DIRECT GRANT THE
REMAINDER WAS SENT TO THE OTHER MEMBERS
Describe the exempt purpose achievements for each of the organization' s three largest program services by expenses.
Section 501 ( c)(3) and ( 4) organizations and 4947( a)(1) trusts are required to report the amount of grants and allocations to
(Code ) (Expenses $ 118,165 including grants of $ ) (Revenue $
AMERICORPS
IL STATE BOARD OF EDUCATION PARENT MENTOR
1
(Code ) ( Expenses $ 104,684 including grants of $ 40,000 ) ( Revenue $
HEALTH CARE ACCESS INITIATIVE
(YOUTH CIVIC ENGAGEMENT
I
(Code ) (Expenses $ 87,342 including grants of $ ) ( Revenue $
DEFERRED ACTION FOR CHILDHOOD ARRIVALS
(COMPREHENSIVE IMMIGRATION REFORM
efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493062009154
SCHEDULE A
Public Charity Status and Public Support
OMBNo 1545- 0047
(Form 990 or 990EZ)
2012 Complete if the organization is a section 501(c)( 3) organization or a section
Department of the Treasury 4947(a)(1) nonexempt charitable trust.
^Attach to Form 990 or Form 990- EZ. ^See separate instructions.
Name of the organization Employer identification number
AND REFUGEE RIGHTS
I
36- 3783551
III=Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organi zation is not a private foundation because it is (For lines 1 through 11, check only one box)
1 1 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2 1 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E )
3 1 A hospital or a cooperative hospital service organization described in section 170( b)(1)(A)(iii).
4 1 A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the
hospital's name, city, and state
5 fl An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170( b)(1)(A)(iv ). (Complete Part II )
6 fl A federal, state, or local government or governmental unit described in section 170( b)(1)(A)(v).
7 F An organization that normally receives a substantial part of its support from a governmental unit or from the general public
described in section 170( b)(1)(A)(vi ). (Complete Part II )
8 1 A community trust described in section 170(b)(1)(A)(vi ) (Complete Part II )
9 1 An organization that normally receives (1) more than 331/3% of its support from contributions, membership fees, and gross
receipts from activities related to its exempt functions- subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975 See section 509( a)(2). (Complete Part III )
10 fl An organization organized and operated exclusively to test for public safety See section 509(a)(4).
11 1 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of
one or more publicly supported organizations described in section 509( a)(1) or section 509(a )( 2) See section 509( a)(3). Check
the box that describes the type of supporting organization and complete lines Ile through 11 h
a fl Type I b 1Type II c fl Type III - Functionally integrated d (- Type III - Non - functionally integrated
e (- By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons
other than foundation managers and other than one or more publicly supported organizations described in section 509( a)(1 ) or
section 509(a)(2)
f If the organization received a written determination from the IRS that it is a Type I, Type II, orType III supporting organization,
check this box (-
g 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) Yes No
and (iii) below, the governing body of the supported organization? 11g(i)
(ii) A family member of a person described in (i) above? 11g(ii)
(iii) A 35% controlled entity of a person described in (i) or (ii) above? 11g(iii)
h Provide the following information about the supported organization(s)
(i) Name of (ii) EIN (iii) Type of (iv) Is the (v) Did you notify (vi) Is the (vii) Amount of
supported organization organization in the organization organization in monetary
organization (described on col (i) listed in in col (i) of your col (i) organized support
lines 1- 9 above your governing support? in the U S ?
or IRC section document?
(see
instructions))
Yes No Yes No Yes No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ . Cat No 11285F
ScheduleA(Form 990 or 990- EZ)2012
Schedule A (Form 990 or 990-EZ) 2012 Page 2
MU^Support Schedule for Organizations Described in Sections 170(b )( 1)(A)(iv) and 170( b)(1)(A)(vi)
(Complete only if y ou checked the box on line 5 , 7, or 8 of Part I or if the organization failed to q ualify under
Part I I I . I f the organization fails to q ualify under the tests listed below, please complete Part I I I . )
Section A. Public Support
Calendar y ear ( or fiscal y ear beginning
(
a) 2008 (b) 2009 (c) 2010 ( d) 2011 (e) 2012 (f) Total
in) 11111
1 G ifts, grants , contributions, and
membership fees received (Do not
6, 935 , 046 7, 890, 336 7, 75 2, 807 7, 865 , 95 2 9, 647, 061 40, 091, 202
include any " unusual
grants " )
2 Tax revenues levied for the
organization ' s benefit and either
paid to or expended on its
behalf
3 The value of services or facilities
furnished by a governmental unit
to the organization without charge
4 Total . Add lines 1 through 3
6, 935 , 046 7, 890, 336 7, 75 2, 807 7, 865 , 95 2 9, 647, 061 40, 091, 202
5 The portion of total contributions
by each person ( other than a
governmental unit or publicly
supported organization ) included
15 , 972
on line 1 that exceeds 2% of the
amount shown on line 11, column
(f)
6 Public support . Subtract line 5
40, 075 , 230
from line 4
Section B . Total Su pport
Calendar y ear ( orfiscaI y ear
(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
beginning in) ^
7 Amounts from line 4
6, 935 , 046 7, 890, 336 7, 75 2, 807 7, 865 , 95 2 9, 647, 061 40, 091, 202
8 G ross income from interest,
dividends, pay ments received on
securities loans, rents, roy alties
14, 794 3, 369 4, 109 342 4 22, 618
and income from similar
sources
9 Net income from unrelated
business activities, whether or
not the business is regularly
carried on
10 Other income Do not include
gain or loss from the sale of
604 4, 780 12, 865 69, 341 87, 5 90
capital assets (Explain in Part
I V )
11 Total support (Add lines 7
40, 201, 410
through 10)
12 G ross receipts from related activities, etc (see instructions)
12 923, 145
13 First five y ears. I f the Form 990 is for the organization' s first, second, third, fourth, or fifth tax y ear as a 5 01(c)(3) organization, check
this box and stop here . I tE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section C. Com p utation of Public Su pport Percenta g e
14 Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
14 99 690
15 Public support percentage for 2011 Schedule A, Part I I , line 14
15 97 180 %
16a 331/ 3%support test -2012. I f the organization did not check the box on line 13, and line 14 is 33 1/ 3% or more, check this box
and stop here . The organization q ualifies as a publicly supported organization
b 331/ 3%support test -2011. I f 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 q ualifies as a publicly supported organization
17a 10%-facts-and -circumstances test -2012. I f 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 I V how the organization meets the " facts-and-circumstances" test The organization q ualifies as a publicly supported
organization
b 10%-facts-and-circumstances test-2011. I f 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 I V how the organization meets the " facts-and-circumstances" test The organization q ualifies as a publicly
supported organization
18 Private foundation . I f the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
Schedule A (Form 990 or 990-EZ) 2012
IMMITMSupport Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under
Part II. If the organization fails to qualify under the tests listed below, please complete Part II. )
Section A . Public Support
Calendar year ( or fiscal year beginning
(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
in) 11111
1 G ifts, grants, contributions, and
membership fees received (Do not
include any "unusual grants ")
2 G ross receipts from admissions,
merchandise sold or services
performed, or facilities furnished in
any activity that is related to the
organization's tax-exempt
purpose
3 G ross 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 1 through 5
7a Amounts included on lines 1, 2,
and 3 received from disqualified
persons
b Amounts included on lines 2 and 3
received from other than
disqualified persons that exceed
the greater of$5,000 or 1% of the
amount on line 13 for the year
c Add lines 7a and 7b
8 Public support (Subtract line 7c
from line 6 )
Section B . Total Suuuort
Calendar year ( or fiscal year beginning
(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
in) ^
9 Amounts from line 6
10a G ross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar
sources
b Unrelated business taxable
income (less section 511 taxes)
from businesses acquired after
June 30, 1975
c Add lines 10a and 10b
11 Net income from unrelated
business activities not included
in line 10b, whether or not the
business is regularly carried on
12 Other income Do not include
gain or loss from the sale of
capital assets (Explain in Part
IV )
13 Total support . (Add lines 9, 1Oc,
11, and 12 )
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here
Section C. Computation of Public Support Percentage
15 Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
15
16 Public support percentage from 2011 Schedule A, Part III, line 15
16
Section D. Com putation of Investment Income Percenta g e
17 Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) 17
18 Investment income percentage from 2011 Schedule A , Part III, line 17 18
19a 331/ 3%support tests-2012. If the organization did not check the box on line 14 , and line 15 is more than 33 1/ 3%, and line 17 is not
more than 33 1/ 3%, check this box and stop here . The organization qualifies as a publicly supported organization
lk'F-
b 331/ 3%support tests-2011 . If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/ 3 % and line 18
is not more than 33 1/ 3%, check this box and stop here . The organization qualifies as a publicly supported organization
lk'F-
20 Private foundation . If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10;
Part II, line 17a or 17b; and Part III, line 12. Als o complete this part for any additional information. (See
ins tructions ).
