Hillside Children's Center, New York 2014 IRS Report
Hillside Children's Center, New York 2014 IRS Report
Hillside Children's Center, New York 2014 IRS Report
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CLIENT'S COPY
UNRELATED BUSINESS INCOME
319341
05-01-13
ENCLOSED ARE THE ORIGINAL AND ONE COPY OF THE 2013 EXEMPT
ORGANIZATION RETURNS, AS FOLLOWS...
FORM 990
Prepared for
HILLSIDE CHILDREN'S CENTER
1183 MONROE AVENUE
ROCHESTER, NY 14620
Prepared by
DOPKINS & COMPANY, LLP
200 INTERNATIONAL DR
BUFFALO, NY 14221-5794
300941
05-01-13
IRS e-file Signature Authorization OMB No. 1545-1878
1a Form 990 check here | X b Total revenue, if any (Form 990, Part VIII, column (A), line 12)~~~~~~~ 1b 100,013,251.
2a Form 990-EZ check here | b Total revenue, if any (Form 990-EZ, line 9) ~~~~~~~~~~~~~~ 2b
3a Form 1120-POL check here | b Total tax (Form 1120-POL, line 22) ~~~~~~~~~~~~~~~~ 3b
4a Form 990-PF check here | b Tax based on investment income (Form 990-PF, Part VI, line 5) ~~~ 4b
5a Form 8868 check here | b Balance Due (Form 8868, Part I, line 3c or Part II, line 8c) ~~~~~~~~ 5b
as my signature on the organization's tax year 2013 electronically filed return. If I have indicated within this return that a copy of the return
is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned ERO to
enter my PIN on the return's disclosure consent screen.
As an officer of the organization, I will enter my PIN as my signature on the organization's tax year 2013 electronically filed return. If I have
indicated within this return that a copy of the return is being filed with a state agency(ies) regulating charities as part of the IRS Fed/State
program, I will enter my PIN on the return's disclosure consent screen.
Officer's signature | Date |
Address
change HILLSIDE CHILDREN'S CENTER
Name
change Doing Business As 16-0743039
Initial
return Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number
Termin-
ated 1183 MONROE AVENUE 585-256-7500
Amended
return City or town, state or province, country, and ZIP or foreign postal code G Gross receipts $ 101,339,794.
Applica-
tion ROCHESTER, NY
14620 H(a) Is this a group return
F Name and address of principal officer:DENNIS RICHARDSON Yes X No
pending
for subordinates? ~~
1183 MONROE AVENUE, ROCHESTER, NY 14620 H(b) Are all subordinates included? Yes No
I Tax-exempt status: X 501(c)(3) 501(c) ( ) § (insert no.) 4947(a)(1) or 527 If "No," attach a list. (see instructions)
J Website: | WWW.HILLSIDE.COM H(c) Group exemption number |
K Form of organization: X Corporation Trust Association Other | L Year of formation: 1837 M State of legal domicile: NY
Part I Summary
1 Briefly describe the organization's mission or most significant activities: PROVIDE FOR A WIDE CONTINUUM OF
Activities & Governance
9 Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~ 99,739,598. 98,423,196.
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ~~~~~~~~~~~~~ 49,181. 96,143.
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) ~~~~~~~~ 464,332. 658,184.
12 Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) ••• 102,399,260. 100,013,251.
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) ~~~~~~~~~~~ 0. 0.
14 Benefits paid to or for members (Part IX, column (A), line 4) ~~~~~~~~~~~~~ 0. 0.
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ~~~ 65,013,074. 64,147,554.
Expenses
16a Professional fundraising fees (Part IX, column (A), line 11e)~~~~~~~~~~~~~~ 0. 0.
b Total fundraising expenses (Part IX, column (D), line 25) | 0.
17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) ~~~~~~~~~~~~~ 35,979,489. 34,835,219.
18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) ~~~~~~~ 100,992,563. 98,982,773.
19 Revenue less expenses. Subtract line 18 from line 12 •••••••••••••••• 1,406,697. 1,030,478.
Fund Balances
End of Year
20 Total assets (Part X, line 16) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 89,831,741. 88,999,211.
21 Total liabilities (Part X, line 26) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 84,140,925. 77,044,685.
22 Net assets or fund balances. Subtract line 21 from line 20 •••••••••••••• 5,690,816. 11,954,526.
Part II Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
=
Here PAUL PERROTTO, CHIEF FINANCIAL OFFICER
Type or print name and title
Print/Type preparer's name Preparer's signature Date Check PTIN
if
SARAH CLARE P01474679
9 9
Paid self-employed
DOPKINS & COMPANY, LLP 16-0929175
9
Preparer Firm's name Firm's EIN
Use Only Firm's address 200 INTERNATIONAL DR
BUFFALO, NY 14221-5794 Phone no.716-634-8800
May the IRS discuss this return with the preparer shown above? (see instructions) ••••••••••••••••••••• X Yes No
332001 10-29-13 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2013)
Form 990 (2013) HILLSIDE CHILDREN'S CENTER 16-0743039 Page 2
Part III Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III •••••••••••••••••••••••••••• X
1 Briefly describe the organization's mission:
HILLSIDE CHILDREN'S CENTER (THE CENTER), WHOSE SOLE CORPORATE MEMBER
IS HILLSIDE FAMILY OF AGENCIES, WAS FORMED TO BENEFIT AND SUPPORT THE
ACTIVITIES OF THE CENTER AND THE FOLLOWING TAX-EXEMPT ORGANIZATIONS:
HILLSIDE CHILDREN'S FOUNDATION, HILLSIDE WORK SCHOLARSHIP CONNECTION,
2 Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes X No
If "Yes," describe these new services on Schedule O.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?~~~~~~ Yes X No
If "Yes," describe these changes on Schedule O.
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 $ 74,889,924. including grants of $ ) (Revenue $ 83,220,002. )
COMMUNITY BASED AND RESIDENTIAL SERVICES TO CHILDREN AND THIER FAMILIES
ENGAGED IN THE CHILD WELFARE, MENTAL HEALTH, MENTAL RETARDATION AND
DEVELOPMENTAL DISABILITY, AND JUVENILE JUSTICE SYSTEMS, AIMED AT
HELPING THEM BECOME CONTRIBUTING MEMBERS OF SOCIETY.
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Part IV Checklist of Required Schedules (continued)
Yes No
21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
government on Part IX, column (A), line 1? If "Yes," complete Schedule I, Parts I and II ~~~~~~~~~~~~~~~~~~ 21 X
22 Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX,
column (A), line 2? If "Yes," complete Schedule I, Parts I and III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 22 X
23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete
Schedule J ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 23 X
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 25a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 24a X
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? ~~~~~~~~~~~ 24b X
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 X
d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? ~~~~~~~~~~~ 24d X
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 X
b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and
that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes," complete
Schedule L, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 25b X
26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so,
complete Schedule L, Part II ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 26 X
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If "Yes," complete Schedule L, Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 27 X
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 X
b A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ~~ 28b X
c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,
director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV~~~~~~~~~~~~~~~~~~~~~ 28c X
29 Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M ~~~~~~~~~ 29 X
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? If "Yes," complete Schedule M ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 30 X
31 Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 31 X
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 X
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, Part I ~~~~~~~~~~~~~~~~~~~~~~~~ 33 X
34 Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 34 X
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ~~~~~~~~~~~~~~~~~~ 35a X
b If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity
within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ~~~~~~~~~~~~~~~~~~~ 35b
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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 36 X
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 X
38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
Note. All Form 990 filers are required to complete Schedule O ••••••••••••••••••••••••••••••• 38 X
Form 990 (2013)
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Part V Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ••••••••••••••••••••••••••• X
Yes No
1a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~ 1a 55
b Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~ 1b 0
c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners? ••••••••••••••••••••••••••••••••••••••••••• 1c X
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements,
filed for the calendar year ending with or within the year covered by this return ~~~~~~~~~~ 2a 1867
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns?~~~~~~~~~~ 2b X
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions) ~~~~~~~~~~~
3a Did the organization have unrelated business gross income of $1,000 or more during the year? ~~~~~~~~~~~~~~ 3a X
b If "Yes," has it filed a Form 990-T for this year? If "No," to line 3b, provide an explanation in Schedule O ~~~~~~~~~~ 3b X
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)?~~~~~~~ 4a X
b If "Yes," enter the name of the foreign country: J
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ~~~~~~~~~~~~ 5a X
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?~~~~~~~~~ 5b X
c If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5c
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit
any contributions that were not tax deductible as charitable contributions? ~~~~~~~~~~~~~~~~~~~~~~~~ 6a X
b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6b
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? 7a X
b If "Yes," did the organization notify the donor of the value of the goods or services provided? ~~~~~~~~~~~~~~~ 7b
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282? •••••••••••••••••••••••••••••••••••••••••••••••••••• 7c X
d If "Yes," indicate the number of Forms 8282 filed during the year ~~~~~~~~~~~~~~~~ 7d
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? ~~~~~~~ 7e X
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ~~~~~~~~~ 7f X
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?~ 7g
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? 7h
8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting
organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year? 8
9 Sponsoring organizations maintaining donor advised funds.
a Did the organization make any taxable distributions under section 4966?~~~~~~~~~~~~~~~~~~~~~~~~~~ 9a
b Did the organization make a distribution to a donor, donor advisor, or related person? ~~~~~~~~~~~~~~~~~~~ 9b
10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 ~~~~~~~~~~~~~~~ 10a
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities ~~~~~~ 10b
11 Section 501(c)(12) organizations. Enter:
a Gross income from members or shareholders ~~~~~~~~~~~~~~~~~~~~~~~~~~ 11a
b Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11b
12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? 12a
b If "Yes," enter the amount of tax-exempt interest received or accrued during the year •••••• 12b
13 Section 501(c)(29) qualified nonprofit health insurance issuers.
a Is the organization licensed to issue qualified health plans in more than one state? ~~~~~~~~~~~~~~~~~~~~~ 13a
Note. See the instructions for additional information the organization must report on Schedule O.
b Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans ~~~~~~~~~~~~~~~~~~~~~~ 13b
c Enter the amount of reserves on hand ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13c
14a Did the organization receive any payments for indoor tanning services during the tax year? ~~~~~~~~~~~~~~~~ 14a X
b If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O •••••••••• 14b
Form 990 (2013)
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Part VI Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response
to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ••••••••••••••••••••••••••• X
Section A. Governing Body and Management
Yes No
1a Enter the number of voting members of the governing body at the end of the tax year ~~~~~~ 1a 21
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 O.
b Enter the number of voting members included in line 1a, above, who are independent ~~~~~~ 1b 20
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 X
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? ~~~~~~~~~~~~~~ 3 X
4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ~~~~~ 4 X
5 Did the organization become aware during the year of a significant diversion of the organization's assets? ~~~~~~~~~ 5 X
6 Did the organization have members or stockholders? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 X
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7a X
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7b X
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a The governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8a X
b Each committee with authority to act on behalf of the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~ 8b X
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 O ••••••••••••••••• 9 X
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes No
10a Did the organization have local chapters, branches, or affiliates? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 10a X
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 X
b Describe in Schedule O 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 X
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ~~~~~~ 12b X
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe
in Schedule O how this was done ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12c X
13 Did the organization have a written whistleblower policy? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13 X
14 Did the organization have a written document retention and destruction policy? ~~~~~~~~~~~~~~~~~~~~~~ 14 X
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 X
b Other officers or key employees of the organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15b X
If "Yes" to line 15a or 15b, describe the process in Schedule O (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 X
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 JNY
18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
X Own website Another's website X Upon request Other (explain in Schedule O)
19 Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial
statements available to the public during the tax year.
20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization: |
PAUL PERROTTO, CFO - 585-256-7500
1183 MONROE AVENUE, ROCHESTER, NY 14620
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Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ••••••••••••••••••••••••••• X
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
¥ List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.
Enter -0- in columns (D), (E), and (F) if no compensation was paid.
¥ List all of the organization's current key employees, if any. See instructions for definition of "key employee."
¥ List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received report-
able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.
¥ List all of the organization's former officers, key employees, and highest compensated employees who received more than $100,000 of
reportable compensation from the organization and any related organizations.
¥ List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization,
more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees;
and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A) (B) (C) (D) (E) (F)
Name and Title Average Position Reportable Reportable Estimated
(do not check more than one
hours per box, unless person is both an compensation compensation amount of
officer and a director/trustee)
week Individual trustee or director from from related other
(list any the organizations compensation
hours for organization (W-2/1099-MISC) from the
Highest compensated
Institutional trustee
employee
below organizations
Former
Officer
line)
(1) NANCY L. CASTRO, PH. D. 0.50
DIRECTOR X 0. 0. 0.
(2) DAVID CLEARY 0.50
DIRECTOR X 0. 0. 0.
(3) CAROLYN FRIEDLANDER 0.50
DIRECTOR X 0. 0. 0.
(4) DR. RICHARD GANGEMI 0.50
DIRECTOR X 0. 0. 0.
(5) JAMES C. MOORE 0.50
DIRECTOR X 0. 0. 0.
(6) CANDICE A. LUCAS 0.50
DIRECTOR X 0. 0. 0.
(7) DOREN NORFLEET 0.50
DIRECTOR X 0. 0. 0.
(8) JAN M. PARISI 0.50
DIRECTOR X 0. 0. 0.
(9) VIRGINA O'NEILL 0.50
DIRECTOR X 0. 0. 0.
(10) CRAIG CURRAN 0.50
DIRECTOR X 0. 0. 0.
(11) GARY MAURO 0.50
DIRECTOR X 0. 0. 0.
(12) DENISE T. DRAGOONE 0.50
DIRECTOR X 0. 0. 0.
(13) JAMES HAEFNER 0.50
DIRECTOR X 0. 0. 0.
(14) JOANNE LARSON, PH. D. 0.50
DIRECTOR X 0. 0. 0.
(15) MARIE MCNABB 0.50
DIRECTOR X 0. 0. 0.
(16) SALLY ADAMS 0.50
VICE CHAIR X 0. 0. 0.
(17) MONICA MONTE 0.50
SECRETARY X 0. 0. 0.
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Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A) (B) (C) (D) (E) (F)
Name and title Average Position Reportable Reportable Estimated
(do not check more than one
hours per box, unless person is both an compensation compensation amount of
officer and a director/trustee)
week from from related other
(list any
Highest compensated
related
Institutional trustee
(W-2/1099-MISC) organization
organizations and related
Key employee
below
employee
organizations
Former
Officer
line)
(18) PHILIP D. FISHBACH 0.50
CHAIR X 0. 0. 0.
(19) TODD LIEBERT 0.50
TREASURER X 0. 0. 0.
(20) DENNIS M. RICHARDSON 4.00
PRESIDENT & CEO 36.00 X 0. 395,405. 132,517.
(21) PAUL PERROTTO 4.00
CFO & STRATEGIC DEVELOPMEN 36.00 X 0. 267,135. 26,343.
(22) T.C. LEWIS 0.50
VICE CHAIR X 0. 0. 0.
(23) STUART LOEB, M.D. 32.00
MEDICAL DIRECTOR 8.00 X 104,206. 155,439. 21,194.
(24) CLYDE COMSTOCK 23.50
COO 16.50 X 0. 270,906. 43,089.
(25) HELEN HALEWSKI 12.00
CHIEF HR & ORG. DEVELOPMEN 28.00 X 0. 202,209. 6,189.
(26) JOHN LYNCH 39.50
PSYCHIATRIST 0.50 X 308,456. 3,400. 26,349.
1b Sub-total ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | 412,662. 1,294,494. 255,681.
c Total from continuation sheets to Part VII, Section A ~~~~~~~~~~ | 791,131. 0. 44,353.
d Total (add lines 1b and 1c) •••••••••••••••••••••••• | 1,203,793. 1,294,494. 300,034.
2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from the organization | 10
Yes No
3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
line 1a? If "Yes," complete Schedule J for such individual ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 X
4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual~~~~~~~~~~~~~ 4 X
5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? If "Yes," complete Schedule J for such person •••••••••••••••••••••••• 5 X
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 Description of services Compensation
CLARK PATTERSON LEE, 205 ST. PAUL STREET
SUITE 500, ROCHESTER, NY 14604 ARCHITECT & ENGINEER 360,414.
BETLAM SERVICES CORP, 704 S. CLINTON AVE,
ROCHESTER, NY 14620-1499 HVAC SERVICES 252,593.
ELMER W. DAVIS CO, 1214 CLIFFORD AVENUE,
ROCHESTER, NY 14621-0562 ROOFING 219,361.
DOMICELLO BROS INC, MASON ASPHALT
CONTRACTORS 6299 DEAN PARKWAY, ONTARIO, NY CONSTRUCTION 209,580.
COLACINO INDUSTRIES
126 HARRISON STREET, NEWARK, NY 14513 ELECTRICAL WORK 202,895.
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 | 5
SEE PART VII, SECTION A CONTINUATION SHEETS Form 990 (2013)
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Part VII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A) (B) (C) (D) (E) (F)
Name and title Average Position Reportable Reportable Estimated
hours (check all that apply) compensation compensation amount of
per from from related other
week the organizations compensation
Institutional trustee
related and related
Key employee
organizations organizations
below
Former
Officer
line)
(27) REBECCA GOLDING 40.00
NURSE PRACTICIONER X 174,046. 0. 8,557.
(28) CAROLYN BENSON 40.00
PSYCHIATRIST X 222,590. 0. 19,400.
(29) FARAH HUSSAIN 40.00
PSYCHIATRIST X 245,432. 0. 15,997.
(30) HOLLY BROWN 40.00
NURSE PRACTICIONER X 149,063. 0. 399.
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Part VIII Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII •••••••••••••••••••••••••
(A) (B) (C) (D)
Total revenue Related or Unrelated Revenue excluded
exempt function business from tax under
sections
revenue revenue 512 - 514
136,923.
Contributions, Gifts, Grants
and Other Similar Amounts
c
d
e
f All other program service revenue ~~~~~
g Total. Add lines 2a-2f ••••••••••••••••• | 98,423,196.
3 Investment income (including dividends, interest, and
other similar amounts)~~~~~~~~~~~~~~~~~ | 107,983. 107,983.
4 Income from investment of tax-exempt bond proceeds |
5 Royalties ••••••••••••••••••••••• |
(i) Real (ii) Personal
6 a Gross rents ~~~~~~~ 259,001.
b Less: rental expenses ~~~ 409,748.
c Rental income or (loss) ~~ -150,747.
d Net rental income or (loss) •••••••••••••• | -150,747. -39,680. -111,067.
7 a Gross amount from sales of (i) Securities (ii) Other
assets other than inventory 903,285. 1,670.
b Less: cost or other basis
and sales expenses ~~~ 916,795. 0.
c Gain or (loss) ~~~~~~~ -13,510. 1,670.
d Net gain or (loss) ••••••••••••••••••• | -11,840. -11,840.
8 a Gross income from fundraising events (not
Other Revenue
including $ of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~ a
b Less: direct expenses~~~~~~~~~~ b
c Net income or (loss) from fundraising events ••••• |
9 a Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~ a
b Less: direct expenses ~~~~~~~~~ b
c Net income or (loss) from gaming activities •••••• |
10 a Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~ a
b Less: cost of goods sold ~~~~~~~~ b
c Net income or (loss) from sales of inventory •••••• |
Miscellaneous Revenue Business Code
11 a MANAGEMENT FEE INCOME 624100 808,931. 808,931.
b
c
d All other revenue ~~~~~~~~~~~~~
e Total. Add lines 11a-11d ~~~~~~~~~~~~~~~ | 808,931.
12 Total revenue. See instructions. ••••••••••••• | 100,013,251. 99,232,127. -39,680. -14,924.
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Part IX Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX ••••••••••••••••••••••••••
Do not include amounts reported on lines 6b, (A) (B) (C) (D)
Total expenses Program service Management and Fundraising
7b, 8b, 9b, and 10b of Part VIII. expenses general expenses expenses
1 Grants and other assistance to governments and
organizations in the United States. See Part IV, line 21
2 Grants and other assistance to individuals in
the United States. See Part IV, line 22 ~~~
3 Grants and other assistance to governments,
organizations, and individuals 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 ~~~~~~~~
6 Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B) ~~~
7 Other salaries and wages ~~~~~~~~~~ 52,396,500. 52,396,500.
8 Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions) 2,177,513. 2,177,513.
