28 Chenango County Chapter ARC

I
.
Form CHAR500
This form used for
Article 7-A, EPTL and dual filers
replaces forms CHAR 497, CHAR
010 and CHAR 006)
1. General Information
a. For the fiscal year beginning
b. Check if applicable for NYS:
I
Address change
Name change
Initial filing
Final filing
Amended filing
NY registration pending
Annual Filing for Charitable Organizations
New York State Department of Law (Office of the Attorney General)
Charities Bureau - Registration Section
120 Broadway
New York, NY 10271
htto://www.charitiesnvs.com
(dd/yyyy)
01/01
/2Ol2 and e
12/31/2012
c. Name of organization
NYS ARC, INC. CHENANGO COUNTY CHAPTER
Number and street (or P.O. box if mail is not delivered to street address)
Room/suite
17 MIDLAND DRIVE
City or town, state or country and zip + 4
NORWICH, NY 13815
2012
Open to Public
Inspection
d.Fed. employer ID no. (EIN) (##-#######)
16-0970103
o. NY State registration no. (##-##-##)
01-32-25
f. Telephone number
(607) 334-5366
g. Email
NORCWS@CWSPACKAGI
NG. COM
2. Certification - Two Signatures Required
We certify under penalties of perjury that we reviewed this repirtcl rig all attachments, and to the best of our knowledge and belief, they
are true, correct and complete in accor a ith toe aState of New York applicable to this report.
a. President or Authorized Officer
y- ILLIAN WHITAKERPRESIDENT
gnaturePrinted NameTitlejate
b. Chief Financial Officer or Treasurer
's nat- 'WKted
Iie
I .
3. Annual Report Exemption Informat n
a. Article 7-A annual report exemption (Article 7-A registrants and dual registrants)
Check - if total contributions from NY State (including residents, foundations, corporations, government agencies, etc.) did not exceed
$25,000 and the organization did not engage a professional fund raiser (PFR) or fund raising counsel (FRC) to solicit
contributions during this fiscal year.
NOTE: An organization may claim this exemption if no PFR or FRC was used and either: 1) it received an allocation from a federated fund,
United \N, OF incorporated conrrtinity appeal and contributions from all sources did not exceed $25,000 or 2) it received all or substantially
all of its contributions from one government agency to which it submitted an annual report similar to that required by Article 7-A.
b. EPTL annual report exemption (EPTL registrants and dual registrants)
Check
if gross receipts did not exceed $25,000 and the assets (market value) did not exceed $25,000 at any time during this fiscal year.
For EPTL or Article 7-A registrants claiming the annual report exemption under the one law under which they are registered and for dual
registrants claiming the annual report exemptions under both laws, simply complete part 1 (General Information), part 2
(Certification) and part 3 (Annual Report Exemption Information) above.
Do not submit a fee, do not complete the following schedules and do not submit any attachments to this form.
4. Article 7-A Schedules
If you did not check the Article 7-A annual report exemption above, complete the following for this fiscal year:
a. Did the organization use a professional fund raiser, fund raising counsel or commercial co-venturer for fund raising activity in NY State?
*
If "Yes, complete Schedule 4a.
b. Did the organization receive government contributions (grants) 7 ................................................
*
If 'Yee, complete Schedule 4b.
Yes*
nX
No
Yes*
F1
No
5. Fee Submitted: See last page for summary of fee requirements.
Indicate the filing fee(s) you are submitting along with this form:
a. Article 7-A filing fee ................................................... $25
Submit only one check or money order
for the total fee, payable to
b. EPTL filing fee........................................................$250.
"NYS Department of Law"
c. Total fee..............................................................$275.
6. Attachments - For organizations that are not claiming annual report exemptions under both laws, see page 4 for required attachments
I
INNYVA9812L 01/16/13Form CHAR500 (2012)
Page 3
16-0970103
Schedule 4b: Government Contributions (Grants)
If you checked the box in question 4.b. on page 1, complete the following schedule for each government contribution (grant).
cooies of this oaae if necessary to list each aovernment contribution (aranfl seoaratelv.