Facts And Circums tances Tes t
Explanation
SCHEDULE C
Po l itic al Camp aign and Lo bbying Ac tiv ities
OMBNo 1545- 0047
(Fo rm 990 o r 990- EZ)
Fo r Organizatio ns Exemp t Fro m Inc o me Tax Under sec tio n 501(c ) and sec tio n 527
2012
Dep artment o f th e Treasu ry
1-
Co mp l ete if th e o rganizatio n is desc ribed bel o w. 0- Attac h to Fo rm 990 o r Fo rm 990- EZ.
Internal Rev enu e Serv ic e
0- See sep arate instru c tio ns. Op en
I Insp ec tio n
If th e o rganizatio n answered " Yes" to Fo rm 990, Part IV , Line 3, o r Fo rm 990- EZ, Part V , l ine 46 ( Po l itic al Camp aign Ac tiv ities), th en
Sec tio n 501(c )(3) o rganizatio ns Co mp l ete Parts I- A and B Do no t c o mp l ete Part I- C
Sec tio n 501(c ) (o th er th an sec tio n 501(c )(3)) o rganizatio ns Co mp l ete Parts I- A and Cbel o w Do no t c o mp l ete Part I- B
Sec tio n 527 o rganizatio ns Co mp l ete Part I- A o nl y
If th e o rganizatio n answered " Yes" to Fo rm 990, Part IV , Line 4, o r Fo rm 990- EZ , Part V I, l ine 47 ( Lo bbying Ac tiv ities), th en
Sec tio n 501(c )(3) o rganizatio ns th at h av e fil ed Fo rm 5768 (el ec tio n u nder sec tio n 501(h )) Co mp l ete Part II- A Do no t c o mp l ete Part II- B
Sec tio n 501(c )(3) o rganizatio ns th at h av e NOTfil ed Fo rm 5768 (el ec tio n u nder sec tio n 501(h )) Co mp l ete Part II- B Do no t c o mp l ete Part II- A
If th e o rganizatio n answered " Yes" to Fo rm 990, Part IV , Line 5 ( Pro xy Tax) o r Fo rm 990- EZ , Part V , l ine 35c ( Pro xy Tax), th en
* Sec tio n 501(c )(4), (5), o r (6) o rganizatio ns Co mp l ete Part III
Name o f th e o rganizatio n Emp l o yer identific atio n nu mber
AND REFUGEE RIGHTS
36- 3783551
Co mp l ete if th e o rganizatio n is exemp t u nder sec tio n 501(c ) o r is a sec tio n 527 o rganizatio n.
1 Pro v ide a desc rip tio n o f th e o rganizatio n's direc t and indirec t p o l itic al c amp aign ac tiv ities in Part IV
2 Po l itic al exp enditu res 0- $
3 V o l u nteer h o u rs
Co mp l ete if th e o rganizatio n is exemp t u nder sec tio n 501(c )(3).
1 Enter th e amo u nt o f any exc ise tax inc u rred by th e o rganizatio n u nder sec tio n 4955 0- $
2 Enter th e amo u nt o f any exc ise tax inc u rred by o rganizatio n managers u nder sec tio n 4955 0- $
3 If th e o rganizatio n inc u rred a sec tio n 4955 tax, did it fil e Fo rm 4720 fo r th is year? fl Yes fl No
4a Was a c o rrec tio n made? fl Yes fl No
b If " Yes, " desc ribe in Part IV
rMWINT-Co mp l ete if th e o rganizatio n is exemp t u nder sec tio n 501(c ), exc ep t sec tio n 501( c )(3).
1 Enter th e amo u nt direc tl y exp ended by th e fil ing o rganizatio n fo r sec tio n 527 exemp t fu nc tio n ac tiv ities 0- $
2 Enter th e amo u nt o f th e fil ing o rganizatio n's fu nds c o ntribu ted to o th er o rganizatio ns fo r sec tio n 527
exemp t fu nc tio n ac tiv ities 0- $
3 To tal exemp t fu nc tio n exp enditu res Add l ines 1 and 2 Enter h ere and o n Fo rm 1120- POL, l ine 17b 0- $
4 Did th e fil ing o rganizatio n fil e Fo rm 1120- POL fo r th is year? fl Yes fl No
5 Enter th e names, addresses and emp l o yer identific atio n nu mber (EIN) o f al l sec tio n 527 p o l itic al o rganizatio ns to wh ic h th e fil ing
o rganizatio n made p ayments Fo r eac h o rganizatio n l isted, enter th e amo u nt p aid fro m th e fil ing o rganizatio n's fu nds Al so enter th e
amo u nt o f p o l itic al c o ntribu tio ns rec eiv ed th at were p ro mp tl y and direc tl y del iv ered to a sep arate p o l itic al o rganizatio n, su c h as a
sep arate segregated fu nd o r a p o l itic al ac tio n c o mmittee (PAC) If additio nal sp ac e is needed, p ro v ide info rmatio n in Part IV
(a) Name (b) Address ( c ) EIN (d ) Amo u nt p aid fro m
fil ing o rganizatio n's
fu nds If no ne, enter - 0-
(e) Amo u nt o f p o l itic al
c o ntribu tio ns rec eiv ed
and p ro mp tl y and
direc tl y del iv ered to a
sep arate p o l itic al
o rganizatio n If no ne,
enter - 0-
i- o r rap erwo rK rteau c tio n Ac t No tic e, see th e instru c tio ns To r c o rm 99U o r yyu - tc .
Cat No 50084S Sc h edu l e C ( Fo rm 990 o r 990- EZ) 2012
Schedule C (Form 990 or 990-EZ) 2012 Page 2
Complete i f the organi zati on i s exempt under s ecti on 501(c)(3) and f i led Form 5768 (electi on
under s ecti on 501(h)).
A Check - (- i f the f i li ng organi zati on belongs to an af f i li ated group (and li s t i n Part IV each af f i li ated group member's name, addres s , EIN,
expens es , and s hare of exces s lobbyi ng expendi tures )
B Check - (- i f the f i li ng organi zati on checked box A and "li mi ted control" provi s i ons apply
Li mi ts on Lobbyi ng Expendi tures
(a) Fi li ng (b) Af f i li ated
(The term "expendi tures " means amounts pai d or i ncurred .)
organi zati on's group
totals totals
la Total lobbyi ng expendi tures to i nf luence publi c opi ni on (gras s roots lobbyi ng)
b Total lobbyi ng expendi tures to i nf luence a legi s lati ve body (di rect lobbyi ng)
c Total lobbyi ng expendi tures (add li nes la and 1b)
d Other exempt purpos e expendi tures
e Total exempt purpos e expendi tures (add li nes 1c and 1d)
f Lobbyi ng nontaxable amount Enter the amount f rom the f ollowi ng table i n both
columns
If the amount on li ne le, column ( a) or (b ) i s : The lobbyi ng nontaxable amount i s :
Not over $500,000 20% of the amount on li ne le
Over $500,000 but not over $1,000,000 $100,000 plus 15% of the exces s over $500,000
Over $1,000,000 but not over $1,500,000 $175,000 plus 10% of the exces s over $1,000,000
Over $1,500,000 but not over $17,000,000 $225,000 plus 5% of the exces s over $1,500,000
Over $17,000,000 $1,000,000
g Gras s roots nontaxable amount (enter 25% of li ne 1f )
h Subtract li ne 1g f rom li ne la If zero or les s , enter-0-
i Subtract li ne 1f f rom li ne 1c If zero or les s , enter-0-
] If there i s an amount otherthan zero on ei ther li ne 1h or li ne li , di d the organi zati on f i le Form 4720 reporti ng
s ecti on 4911 tax f or thi s year?
27,212
29,810
57,022
9,463,909
9,520,931
626,047
156,512
0
0
F- Yes F- No
4-Year Averagi ng Peri od Under Secti on 501(h)
(Some organi zati ons that made a s ecti on 501(h) electi on do not have to complete all of the f i ve
columns below. See the i ns tructi ons f or li nes 2a through 2f on page 4.)
