Sample Form 990 - Return Of Organization Exempt From Income Tax

26P0007 10/13/2016 12:54 PM

PHILADELPHIA VETERANS COMFORT HOUSE 23-2694118

Form 990 (2015)

Page

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

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Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year

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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.

Enter the number of voting members included in line 1a, above, who are independent

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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?

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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?

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Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

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Did the organization become aware during the year of a significant diversion of the organization’s assets?

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Did the organization have members or stockholders?

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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?

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Are any governance decisions of the organization reserved to (or subject to approval by) members,

stockholders, or persons other than the governing body?

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Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body?

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Each committee with authority to act on behalf of the governing body?

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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

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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

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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

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11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

11a

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

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Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?

12b

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,”

describe in Schedule O how this was done

12c

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Did the organization have a written whistleblower policy?

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Did the organization have a written document retention and destruction policy?

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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?

The organization’s CEO, Executive Director, or top management official

15a

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Other officers or key employees of the organization

15b

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If “Yes” to line 15a or 15b, describe the process in Schedule O (see instructions).

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement

16a

with a taxable entity during the year?

16a

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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

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Section C. Disclosure



List the states with which a copy of this Form 990 is required to be filed

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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.

Own website

Another's website

Upon request

Other (explain in Schedule O)

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.



State the name, address, and telephone number of the person who possesses the organization's books and records:

BILL CHAMPION

4108 BALTIMORE AVENUE