Government Agency Name Grant Amount
DASNY.$
250,000.
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
I s
Total Government Contributions (Grants) $250, 000.

IN NYVA9834L01116113 Form CHAR500 (2012)
Page 4
16-0970103
5. Fee Instructions
The filing fee depends on the organization' s Registration Type. For details on Registration Type and filing fees, see the Instructions for
Form CHAR500.
Organization's Registration Type Fee Instructions
Article 7-ACalculate the Article 7-A filing fee using the table in part a below. The EPTL filing fee is $0.
EPTL
Calculate the EPTL filing fee using the table in part b below, the Article 7-A filing fee is $0.
Dual Calculate both the Article 7-A and EPTL filing fees using the tables in parts a and b below. Add the
Article 7-A and EPTL filing fees together to calculate the total fee. Submit a single check or money
order for the total fee.
a) Article 7-A filing fee
I
Total Support & Revenue
I
Article 7-A Fee
more than $250,000$25
up to $250,000
*
$10
b) ETPL filing fee
Any organization that contracted with or used the services of a professional fund
raiser (PFR) or fund raising counsel (FRC) during the reporting period must pay ar
Article 7-A filing fee of $25, regardless of total support and revenue.
6. Attachments - Document Attachment Check-List
Check the boxes for the documents you are attaching.
For All Filers
Filing Fee
Single check or money order payable to 'NYS Department of Law'
Copies of Internal Revenue Service Forms
F x l
IRS Form 990
All required schedules (including
Schedule B
LI
IRS Form 990-T
IRS Form 990-EZ
LI
Schedule B
IRS Form 990-T
IRS Form 990-PF
Schedule B
IRS Form 990-T
Additional Article 7-A Document Attachment Requirement
Independent Accountant's Report
nX
Audit Report (total support & revenue more than $250,000)
LI
Review Report (total support & revenue $100,001 to $250,000)
LINo Accountant's Report Required (total support & revenue not more than $100,000)
INNWA9834L 01/16/13Form CHAR500 (2012)
CHENANGO COUNTY CHAPTER
NEW YORK STATE ASSOCIATION FOR
RETARDED CHILDREN, INC.
FINANCIAL STATEMENTS
DECEMBER 31, 2012
(:IEENANGO COUNTY CIIAVI'ER
NEW YORK STATE ASSOCIATION FOR RETARDED CHILDREN, INC.
CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2012
INDEX
tage
[-2 Independent Auditors' Report
Consolidated Statements of Financial Position as of
December 31, 2012 and 2011
Consolidated Statements of Activities for the Years
Ended December 31, 2012 and 2011
Consolidated Statements of Functional Expenses for the
Years Ended December 31, 2012 and 2011
Consolidated Statements of Cash Flows for the Years Ended
December 31, 2012 and 2011
Notes to Consolidated Financial Statements
Independent Auditors' Report on Supplementary Information
Schedule I - Consolidating Statement of Financial Position
as of December 31, 2012
Schedule 2 - Consolidating Statement of Financial Position
as of December 31, 2011
Schedule 3 - Consolidating Statements of Activities for the
Years Ended December 31, 2012 and 2011
Schedule 4 - Schedules of Total Revenue for the Years
Ended December 31, 2012 and 2011
Schedule 5 - Consolidating Statement of Functional Expenses
For the Year Ended December 31, 2012
Schedule 6 - Consolidating Statement of Functional N\perlses
For the Year Ended December 31, 201l
3-4
5
6
7
8-17
18
19-20
21-22
23
24
25
26
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It th ud A. I, itult.
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h iuttuit V . 'iiI ryk. i
Pia ker & Lyons
CERTIFIED PUBUC ACCOUNTANTS
I:LhhhII
(607) :l:l(i-SthI 1 8
I;ux: (607) :1 1 6-62-2t
\ \ u'ltstlt: p iiltiv a .euuun
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Ill\ I tr Iuuil
INDEPENDENT AUDITORS' REPORT
To th e Boa rd of Directors
Ch ena ngo County Ch a p ter
New York Sta te Associa tion
for Reta rded Ch ildren, I nc.