Lobbvi na Exoendi tures Duri ng 4-Year Averaai na Peri od
Calendar year (or f i s cal year
(a) 2009 (b) 2010 ( c) 2011 (d) 2012 (e) Total
begi nni ng i n)
2a Lobbyi ng nontaxable amount 542,499 527,704 511,838 626,047 2,208,088
b Lobbyi ng cei li ng amount
(150% of li ne 2a, column (e))
3,312,132
c Total lobbyi ng expendi tures 114,960 73 ,616 68,626 57,022 314,224
d Gras s roots nontaxable amount 135,625 131,926 127,960 156,512 552,023
e Gras s roots cei li ng amount
828,035
150% of li ne 2d column a
f Gras s roots lobbyi ng expendi tures 54,937 27,040 24,540 27,212 133,729
Schedule C (Form 990 or 990-EZ) 2012
Schedule C (Form 990 or 990-EZ) 2012
Pa g e 3
Complete i f the org ani zati on i s exempt under s ecti on 501(c)(3) and has NOT
f i led Form 5768 ( electi on under s ecti on 501(h)).
For each "Yes " res pons e to li nes la throug h li below, provi de i n Part IV a detai led des cri pti on of the lobbyi ng
(a)
(b)
acti vi ty. Yes No Amount
1 Duri ng the year, di d the f i li ng org ani zati on attempt to i nf luence f orei g n, nati onal, s tate or local
leg i s lati on, i ncludi ng any attempt to i nf luence publi c opi ni on on a leg i s lati ve matter or ref erendum,
throug h the us e of
a Volunteers ?
b Pai d s taf f or manag ement (i nclude compens ati on i n expens es reported on li nes 1c throug h 1i )?
c Medi a adverti s ements ?
d Mai li ng s to members , leg i s lators , or the publi c?
e Publi cati ons , or publi s hed or broadcas t s tatements ?
f Grants to other org ani zati ons f or lobbyi ng purpos es ?
g Di rect contact wi th leg i s lators , thei r s taf f s , g overnment of f i ci als , or a leg i s lati ve body?
h R alli es , demons trati ons , s emi nars , conventi ons , s peeches , lectures , or any s i mi lar means ?
i Other acti vi ti es ?
j Total Add li nes 1c throug h 1i
2a Di d the acti vi ti es i n li ne 1 caus e the org ani zati on to be not des cri bed i n s ecti on 501(c)(3)?
b If "Yes ," enter the amount of any tax i ncurred under s ecti on 4912
c If "Yes ," enter the amount of any tax i ncurred by org ani zati on manag ers under s ecti on 4912
d If the f i li ng org ani zati on i ncurred a s ecti on 4912 tax, di d i t f i le Form 4720 f or thi s year?
Complete i f the org ani zati on i s exempt under s ecti on 501(c)(4), s ecti on 501(c)(5), or s ecti on
501(c)(6).
1 Were s ubs tanti ally all (90% or more) dues recei ved nondeducti ble by members ?
2 Di d the org ani zati on make only i n-hous e lobbyi ng expendi tures of $2,000 or les s ?
3 Di d the org ani zati on ag ree to carry over lobbyi ng and poli ti cal expendi tures f rom the pri or year?
No
Complete i f the org ani zati on i s exempt under s ecti on 501(c)(4), s ecti on 501(c)(5), or s ecti on
501(c)( 6) and i f ei ther (a) BOTH Part III-A, li nes 1 and 2, are ans wered "No " OR (b) Part III-A,
li ne 3, i s ans wered "Yes ."
1 Dues , as s es s ments and s i mi lar amounts f rom members 1
2 Secti on 162(e) nondeducti ble lobbyi ng and poli ti cal expendi tures (do not i nclude amounts of poli ti cal
expens es f or whi ch the s ecti on 527(f ) tax was pai d).
a Current year
2a
b Carryover f rom las t year 2b
c Total 2c
3 Ag g reg ate amount reported i n s ecti on 6033(e)(1 )(A) noti ces of nondeducti ble s ecti on 162(e) dues 3
4 If noti ces were s ent and the amount on li ne 2c exceeds the amount on li ne 3, what porti on of the exces s
does the org ani zati on ag ree to carryover to the reas onable es ti mate of nondeducti ble lobbyi ng and
poli ti cal expendi ture next year? 4
5 Taxable amount of lobbyi ng and poli ti cal expendi tures (s ee i ns tructi ons ) 5
Supplemental Inf ormati on
Complete thi s part to provi de the des cri pti ons requi red f or Part I-A, li ne 1, Part I-B, li ne 4, Part I-C, li ne 5, Part II-A (af f i li ated g roup li s t),
Part II-A. li ne 2. and Part II-B. li ne 1 Als o. comDlete thi s Dart f or any addi ti onal i nf ormati on
Identi f i er
I
R eturn R ef erence Explanati on
Schedule C (Form 990 or 990EZ) 2012
lefile GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93493062009154
SCHEDULE D
(Form 990)
Department of th e Treasu ry
Internal Revenu e Servic e
Name of th e organization
OMBNo 1545- 0047
2012
Employ er identific ation nu mber
AND REFUGEE RIGHTS
36- 3783551
Organizations Maintaining Donor Advised Fu nds or Oth er Similar Fu nds or Ac c ou nts. Complete if th e
or g anization answered "Yes" to Form 990, Part IV , line 6.
(a) Donor advised fu nds (b) Fu nds and oth er ac c ou nts
1 Total nu mber at end of y ear
2 Aggregate c ontribu tions to (du ring y ear)
3 Aggregate grants from ( du ring y ear)
4 Aggregate valu e at end of y ear
5 Did th e organization inform all donors and donor advisors in writing th at th e assets h eld in donor advised
fu nds are th e organization ' s property , su bjec t to th e organization ' s exc lu sive legal c ontrol? F Yes INo
6 Did th e organization inform all grantees, donors, and donor advisors in writing th at grant fu nds c an be
u sed only for c h aritable pu rposes and not for th e benefit of th e donor or donor advisor, or for any oth er pu rpose
c onferring impermissible private benefit?
fl Yes fl No
MRSTI-Conservation Easements. Complete if th e organization answered "Yes" to Form 990, Part IV, line 7.
1 Pu rpose ( s) of c onservation easements h eld by th e organization ( c h ec k all th at apply )
1 Preservation of land for pu blic u se (e g , rec reation or edu c ation ) 1 Preservation of an h istoric ally important land area
1 Protec tion of natu ral h abitat 1 Preservation of a c ertified h istoric stru c tu re
fl Preservation of open spac e
2 Complete lines 2a th rou gh 2d if th e organization h eld a qu alified c onservation c ontribu tion in th e form of a c onservation
easement on th e last day of th e tax y ear
a Total nu mber of c onservation easements
b Total ac reage restric ted by c onservation easements
c Nu mber of c onservation easements on a c ertified h istoric stru c tu re inc lu ded in (a)
d Nu mber of c onservation easements inc lu ded in (c ) ac qu ired after 8/17/06, and not on a
h istoric stru c tu re listed in th e National Register
Held at th e End of th e Year
2a
2b
2c
2d
3 N u mber of c onservation easements modified, transferred, released, extingu ish ed , or terminated by th e organization du ring
th e tax y ear 0-
4 N u mber of states wh ere property su bjec t to c onservation easement is loc ated 0-
5 Does th e organization h ave a written polic y regarding th e periodic monitoring , inspec tion , h andling of violations, and
enforc ement of th e c onservation easements it h olds? fl Yes fl No
6 Staff and volu nteer h ou rs devoted to monitoring , inspec ting , and enforc ing c onservation easements du ring th e y ear
0-
7 Amou nt of expenses inc u rred in monitoring , inspec ting , and enforc ing c onservation easements du ring th e y ear
0- $
8 Does eac h c onservation easement reported on line 2(d) above satisfy th e requ irements of sec tion 170(h ) (4) (B) (i)
and sec tion 170(h ) (4) (B) (ii) ? F Yes 1No
9 In Part XIII, desc ribe h ow th e organization reports c onservation easements in its revenu e and expense statement, and
balanc e sh eet, and inc lu de, if applic able, th e text of th e footnote to th e organization' s financ ial statements th at desc ribes
th e organization' s ac c ou nting for c onservation easements
Organizations Maintaining Collec tions of Art, Historic al Treasu res, or Oth er Similar Assets.