9 Other employee benefits ~~~~~~~~~~ 4,869,757. 4,869,757.
10 Payroll taxes ~~~~~~~~~~~~~~~~ 4,703,784. 4,703,784.
11 Fees for services (non-employees):
a Management ~~~~~~~~~~~~~~~~ 10,618,276. 10,618,276.
b Legal ~~~~~~~~~~~~~~~~~~~~ 1,103. 1,103.
c Accounting ~~~~~~~~~~~~~~~~~
d Lobbying ~~~~~~~~~~~~~~~~~~
e Professional fundraising services. See Part IV, line 17
f Investment management fees ~~~~~~~~ 7,955. 7,955.
g Other. (If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.) 2,071,065. 2,071,065.
12 Advertising and promotion ~~~~~~~~~ 9,367. 9,367.
13 Office expenses~~~~~~~~~~~~~~~ 2,727,165. 2,727,165.
14 Information technology ~~~~~~~~~~~
15 Royalties ~~~~~~~~~~~~~~~~~~
16 Occupancy ~~~~~~~~~~~~~~~~~ 9,274,272. 9,274,272.
17 Travel ~~~~~~~~~~~~~~~~~~~ 1,522,524. 1,522,524.
18 Payments of travel or entertainment expenses
for any federal, state, or local public officials
19 Conferences, conventions, and meetings ~~ 97,258. 97,258.
20 Interest ~~~~~~~~~~~~~~~~~~ 329,395. 329,395.
21 Payments to affiliates ~~~~~~~~~~~~
22 Depreciation, depletion, and amortization ~~ 4,144,928. 4,144,928.
23 Insurance ~~~~~~~~~~~~~~~~~
24 Other expenses. Itemize expenses not covered
above. (List miscellaneous expenses in line 24e. If line
24e amount exceeds 10% of line 25, column (A)
amount, list line 24e expenses on Schedule O.) ~~
a FOOD SERVICES 2,629,811. 2,629,811.
b RECREATION, WORK ACTIVI 701,875. 701,875.
c CLOTHING AND LINEN 262,051. 262,051.
d BOARDING HOME PAYMENTS 252,368. 252,368.
e All other expenses 185,806. 185,806.
25 Total functional expenses. Add lines 1 through 24e 98,982,773. 88,356,542. 10,626,231. 0.
26 Joint costs. Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Check here | if following SOP 98-2 (ASC 958-720)
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Part XI Reconciliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ••••••••••••••••••••••••••• X
1 Total revenue (must equal Part VIII, column (A), line 12) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 100,013,251.
2 Total expenses (must equal Part IX, column (A), line 25) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 2 98,982,773.
3 Revenue less expenses. Subtract line 2 from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 1,030,478.
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ~~~~~~~~~~ 4 5,690,816.
5 Net unrealized gains (losses) on investments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 -25,472.
6 Donated services and use of facilities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6
7 Investment expenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7
8 Prior period adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 8 129,863.
9 Other changes in net assets or fund balances (explain in Schedule O) ~~~~~~~~~~~~~~~~~~~ 9 5,128,841.
10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B)) ••••••••••••••••••••••••••••••••••••••••••••••• 10 11,954,526.
Part XII Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII ••••••••••••••••••••••••••• X
Yes No
1 Accounting method used to prepare the Form 990: Cash X Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
2a Were the organization's financial statements compiled or reviewed by an independent accountant? ~~~~~~~~~~~~ 2a X
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:
Separate basis Consolidated basis Both consolidated and separate basis
b Were the organization's financial statements audited by an independent accountant? ~~~~~~~~~~~~~~~~~~~ 2b X
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:
Separate basis Consolidated basis X Both 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 X
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit
Act and OMB Circular A-133? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a X
b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain why in Schedule O and describe any steps taken to undergo such audits •••••••••••••••• 3b X
Form 990 (2013)
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SCHEDULE A OMB No. 1545-0047
Total
LHA For Paperwork Reduction Act Notice, see the Instructions for Schedule A (Form 990 or 990-EZ) 2013
Form 990 or 990-EZ.
332021
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HILLSIDE CHILDREN'S CENTER
Schedule A (Form 990 or 990-EZ) 2013 16-0743039 Page 2
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) | (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~ 96862696.10661662310321253410188574899258924.507836525
2 Tax revenues levied for the organ-
ization'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 ~~~ 96862696.10661662310321253410188574899258924.507836525
5 The portion of total contributions
by each person (other than a
governmental unit or publicly
supported organization) included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f) ~~~~~~~~~~~~
6 Public support. Subtract line 5 from line 4. 507836525
Section B. Total Support
Calendar year (or fiscal year beginning in) | (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4 ~~~~~~~ 96862696.10661662310321253410188574899258924.507836525
8 Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~ 440,332. 729,232. 342,729. 354,081. 366,985. 2233359.
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 capital
assets (Explain in Part IV.) ~~~~ 2931292. 412,389. 234,888. 499,679. 808,931. 4887179.
11 Total support. Add lines 7 through 10 514957063
12 Gross receipts from related activities, etc. (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~ 12
13 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and stop here ••••••••••••••••••••••••••••••••••••••••••••• |
Section C. Computation of Public Support Percentage
14 Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) ~~~~~~~~~~~~ 14 98.62 %
15 Public support percentage from 2012 Schedule A, Part II, line 14 ~~~~~~~~~~~~~~~~~~~~~ 15 98.23 %
16a 33 1/3% support test - 2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | X
b 33 1/3% support test - 2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
17a 10% -facts-and-circumstances test - 2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,
and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~ |
b 10% -facts-and-circumstances test - 2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or
more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part IV how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~ |
18 Private foundation. If 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) 2013
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HILLSIDE CHILDREN'S CENTER
Schedule A (Form 990 or 990-EZ) 2013 16-0743039 Page 3
Part III Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to
qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) | (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.") ~~
2 Gross receipts from admissions,
merchandise sold or services per-
formed, or facilities furnished in
any activity that is related to the
organization's tax-exempt purpose
3 Gross receipts from activities that
are not an unrelated trade or bus-
iness under section 513 ~~~~~
4 Tax revenues levied for the organ-
ization'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 ~~~
7 a 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 ~~~~~~
2013
| Attach to Form 990, Form 990-EZ, or Form 990-PF.
or 990-PF)
Department of the Treasury
| Information about Schedule B (Form 990, 990-EZ, or 990-PF) and
Internal Revenue Service its instructions is at www.irs.gov/form990 .
Name of the organization Employer identification number
General Rule
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one
contributor. Complete Parts I and II.
Special Rules
X For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections
509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or (2) 2%
of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
total contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did not total to more than $1,000.
If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc.,
purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc., contributions of $5,000 or more during the year ~~~~~~~~~~~~~~~~~ | $
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),
but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to
certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
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Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page 2
Name of organization Employer identification number
Part I Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
Person
Payroll
$ Noncash
(Complete Part II for
noncash contributions.)
Person
Payroll
$ Noncash
(Complete Part II for
noncash contributions.)
Person
Payroll
$ Noncash
(Complete Part II for
noncash contributions.)
323452 10-24-13 Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
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Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page 3
Name of organization Employer identification number
Part II Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
(a)
(c)
No. (b) (d)
FMV (or estimate)
from Description of noncash property given Date received
(see instructions)
Part I
$
323453 10-24-13 Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
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Schedule B (Form 990, 990-EZ, or 990-PF) (2013) Page 4
Name of organization Employer identification number
(a) No.
from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
Part I
(a) No.
from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
Part I
(a) No.
from (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
Part I
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2013
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Schedule D (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 2
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets(continued)
3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items
(check all that apply):
a Public exhibition d Loan or exchange programs
b Scholarly research e Other
c 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? •••••••••••• Yes No
Part IV Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or
reported an amount on Form 990, Part X, line 21.
1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
b If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
cBeginning balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1c
dAdditions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1d
eDistributions during the year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1e
fEnding balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1f
2aDid the organization include an amount on Form 990, Part X, line 21? ~~~~~~~~~~~~~~~~~~~~~~~~~ Yes No
bIf "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII •••••••••••••
Part V Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ~~~~~~~ 3,511,455. 2,579,193. 2,517,655. 1,693,294. 1,500,899.
b Contributions ~~~~~~~~~~~~~~ 130,553. 619,720. 138,226. 349,105. 40,441.
c Net investment earnings, gains, and losses 690,444. 367,681. -50,278. 485,706. 151,954.
d Grants or scholarships ~~~~~~~~~
e Other expenditures for facilities
and programs ~~~~~~~~~~~~~ 98,459. 55,139. 26,410. 10,450.
f Administrative expenses ~~~~~~~~
g End of year balance ~~~~~~~~~~ 4,233,993. 3,511,455. 2,579,193. 2,517,655. 1,693,294.
2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a Board designated or quasi-endowment | %
b Permanent endowment | 62.98 %
c Temporarily restricted endowment | 37.02 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a Are there endowment funds not in the possession of the organization that are held and administered for the organization
by: Yes No
(i) unrelated organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(i) X
(ii) related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3a(ii) X
b If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? ~~~~~~~~~~~~~~~~~~~~~~ 3b X
4 Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI Land, Buildings, and Equipment.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other (b) Cost or other (c) Accumulated (d) Book value
basis (investment) basis (other) depreciation
1a Land ~~~~~~~~~~~~~~~~~~~~ 533,459. 533,459.
b Buildings ~~~~~~~~~~~~~~~~~~ 92,592,122. 37,060,977. 55,531,145.
c Leasehold improvements ~~~~~~~~~~ 4,100,208. 1,710,376. 2,389,832.
d Equipment ~~~~~~~~~~~~~~~~~ 4,813,736. 2,780,178. 2,033,558.
e Other •••••••••••••••••••• 627,508. 627,508.