Rep ort on th e Fina ncia l Sta tements
We h a v e a udited th e a ccomp a nying consolida ted fina ncia l sta tements of th e CHENANGO COUNTY
CHAPTER NEW YORK STATE ASSOCIATION FOR RETARDED CHILDREN, INC. ( a non-p rofit
organization) AND RELATED COMPANIES wh ich comp rise th e consolida ted sta tements of fina ncia l
p osition a s of December 31 , 20 1 2 a nd 20 1 1 , a nd th e rela ted consolida ted sta tements of a ctiv ities, functiona l
exp enses a nd ca sh flows for th e yea rs th en ended, a nd th e rela ted notes to th e consolida ted fina ncia l
sta tements.
Ma na gement's Resp onsibility for th e Fina ncia l Sta tements
Ma na gement is resp onsible for th e p rep a ra tion a nd fa ir p resenta tion of th ese consolida ted fina ncia l
sta tements in a ccorda nce with a ccounting p rincip les genera lly a ccep ted in th e United Sta tes of America ; th is
includes th e design, imp lementa tion, a nd ma intena nce of interna l control relev a nt to th e p rep a ra tion a nd fa ir
p resenta tion of consolida ted fina ncia l sta tements th a t a re free from ma teria l missta tement, wh eth er due to
fra ud or error.
Auditors' Resp onsibility
Our resp onsibility is to exp ress a n op inion on th ese consolida ted fina ncia l sta tements ba sed on our
a udit. We conducted our a udit in a ccorda nce with a uditing sta nda rds genera lly a ccep ted in th e United
Sta tes of America . Th ose sta nda rds require th a t we p la n a nl p erform th e a udit to obta in rea sona ble
a ssura nce a bout wh eth er th e consoiidted fina ncia l sta tements .ire free of ma teria l missta tement.
An , itid it inv olv es p erforming p rocedures to obta in a udit ev idence a bout th e a lflOU n ts .1 nI l
disclosures in th e consolida ted fina ncia l sta tements. Th e p rocedti res selected dep end on th e a uditors'
judgment, including th e a , sesscncnt of th e risks of iiia teria I ii issta tenlent of th e consolida ted fina ncia l
'.ta teincii ts, wh eth er due to fra ud or error, in ma king th ose risk a ssesmcnts, th e a uditor considers interna l
control relev a nt to th e entity's iur1 p , lr, I tioI 1 a nd fa ir p resenta tion of th e consolida ted fina ncia l sta tement in
order to design a udit p roci'dtin's th a t .ire a p p rop ria te in th e circlimst.lnces, but iiot for th e p urp ose of
e\ p re'.sing a n op inion oil tile i'f1 ecliv 1 2ne'. ot th e entity's in t( 'rlh ll control. Accordingly, we e p re'.s no such
op inion. An a udit ilsut illcludes ev a lua ting th e .lp p rup ri.I teI I e'.S ot I ca tI llltiI lg p olicies iis&'d a nd th e
I ea sun.ih leness of '.ignitica llt .lcC
oil
llIiIli ll t''.till Illtl'S iiia de by l l l IIl .Ig&'l l I t' IIt, ,i', will a s tv .ilii.itiiig hit ( ) v t'r, I ii
iuni1 I it, 1 ti0 I l of tlit COIl',(Iiiil,lI('il IlIlIlli 1,11 ', t, lI ( 'lI I i'lit', .
, st' (u,tnihh ush t2 I 'll h h ti\ 1 0 1 1 Nut ti h i. \u,uuuik I h h i-lI l'.iI )
Chenango County Chapter
New York State Association
for Retarded Children, Inc.
Page l'wo
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis
for our audit opinion.
