TY 2015 Form 990 Schedule O

efile Public Visual Render ObjectId: 201601699349300205 - Submission: 2016-06-17 TIN: 22-2592628

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 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

PISCATAQUIS REGIONAL YMCA

Employer identification number

22-2592628

Return Reference	Explanation
Form 990, Part VI, Line 6 Classes of members or stockholders	THE ORGANIZATION OFFERS MEMBERSHIPS TO THE COMMUNITY. INDIVIDUALS OR FAMILIES WISHING TO BECOME MEMBERS PAY A MONTHLY OR ANNUAL MEMBERSHIP RATE IN EXCHANGE FOR USE OF THE FACILITY AND FOR THE OPPORTUNITY TO PARTICIPATE IN CERTAIN PROGRAMS FOR FREE OR FOR A REDUCED RATE. THE FACILITY INCLUDES A FITNESS CENTER, AN INDOOR POOL, AND OFFERS SEVERAL FITNESS CLASSES FOR PERSONS OF ALL AGES.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Members of the PRYMCA elect the board of directors at the annual meeting. All members are invited to attend the annual meeting and participate in the election of the board of directors.
Form 990, Part VI, Line 11b Review of form 990 by governing body	This 990 will be completed and thoroughly reviewed by the treasurer, CEO, and finance director. A printed copy of this 990 will be presented at the monthly board meeting for review by all board members.
Form 990, Part VI, Line 12c Conflict of interest policy	THE PRYMCA HAS A THOROUGH POLICY THAT SPECIFICALLY CALLS FOR PERIODIC MONITORING BE DONE TO ENSURE THAT THE INTERESTS OF THE PRYMCA ARE SERVED IN ALL CASES AND THAT THE PRYMCA OPERATES IN A MANNER THAT DOES NOT CONFLICT WITH OUR MISSION AND DOES NOT JEOPARDIZE OUR TAX EXEMPT STATUS. KEY PERSONS ARE REQUIRED TO SIGN A STATEMENT CONFIRMING THEY HAVE RECEIVED THE POLICY AND THAT THEY HAVE READ AND UNDERSTAND THE POLICY
Form 990, Part VI, Line 19 Required documents available to the public	THE PISCATAQUIS REGIONAL YMCA MAKES ITS 990 AVAILABLE UPON REQUEST TO ANYONE WHO VISITS OUR FACILITY AT 48 PARK STREET, DOVER-FOXCROFT, ME 04426. IT IS ALSO AVAILABLE FOR VIEWING ON SEVERAL INDEPENDENT WEBSITES WHO PROVIDE SUCH SERVICES.
Form 990, Part VIII, Line 2f Other Program Service Revenue	- Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;

Return Reference

Explanation

Form 990, Part VI, Line 6 Classes of members or stockholders

THE ORGANIZATION OFFERS MEMBERSHIPS TO THE COMMUNITY. INDIVIDUALS OR FAMILIES WISHING TO BECOME MEMBERS PAY A MONTHLY OR ANNUAL MEMBERSHIP RATE IN EXCHANGE FOR USE OF THE FACILITY AND FOR THE OPPORTUNITY TO PARTICIPATE IN CERTAIN PROGRAMS FOR FREE OR FOR A REDUCED RATE. THE FACILITY INCLUDES A FITNESS CENTER, AN INDOOR POOL, AND OFFERS SEVERAL FITNESS CLASSES FOR PERSONS OF ALL AGES.

Form 990, Part VI, Line 7a Members or stockholders electing members of governing body

Members of the PRYMCA elect the board of directors at the annual meeting. All members are invited to attend the annual meeting and participate in the election of the board of directors.

Form 990, Part VI, Line 11b Review of form 990 by governing body

This 990 will be completed and thoroughly reviewed by the treasurer, CEO, and finance director. A printed copy of this 990 will be presented at the monthly board meeting for review by all board members.

Form 990, Part VI, Line 12c Conflict of interest policy

THE PRYMCA HAS A THOROUGH POLICY THAT SPECIFICALLY CALLS FOR PERIODIC MONITORING BE DONE TO ENSURE THAT THE INTERESTS OF THE PRYMCA ARE SERVED IN ALL CASES AND THAT THE PRYMCA OPERATES IN A MANNER THAT DOES NOT CONFLICT WITH OUR MISSION AND DOES NOT JEOPARDIZE OUR TAX EXEMPT STATUS. KEY PERSONS ARE REQUIRED TO SIGN A STATEMENT CONFIRMING THEY HAVE RECEIVED THE POLICY AND THAT THEY HAVE READ AND UNDERSTAND THE POLICY

Form 990, Part VI, Line 19 Required documents available to the public

THE PISCATAQUIS REGIONAL YMCA MAKES ITS 990 AVAILABLE UPON REQUEST TO ANYONE WHO VISITS OUR FACILITY AT 48 PARK STREET, DOVER-FOXCROFT, ME 04426. IT IS ALSO AVAILABLE FOR VIEWING ON SEVERAL INDEPENDENT WEBSITES WHO PROVIDE SUCH SERVICES.

Form 990, Part VIII, Line 2f Other Program Service Revenue

- Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Software ID:	15000238
Software Version:	2015v2.1