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).) •••••••••••• | 61,115,502.
Schedule D (Form 990) 2013
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Part VII Investments - Other Securities.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category (including name of security) (b) Book value (c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives ~~~~~~~~~~~~~~~
(2) Closely-held equity interests ~~~~~~~~~~~
(3) Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
Part VIII Investments - Program Related.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation: Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Part IX Other Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) BENEFICIAL INTEREST IN NET ASSETS OF HILLSIDE CHILDREN'S
(2) FOUNDATION 6,234,842.
(3) RESTRICTED ASSETS HELD IN TRUST 194,734.
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.) •••••••••••••••••••••••••••• | 6,429,576.
Part X Other Liabilities.
Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1. (a) Description of liability (b) Book value
(1) Federal income taxes
(2) INTERAFFILIATE PAYABLE - NET 33,934,240.
(3) INTEREST RATE SWAP LIABILITY 416,483.
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 25.) ••••• | 34,350,723.
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the
organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII X
Schedule D (Form 990) 2013
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Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ~~~~~~~~~~~~~~~~~~~ 1 98,837,890.
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 17,100.
c Recoveries of prior year grants ~~~~~~~~~~~~~~~~~~~~~~~~~ 2c
d Other (Describe in Part XIII.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 2d
e Add lines 2a through 2d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2e 17,100.
3 Subtract line 2e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 98,820,790.
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 1,192,461.
c Add lines 4a and 4b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1,192,461. 4c
5 100,013,251.
Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ••••••••••••••••• 5
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 99,266,447.
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ~~~~~~~~~~~~~~~~~~~~~~ 2a 17,100.
b Prior year adjustments ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2b
c Other losses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2c
d Other (Describe in Part XIII.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 2d
e Add lines 2a through 2d ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2e 17,100.
3 Subtract line 2e from line 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3 99,249,347.
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 -266,574.
c Add lines 4a and 4b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4c -266,574.
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) •••••••••••••••• 5 98,982,773.
Part XIII Supplemental Information.
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b 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.
PART V, LINE 4:
EXPLANATION: ENDOWMENT FUND PROCEEDS ARE USED IN COMPLIANCE WITH THE DONOR
ARE HELD BY THE FOUNDATION UNTIL USED TO FURTHER THE MISSIONS OF HILLSIDE
PART X, LINE 2:
EXPLANATION: IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN FOR INCOME TAX
WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION
TO THE CENTER.
(Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
| Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
2013
Department of the Treasury | Attach to Form 990. | See separate instructions. Open to Public
Internal Revenue Service | Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990. Inspection
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
Part I Questions Regarding Compensation
Yes No
1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990,
Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel Housing allowance or residence for personal use
Travel for companions Payments for business use of personal residence
Tax indemnification and gross-up payments Health or social club dues or initiation fees
Discretionary spending account Personal services (e.g., maid, chauffeur, chef)
b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain ~~~~~~~~~~~ 1b
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees, and officers, including the CEO/Executive Director, regarding the items checked in line 1a? ~~~~~~~~~~~~ 2
3 Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part III.
X Compensation committee X Written employment contract
X Independent compensation consultant X Compensation survey or study
X Form 990 of other organizations X Approval by the board or compensation committee
4 During the year, did any person listed in Form 990, Part VII, Section A, line 1a, with respect to the filing
organization or a related organization:
a Receive a severance payment or change-of-control payment? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4a X
b Participate in, or receive payment from, a supplemental nonqualified retirement plan? ~~~~~~~~~~~~~~~~~~~~ 4b X
c Participate in, or receive payment from, an equity-based compensation arrangement?~~~~~~~~~~~~~~~~~~~~ 4c X
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only section 501(c)(3) and 501(c)(4) organizations must complete lines 5-9.
5 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the revenues of:
a The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5a X
b Any related organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5b X
If "Yes" to line 5a or 5b, describe in Part III.
6 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any compensation
contingent on the net earnings of:
a The organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6a X
b Any related organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6b X
If "Yes" to line 6a or 6b, describe in Part III.
7 For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed payments
not described in lines 5 and 6? If "Yes," describe in Part III ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 7 X
8 Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III ~~~~~~~~~~~ 8 X
9 If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958-6(c)? ••••••••••••••••••••••••••••••••••••••••••••• 9
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Form 990) 2013
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Part II Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii).
Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and (D) Nontaxable (E) Total of columns (F) Compensation
other deferred benefits (B)(i)-(D) reported as deferred
(i) Base (ii) Bonus & (iii) Other compensation in prior Form 990
(A) Name and Title compensation incentive reportable
compensation compensation
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SCHEDULE K Supplemental Information on Tax-Exempt Bonds OMB No. 1545-0047
(Form 990) | Complete if the organization answered "Yes" on Form 990, Part IV, line 24a. Provide descriptions, 2013
Department of the Treasury explanations, and any additional information in Part VI. Open to Public
Internal Revenue Service | Attach to Form 990. | See separate instructions. | Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990. Inspection
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
Part I Bond Issues SEE PART VI FOR COLUMN (F) CONTINUATIONS
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On behalf (i) Pooled
of issuer financing
Yes No Yes No Yes No
DORMITORY AUTHORITY OF RENOVATIONS AT
A THE STATE OF NEW YORK 14-6000293649903E98 06/17/08 4,720,000.THE MONROE AVENUE X X X
D
Part II Proceeds
A B C D
1 Amount of bonds retired ••••••••••••••••••••••••••••••
2 Amount of bonds legally defeased •••••••••••••••••••••••••
3 Total proceeds of issue ••••••••••••••••••••••••••••••• 4,789,992.
4 Gross proceeds in reserve funds •••••••••••••••••••••••••• 422,498.
5 Capitalized interest from proceeds •••••••••••••••••••••••••
6 Proceeds in refunding escrows ••••••••••••••••••••••••••
7 Issuance costs from proceeds ••••••••••••••••••••••••••• 195,994.
8 Credit enhancement from proceeds ••••••••••••••••••••••••
9 Working capital expenditures from proceeds ••••••••••••••••••••
10 Capital expenditures from proceeds ••••••••••••••••••••••••
11 Other spent proceeds •••••••••••••••••••••••••••••••
12 Other unspent proceeds ••••••••••••••••••••••••••••••
13 Year of substantial completion ••••••••••••••••••••••••••• 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? •••••••••••• X
15 Were the bonds issued as part of an advance refunding issue? ••••••••••• X
16 Has the final allocation of proceeds been made? •••••••••••••••••• X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? •••• X
Part III Private Business Use
A B C D
1 Was the organization a partner in a partnership, or a member of an LLC, Yes No Yes No Yes No Yes No
which owned property financed by tax-exempt bonds? ••••••••••••••• X
2 Are there any lease arrangements that may result in private business use of
bond-financed property? •••••••••••••••••••••••••••••• X
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30 Schedule K (Form 990) 2013
Schedule K (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 2
Part III Private Business Use (Continued)
A B C D
3a Are there any management or service contracts that may result in private Yes No Yes No Yes No Yes No
business use of bond-financed property? ••••••••••••••••••••••• X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside
counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside
counsel to review any research agreements relating to the financed property? •••••
4 Enter the percentage of financed property used in a private business use by
entities other than a section 501(c)(3) organization or a state or local government •• | % % % %
5 Enter the percentage of financed property used in a private business use as a result of
unrelated trade or business activity carried on by your organization, another
section 501(c)(3) organization, or a state or local government •••••••••••• | % % % %
6 Total of lines 4 and 5 ••••••••••••••••••••••••••••••••• % % % %
7 Does the bond issue meet the private security or payment test? •••••••••••• X
8a Has there been a sale or disposition of any of the bond-financed property to a non-
governmental person other than a 501(c)(3) organization since the bonds were issued? X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed
of •••••••••••••••••••••••••••••••••••••••••• % % % %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections
1.141-12 and 1.145-2? ••••••••••••••••••••••••••••••••
9 Has the organization established written procedures to ensure that all nonqualified
bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ••••••••••••••••••••• X
Part IV Arbitrage
A B C D
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Yes No Yes No Yes No Yes No
Penalty in Lieu of Arbitrage Rebate? ••••••••••••••••••••••••• X
2 If "No" to line 1, did the following apply? •••••••••••••••••••••••
a Rebate not due yet? ••••••••••••••••••••••••••••••••• X
b Exception to rebate? ••••••••••••••••••••••••••••••••• X
c No rebate due? •••••••••••••••••••••••••••••••••••• X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate
computation was performed •••••••••••••••••••••••••••••
3 Is the bond issue a variable rate issue? •••••••••••••••••••••••• X
4a Has the organization or the governmental issuer entered into a qualified
hedge with respect to the bond issue? •••••••••••••••••••••••• X
b Name of provider •••••••••••••••••••••••••••••••••••
c Term of hedge ••••••••••••••••••••••••••••••••••••
d Was the hedge superintegrated? •••••••••••••••••••••••••••
e Was the hedge terminated? •••••••••••••••••••••••••••••
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Schedule K (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 3
Part IV Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? •••••• X
b Name of provider •••••••••••••••••••••••••••••••••••
c Term of GIC •••••••••••••••••••••••••••••••••••••
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied?
6 Were any gross proceeds invested beyond an available temporary period? •••••• X
7 Has the organization established written procedures to monitor the requirements of
section 148? ••••••••••••••••••••••••••••••••••••• X
Part V Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of
federal tax requirements are timely identified and corrected through the voluntary
closing agreement program if self-remediation is not available under applicable
regulations? ••••••••••••••••••••••••••••••••••••• X
Part VI Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
SCHEDULE K, PART I, BOND ISSUES:
(A) ISSUER NAME: DORMITORY AUTHORITY OF THE STATE OF NEW YORK
(F) DESCRIPTION OF PURPOSE: RENOVATIONS AT THE MONROE AVENUE CAMPUS
332123
10-09-13 Schedule K (Form 990) 2013
SCHEDULE L Transactions With Interested Persons OMB No. 1545-0047
(Form 990 or 990-EZ) | Complete if the organization answered "Yes" on Form 990, Part IV, line 25a, 25b, 26, 27, 28a,
28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b. 2013
Department of the Treasury | Attach to Form 990 or Form 990-EZ. | See separate instructions. Open To Public
Internal Revenue Service | Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990. Inspection
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
Part I Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1 (b) Relationship between disqualified (d) Corrected?