Opinion
In our opinion, the consolidated financial statements referred to above present fairly, in all material
respects, the financial position of Chenango County Chapter New York State Association for Retarded
Children, Inc. and Related Companies as of December 31, 2012 and 2011, and the changes in its net assets
and its cash flows for the years then ended in accordance with accounting principles generally accepted in
the United States of America.
T L , , MS4^j^^
4
MAKER & LYONS, P.C.
Norwich, New York
March 25, 2013
CONSOLIDATED STATEMENTS OF FINANCIAL POSITION
('IIENANGO COUNTY ChAPTER
DECEMBER 31, 2012 AND 2011
Restated
20122011
ASSETS
Current Assets
Cash and Cash Equivalents
Certificates of Deposit
Accounts Receivable, Net of Allowance for Doubtful Accounts of $30,000
at December 31, 2012 and 2011
Program Receivables
Medicaid Receivable, Net of Allowance for Doubtful Accounts of $13,200
at December 31, 2012 and 2011
Inventory
Prepaid Expenses and Other Assets
Total Current Assets
Investments
Fixed Assets
Land and Land Improvements
Buildings and Improvements
Equipment and Fixtures
Transportation Equipment
Construction in Process
Less: Accumulated Depreciation
Net Fixed Assets
Other Assets
Debt Reserve Fund
Debt Acquisition Costs, Net of Amortization of $59,689 and $52,119 at
December 31, 2012 and 2011, Respectively
Loan to Nonprofit Organization
Total Other Assets
$ 1,064,194 $ 609,668
97,581609,000
837,749824,598
488,166160,683
448,943520,741
366,117371,108
103,76317,942
3,406,5133,113,740
1,699,1691,572,869
423,119432,027
7,016,1336,843,642
3,674,9243,462,095
673,500678,623
577,871166,371
12,365,54711,582,758
7,052,0986,601,751
5,313,4494,981,007
105,739105,739
13,99721,567
10,00010,000
129,736137,306
TOTAL ASSETS
$ 10,548,867 $ 9,804,922
See the accom panyilig notes to financial statements.
3
CIIENANGO COUNTY CHAPTER
DECEMBER 31, 2012 AND 2011
Restated
20122011
LIABILITIES AND NET ASSETS
Current Liabilities
Current Maturities of Long-Term Debt
$185,758 $225,503
Line of Credit
310,450250,250
Accounts Payable
297,931362,381
Deferred Revenue
123,83253,959
Accrued Expenses
298,231266,885
Accrued Payroll and Payroll Taxes
116,951114,668
Accrued Pension Expense
200,487276,280
Total Current Liabilities
1,533,6401,549,926
Other Liabilities
Long-Term Debt - Less Current Maturities
1,014,323868,998
Accrued Bank Flours
448,946417,530
Deferred Compensation Payable
259,764176,395
Total Other Liabilities
1,723,0331,462,923
Total Liabilities
3,256,6733,012,849
Net Assets
Teiiporarily Restricted
43,85443,854
Unrestricted: Board Designated
200,000200,000
Undesignated
7,048,3406,548,219
Total Net Assets
7,292,1946,792,073
'['OTA I LEA B I LITEES AND N El' ASSETS
$ 10,548,867 $9,804,922
See the acom pany ing notes In financial sta terneiits.
$ 8,559,816
1,985,363
320,838
72,626
37,793
361,758
1,412,272
$ 8,714,193
2,060,784
285,938
77,318
38,363
184,422
1,524,467
7,428,487
1,798,809
256,391
73,273
33,808
226,004
1,128,477
10,945,249
7,419,018
1,677,996
251,841
69,035
31,817
159,813
1,119,315
10,728,835
1,329,0221,457,515
28,82220,294
1,357,8441,477,809
12,303,09312,206,644
500,121698,463
6,792,0736,497,796
-(404,186)
6,792,0736,093,610
$ 7,292,194 $ 6,792,073
t
c .
