TY 2012 Form 990 Schedule O

efile Public Visual Render ObjectId: 201333179349300938 - Submission: 2013-11-13 TIN: 34-4473288

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

SHELBY COUNTY UNITED WAY

Employer identification number

34-4473288

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	SHELBY COUNTY UNITED WAY, INC. CONDUCTS AN ANNUAL FUND RAISING CAMPAIGN TO PROVIDE FUNDING TO HUMAN SERVICE ORGANIZATIONS IN SHELBY COUNTY. OUR MISSION IS TO CONTINUALLY IDENTIFY, EVALUATE AND MAKE POSSIBLE THE HUMAN SERVICES NEEDED IN OUR COMMUNITY. WE STRIVE TO PROMOTE THE VALUES OF COMPASSION, INTEGRITY, COMMUNITY, LEADERSHIP, SERVICE AND VOLUNTEERISM IN OUR ORGANIZATION AND IN THE AREAS THAT WE SERVE. THE VISION OF THE SHELBY COUNTY UNITED WAY IS TO LEAD COLLABORATIVE EFFORTS IN BUILDING A BETTER COMMUNITY.
FIRST ACCOMPLISHMENT DESCRIPTION	FORM 990, PAGE 2, PART III, LINE 4A	SERVICE: INFORMATION & REFERRAL AND COMMUNITY COLLABORATION ACTIVITIES. COMMUNITY IMPACT MEASURES THAT OUR ORGANIZATION PROVIDES INCLUDE THE PROMOTION, HEALTH AND WELL BEING OF ELIGIBLE INDIVIDUALS WITH MEDICAL NEEDS AND DEVELOPMENTAL DISABILITIES, THE STRENGTHENING OF FAMILIES AND INDIVIDUALS, THE INVESTING OF OUR SERVICES IN THE YOUTH AND CHILDREN OF THE COMMUNITY, THE ENRICHMENT OF THE LIVES OF SENIORS AND THE CARING FOR PEOPLE IN CRISIS. AGENCY: SHELBY COUNTY UNITED WAY ADDRESS: 232 S OHIO AVE., P.O. BOX 751, SIDNEY, OH 45365-0751 PHONE: 937-492-2101 FAX: 937-492-1552 E-MAIL: SBARR@SHELBYCOUNITEDWAY.ORG HOURS: 8:30 AM - 5:00 PM SERVICE AREA: SHELBY COUNTY FEE POLICY: N/A ELIGIBILITY: RESIDENTS AND EMPLOYEES OF SHELBY COUNTY CAN ACCESS UNITED WAY AGENCY SERVICES
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	A COPY OF FORM 990 IS PRESENTED TO THE GOVERNING BODY PRIOR TO THE FILING. THE GOVERNING BODY THEN REVIEWS AND APPROVES THE FORM 990 AT ITS REGULAR MEETING.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	VOLUNTEERS, TRUSTEES AND STAFF WHO BECOME AWARE OF A CONFLICT OF INTEREST MUST DISCLOSE IT TO THE BOARD OF TRUSTEES. THIS DISCLOSURE IS REQUIRED TO BE MADE PRIOR TO THE BOARD'S FORMAL DISCUSSION REGARDING AN ISSUE WHICH FORMS THE BASIS OF THE CONFLICT OF INTEREST.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE ORGANIZATION'S PROCESS FOR THE DETERMINATION OF COMPENSATION FOR THE EXECUTIVE DIRECTOR INCLUDES THE COMPARISON OF ORGANIZATIONS SIMILAR IN BOTH SIZE AND JOB RESPONSIBILITIES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER	FORM 990, PART XI, LINE 9	DIRECT AGENCY DONOR DESIGNATIONS -175,661 OTHER UNITED WAY DONATION -110,260 DIRECT AGENCY DONOR DESIGNATIONS 175,661 OTHER UNITED WAY DONATION 110,260