Complete if th e oraanization answered "Yes" to Form 990. Part IV. line 8.
la
If th e organization elec ted, as permitted u nder SFAS 116 (ASC 958) , not to report in its revenu e statement and balanc e sh eet
works of art, h istoric al treasu res, or oth er similar assets h eld for pu blic exh ibition, edu c ation, or researc h in fu rth eranc e of pu blic
servic e, provide, in Part XIII, th e text of th e footnote to its financ ial statements th at desc ribes th ese items
b If th e organization elec ted, as permitted u nder SFAS 116 (ASC 958) , to report in its revenu e statement and balanc e sh eet
works of art, h istoric al treasu res, or oth er similar assets h eld for pu blic exh ibition, edu c ation, or researc h in fu rth eranc e of pu blic
servic e, provide th e following amou nts relating to th ese items
(i) Revenu es inc lu ded in Form 990, Part VIII, line 1 $
(ii) Assets inc lu ded in Form 990, Part X $
2 If th e organization rec eived or h eld works of art, h istoric al treasu res, or oth er similar assets for financ ial gain, provide th e
following amou nts requ ired to be reported u nder SFAS 116 (ASC 958) relating to th ese items
a Revenu es inc lu ded in Form 990, Part VIII, line 1 $
b Assets inc lu ded in Form 990, Part X $
For Paperwork Redu c tion Ac t Notic e, see th e Instru c tions for Form 990. Cat No 52283D Sc h edu le D ( Form 990) 2012
Su pplemental Financ ial Statements
0- Complete if th e organization answered "Yes, " to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c , 11d, 11e, 11f, 12a, or 12b
0- Attac h to Form 990. 0- See separate instru c tions.
Schedule D (Form 990) 2012 Page 2
r:FTnFW Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3 Using the organization' s acq uisition, accession, and other records, check any of the follow ing that are a significant use of its
collection items (check all that apply)
a F_ Public exhibition
d fl Loan or exchange programs
b 1 Scholarly research e (- Other
c F Preservation for future generations
4 Provide a description of the organization' s collections and explain how they further the organization' s exempt purpose in
Part XIII
5 During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization' s collection? 1 Yes 1 No
Escrow and Custodial Arrangements. Complete if the organization answ ered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
la Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? 1 Yes F No
b If "Yes, " explain the arrangement in Part XIII and complete the follow ing table
c Beginning balance 1c
d Additions during the year ld
e Distributions during the year le
f Ending balance if
A mount
2a Did the organization include an amount on Form 990, Part X, line 21? fl Yes fl No
b If"Yes, " explain the arrangement in Part XIII Check here if the explanation has been provided in Part XI II . . . . . . . . F
MWAF-Endow ment Funds. Com p lete If the org anization answ ered "Yes" to Form 990, Part IV , line 10.
la Beginning of year balance .
b Contributions
c Net investment earnings, gains, and losses
d Grants or scholarships
e Other expenditures for facilities
and programs
f Administrative expenses .
g End of year balance
(a)Current year (b)Prior year b (c)Tw o years back (d)Three years back (e)Four years back
2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as
a Board designated or q uasi-endow ment 0-
b Permanent endow ment 0-
c Temporarily restricted endow ment 0-
The percentages in lines 2a, 2b, and 2c should eq ual 100%
3a Are there endow ment funds not in the possession of the organization that are held and administered for the
organization by Yes No
(i) unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . 3a(i)
(ii) related organizations . . . . . . . . . . . . . . . . . . . . . .
3a(ii)
b If "Yes" to 3a(ii), are the related organizations listed as req uired on Schedule R? . . I 3b
4 Describe in Part XIII the intended uses of the organization' s endow ment funds
Land . Buildings . and Eauiument. See Form 990. Part X. line 10.
Description of property ( a) Cost or other
basis ( investment)
(b)Cost or other
basis (other)
( c) Accumulated
depreciation
( d) Book value
la Land
b Buildings
c Leasehold improvements . .
d Eq uipment 132, 851 113, 591 19, 260
e Other
Total . Add lines 1a through 1 e (Column (d) must eq ual Form 990, Part X, column (B), line 10(c). ) . 19, 260
Schedule D (Form 990) 2012
Investments-Other Securities. See Form 990 , Part X, line 12.
(a) Description of security or category (b)Book value (c) Method of valuation
(including name of security) Cost or end-of -year market value
(1 )Financial derivatives
(2)Closely-held equity interests
Other
T otal . (Column (b) mustequal Form 990, Part X, col (B) line 12 )
0. 1
I VIIIIJOIr Investments-Pro g ram Related . See Form 990, Part X, line 13.
(a) Description of investment type
I I
(b) Book value (c) Method of valuation
Cost or end-of -year market value
T otal . (Column (b) mustequal Form 990, Part X, col (8 ) line 13 )
0. 1
Other Assets. See Form 990, Part X line 15.
(a) DescriDtion (b) Book value
(1) DUE FROM RELAT ED PART Y 1 28 4. 644
T otal . (Column (b) mustequal Form 990, Part X, co/ . (8 ) line 15. )
Other Liabilities. See Form 990, Part X line 25.
1 (a) Description of liability (b) Book value
Federal income taxes
See Additional Data T able
28 4. 644
T otal . (Column ( b) mustequal Form 990, Part X, col (8 ) line 25) p.
1
2. Fin 48 (A SC 740) Footnote In Part XIII, provide the text of the f ootnote to the organization' s f inancial statements that reports the
organization' s liability f or uncertain tax positions under FIN 48 (A SC 740 ) Check here if the text of the f ootnote has been provided in
Part XIII F
- Reconciliation of Revenue p er Audited Financial Statements With Revenue p er Return 171174T
1 Total revenue, gains, and other support per audited financial statements . 1 10,039,033
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12
a Net unrealized gains on investments . 2a
b Donated services and use of facilities . 2b
c Recoveries of prior year grants 2c
d Other (Describe in Part XIII ) . . . . . . . . . . . 2d 333,290
e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . 2e 333,290
3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . 3 9,705,743
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a
b Other (Describe in Part XIII ) . . . . . . . . . . 4b
c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . 4c 0
5 Total revenue Add lines 3 and 4c. (This must equal Form 990, Part I, line 12 ) . . . . .
-
5 9,705,743
of Ex p enses p er Audited Financial Statements With Ex p enses p er Return 191M. O ff
1 Total expenses and losses per audited financial statements 1 9,929,626
2 Amounts included on line 1 but not on Form 990, Part IX, line 25
a Donated services and use of facilities . 2a
b Prior year adjustments 2b
c Other losses . . . . . . . . . . . . . . . 2c
d Other (Describe in Part XIII . . . . . . . . . . . 2d 408,695
e Add lines 2a through 2d . . . . . . . . . . . . . . . . . . . . . 2e 408,695
3 Subtract line 2e from line 1 . . . . . . . . . . . . . . . . . . . . 3 9,520,931
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a
b Other (Describe in Part XIII ) . . . . . . . . . . . 4b
c Add lines 4a and 4b . . . . . . . . . . . . . . . . . . . . . . 4c 0
5 Total expenses Add lines 3 and 4c. (This must equal Form 990, Part I, line 18 ) . . . . . 5 9,520,931
OTIT. "MSu pp lemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9, Part III, lines la and 4, Part IV, lines lb 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
Identifier Return Reference Explanation
DESCRIPTION OF UNCERTAIN PART X, LINE 2 IN A LETTER DATED MAY 21, 1996, THE INTERNAL
TAX POSITIONS UNDER FIN 48 REVENUE SERVICE GRANTED THE COALITION AN
EXEMPTION FROMFEDERAL INCOME TAX UNDER SECTION
501(C)(3)OFTHE INTERNAL REVENUE CODE THE ACTION
HAS BEEN DETERMINED TO BE EXEMPT FROMINCOME
TAXES UNDER SECTION 501(C)(4) OFTHE INTERNAL
REVENUE CODE PURSUANTTO A LETTER DATED JUNE 3,
2008 THE COALITION AND THE ACTION FOLLOW
AUTHORITATIVE GUIDANCE ISSUED BY THE FINANCIAL
ACCOUNTING STANDARDS BOARD (FASB)THAT
CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN
INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL
STATEMENTS AND PRESCRIBES A RECOGNITION
THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE
SUSTAINED UPON EXAMINATION MEASUREMENT OFTHE
TAX UNCERTAINTY OCCURS IF THE RECOGNITION
THRESHOLD HAS NOT BEEN MET THIS GUIDANCE ALSO
ADDRESSES DERECOGNITION, CLASSIFICATION,
INTEREST AND PENALTIES, DISCLOSURE, AND
TRANSITION THE COALITION AND THE ACTION
CONDUCTS BUSINESS SOLELY IN THE U S AND, AS A
RESULT, FILES INCOME TAX AND INFORMATION RETURNS
FOR U S AND ILLINOIS IN THE NORMAL COURSE OF
BUSINESS, THE COALITION IS SUBJECT TO EXAMINATION
BY TAXING AUTHORITIES THE COALITION AND THE
ACTION'S TAX AND INFORMATION RETURNS FOR YEARS
SUBSEQUENTTO FISCAL 2009 ARE OPEN, BY STATUTE,
FOR REVIEW BY AUTHORITIES HOWEVER, AT PRESENT,
THERE ARE NO ONGOING INCOME TAX AUDITS OR
UNRESOLVED DISPUTES WITH THE VARIOUS TAX
AUTHORITIES THAT THE COALITION AND THE ACTION
CURRENTLY FILES OR HAS FILED WITH
PART XI, LINE 2D - OTHER SPECIAL EVENT EXPENSE 42,319 ILLINOIS IMMIGRANT
ADJUSTMENTS ACTION REVENUE - CONSOLIDATED ENTITY 290,971
PART XII, LINE 2D - OTHER SPECIAL EVENT EXPENSE 42,319 ILLINOIS IMMIGRANT
ADJUSTMENTS ACTION EXPENSES - CONSOLIDATED ENTITY 366,376
SCHEDULEG
SU l emental Information Re ardin
OMBNo 1545- 0047
(Form 990 or 990- EZ) pp g g
Fundraising or Gaming Ac tiv ities
Compl ete if the organization answered "Yes" to Forth 990, Part IV , l ines 17, 18, or 19, or if the organization entered
more than $15,000 on Form 990- EZ, l ine 6a. Form 990- EZ fil ers are not required to c ompl ete this part.