CIIENANGO COUNTY CFIAI'TER
CONSOLIDATED STATEMENTS OF ACTIVITIES
FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011
Restated
2012
2011
Changes in Unrestricted Net Assets:
Revenue
Program
Workshop, Including Investment Return of $156,168 and $24,815
For The Years Ended December 31, 2012 and 2011, Respectively
Supervised Individual Residential Alternative
Supportive Apartments
Clinic
Respite Program
Medicaid Service Coordination
Habilitation - Day and Residential
Other Support
Foundation Revenue, Including Investment Return of $34,309 and $1,710
For The Years Ended December 31, 2012 and 2011, Respectively
Total Revenue
Expenses
Program
Workshop
Clinic
Respite Program
I labilitation - Day and Residential
Total Program Expenses
Supporting Services
Management and General
Fundraising
Total Supporting Services
Total Expenses
Increase in Unrestricted Net Assets
Net Assets - January 1
Prior Period Adjustment
Net ,\ssets - January 1 Restated
Net Assets - December 31
52,74819,622
12,803,21412,905,107
Se the ICCOffl pa flying notes to financial sta tetuents.
5
CIIENANGO COUNTY CHAPTER
CONSOLIDATED STATEMENTS OF FUNCTIONAL EXPENSES
Restated
2012
2011
ManagementManagement
and
and
ProgramGeneralFundraisingTotalProgramGeneralFundraisingTotal
Compensation and Fringe
Salaries, Temporary Services and Participant Compensation
Payroll Taxes and Fringe
Total Compensation and Fringe
Other Expenses
Amortization
Assessment, Dues and Subscriptions
Bad Debt Expense
Cafeteria Purchases
Participant Transportation
Depreciation
Food
Household Supplies
Insurance
Interest Expense
Office Supplies and Expense
Participant Allowance
Professional Fees
Real Estate Taxes
Recreation
Rent Expense
Repairs and Maintenance
Miscellaneous Fundraising Expenses
Staff Training
Sundry
Telephone
Therapeutic and Diagnostic
Travel
Utilities
Vehicle Expense
Program Supplies
Total Other Expenses
TOTAL EXPENSES
$ 5,936,948$ 762,739$3,047$ 6,702,734$ 6,562,490$ 806,559$9,799$ 7,378,848
1,527,781212,1211,4781,741,3801,312,020221,2393,0191,536,278
7,464,729974,8604,5258,444,1147,874,5101,027,79812,8188,915,126
7,570--7,5707,570-
-7,570
605,559-5,6192,9667,303-10,269
----1,427--1,427
69,058--69,05877,822--77,822
367,686--367,686334,784--334,784
469,17356,142-525,315373,16257,468-430,630
112,492--112,49294,596--94,596
25,118--25,11827,770--27,770
41,64817,609-59,25737,19016,859-54,049
65,564--65,56474,532--74,532
10,65850,978-61,63617,35459,723-77,077
80,367--80,36783,080--83,080
31,902110,2041,553143,65937,693170,3491,396209,438
10,915--10,9155,167--5,167
12,182--12,18218,186--18,186
46,000--46,000----
264,61715,859-280,476209,1323,424-212,556
--22,74422,744--6,0006,000
16,4887,418-23,90610,94911,859-22,808
2,40536,469-38,8745,41353,658-59,071
26,25130,627-56,87824,63726,280-50,917
4002,497-2,8978352,480-3,315
5,5838,115-13,69816,3779,5808026,037
224,390--224,390258,246--258,246
42,13912,685-54,82445,10610,734-55,840
1,547,854--1,547,8541,090,331--1,090,331
3,480,520354,16224,2973,858,9792,854,325429,7177,4763,291,518
$ 10,945,249$ 1,329,022$28,822$ 12,303,093$10,728,835$ 1,457,515$20,294$ 12,206,644

See the accompanying notes to financial statements.