(a) Name of disqualified person person and organization (c) Description of transaction
Yes No
2 Enter the amount of tax incurred by the organization managers or disqualified persons during the year under
section 4958 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ | $
3 Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ~~~~~~~~~~~~~~~~ | $
Total •••••••••••••••••••••••••••••••••••••••• | $
Part III Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between (c) Amount of (d) Type of (e) Purpose of
interested person and assistance assistance assistance
the organization
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule L (Form 990 or 990-EZ) 2013
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HILLSIDE CHILDREN'S CENTER
Schedule L (Form 990 or 990-EZ) 2013 16-0743039 Page 2
Part IV Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested (c) Amount of (d) Description of (e) Sharing of
organization's
person and the organization transaction transaction revenues?
Yes No
CLARK PATTERSON LEE CONSTRTODD LIEBERT: BOARD 287,238.CONSTRUCTIO X
ORGANIZATION.
EXPLANATION: THE BY-LAWS STATE THAT THE SOLE MEMBER, HILLSIDE FAMILY OF
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2013)
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Schedule O (Form 990 or 990-EZ) (2013) Page 2
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
EXPLANATION: THE CHIEF FINANCIAL OFFICER, REVIEWS THE 990 AND AFTER HIS
REVIEW, SHARES THE 990 WITH THE BOARD OF DIRECTORS. THE PERFORMANCE AND
COMPENSATION COMMITTEE ALSO REVIEWS AND APPROVES COMPENSATION FOR THE COO,
YEAR WITH THE CEO TO REVIEW PERFORMANCE AND REPORTS TO THE WHOLE BOARD AT
AND COMPENSATION COMMITTEE ALSO REVIEWS AND APPROVES COMPENSATION FOR THE
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Schedule O (Form 990 or 990-EZ) (2013) Page 2
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
THE RETURN AND OTHER DOCUMENTS OPEN FOR PUBLIC INSPECTION ARE AVAILABLE
REQUEST.
INTERRELATED ENTITY AND THE SOLE CORPORATE MEMBER OF THE CENTER, AND
AND OTHER RELATED ENTITIES. THE COSTS OF THESE SERVICES ARE ALLOCATED
TO THE RECEIVING ENTITIES BASED UPON COST STUDIES AND/OR ACTUAL AMOUNTS
INCURRED.
HOURS
COST 3,801,774.
THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. AS ALLOWED UNDER THE
BASIS FOR ALL ENTITIES UNDER COMMON CONTROL OF THE HILLSIDE FAMILY OF
332212
09-04-13 Schedule O (Form 990 or 990-EZ) (2013)
39
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
OMB No. 1545-0047
SCHEDULE R Related Organizations and Unrelated Partnerships
(Form 990) |Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37. 2013
| Attach to Form 990. | See separate instructions.
Department of the Treasury Open to Public
Internal Revenue Service |Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990. Inspection
Name of the organization Employer identification number
HILLSIDE CHILDREN'S CENTER 16-0743039
Part I Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt
Part II
organizations during the tax year.
(a) (b) (c) (d) (e) (f) (g)
Section 512(b)(13)
Name, address, and EIN Primary activity Legal domicile (state or Exempt Code Public charity Direct controlling controlled
of related organization foreign country) section status (if section entity entity?
501(c)(3)) Yes No
HILLSIDE CHILDREN'S FOUNDATION - 16-1493404
1183 MONROE AVENUE 509(A)(3)TYP
ROCHESTER, NY 14620 RAISE FUNDS FOR AFFILIATES NEW YORK 501(C)(3) I N/A X
CRESTWOOD CHILDREN'S CENTER - 16-0743039
2075 SCOTTSVILLE ROAD PROGRAMS FOR CHILDREN AND
ROCHESTER, NY 14623 FAMILIES NEW YORK 501(C)(3) 170(B)(1)(A) N/A X
HILLSIDE WORK-SCHOLARSHIP CONNECTION -
16-1453581, 1183 MONROE AVENUE, ROCHESTER,
NY 14620 YOUTH ADVOCACY PROGRAM NEW YORK 501(C)(3) 170(B)(1)(A) N/A X
SNELL FARM CHILDREN'S CENTER - 16-1199261
1183 MONROE AVENUE RESIDENTIAL TREATMENT FOR
ROCHESTER, NY 14620 TEENAGE BOYS NEW YORK 501(C)(3) 170(B)(1)(A) N/A X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2013
332161
09-12-13 LHA 40
Schedule R (Form 990) HILLSIDE CHILDREN'S CENTER 16-0743039
332222
05-01-13 41
Schedule R (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 2
Part III Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related
organizations treated as a partnership during the tax year.
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
Legal
Name, address, and EIN Primary activity domicile Direct controlling Predominant income Share of total Share of Disproportionate Code V-UBI General or Percentage
of related organization (state or entity (related, unrelated, income end-of-year allocations?
amount in box managing ownership
foreign excluded from tax under assets 20 of Schedule partner?
country) sections 512-514) Yes No K-1 (Form 1065) Yes No
Part IV Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on 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) (b) (c) (d) (e) (f) (g) (h) (i)
Section
Name, address, and EIN Primary activity Legal domicile Direct controlling Type of entity Share of total Share of Percentage 512(b)(13)
of related organization (state or entity (C corp, S corp, income end-of-year ownership controlled
foreign entity?
country) or trust) assets
Yes No
Part V Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule. Yes No
1 During the tax year, did the organization engage in any of the 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1a X
b Gift, grant, or capital contribution to related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b X
c Gift, grant, or capital contribution from related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1c X
d Loans or loan guarantees to or for related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1d X
e Loans or loan guarantees by related organization(s) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1e X
(1)
(2)
(3)
(4)
(5)
(6)
332163 09-12-13 43 Schedule R (Form 990) 2013
Schedule R (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 4
Part VI Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)
that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
Are all
Name, address, and EIN Primary activity Legal domicile Predominant income partners sec. Share of Share of Dispropor-Code V-UBI General or Percentage
of entity (state or foreign (related, unrelated, 501(c)(3)
total end-of-year amount in box 20 managing ownership
tionate
excluded from tax orgs.? of Schedule K-1 partner?
allocations?
country) under section 512-514) Yes No income assets Yes No (Form 1065) Yes No
332164
09-12-13 44
Schedule R (Form 990) 2013 HILLSIDE CHILDREN'S CENTER 16-0743039 Page 5
Part VII Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
FORM 990-T
Prepared for
HILLSIDE CHILDREN'S CENTER
1183 MONROE AVENUE
ROCHESTER, NY 14620
Prepared by
DOPKINS & COMPANY, LLP
200 INTERNATIONAL DR
BUFFALO, NY 14221-5794
300941
05-01-13
Form 990-T Exempt Organization Business Income Tax Return OMB No. 1545-0687
A Check box if Name of organization ( Check box if name changed and see instructions.) D Employer identification number
(Employees' trust, see
address changed instructions.)
= =
May the IRS discuss this return with
Here OFFICER the preparer shown below (see
Signature of officer Date Title instructions)? X Yes No
Print/Type preparer's name Preparer's signature Date Check if PTIN
self- employed
Paid
9 9
SARAH CLARE P01474679
Preparer
DOPKINS & COMPANY, LLP 16-0929175
Use Only Firm's name Firm's EIN
9
200 INTERNATIONAL DR
Firm's address BUFFALO, NY 14221-5794 Phone no. 716-634-8800
323711 12-12-13 Form 990-T (2013)
47
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER
Form 990-T (2013) 16-0743039 Page 3
Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property)(see instructions)
1. Description of property
(1)
(2)
(3)
(4)
2. Rent received or accrued
3(a) Deductions directly connected with the income in
(a) From personal property (if the percentage of (b) From real and personal property (if the percentage columns 2(a) and 2(b) (attach schedule)
rent for personal property is more than of rent for personal property exceeds 50% or if
10% but not more than 50%) the rent is based on profit or income)
(1)
(2)
(3)
(4)
Total 0. Total 0.
(c) Total income. Add totals of columns 2(a) and 2(b). Enter (b) Total deductions.
Enter here and on page 1,
here and on page 1, Part I, line 6, column (A) ••••••• | 0. Part I, line 6, column (B) • | 0.
Schedule E - Unrelated Debt-Financed Income (see instructions)
3. Deductions directly connected with or allocable
2. Gross income from to debt-financed property
or allocable to debt- (a) Straight line depreciation
1. Description of debt-financed property financed property
(b) Other deductions
(attach schedule) (attach schedule)
STATEMENT 2 STATEMENT 3
(1) ATLANTIC AVENUE 170,015. 65,568. 235,659.
(2) METRO PARK 52,686. 16,619. 56,947.
(3) WYOMING ST. 36,300. 9,868. 25,087.
(4)
4. Amount of average acquisition 5. Average adjusted basis 6. Column 4 divided 7. Gross income 8. Allocable deductions
debt on or allocable to debt-financed of or allocable to by column 5 reportable (column (column 6 x total of columns
property (attach schedule) debt-financed property 2 x column 6) 3(a) and 3(b))
STATEMENT 4 STATEMENT 5
(attach schedule)
(1)
(2)
(3)
(4)
Nonexempt Controlled Organizations
7. Taxable Income 8. Net unrelated income (loss) 9. Total of specified payments 10. Part of column 9 that is included 11. Deductions directly connected
(see instructions) made in the controlling organization's with income in column 10
gross income
(1)
(2)
(3)
(4)
Add columns 5 and 10. Add columns 6 and 11.
Enter here and on page 1, Part I, Enter here and on page 1, Part I,
line 8, column (A). line 8, column (B).
Totals •••••••••••••••••••••••••••••••••••••••• J 0. 0.