PrAttac h to Form 990 or Forth 990- EZ. PrSee separate instruc tions.
Internal Rev enue Serv ic e
2012
Name of the organization Empl oyer identific ation number
AND REFUGEE RIGHTS 36- 3783551
Fundraising Ac tiv ities. Compl ete if the organization answered "Yes" to Form 990, Part IV , l ine 17.
Indic ate whether the organization raised funds through any of the fol l owing ac tiv ities Chec k al l that appl y
a 1 Mail sol ic itations e 1 Sol ic itation of non- gov ernment grants
b 1 Internet and email sol ic itations f 1 Sol ic itation of gov ernment grants
c 1 Phone sol ic itations g 1 Spec ial fundraising ev ents
d 1 In- person sol ic itations
2a Did the organization hav e a written or oral agreement with any indiv idual (inc l uding offic ers, direc tors, trustees
or key empl oyees l isted in Form 990, Part V II) or entity in c onnec tion with professional fundraising serv ic es?
1'
Yes 1! No
b If "Yes," l ist the ten highest paid indiv idual s or entities (fundraisers) pursuant to agreements under whic h the fundraiser is
to be c ompensated at l east $5,000 by the organization
(i) Name and address of
indiv idual
or entity (fundraiser)
(ii) Ac tiv ity (iii) Did
fundraiser hav e
c ustody or
c ontrol of
c ontributions?
(iv ) Gross rec eipts
from ac tiv ity
(v ) Amount paid to
(or retained by)
fundraiser l isted in
c ol (i)
(v i) Amount paid to
(or retained by)
organization
Yes No
Total . . . . . . . . . . . . . . . .
3 List al l states in whic h the organization is registered or l ic ensed to sol ic it funds or has been notified it is exempt from registration or
l ic ensing
For Paperwork Reduc tion Ac t Notic e, see the Instruc tions for Form 990or 990- EZ . Cat No 50083H Sc hedul e G (Form 990 or 990- EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012 Page 2
Fundraising Events . Complete if the organization answered "Yes" to Form 990, Part I V , line 18 , or reported
more than $15,000 of f undraising event contrib utions and gross income on Form 990-EZ, lines 1 and 6 b . L ist
events with gross receipts greater than $5,000.
(a) Event #1 (b ) Event #2 (c) Other events (d) Total events
(add col (a) through
I CI RR ANNUAL col (c))
GAL A (event type) (total numb er)
(event type)
co
1 Gross receipts
112,750 112,750
75
T 2 L ess Contrib utions
105,6 50 105,6 50
3 Gross income (line 1
minus line 2 ) 7,100
4 Cash prizes
5 Noncash prizes
u7
7,100
6 Rent/f acility costs 6 ,120 6 ,120
7 Food and b everages 13,471 13,471
8 Entertainment 3,000 3,000
9 Other direct expenses 19,728 19,728
10 Direct expense summary Add lines 4 through 9 in column (d) . ^
(42,319)
11 Net income summary Comb ine line 3, column (d), and line 10 . . . . . . . . . . 111k .
-35,219
Gaming . Complete if the organization answered "Yes" to Form 990, Part I V , line 19, or reported more than
$15,000 on Form 990-EZ, line 6 a.
(a) Bingo (b ) Pull tab s/I nstant (c) Other gaming (d) Total gaming (add
b ingo/progressive b ingo col (a) through col
c o
(c))
1 Gross revenue .
2 Cash prizes
u)
C
3 Non-cash prizes
L I J
4 Rent/f acility costs .
5 Other direct expenses
F Yes
6 V olunteer lab or
f l
No
F
Yes-------------------
F Yes-
f l No F No
7 Direct expense summary Add lines 2 through 5 in column (d) . . . . . . . . . . . ^
8 Net gaming income summary Comb ine lines 1 and 7 in column (d) . . . . . . . . . . ^
9 Enter the state (s) in which the organization operates gaming activities
a I s the organization licensed to operate gaming activities in each of these states? . . . . . . . . . . . . . Yes r No
b I f "No," explain
------------- ------------------------- ------------------------- ------------------------- ------------------------ ------------------------- ------------------------- ------------------------- -------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
10a Were any of the organization ' s gaming licenses revok ed, suspended or terminated during the tax year? . . . . . F Yes F No
b I f "Yes," explain
Schedule G (Form 990 or 990-EZ) 2012
Does the organization operate gaming activities with nonmembers? . . . . . . . . . . . . . . . . .
. Yes r- No
12 Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . . . . . . . . . . .
. Yes r- No
13 Indicate the percentage of gaming activity operated in
a The organization ' s facility 13a
b An outside facility 13b
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 contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
r- Yes r- No
b If "Yes," enter the amount of gaming revenue received by the organization ^$ and the
amount 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 llik^
------------ ----------------------- ---------------------- ----------------------- ----------------------- ----------------------- ---------------------- -
Gaming manager compensation ^$ _
--------------------------------------------
Description of services provided
---------- ------------------ ------------------ ------------------ ------------------- ------------------ ------------------ ------------------ ----------
r- Director/officer Employee Independent contractor
17 Mandatory distributions
a Is the organization required understate law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
r-Yes r-No
b Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization' s own exempt activities during the tax year $
Supplemental Information . Complete this part to provide the explanations required by P art I, line 2b,
columns (iii) and (v), and P art III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this
part to provide any additional information (see instructions).
I
Identifier Return Reference
I
Explanation
P age 3
11
efile GRAPHIC print - DO NOT PROCESS I As Filed Data - I DLN: 93493062009154
Schedule I
OMBNo 1545- 0047
(Form 990) Grants and Other Assistance to Org aniz ations,
2012 Governments and Individuals in the United States
Complete if the org aniz ation answered " Yes, " to Form 990, Part IV, line 21 or 22.
l Attach to Form 990
Name of the org aniz ation Employer identification number
AND REFUGEE RIGHTS
136- 3783551
JE^ll General Information on Grants and Assistance
1 Does the org aniz ation maintain records to substantiate the amount of the g rants or assistance, the g rantees' elig ibility for the g rants or assistance, and
the selection criteria used to award the g rants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F Yes 1No
2 Describe in Part IV the org aniz ation's procedures for monitoring the use of g rant funds in the U nited States
Grants and Other Assistance to Governments and Org aniz ations in the United States. Complete if the org aniz ation answered " Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5, 000. Part II can be duplicated if additional space is needed.