6
CFIENANGO COUNTY CHAPTER
CONSOLIDATED STATEMENTS OF CASH FLOWS
Restated
20122011
Cash Flows Provided By Operating Activities:
Change in Net Assets
Adjustments to Reconcile Change in Net Assets
to Net Cash Provided By Operating Activities
Depreciation
Amortization
Net Gain on Fixed Assets
Net (Gain) Loss on Investments
Change in Assets and Liabilites:
Accounts Receivable
Program Receivables
Medicaid Receivable
Inventory
Accounts Payable
Deferred Revenue
Accrued Expenses and Deferred Compensation Payable
Accrued Bank Hours
Net Cash Provided By Operating Activities
Cash Flows Provided By (Used In) Investing Activities:
Fixed Asset Acquisitions
Proceeds From Sale of Fixed Assets
Proceeds From Sale of Investments
Purchases of Investments
Net Cash Used In Investing Activities
Cash Flows Used In Financing Activities:
Proceeds from Line of Credit
Repayment of Debt
Net Cash Provided By (Used In) Financing Activities
Net Increase (Decrease) In Cash
Cash and Cash Equivalents - January 1
Cash and Cash Equivalents - December 31
Supplemental Notes
Interest Paid
Income Taxes Paid
$ 500,121 $ 698,463
525,315
430,630
7,570
7,570
(539)
(3,434)
(134,943)
21,163
(13,151)(211,221)
(327,483)336
71,798(93,154)
4; 991(209,709)
(85,821)(14,112)
(64,450)61,341
69,87331,459
114,715(143,135)
2,2838,553
31,41613,344
(75,793)30,106
625,902628,200
(526,660)(1,325,271)
5393,434
511,419168,000
199,603303,883
(190,960)(518,787)
(6,059)(1,368,741)
60,200250,250
(225,517)(218,362)
(165,317)31,888
454,526(708,653)
609,6681,318,321
$ 1,064,194$
609,668
$65,564 $72,003
7
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
DECEMBER 31, 2012
NOTE 1- NATURE OF ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES
NATURE OF ORGANIZATION
The Chenango County Chapter New York State Association for Retarded Children, Inc. (the
Association) is a non-profit entity and is one of 57 county based unincorporated chapters of the affiliate state
association, NYSARC, Inc. Each chapter operates facilities for the care, treatment and training of individuals
with mental retardation and developmental disabilities. The Association provides services such as home
support, therapy, treatment, live-in services, residential and day habilitation, training and a simulated work
environment. The primary funding sources are Medicaid, operating contracts from the Office of People With
Developmental Disabilities, and fees for packaging and assembling services. The Association utilizes the
buildings owned by Community Residence, Inc. for certain residential programs. CWS Charitable
Foundation, Inc. was established for the purpose of providing centralized planning, management, financial
services and fund raising services to benefit the Association.
The following is a listing of major programs offered by the Association. All programs provide
services to the developmentally disabled population of Chenango County and surrounding areas.
Workshop - a Sheltered Workshop program providing vocational rehabilitation and job readiness training.
Supervised IRA (Individualized Residential Alternative) there are currently four homes providing 24 hour
staff supervision assisting individuals in their activities of daily living.
Supportive Apartments - five 2-bed apartments provide up to 21 hours per week of staff assistance in the
activities of daily living for the more independent population.
Clinic - provides necessary dental services for the developmentally disabled population in and around
Chenango County.
Respite - provides various recreational activities to individuals with disabilities that might otherwise not be
accessible and thereby allows a short break from the daily demands faced by the individuals care providers.
Medicaid Service Coordination - provides assistance in linking the individual with appropriate services and
programs.
Day
Habilitation - consists of staff assisted day programs allowing individuals to receive community
integration while providing various trainings and activities.
SIGNIFICANT ACCOUNTING POLICIES
A. Principles of Consolidation - The accompanying consolidated financial statements reflect the
consolidated financial statements of the Chenango County Chapter New York State Association for Retarded
Children, Inc., Chenango Community Residences, Inc. and CWS Charitable Foundation, Inc. The Chenango
County Chapter New York State Association for Retarded Children, Inc., exercises control over and has an
economic interest in Chenango Community Residences, Inc. and CWS Charitable Foundation, Inc.