323721 12-12-13 Form 990-T (2013)
48
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER
Form 990-T (2013) 16-0743039 Page 4
Schedule G - Investment Income of a Section 501(c)(7), (9), or (17) Organization
(see instructions)
3. Deductions 4. Set-asides 5. Total deductions
1. Description of income 2. Amount of income directly connected
(attach schedule)
and set-asides
(attach schedule) (col. 3 plus col. 4)
(1)
(2)
(3)
(4)
Enter here and on page 1, Enter here and on page 1,
9
Part I, line 9, column (A). Part I, line 9, column (B).
Totals •••••••••••••••••••••••••••••• 0. 0.
Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income
(see instructions)
(1)
(2)
(3)
(4)
Enter here and on Enter here and on Enter here and
page 1, Part I, page 1, Part I, on page 1,
9
line 10, col. (A). line 10, col. (B). Part II, line 26.
Totals •••••••••• 0. 0. 0.
Schedule J - Advertising Income (see instructions)
Part I Income From Periodicals Reported on a Consolidated Basis
(1)
(2)
(3)
(4)
9
Totals (carry to Part II, line (5)) ••
Part II
0. 0.
Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in
0.
(1)
(2)
(3)
(4)
Totals from Part I 0. 0. 0.
Enter here and on Enter here and on Enter here and
page 1, Part I, page 1, Part I, on page 1,
9
line 11, col. (A). line 11, col. (B). Part II, line 27.
(1) %
(2) %
(3) %
9
(4) %
Total. Enter here and on page 1, Part II, line 14 ••••••••••••••••••••••••••••••••••• 0.
Form 990-T (2013)
323731
12-12-13
49
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER 16-0743039
}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-T NET OPERATING LOSS DEDUCTION STATEMENT 1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
LOSS
PREVIOUSLY LOSS AVAILABLE
TAX YEAR LOSS SUSTAINED APPLIED REMAINING THIS YEAR
}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}}
06/30/11 6,259. 0. 6,259. 6,259.
06/30/12 14,228. 0. 14,228. 14,228.
06/30/13 8,488. 0. 8,488. 8,488.
}}}}}}}}}}}}}} }}}}}}}}}}}}}}
NOL CARRYOVER AVAILABLE THIS YEAR 28,975. 28,975.
~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-T SCHEDULE E - DEPRECIATION DEDUCTION STATEMENT 2
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ACTIVITY
DESCRIPTION NUMBER AMOUNT TOTAL
}}}}}}}}}}} }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}
DEPRECIATION 65,568.
- SUBTOTAL - 1 65,568.
DEPRECIATION 16,619.
- SUBTOTAL - 2 16,619.
DEPRECIATION 9,868.
- SUBTOTAL - 3 9,868.
}}}}}}}}}}}}}
TOTAL OF FORM 990-T, SCHEDULE E, COLUMN 3(A) 92,055.
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-T SCHEDULE E - OTHER DEDUCTIONS STATEMENT 3
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ACTIVITY
DESCRIPTION NUMBER AMOUNT TOTAL
}}}}}}}}}}} }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}
OFFICE SUPPLIES 317.
POS MAINTENANCE 57,051.
SUPPLIES 4,915.
REPAIR & MAINTENANCE 34,398.
UTILITIES 66,632.
PERMITS 81.
TELEPHONE 2,049.
INTEREST 14,730.
REAL ESTATE TAXES 53,340.
AMORTIZATION ON DEBT CLOSING COSTS 2,146.
- SUBTOTAL - 1 235,659.
TELEPHONE 96.
ADVISORY FEES 962.
REAL ESTATE TAXES 100.
POS MAINTENANCE 23,807.
50 STATEMENT(S) 1, 2, 3
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER 16-0743039
}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
SUPPLIES 989.
REPAIR & MAINTENANCE 7,177.
UTILITIES 17,585.
INTEREST 6,231.
- SUBTOTAL - 2 56,947.
TELEPHONE 4,047.
POSTAGE 693.
POS MAINTENANCE 5,432.
SUPPLIES 2,395.
REPAIR & MAINTENANCE 3,220.
UTILITIES 5,948.
INTEREST 1,661.
REAL ESTATE TAXES 1,691.
- SUBTOTAL - 3 25,087.
}}}}}}}}}}}}}
TOTAL OF FORM 990-T, SCHEDULE E, COLUMN 3(B) 317,693.
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-T AVERAGE ACQUISITION DEBT ON OR STATEMENT 4
ALLOCABLE TO DEBT-FINANCED PROPERTY
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ACTIVITY
DESCRIPTION NUMBER AMOUNT TOTAL
}}}}}}}}}}} }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}
ATLANTIC AVENUE 742,500.
- SUBTOTAL - 1 742,500.
METRO PARK 485,000.
- SUBTOTAL - 2 485,000.
WYOMING ST. 412,222.
- SUBTOTAL - 3 412,222.
}}}}}}}}}}}}}
TOTAL OF FORM 990-T, SCHEDULE E, COLUMN 4 1,639,722.
~~~~~~~~~~~~~
51 STATEMENT(S) 3, 4
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER 16-0743039
}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
FORM 990-T AVERAGE ADJUSTED BASIS OF OR STATEMENT 5
ALLOCABLE TO DEBT-FINANCED PROPERTY
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ACTIVITY
DESCRIPTION NUMBER AMOUNT TOTAL
}}}}}}}}}}} }}}}}}}} }}}}}}}}}}}}}} }}}}}}}}}}}}}
ATLANTIC AVENUE 3,260,774.
- SUBTOTAL - 1 3,260,774.
METRO PARK 1,101,542.
- SUBTOTAL - 2 1,101,542.
WYOMING ST. 2,463,901.
- SUBTOTAL - 3 2,463,901.
}}}}}}}}}}}}}
TOTAL OF FORM 990-T, SCHEDULE E, COLUMN 5 6,826,217.
~~~~~~~~~~~~~
52 STATEMENT(S) 5
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
4562
OMB No. 1545-0172
Form
Depreciation and Amortization E- 1
2013
9 9
Department of the Treasury
(Including Information on Listed Property) Attachment
Internal Revenue Service (99) See separate instructions. Attach to your tax return. Sequence No. 179
Name(s) shown on return Business or activity to which this form relates Identifying number
9
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 •••••••••••• 12
13 Carryover of disallowed deduction to 2014. Add lines 9 and 10, less line 12 •••• 13
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
Part II Special Depreciation Allowance and Other Depreciation (Do not include listed property.)
14 Special depreciation allowance for qualified property (other than listed property) placed in service during
the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14
15 Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15
16 Other depreciation (including ACRS) ••••••••••••••••••••••••••••••••••••• 16 65,568.
Part III MACRS Depreciation (Do not include listed property.) (See instructions.)
Section A
17 MACRS deductions for assets placed in service in tax years beginning before 2013 ~~~~~~~~~~~~~~ 17
18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here ••• J
Section B - Assets Placed in Service During 2013 Tax Year Using the General Depreciation System
(b) Month and (c) Basis for depreciation
(a) Classification of property year placed (business/investment use (d) Recovery (e) Convention (f) Method (g) Depreciation deduction
in service only - see instructions) period
! !
26 Property used more than 50% in a qualified business use:
! !
%
! !
%
%
! !
27 Property used 50% or less in a qualified business use:
! !
% S/L -
! !
% S/L -
% S/L -
28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~ 28
29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 ••••••••••••••••••••••••••• 29
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
! !
42 Amortization of costs that begins during your 2013 tax year:
! !
43 Amortization of costs that began before your 2013 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~ 43
44 Total. Add amounts in column (f). See the instructions for where to report ••••••••••••••••••• 44
316252 12-19-13 Form 4562 (2013)
54
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
4562
OMB No. 1545-0172
Form
Depreciation and Amortization E- 2
2013
9 9
Department of the Treasury
(Including Information on Listed Property) Attachment
Internal Revenue Service (99) See separate instructions. Attach to your tax return. Sequence No. 179
Name(s) shown on return Business or activity to which this form relates Identifying number
9
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 •••••••••••• 12
13 Carryover of disallowed deduction to 2014. Add lines 9 and 10, less line 12 •••• 13
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
Part II Special Depreciation Allowance and Other Depreciation (Do not include listed property.)
14 Special depreciation allowance for qualified property (other than listed property) placed in service during
the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14
15 Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15
16 Other depreciation (including ACRS) ••••••••••••••••••••••••••••••••••••• 16 16,619.
Part III MACRS Depreciation (Do not include listed property.) (See instructions.)
Section A
17 MACRS deductions for assets placed in service in tax years beginning before 2013 ~~~~~~~~~~~~~~ 17
18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here ••• J
Section B - Assets Placed in Service During 2013 Tax Year Using the General Depreciation System
(b) Month and (c) Basis for depreciation
(a) Classification of property year placed (business/investment use (d) Recovery (e) Convention (f) Method (g) Depreciation deduction
in service only - see instructions) period
! !
26 Property used more than 50% in a qualified business use:
! !
%
! !
%
%
! !
27 Property used 50% or less in a qualified business use:
! !
% S/L -
! !
% S/L -
% S/L -
28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~ 28
29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 ••••••••••••••••••••••••••• 29
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
! !
42 Amortization of costs that begins during your 2013 tax year:
! !
43 Amortization of costs that began before your 2013 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~ 43
44 Total. Add amounts in column (f). See the instructions for where to report ••••••••••••••••••• 44
316252 12-19-13 Form 4562 (2013)
56
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
4562
OMB No. 1545-0172
Form
Depreciation and Amortization E- 3
2013
9 9
Department of the Treasury
(Including Information on Listed Property) Attachment
Internal Revenue Service (99) See separate instructions. Attach to your tax return. Sequence No. 179
Name(s) shown on return Business or activity to which this form relates Identifying number
9
12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 •••••••••••• 12
13 Carryover of disallowed deduction to 2014. Add lines 9 and 10, less line 12 •••• 13
Note: Do not use Part II or Part III below for listed property. Instead, use Part V.
Part II Special Depreciation Allowance and Other Depreciation (Do not include listed property.)