(a) Name and address of (b) EIN (c) IRC Code (d) Amount of cash (e) Amount of non- (f) Method of (g ) Description of (h) Purpose of g rant
org aniz ation section g rant cash valuation non- cash assistance or assistance
or g overnment if applicable assistance (book, FMV,
appraisal,
other)
See Additional Data Table
2 Entertotal number of section 501(c)(3) and g overnment org aniz ations listed in the line 1 table . ^ 63
3 Enter total number of other org aniz ations listed in the line 1 table . . 0
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat No 50055P Schedule I (Form 990) 2012
Schedule I (Form 990) 2012 Pa g e 2
Grants and Other Assistance to I ndividuals in the United States. Complete if the org anization answered "Yes" to Form 990, Part I V, line 22.
Part I I I can be duplicated if additional space is needed.
(a)Type of g rant or assistance (b)N umber of (c)Amount of (d)Amount of (e)Method of valuation (f )Description of non-cash assistance
recipients cash g rant non-cash assistance (book,
FMV, appraisal, other)
I dentif ier Return Ref erence Explanation
PROCEDURE FOR PART I , LI NE 2 SCHEDULE I , PART I , LI NE 2 I CI RR MAI NTAI NS FI LES OF CONTRACTS, WORKPLANS, BUDGETS, MONTHLY
MONI TORI NG GRANTS FI NANCI AL REPORTS AND PAYMENTS (AUDI TED) I N ADDI TI ON I CI RR SUBMI TS QUARTERLY FI NANCI AL AND
I N THE U S PROGRAM REPORTS TO THE STATE
Schedule I (Form 990) 2012
Complete this Dart to provide the inf ormation required in Part I . line 2. Part I I I . column (b). and any other additional inf ormation
Additional Data
Software ID:
Software Version:
EIN: 36 -3783551
AND REFUGEE RIGHTS
Form 990,Schedule I, Part II, Grants and Other Assistance to Governments and Organizations in the United States
Return to Form
(a) Name and address of (b) EIN (c) IRC Code section (d) Amount of cash (e) Amount of non- (f) Method of (g) Description of (h) Purpose of grant
organization if applicable grant cash valuation non-cash assistance or assistance
or government assistance (book, FMV, appraisal,
other)
AFIRE5051 MAIN ST 31-1815061 501(C)(3) 35,000 REFUGEE AND
SKOKIE,IL 60077 IMMIGRANT
A SSISTANCE
ARAB AMERICAN ACTION 36-4034958 501(C)(3) 124,664 REFUGEE AND
NETWORK3148 S 63RD ST IMMIGRANT
CHICAGO,IL 60629 A SSISTANCE
Form 990,Schedule I , Part I I , Grants and Other Assistance to Governments and Organizations in the United States
(a) Name and address of (b) EI N (c) I RC Code section (d) Amount of cash (e) Amount of non- (f ) Method of (g) Description of (h) Purpose of grant
other)
ARAB AMERI CAN FAMI LY 60-0002593 501(C)(3) 80,500 REFUGEE AND
SERVI CES9044 S OCTAVI A I MMI GRANT
BRI DGEVI EW,I L 60455 A SSI STANCE
ASSOCI ATI ON HOUSE 36-2166961 501(C)(3) 23,779 REFUGEE AND
1116 N KEDZI E AVE I MMI GRANT
CHI CAGO,I L 60651 A SSI STANCE
other)
BRI HGTON PARK 36-4229387 501(C)(3) 28,072 REFUGEE AND
NEI GHBORHOOD COUNCI L I MMI GRANT
4477 S ARCHER AVE A SSI STANCE
CHI CAGO,I L 60632
CAMBODI AN 36-3129057 501(C)(3) 24,500 REFUGEE AND
ASSOCI ATI ON2831 W I MMI GRANT
LAWRENCE AVE A SSI STANCE
CHI CAGO,I L 60625
other)
CASA GUANAJUATO525 36-4272727 501(C)(3) 94,966 REFUGEE AND
16T ST I MMI GRANT
MOLI NE,I L 61265 A SSI STANCE
CATHOLI C CHARI TI ES OF 36-2170821 501(C)(3) 43,000 REFUGEE AND
CHI CAGO651 WLAKE ST I MMI GRANT
other)
CENTRO DE I NFORMACI ON 36-2776988 501(C)(3) 124,525 REFUGEE AND
28 N GROVE ST I MMI GRANT
ELGI N,I L 60120 A SSI STANCE
CENTRO ROMERO6216 N 36-3517408 501(C)(3) 118,192 REFUGEE AND
CLARK ST I MMI GRANT
other)
CHI NESE AMERI CAN 36-2984043 501(C)(3) 201,996 REFUGEE AND
SERVI CE LEAGUE2141 TAN I MMI GRANT
COURT A SSI STANCE
CHI CAGO,I L 60616
CHI NESE MUTUAL AI D 36-3139799 501(C)(3) 191,975 REFUGEE AND
ASSOCI ATI ON1016 W I MMI GRANT
ARGYLE A SSI STANCE
CHI CAGO,I L 60640
other)
COALI TI ON OF AFRI CAN 32-0155847 501(C)(3) 32,612 REFUGEE AND
ARAB ASI AN EUROPEAN I MMI GRANT
AND LATI NO I MMI GRANTS A SSI STANCE
4300 N HERMI TAGE AVE
CHI CAGO,I L 60622
COALI TI ON OF LI MI TED 501(C)(3) 27,548 REFUGEE AND
ENGLI SH SPEAKI NG I MMI GRANT
ELDERLY53 WEST A SSI STANCE
JACKSON STE 1301
CHI CAGO,I L 60604
other)
COMMUNI TY HEALTH 36-3798678 501(C)(3) 46,000 REFUGEE AND
PARTNERSHI P205 W I MMI GRANT
RANDOLPH ST A SSI STANCE
CHI CAGO,I L 60606
DEVELOPI NG 36-3482705 501(C)(3) 36,479 REFUGEE AND
COMMUNI TI ES PROJECT I MMI GRANT
212 E 95TH ST A SSI STANCE
CHI CAGO,I L 60619
other)
ECI RMAC302 S BI RCH ST 37-1122770 501(C)(3) 39,732 REFUGEE AND
URBANA,I L 60801 I MMI GRANT
A SSI STANCE
ENLACE3948 WEST 26TH 36-3727669 501(C)(3) 37,893 REFUGEE AND
STREET I MMI GRANT
other)
ERI E NEI GHBORHOOD 36-0343253 501(C)(3) 216,590 REFUGEE AND
HOUSE1701 WSUPERI OR I MMI GRANT
ST A SSI STANCE
CHI CAGO,I L 60622
FAMI LY FOCUS AURORA 36-2884042 501(C)(3) 289,901 REFUGEE AND
555 BENTON ST I MMI GRANT
AURORA,I L 60505 A SSI STANCE
other)
FEDECMI 1638 S BLUE 41-2061019 501(C)(3) 68,200 REFUGEE AND
I SLAND I MMI GRANT
HACES705 YEOMAN ST 38-3725489 501(C)(3) 129,297 REFUGEE AND
WAUKEGAN,I L 60085 I MMI GRANT
SSI STANCE
other)
HAMDARD CENTER1542 W 36-3917885 501(C)(3) 41,500 REFUGEE AND
DEVON AVE I MMI GRANT
HANUL FAMI LY ALLI ANCE 36-3519498 501(C)(3) 137,774 REFUGEE AND
5008-14 N KEDZI E AVE I MMI GRANT
other)
HEALTHY ROAD MEDI A 45-5127926 501(C)(3) 18,000 REFUGEE AND
10241 WATERRI DGE CI R I MMI GRANT
SAN DI EGO,CA 92121 A SSI STANCE
HEBREWI MMI GRANT AI D 36-4310817 501(C)(3) 257,414 REFUGEE AND
SOCI ETYONE SOUTH I MMI GRANT
FRANKLI N SUI TE 411 A SSI STANCE
CHI CAGO,I L 60606
other)
HOLY FAMI LY PARI SHFR 80-0432313 501(C)(3) 53,149 REFUGEE AND
GARY GRAF CENTER450 I MMI GRANT
KELLER AVENUE A SSI STANCE
WAUKEGAN,I L 60085
I MMI GRATI ON PROJECT 43-1700482 501(C)(3) 76,694 REFUGEE AND
510 E WASHI NGTON ST I MMI GRANT
BLOOMI NGTON,I L 61702 A SSI STANCE
other)
I NDO-AMERI CAN CENTER 36-3689665 501(C)(3) 113,624 REFUGEE AND
6328 NORTH CALI FORNI A I MMI GRANT
AVE A SSI STANCE
CHI CAGO,I L 60659
I NSTI TUTO DEL 36-2937375 501(C)(3) 543,040 REFUGEE AND
PROGRESO LATI NO2570 S I MMI GRANT
BLUE I SLAND A SSI STANCE
CHI CAGO,I L 60608
other)
I NTERFAI TH LEADERSHI P 36-3766982 501(C)(3) 40,733 REFUGEE AND
PROJECT1510 S 49TH I MMI GRANT
COURT A SSI STANCE
CI CERO,I L 60804
KOREAN AMERI CAN 36-2746468 501(C)(3) 152,366 REFUGEE AND