Therefore, the consolidated financial statements present the financial position, changes in net assets,
functional expenses and cash flows of an economic unit rather than a legal unit (hereinafter referred to as the
Association). All material intercompany accounts and transactions have been eliminated.
IF
DECEMBER 31, 2012
NOTE 1- SIGNIFICANT ACCOUNTING POLICIES (Continued)
B. Basis of Accounting - The Association's policy is to prepare its financial statements on the
accrual basis of accounting. Under this method, revenues are recognized as earned and expenses are
recognized as they are incurred.
Expenses are accounted for by program and by function. Expenses directly identified are
charged to specific programs. Salaries, other than management and general, are allocated based upon
estimated time spent by the employees on the programs. Management and general expenses are allocated
among programs based upon the relative direct costs of the various programs.
C. Financial Statement Presentation - The Association is required to report information
regarding its financial position and activities according to three classes of net assets: unrestricted net assets,
temporarily restricted net assets, and permanently restricted net assets. As of December 31, 2012 and 2011
there were $43,854 of temporarily restricted net assets to be used for the expansion of manufacturing
facilities and no permanently restricted assets. The Association is also required to present a statement of cash
flows.
The Board has designated unrestricted net assets to be used for the activities of the CWS
Charitable Foundation, Inc. During 2010 the board contributed $100,000 to the foundation and $100,000 was
contributed in a prior year. The designated net assets are based upon the two $100,000 contributions made
by the Association to the Foundation. The Foundation invested the two $100,000 contributions in marketable
securities. As of December 31, 2012 and 2011 the investment value was over the original contribution and
the board had designated net assets of $200,000.
D. Contributions - Contributions are recognized when the donor makes a promise to give to the
Association that is, in substance, unconditional. Contributions that are restricted by the donor are reported
as increases in unrestricted net assets if the restrictions expire in the fiscal year in which the contributions are
recognized. All other donor-restricted contributions are reported as increases in temporarily or permanently
restricted net assets depending on the nature of the restrictions. When a restriction expires, temporarily
restricted net assets are reclassified to unrestricted net assets. As of December 31, 2012 and 2011,
unrestricted contributions in the amounts of $2,204 and $1,205, respectively, were recognized.
E. Contributed Services - During the years ended December 31, 2012 and 2011, the value of
contributed services meeting the requirements for recognition in the financial statements were not material
and have not been recorded.
F. Investments - The Association carries investments in marketable securities with readily
determinable fair values and all debt securities at fair values in the statement of financial position.
Unrealized gains and losses are included in the change in net assets in the accompanying statement of
activities.
G. Taxes - The Internal Revenue Service has determined that the Chenango County Chapter New
York State Association for Retarded Children Inc. and CWS Charitable Foundation, Inc. are exempt from
taxes on income generated from activities related to their exempt purposes under Section 501(c)(3) of the
Internal Revenue Code. The Internal Revenue Service has determined that Chenango Community
Residences, Inc. is exempt under Section 501(c)(2) of the Internal Revenue Code. The Organizations are not
liable for federal unemployment insurance.
9
DECEMBER 31, 2012
H. Uncertainty in Income Taxes - The Association files informational returns in the U.S. federal
jurisdiction and New York State jurisdiction. With few exceptions, the Association is no longer subject to
U.S. federal or state tax examinations by authorities for years before 2009. The Association has not been
informed of any tax examinations by either the Internal Revenue Service (IRS) or New York State tax
authorities for any years not barred by statute of limitations.
The Association has adopted the provisions of the Financial Accounting Standards Board
(FASB) Accounting Standards Codification (ASC) No. 740, "Income Taxes", as amended by FASB
Accounting Standards Update (ASU) No. 2009-06, "Implementation Guidance on Accounting for
Uncertainty in Income Taxes and Disclosure Amendments for Nonpublic Entities". Management had
determined there were no liabilities for unrecognized tax benefits as a result of the implementation of FASB
ASC No. 740, as amended. Furthermore, management has estimated that there are no material unrecognized
tax benefits for either the U.S. federal jurisdiction or New York State jurisdiction for which it is subject to
reporting as of December 31, 2012 and 2011.