14 Special depreciation allowance for qualified property (other than listed property) placed in service during
the tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14
15 Property subject to section 168(f)(1) election ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15
16 Other depreciation (including ACRS) ••••••••••••••••••••••••••••••••••••• 16 9,868.
Part III MACRS Depreciation (Do not include listed property.) (See instructions.)
Section A
17 MACRS deductions for assets placed in service in tax years beginning before 2013 ~~~~~~~~~~~~~~ 17
18 If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here ••• J
Section B - Assets Placed in Service During 2013 Tax Year Using the General Depreciation System
(b) Month and (c) Basis for depreciation
(a) Classification of property year placed (business/investment use (d) Recovery (e) Convention (f) Method (g) Depreciation deduction
in service only - see instructions) period
! !
26 Property used more than 50% in a qualified business use:
! !
%
! !
%
%
! !
27 Property used 50% or less in a qualified business use:
! !
% S/L -
! !
% S/L -
% S/L -
28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~ 28
29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 ••••••••••••••••••••••••••• 29
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
! !
42 Amortization of costs that begins during your 2013 tax year:
! !
43 Amortization of costs that began before your 2013 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~ 43
44 Total. Add amounts in column (f). See the instructions for where to report ••••••••••••••••••• 44
316252 12-19-13 Form 4562 (2013)
58
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
Form 8868 Application for Extension of Time To File an
(Rev. January 2014)
Exempt Organization Return OMB No. 1545-1709
Department of the Treasury
| File a separate application for each return.
Internal Revenue Service | Information about Form 8868 and its instructions is at www.irs.gov/form8868 .
¥ If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box ~~~~~~~~~~~~~~~~~~~ | X
¥ If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.
Electronic filing (e-file) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation
required to file Form 990-T), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension
of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain
Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,
visit www.irs.gov/efile and click on e-file for Charities & Nonprofits.
Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed).
A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete
Part I only ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |
All other corporations (including 1120-C filers), partnerships, REMICs, and trusts must use Form 7004 to request an extension of time
to file income tax returns.
Enter filer's identifying number
Type or Name of exempt organization or other filer, see instructions. Employer identification number (EIN) or
print
HILLSIDE CHILDREN'S CENTER 16-0743039
File by the
due date for Number, street, and room or suite no. If a P.O. box, see instructions. Social security number (SSN)
filing your 1183 MONROE AVENUE
return. See
instructions. City, town or post office, state, and ZIP code. For a foreign address, see instructions.
ROCHESTER, NY 14620
Enter the Return code for the return that this application is for (file a separate application for each return) ~~~~~~~~~~~~~~~~~ 0 1
2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial return Final return
Change in accounting period
3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions. 3a $ 0.
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit. 3b $ 0.
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
by using EFTPS (Electronic Federal Tax Payment System). See instructions. 3c $ 0.
Caution. If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment
instructions.
LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev. 1-2014)
323841
12-31-13
59
12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
TAX RETURN FILING INSTRUCTIONS
NEW YORK FORM CHAR500
Prepared for
HILLSIDE CHILDREN'S CENTER
1183 MONROE AVENUE
ROCHESTER, NY 14620
Prepared by
DOPKINS & COMPANY, LLP
200 INTERNATIONAL DR
BUFFALO, NY 14221-5794
300082
05-01-13
CHAR500 Send with fee and attachments to:
NYS Office of the Attorney General
Charities Bureau Registration Section
2013
NYS Annual Filing for Charitable Organizations 120 Broadway Open to Public
www.CharitiesNYS.com New York, NY 10271 Inspection
1.General Information
For Fiscal Year Beginning (mm/dd/yyyy) 07/01/2013 and Ending (mm/dd/yyyy) 06/30/2014
Check if Applicable: Name of Organization: Employer Identification Number (EIN):
Address Change HILLSIDE CHILDREN'S CENTER 16-0743039
Name Change Mailing Address: NY Registration Number:
Initial Filing 1183 MONROE AVENUE 00-31-78
Final Filing City / State / ZIP: Telephone:
Amended Filing ROCHESTER, NY 14620 585 256 7500
Reg ID Pending Website: Email:
WWW.HILLSIDE.COM
Check your organization's
Find your registration category in the
registration category: 7A only EPTL only X DUAL (7A & EPTL) EXEMPT Charities Registry at www.CharitiesNYS.com
2. Certification
See instructions for certification requirements. Improper certification is a violation of law that may be subject to penalties.
We certify under penalties of perjury that we reviewed this report, including all attachments, and to the best of our knowledge and belief,
they are true, correct and complete in accordance with the laws of the State of New York applicable to this report.
3a. 7A filing exemption: Total contributions from NY State including residents, foundations, government agencies, etc, did not
exceed $25,000 and the organization did not engage a professional fund raiser (PFR) or fund raising counsel (FRC) to solicit
contributions during the fiscal year. Or the organization qualifies for another 7A exemption (see instructions).
3b. EPTL filing exemption: Gross receipts did not exceed $25,000 and the market value of assets did not exceed $25,000 at any time
during the fiscal year.
5. Fee
See the checklist on the 7A filing fee: EPTL filing fee: Total fee:
Make a single-check or money order
next page to calculate your
payable to:
fee(s). Indicate fee(s) you
25. 750. 775. "Department of Law"
are submitting here: $ $ $
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12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
HILLSIDE CHILDREN'S CENTER
CHAR500 Simply submit the certified CHAR500 with no fee, schedule, or additional attachments IF:
- Your organization is registered as 7A only and you marked the 7A filing exemption in Part 3.
- Your organization is registered as EPTL only and marked the EPTL filing exemption in Part 3.
Annual Filing Checklist
- Your organization is registered as DUAL and you marked both the 7A and EPTL filing exemption in Part 3.
Check the schedules you must submit with your CHAR500 as described in Part 4:
If you answered "yes" in Part 4a, submit Schedule 4a: Professional Fund Raisers (PFR), Fund Raising Counsel (FRC), Commercial Co-Venturers (CCV)
If you answered "yes" in Part 4b, submit Schedule 4b: Government Grants
Check the financial attachments you must submit with your CHAR500:
X IRS Form 990, 990-EZ, or 990-PF, and 990-T if applicable
X All additional IRS Form 990 Schedules including Schedule B (Schedule of Contributors).
IRS Form 990-T if applicable
If you are a 7A only or DUAL filer, submit the applicable independent Certified Public Accountant's Review or Audit Report:
Review Report if you received total revenue and support greater than $250,000 and up to $500,000.
X Audit Report if you received total revenue and support greater than $500,000
No Review Report or Audit Report is required because total revenue and support is less than $250,000
Note: The Audit and Review requirements are set to change in 2017 and 2021 in accordance with the Non Profit Revitalization Act of 2013.
For more details, visit www.CharitiesNYS.com.
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12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
2013
New York State Department of Taxation and Finance
Request for Six-Month Extension to File
CT-5
(for franchise/business taxes, MTA surcharge, or both)
b
All filers must enter tax period:
b
Tax Law - Articles 9-A, 13, 32, and 33
beginning 07-01-13 ending 06-30-14
b b
Employer identification number (EIN) File number Business telephone number
c/o NY
Date of incorporation
Number and street or PO box
1183 MONROE AVENUE
State ZIP code Foreign corporations: date began Audit use
City business in NYS
ROCHESTER, NY 14620
If you need to update your address or phone information for corporation tax, or other tax types, you can do so online.
See Business Information in Form CT-1.
Request for extension of time to file the following forms: Mark box(es) for one article only. Submit only one Form CT-5 and mark an X in both boxes in
the appropriate article if you are requesting an extension for both the franchise tax and MTA surcharge returns. For example, mark an X in both the CT-3 box and the
CT-3M/4M box under Article 9-A if you are requesting an extension of time to file both returns.
NOTE: Do not use this form if you are a combined filer; use Form CT-5.3 instead.
b b b
Article 9-A Article 13 Article 32 Article 33
b b b b
CT-3 CT-33 CT-33-M
b
X
b b
or CT-3M/4M CT-13 CT-32 CT-32-M
CT-4 CT-33-C CT-33-NL
/ b
Payment enclosed
A. Pay amount shown on line 11. Make payable to: New York State Corporation Tax
Attach your payment here. Detach all check stubs. (See instructions for details.) A. 250.
b
Computation of estimated franchise tax
b
1 Franchise tax from the worksheet in Form CT-5-I ~~~~~~~~~~~~~~~~~~~~~ 1. 250.
2 First installment of estimated tax for the next tax year (see instructions) ~~~~~~~~~~ 2.
b
3 Total franchise tax and first installment (add lines 1 and 2) ~~~~~~~~~~~~~~~~~ 3. 250.
b
4 Prepayments of franchise tax (from line 16, column A) ~~~~~~~~~~~~~~~~~~~ 4. 0.
5 Balance due - franchise tax (subtract line 4 from line 3) •••••••••••••••••• 5. 250.
b
Computation of estimated MTA surcharge
b
6 MTA surcharge from the worksheet in Form CT-5-I ~~~~~~~~~~~~~~~~~~~~ 6.
7 First installment of estimated MTA surcharge for the next tax year (see instrucions) ~~~~ 7.
b
8 Total MTA surcharge and first installment (add lines 6 and 7) ~~~~~~~~~~~~~~~ 8.
b
9 Prepayments of MTA surcharge (from line 16, column B) ~~~~~~~~~~~~~~~~~ 9.
10 Balance due - MTA surcharge (subtract line 9 from line 8) ~~~~~~~~~~~~~~~~~ 10.
11 Total balance due (add lines 5 and 10 and enter here; enter the payment amount on line A above) 11. 250.
Composition of prepayments - Use this worksheet to determine the prepayments of franchise tax on line 4 and the prepayments of the
MTA surcharge on line 9. See instructions. Date paid A. Franchise tax B. MTA surcharge
12 Mandatory first installment ~~~~~~~~~~ 12.
13 a Second installment from Form CT-400~~~~~ 13a.
13 b Third installment from Form CT-400 ~~~~~~ 13b.
13 c Fourth installment from Form CT-400 ~~~~~ 13c.
