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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Clovernook Center For the Blind
and Visually Impaired
Employer identification number

31-0584310
Return Reference Explanation
Form 990, Part VI, Section B, line 11b The Controller and members of the finance committee reviewed the 990 before the return was given to the Board of Directors, prior to filing.
Form 990, Part VI, Section B, line 12c In order to monitor adherence to our Conflict of Interest Policy, all Board members, Committee members (non-Board), the CEO, and Vice Presidents/Officers of the agency are required to review and sign off on the policy on an annual basis.
Form 990, Part VI, Section B, line 15 Compensation is based on the results of the review of the performance of the individual for the period under review. The CEO's review is done by the Chairman of the Board of Trustees. The review of senior management is performed by the CEO.
Form 990, Part VI, Section C, line 19 Governing documents and conflict of interest policy are available upon request. Financial statement information is available online from both the annual report and the Form 990 at www.clovernook.org. Annual reports are also mailed to donors and are available for pickup at both Clovernook locations.
Form 990, Part XII, Line 2c The Finance Committee is responsible for audit oversight. This process has not changed in the current year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


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