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.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet 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
BCCAP - SH INC
 
Employer identification number

22-3277404
Return Reference Explanation
PART VI SECTION A LINE 2 THE FOLL0WING OFFICERS AND DIRECTORS ARE ALSO OFFICERS AND DIRECTORS OF A RELATED TAX-EXEMPT ORGANIZATION, BURLINGTON COUNTY COMMUNITY ACTION PROGRAM: NAME TITLE ----------- ----- HENRY ADAMS TREASURER/BOARD MEMBER HENRY GILYARD 2ND VP/BOARD MEMBER WILLIAM PROBSTING PRESIDENT/BOARD MEMBER ODESSA JOHNSON SECRETARY/BOARD MEMBER FERNAND OULLETTE TREASURER MARY LAWRENCE 1ST VP/BOARD MEMBER SILAS M. TOWNSEND FORMER EXECUTIVE DIRECTOR MARY L. SCANLON CONTROLLER AND ACTING EXECUTIVE DIRECTOR
PART VI SECTION B LINE 11A A draft of the form 990 is reviewed and authorized by a member of the board of directors prior to filing with the IRS.
PART VI SECTION B LINE 12C BOARD AND STAFF REVEAL ANY POSSIBLE CONFLICT OF INTEREST THAT THEY MAY HAVE.
PART VI SECTION C LINE 19 The organization's governing documents and policies are available for public inspection at the organization's office during regular business hours upon request.
PART VI SECTION B LINE 15 AN ANNUAL WAGE COMPARABILITY STUDY IS COMPLETED FOR ALL POSITIONS.
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


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