COMMUNI TY SERVI CES I MMI GRANT
4300 N CALI FORNI A AVE A SSI STANCE
CHI CAGO,I L 60618
other)
KOREAN AMERI CAN 36-3991857 501(C)(3) 54,150 REFUGEE AND
RESOURCE &CULTURAL I MMI GRANT
CENTER5008-14 N KEDZI E A SSI STANCE
AVE
CHI CAGO,I L 60201
LATI NO ORGANI ZATI ON 36-4469997 501(C)(3) 96,850 REFUGEE AND
OF THE SOUTHWEST6507 S I MMI GRANT
KEDZI E A SSI STANCE
CHI CAGO,I L 60629
other)
LAVOZ LATI NAS412 36-2810675 501(C)(3) 59,750 REFUGEE AND
MARKET STREET I MMI GRANT
ROCKFORD,I L 61107 A SSI STANCE
LI NCOLN LAND 37-0900960 501(C)(3) 8,589 REFUGEE AND
COMMUNI TY COLLEGE I MMI GRANT
5250 SHEPHERD RD A SSI STANCE
SPRI NGFI ELD,I L 62794
other)
LOGAN SQUARE 36-2638491 501(C)(3) 323,430 REFUGEE AND
NEI GHBORHOOD I MMI GRANT
ASSOCI ATI ON2840 N A SSI STANCE
MI LWAUKEE
CHI CAGO,I L 60618
MANO A MANO6 E MAI N ST 36-4418084 501(C)(3) 112,292 REFUGEE AND
ROUND LAKE PARK,I L I MMI GRANT
60073 A SSI STANCE
other)
MUJERES LATI NAS I N 36-2877520 501(C)(3) 148,583 REFUGEE AND
ACCI ON2124 W21ST I MMI GRANT
PLACE A SSI STANCE
CHI CAGO,I L 60608
MUSLI M WOMEN 68-0489248 501(C)(3) 110,930 REFUGEE AND
RESOURCE CENTER6349 N I MMI GRANT
WESTERN AVE STE 205 A SSI STANCE
CHI CAGO,I L 60659
(a) Name and address of
organization
or government
NATI ONAL I MMI GRANT
JUSTI CE CENTER208 S
LASALLE ST 1818
CHI CAGO,I L 60604
NI LES TOWNSHI P
PROGRAMOPEN COMM
5255 MAI N STREET
SKOKI E,I L 600772160
(b) EI N (c) I RC Code section (d) Amount of cash (e) Amount of non- (f ) Method of (g) Description of (h) Purpose of grant
if applicable grant cash valuation non-cash assistance or assistance
assistance (book, FMV, appraisal,
other)
36-2934709
501(C)(3) 66,571 REFUGEE AND
I MMI GRANT
SSI STANCE
501(C)(3) 27,436 REFUGEE AND
I MMI GRANT
SSI STANCE
other)
NORTHWEST 36-3085002 501(C)(3) 37,856 REFUGEE AND
NEI GHBORHOOD I MMI GRANT
FEDERATI ON3249 N A SSI STANCE
CENTRAL AVE
CHI CAGO,I L 60641
ONE AMERI CA 501(C)(3) 25,000 REFUGEE AND
I MMI GRANT
A SSI STANCE
other)
PASO1115 N 23RD AVE 36-2717084 501(C)(3) 38,643 REFUGEE AND
MELROSE PARK,I L 60160 I MMI GRANT
A SSI STANCE
POLI SH AMERI CAN 36-2240816 501(C)(3) 279,227 REFUGEE AND
ASSOCI ATI ON3834 N I MMI GRANT
CI CERO AVE A SSI STANCE
CHI CAGO,I L 60641
other)
PAN AFRI CAN 56-2388978 501(C)(3) 23,700 REFUGEE AND
ASSOCI ATI ON6163 N I MMI GRANT
BROADWAY ST A SSI STANCE
CHI CAGO,I L 60660
PUENTES (HOYLETON 37-1222958 501(C)(3) 55,997 REFUGEE AND
FAMI LY SERVI CES)PO BOX I MMI GRANT
218 A SSI STANCE
HOYLETON,I L 62803
other)
REFUGEE ONE 36-3817743 501(C)(3) 102,840 REFUGEE AND
(I NTERFAI TH REFUGEE & I MMI GRANT
I MMG MI NS)4753 N A SSI STANCE
BROADWAY STE 401
CHI CAGO,I L 60640
THE RESURRECTI ON 36-3576073 501(C)(3) 25,864 REFUGEE AND
PROJECT1818 S PAULI NA I MMI GRANT
ST A SSI STANCE
CHI CAGO,I L 60608
other)
ROCK VALLEY COLLEGE 36-3037232 501(C)(3) 110,818 REFUGEE AND
3301 N MULFORD ROAD I MMI GRANT
ROCKFORD,I L 611145699 A SSI STANCE
SARGENT SHRI VER 36-3151279 501(C)(3) 22,050 REFUGEE AND
NATI ONAL CENTER ON I MMI GRANT
POVERTY LAW50 EAST A SSI STANCE
WASHI NGTON STE 500
CHI CAGO,I L 60605
other)
SOUTHWESTERN I LLI NOI S 36-2179770 501(C)(3) 16,806 REFUGEE AND
COLLEGE2500 CARLYLE I MMI GRANT
AVE A SSI STANCE
BELLEVI LLE,I L 62221
SOUTH EAST ASI A CENTER 36-3168093 501(C)(3) 75,500 REFUGEE AND
5120 N BROADWAY I MMI GRANT
other)
ST ANTHONY PROGRAMA 51-0217097 501(C)(3) 37,264 REFUGEE AND
CI ELO2408 S ALBANY ST I MMI GRANT
SOUTHWEST SUBURBAN 36-3783511 501(C)(3) 38,467 REFUGEE AND
I MMI GRATI ON PROJECTPO I MMI GRANT
BOX 208 A SSI STANCE
BOLI NGBROOK,I L 60440
other)
SOUTHWEST ORGANI ZI NG 36-4090773 501(C)(3) 221,794 REFUGEE AND
PROJECT2609 W63RD ST I MMI GRANT
TOWNSHI P HI GH SCHOOL 51-0217097 501(C)(3) 86,854 REFUGEE AND
DI STRI CT 2142121 SOUTH I MMI GRANT
GOEBBERT RD A SSI STANCE
ARLI NGTON HEI GHTS,I L
600054297
other)
THE CENTER RESOURCES 36-4248651 501(C)(3) 67,708 REFUGEE AND
FOR TEACHI NG AND I MMI GRANT
LEARNI NG2626 S A SSI STANCE
CLEARBROOK DRI VE
ARLI NGTON HEI GHTS,I L
600054626
UNI TED AFRI CAN 01-0897461 501(C)(3) 91,000 REFUGEE AND
ORGANI ZATI ON10 W35TH I MMI GRANT
STREET STE 9D3-1 A SSI STANCE
CHI CAGO,I L 60619
other)
WORLD RELI EF-MOLI NE 23-6393344 501(C)(3) 45,000 REFUGEE AND
3115 AVE OFTHE CI TI ES I MMI GRANT
MOLI NE,I L 61265 A SSI STANCE
WORLD RELI EF-CHI CAGO 23-6393344 501(C)(3) 118,651 REFUGEE AND
3507 WLAWRENCE AVE I MMI GRANT
other)
WORLD RELI EF-DUPAGE 23-6393344 501(C)(3) 164,798 REFUGEE AND
1825 COLLEGE AVE STE I MMI GRANT
230 A SSI STANCE
WHEATON,I L 60187
YOUTH SERVI CE BUREAU 36-2852862 501(C)(3) 73,906 REFUGEE AND
OF I LLI NOI S VALLEY424 W I MMI GRANT
MADI SON ST A SSI STANCE
OTTAWA,I L 61350
efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493062009154
SCHEDULE 0
OMBNo 1545 0047
(Form 990 or 990- EZ)
Supplemental Information to Form 990 or 990- EZ
2012
Department of th e Treasury
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information . Open
1- Attach to Form 990 or 990- EZ. Inspection
Name of th e organization Employ er identification number
AND REFUGEE RIGHTS 11 o r r,
Identifier Return Explanation
Reference
FORM990, PART A DRAFTOF THE990 WASREVIEWEDANDAPPROVEDBY THEFINANCE/EXECUTIVECOMMITTEEOF THE
VI, SECTION B, BOARD
LINE 11
FORM990, PART THEPOLICY DOCUMENT IS SIGNED BY EACH BOARDMEMBERANNUALLY, BOARDMEMBERS RECUSE
VI, SECTION B, THEMSELVES FROMANY DISCUSSIONS INVOLVINGTHEIR ORGANIZATIONS
LINE 12C
FORM990, PART THEBOARDAPPOINTS A SUBCOMMITTE FOR EXECUTIVE DIRECTOR REVIEW, THECOMMITTEEGATHERS
VI, SECTION B, COMPARATIVEDATA, CONDUCTS INTERVIEWS, ANDCOMPLETES AWRITTEN EVALUATION THE
LINE 15 COMPENSATION RECOMMENDATION IS PRESENTEDTOTHEFULL BOARDOF DIRECTORS THE
COMPENSATION OF THEOFFICERS IS DETERMINED BY THEEXECUTIVE DIRECTOR INFORMALLY CONSULTING
THEEXECUTIVECOMMITTEE/BOARDOF DIRECTORS
FORM990, PART THEGOVERNING DOCUMENTS, FINANCIAL STATEMENTS ANDCONFLICTOF INTEREST POLICY ARE
VI, SECTION C, AVAILABLETOTHEPUBLIC UPONWRITTEN REQUEST
LINE 19
jefile GRAPHIC print - DO NOT PROCESS
SCHEDULE R
(Form 990)
Depa rtment of th e Trea s u ry
Interna l Revenu e Servic e
As Filed Da ta -
Rela ted Orga niza tions a nd Unrela ted Pa rtners h ips
1 - Complete if th e orga niza tion a ns wered "Yes " to Form 990, Pa rt IV, line 33, 34, 35, 36, or 37.