14 Overpayment credited from prior years •••••••••••••• 14.
15 Overpayment credited from Form CT- Period 15.
16 Total prepayments (total all entries in column A and column B) ~~~ 16.
b
Firm's name (or yours if self-employed) Firm's EIN Preparer's PTIN or SSN
Paid DOPKINS & COMPANY, LLP 16-0929175 P00956557
preparer Signature of individual preparing this document
use Address City State ZIP code
only 200 INTERNATIONAL DR BUFFALO NY 14221-5794
E-mail address of individual preparing this document Preparer's NYTPRIN Date
[email protected]
See instructions for where to file
368511
10-09-13
TAX RETURN FILING INSTRUCTIONS
NEW YORK FORM CT-13
Prepared for
HILLSIDE CHILDREN'S CENTER
1183 MONROE AVENUE
ROCHESTER, NY 14620
Prepared by
DOPKINS & COMPANY, LLP
200 INTERNATIONAL DR
BUFFALO, NY 14221-5794
300941
05-01-13
2013 CT-2 New York State Department of Taxation and Finance
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11-05-13 1019
HILLSIDE CHILDREN'S CENTER 16-0743039
Page 2 of 2 CT-2 (2013)
52 Provided telecommunication services in the MCTD this year? (None = 0, Y = 1, N = 2, Both = 3) 52.
53 Subject to supervision of the Department of Public Service and provided utility services in the MCTD this year? (None = 0, Y = 1, N = 2, Both = 3) 53.
384952
11-05-13 1019
New York State
e-file
New York State E-File Signature Authorization for Tax Year 2013
www.tax.ny.gov
For Form CT-3, CT-3-A, CT-3M/4M, CT-3-S, CT-4, CT-13,
CT-240, CT-245, or CT-400
Electronic return originator (ERO)/paid preparer: do not mail this form to the Tax Department. Keep it for your records.
Return type (mark all that apply): CT-3 CT-3-A CT-3M/4M CT-3-S CT-4 X CT-13 CT-240
CT-245 CT-400
Purpose performs as both the paid preparer and the ERO, he or she is only
Form TR-579-CT must be completed to authorize an ERO to e-file a required to sign as the paid preparer. It is not necessary to include the
corporation tax return and to transmit bank account information for ERO signature in this case. Note that an alternative signature can be
the electronic funds withdrawal. used as described in TSB-M-05(1)C, Alternative Methods of Signing for
Tax Return Preparers. Go to our Web site at www.tax.ny.gov to find this
General instructions document.
Part A must be completed by an officer of the corporation who is
authorized to sign the corporation's return before the ERO transmits Do not mail this form to the Tax Department. EROs/paid preparers
the electronically filed Form CT-3, General Business Corporation must keep this form for three years and present it to the Tax
Franchise Tax Return; CT-3-A, General Business Corporation Combined Department upon request.
Franchise Tax Return; CT-3M/4M, General Business Corporation MTA
Surcharge Return; CT-3-S, New York S Corporation Franchise Tax Do not use this form for electronically filed Form CT-5, Request for
Six-Month Extension to File (for franchise/business taxes, MTA
Return; CT-4, General Business Corporation Franchise Tax Return
Short Form; CT-13, Unrelated Business Income Tax Return; CT-240, surcharge, or both), Form CT-5.3, Request for Six-Month Extension to
File (for combined franchise tax return, or combined MTA surcharge,
Foreign Corporation License Fee Return; CT-245, Maintenance Fee and or both), Form CT-5.4, Request for Six-Month Extension to File New
Activities Return For a Foreign Corporation Disclaiming Tax Liability; or York S Corporation Franchise Tax Return, Form CT-5.9, Request for
CT-400, Estimated Tax for Corporations. Three-Month Extension to File (for Article 9 tax return, MTA surcharge,
EROs/paid preparers must complete Part B prior to transmitting or both), or Form CT-5.9-E, Request for Three-Month Extension to File
electronically filed corporation tax returns. Both the paid preparer Form CT-186-E. Instead use Form TR-579.1-CT, New York State
and the ERO are required to sign Part B. However, if an individual Authorization for Electronic Funds Withdrawal For Tax Year 2013.
Part A - Declaration of authorized corporate officer for Form CT-3, CT-3-A, CT-3M/4M, CT-3-S, CT-4, CT-13, CT-240, CT-245, or CT-400
Under penalty of perjury, I declare that I have examined the information on this 2013 New York State electronic corporate tax return, including any
accompanying schedules, attachments, and statements, and certify that this electronic return is true, correct, and complete. If this filing includes
Form DTF-686, Tax Shelter Reportable Transactions, as an authorized officer of the corporation, I hereby consent to the waiver of the secrecy
provisions of Tax Law sections 202, 211.8, 1467, and 1518 as such provisions relate to the disclosure requirements of Tax Law section 25. The
ERO has my consent to send this 2013 New York State electronic corporate return to New York State through the Internal Revenue Service (IRS).
I understand that by executing this Form TR-579-CT, I am authorizing the ERO to sign and file this return on behalf of the corporation and agree
that the ERO's submission of the corporation's return to the IRS, together with this authorization, will serve as the electronic signature for the return
and any authorized payment transaction. If I am paying New York State corporation taxes due by electronic funds withdrawal, I authorize the
New York State Tax Department and its designated financial agents to initiate an electronic funds withdrawal from the financial institution account
indicated on this 2013 electronic return, and I authorize the financial institution to withdraw the amount from the account. I understand and agree
that I may revoke this authorization for payment only by contacting the Tax Department no later than five business days prior to the payment date.
TR-579-CT (10/13)
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12240213 758929 61364 2013.05060 HILLSIDE CHILDREN'S CENTER 61364__1
CT-13 New York State Department of Taxation and Finance
b
If you claim an
b
Employer identification number (EIN) File number Business telephone number
overpayment, mark
16-0743039 MM2 585-256-7500 an X in the box
Legal name of corporation Trade name/DBA
b b
NAICS business code number (from federal return) If address/phone If you need to update your address or Audit (for Tax Department use only)
above is new, phone information for corporation tax,
531120 mark an X in the box
Principal unrelated business activity (see instructions)
or other tax types, you can do so
online. See Business information
DEBT FINANCED RENTAL INCOME in Form CT-1.
Have you filed New York State Form CT-247, Application for Exemption from Corporation Franchise Taxes by a Not-For-Profit Organization? Yes No X
Mark an X in this box if you are an employee trust as defined in Internal Revenue Code (IRC) section 401(a) ~~~~~~~~~~~~~~~~~~~~~~~
Mark an X in this box if you ceased operating the unrelated business during the tax year covered by this return (see section Who must file Form CT-13 in the instructions) ¥
b
Payment enclosed
A. Pay amount shown on line 22. Make payable to: New York State Corporation Tax
§ Attach your payment here. Detach all check stubs. (See instructions for details.) A
Computation of income and tax
1 Federal unrelated business taxable income before net operating loss deduction and after $1,000
specific deduction ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 <38,845.>
2 New York State Article 13 and Article 23 tax deducted on federal return ~~~~~~~~~~~~~~~~~~~~ 2
3 Additions required for shareholders of federal S corporations (see instructions) ~~~~~~~~~~~~~~~~~ 3
4 Grossed-up taxes for shareholders of New York S corporations (see instructions) •••••••••••••••• 4
5 Other additions (see instructions) ¥ IRC section 199 deduction: ~~~~~~~~~~ 5
6 Add lines 1 through 5 ••••••••••••••••••••••••••••••••••••••••••••• 6 <38,845.>
7 Other income (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~ 7
8 Federal S corporation shareholder subtractions (see instructions) ~~~~~~~ 8
9 Other subtractions (see instructions)~~~~~~~~~~~~~~~~~~~~~~ 9
10 Total subtractions (add lines 7, 8, and 9) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 10
11 Taxable income before net operating loss deduction (subtract line 10 from line 6)~~~~~~~~~~~~~~~~ 11 <38,845.>
12 New York net operating loss deduction (attach federal and NYS computations; see instructions) ~~~~~~~~ 12
13 Taxable income (subtract line 12 from line 11) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 13 <38,845.>
14 Allocated taxable income (multiply line 13 by % from line 42; or enter amount
from line 13 if allocation is not claimed) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~¥ 14 <38,845.>
15 Tax based on income (multiply line 14 by 9% (.09)) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15 0.
b
16 Minimum tax ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16 250 { 00
17 Tax (line 15 or line 16, whichever is larger) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 17 250.
18 Total prepayments from line 46 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~¥ 18 250.
19 Balance (if line 18 is less than line 17, subtract line 18 from line 17) ~~~~~~~~~~~~~~~~~~~~~~~ 19
20 Interest on late payment (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~¥ 20
b
21 Late filing and late payment penalties (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~¥ 21
22 Balance due (add lines 19, 20, and 21 and enter here; enter the payment amount on line A above)~~~~~~~~ 22
b
23 Overpayment (if line 17 is less than line 18, subtract line 17 from line 18) ~~~~~~~~~~~~~~~~~~~~ 23
b
24 Amount of overpayment on line 23 to be credited to next year ~~~~~~~~~~~~~~~~~~~~~~~~ 24
25 Amount of overpayment on line 23 to be refunded (subtract line 24 from line 23) •••••••••••••••• 25
See page 3 for third-party designee, certification, and signature entry areas.
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Page 2 of 3 CT-13 (2013)
Have you been audited by the Internal Revenue Service in the past 5 years? Yes No X If Yes, list years:
Federal return was filed on: 990-T X Other: Attach a complete copy of your federal return.
Federal return filed ~~~ Form 1139 ¥ Amended Form 990-T ~~~~~~~~~~~~~~~~~~~~~~~ ¥
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CT-13 (2013) Page 3 of 3
b
Firm's name (or yours if self-employed) Firm's EIN Preparer's PTIN or SSN
DOPKINS & COMPANY, LLP 16-0929175 P01474679
Paid Signature of individual preparing this return Address City State ZIP code
preparer 200 INTERNATIONAL DR
use
only BUFFALO, NY 14221-5794
E-mail address of individual preparing this return Preparer's NYTPRIN Date
[email protected]
See instructions for where to file.
368432
11-07-13