Identifier

Return Reference

Explanation

ORGANIZATION'S MISSION

FORM 990 - ORGANIZATION'S MISSION

SHELBY COUNTY UNITED WAY, INC. CONDUCTS AN ANNUAL FUND RAISING CAMPAIGN TO PROVIDE FUNDING TO HUMAN SERVICE ORGANIZATIONS IN SHELBY COUNTY. OUR MISSION IS TO CONTINUALLY IDENTIFY, EVALUATE AND MAKE POSSIBLE THE HUMAN SERVICES NEEDED IN OUR COMMUNITY. WE STRIVE TO PROMOTE THE VALUES OF COMPASSION, INTEGRITY, COMMUNITY, LEADERSHIP, SERVICE AND VOLUNTEERISM IN OUR ORGANIZATION AND IN THE AREAS THAT WE SERVE. THE VISION OF THE SHELBY COUNTY UNITED WAY IS TO LEAD COLLABORATIVE EFFORTS IN BUILDING A BETTER COMMUNITY.

FIRST ACCOMPLISHMENT DESCRIPTION

FORM 990, PAGE 2, PART III, LINE 4A

SERVICE: INFORMATION & REFERRAL AND COMMUNITY COLLABORATION ACTIVITIES. COMMUNITY IMPACT MEASURES THAT OUR ORGANIZATION PROVIDES INCLUDE THE PROMOTION, HEALTH AND WELL BEING OF ELIGIBLE INDIVIDUALS WITH MEDICAL NEEDS AND DEVELOPMENTAL DISABILITIES, THE STRENGTHENING OF FAMILIES AND INDIVIDUALS, THE INVESTING OF OUR SERVICES IN THE YOUTH AND CHILDREN OF THE COMMUNITY, THE ENRICHMENT OF THE LIVES OF SENIORS AND THE CARING FOR PEOPLE IN CRISIS. AGENCY: SHELBY COUNTY UNITED WAY ADDRESS: 232 S OHIO AVE., P.O. BOX 751, SIDNEY, OH 45365-0751 PHONE: 937-492-2101 FAX: 937-492-1552 E-MAIL: SBARR@SHELBYCOUNITEDWAY.ORG HOURS: 8:30 AM - 5:00 PM SERVICE AREA: SHELBY COUNTY FEE POLICY: N/A ELIGIBILITY: RESIDENTS AND EMPLOYEES OF SHELBY COUNTY CAN ACCESS UNITED WAY AGENCY SERVICES

ORGANIZATION'S PROCESS USED TO REVIEW FORM 990

FORM 990, PAGE 6, PART VI, LINE 11B

A COPY OF FORM 990 IS PRESENTED TO THE GOVERNING BODY PRIOR TO THE FILING. THE GOVERNING BODY THEN REVIEWS AND APPROVES THE FORM 990 AT ITS REGULAR MEETING.

ENFORCEMENT OF CONFLICTS POLICY

FORM 990, PAGE 6, PART VI, LINE 12C

VOLUNTEERS, TRUSTEES AND STAFF WHO BECOME AWARE OF A CONFLICT OF INTEREST MUST DISCLOSE IT TO THE BOARD OF TRUSTEES. THIS DISCLOSURE IS REQUIRED TO BE MADE PRIOR TO THE BOARD'S FORMAL DISCUSSION REGARDING AN ISSUE WHICH FORMS THE BASIS OF THE CONFLICT OF INTEREST.

COMPENSATION PROCESS FOR TOP OFFICIAL

FORM 990, PAGE 6, PART VI, LINE 15A

THE ORGANIZATION'S PROCESS FOR THE DETERMINATION OF COMPENSATION FOR THE EXECUTIVE DIRECTOR INCLUDES THE COMPARISON OF ORGANIZATIONS SIMILAR IN BOTH SIZE AND JOB RESPONSIBILITIES.

GOVERNING DOCUMENTS DISCLOSURE EXPLANATION

FORM 990, PAGE 6, PART VI, LINE 19

GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

RECONCILIATION OF CHANGES - OTHER

FORM 990, PART XI, LINE 9

DIRECT AGENCY DONOR DESIGNATIONS -175,661 OTHER UNITED WAY DONATION -110,260 DIRECT AGENCY DONOR DESIGNATIONS 175,661 OTHER UNITED WAY DONATION 110,260

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

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