1 - Atta c h to Form 990. 1 - See s epa ra te ins tru c tions .
DLN:934930620091 54
OMBNo 1 545- 0047
201 2
Na me of th e orga niza tion Employ er identific a tion nu mber
AND REFUGEE RIGHTS
36- 3783551
Identific a tion of Dis rega rded Entities (Complete if th e orga niza tion a ns wered "Yes " to Form 990, Pa rt IV, line 33.)
(a )
Na me, a ddres s , a nd EIN (if a pplic a ble) of dis rega rded entity
(b)
Prima ry a c tivity
(c )
Lega l domic ile (s ta te
or foreign c ou ntry )
(d)
Tota l inc ome
(e)
End- of- y ea r a s s ets
(f)
Direc t c ontrolling
entity
Identific a tion of Rela ted Ta x- Exempt Orga niza tions (Complete if th e orga niza tion a ns wered "Yes " to Form 990, Pa rt IV, line 34 bec a u s e it h a d one
or more rela ted ta x- exempt orga niza tions du ring th e ta x y ea r.)
(a )
Na me, a ddres s , a nd EIN of rela ted orga niza tion
( b)
Prima ry a c tivity
(c )
Lega l domic ile (s ta te
or foreign c ou ntry )
(d)
Exempt Code s ec tion
(e)
Pu blic c h a rity s ta tu s
(if s ec tion 501 (c )(3))
(f)
Direc t c ontrolling
entity
(g)
Sec tion 51 2(b)
(1 3) c ontrolled
entity ?
Yes No
(1 ) ILLINOIS IMMIGRANT ACTION
55 E JACKSON BLVD SUITE 2075
CHICAGO, IL 606044466
26- 31 87498
GRASSROOTS AND DIRECT
LOBBYING
IL 501 (C)(4)
N/A
No
For Pa perwork Redu c tion Ac t Notic e, s ee th e Ins tru c tions for Form 990. Ca t No 501 35Y Sc h edu le R (Form 990) 201 2
Schedule R (Form 990) 2012 Page 2
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV , line 34
because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activ ity
(c)
Legal
domicile
(state or
foreign
country)
(d)
D irect
controlling
entity
(e)
Predominant
income(related,
unrelated,
excluded from
tax under
sections 512-
514)
(f)
Share of
total income
(g)
Share of
end-of-year
assets
(h)
D isproprtionate
allocations?
(i)
Code V -UBI
amount in box
20 of
Schedule K-1
(Form 1065)
U)
General or
managing
partner?
(k )
Percentage
ownership
Yes No Yes No
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to Form 990, Part IV ,
line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of
related organization
(b)
Primary activ ity
(c)
Legal
domicile
(state or foreign
country)
(d)
D irect controlling
entity
(e)
Type of entity
(C corp, S
corp,
or trust)
(f)
Share of total
income
(g)
Share of end-
of-year
assets
(h)
Percentage
ownership
(i)
Section 512
(b)(13)
controlled
entity?
Yes No
Schedule R (Form 990) 2012
ff^Transactions With Related Organizations (Complete ifthe organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note . Complete line 1 ifany entity is listed in Parts II, III, or IV ofthis schedule
1 During the tax year, did the orgranization engage in any ofthe following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of(i) interest (ii) annuities (iii) royalties or (iv ) rent from a controlled entity
b G ift, grant, or capital contribution to related organization(s)
c G ift, grant, or capital contribution from related organization(s)
d Loans or loan guarantees to or for related organization(s)
e Loans or loan guarantees by related organization(s)
f Div idends from related organization(s)
g Sale ofassets to related organization(s)
h Purchase ofassets from related organization(s)
i Exchange ofassets with related organization(s)
j Lease offacilities, equipment, or other assets to related organization(s)
k Lease offacilities, equipment, or other assets from related organization(s)
I Performance ofserv ices or membership or fundraising solicitations for related organization(s)
m Performance ofserv ices or membership or fundraising solicitations by related organization(s)
n Sharing offacilities, equipment, mailing lists, or other assets with related organization(s)
o Sharing ofpaid employees with related organization(s)
p Reimbursement paid to related organization(s) for expenses
q Reimbursement paid by related organization(s) for expenses
r Other transfer ofcash or property to related organization(s)
s Other transfer ofcash or property from related organization(s)
Page 3
YesFNo
No
No
No
No
No
if No
lg No
lh No
li No
li No
lk No-
ll No
lm No
In Yes
to Yes
I I
lp No
lq Yes
lr No
is No
2 Ifthe answer to any ofthe abov e is "Yes," see the instructions for information on who must complete this line, including cov ered relationships and transaction thresholds
(a)
Name ofother organization
(b)
Transaction
type (a-s)
(c)
Amount inv olv ed
(d)
Method ofdetermining amount inv olv ed
(1) ILLINOIS IMMIG RANT ACTION N 52,966 FMV
(2) ILLINOIS IMMIG RANT ACTION 0 173,475 FMV
(3) ILLINOIS IMMIG RANT ACTION Q 139,935 FMV
Schedule R (Form 990) 2012 Page 4
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the f ollowing inf ormation f or each entity taxed as a partnership through which the organization conducted more than f ive percent of its activities (measured by total assets or gross
revenue) that was not a related organization See instructions regarding exclusion f or certain investment partnerships
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal
domicile
(state or
f oreign
country)
(d)
Predominant
income
(related,
unrelated,
excluded f rom
tax under
section 512-
(e)
Are all partners
section
501(c)(3)
organizations?
(f )
Share of
total
income
(g)
Share of
end-of -year
assets
(h)
Disproprtionate
allocations?
(i)
Code V-UBI
amount in
box 20
of Schedule
K-1
(Form 1065)
U)
General or
managing
part ner?
(k )
Percentage
ownership
514)
Yes No Yes No Yes No
Additional Data
Software ID:
Software Version:
EIN: 36 -3783551
AND REFUGEE RIGHTS
Return to Form
Page 5
JL^ffillll Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions)
Identifier I Return Reference I Explanation

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