The Association has not recognized any interest or penalties related to unrecognized tax
benefits in the statement of activities nor has it accrued any in the statement of financial position as of
December 31, 2012 and 2011.
I. Inventories - Inventories are stated at the lower of cost (using the first-in, first-out method) or
market. The Association's inventory consisted primarily of raw materials at December 31, 2012 and 2011.
J.
Cash and Cash Equivalents - For purposes of the statement of cash flows, the Association
considers all highly liquid instruments purchased with a maturity of three months or less to be cash
equivalents.
K. Accounts Receivable/Program and Medicaid Receivables - The Association subcontracts
packaging and assembly services with various manufacturers. The Association extends credit to many of its
customers. The Association accounts for trade receivables under the accrual method of accounting.
Therefore, the receivable is recorded at the time of sale. Program and Medicaid receivables represents
balances owed to the Association for services provided to consumers. The Association performs ongoing
credit evaluations and does not require collateral. The Association uses the reserve method to account for
uncollectible accounts. Management considers such factors as the age of the accounts receivable, how
recently payments have been received and a customer's ability to pay when reviewing an account for
collectability. Accounts receivable are stated at the amount management expects to collect from outstanding
balances. Management provides for probable uncollectible amounts through a charge to earnings and a
credit to the allowance for uncollectible accounts based on the current status of individual accounts.
Balances that are still outstanding after management has used reasonable collection efforts are written off
through a charge to the allowance and a credit to accounts receivable. Receivables have been reduced by
allowances for uncollectible accounts in the amount of $43,200 for each of the years ended December 31, 2012
and 2011.
L. Property, Plant and Equipment - Property, plant and equipment with a purchased cost basis
or fair market value (if donated) of at least $5,000 and an estimated useful life of at least two years was
capitalized. Assets are being depreciated over their estimated useful lives by the straight-line method.
Depreciation totaled $525,315 and $430,630 for the years ended December 31, 2012 and 2011, respectively.
E D
DECEMBER 31, 2012
M. Construction in Process - Construction in process as of December 31, 2011 consisted of cost
related to various improvements being made to the office and apartments and equipment which were
completed and placed in service during 2012. Construction in process as of December 31, 2012 consisted of
costs related to various improvements being made to the office, warehouse, and apartments and equipment
which have not been completed or placed in service.
N. Use of Estimates - Management uses estimates and assumptions in preparing financial
statements. Those estimates and assumptions affect the reported amounts of assets and liabilities, the
disclosure of contingent assets and liabilities, and reported revenues and expenses. Significant estimates
used in preparing these financial statements include those assumed in computing the revenue and expenses
for the workshop activities and health care costs under the deferred compensation agreement. It is at least
reasonably possible that the significant estimates used will change within the next year.
0. Accrued Bank Hours - Employees are eligible to bank hours of unused vacation time each
year if certain criteria are met. After 15 years of full time employment the employee is eligible to be paid out
over time all unused banked hours if proper notice is given upon leaving the Association. The Association
estimates this liability for all employees who have reached the 15 years of full time employment requirement.
The liability is calculated based on the number of hours banked times the employees' current rate of pay for
the year then ended.
P. Advertising - The Association expenses advertising and marketing expenses as incurred.
Advertising and marketing expenses are included in sundry and program supplies in the statement of
functional expenses and totaled $3,126 and $3,240 for the years ended December 31, 2012 and 2011,
respectively.
Q.
Amortization of Debt Acquisition Costs - The Association has incurred $73,686 in debt
acquisition costs in connection with the issuance of bonds and refinancing of notes. Such costs are being
amortized over the life of the bonds and notes payable. Amortization incurred totaled $7,570 for each of the
years ended December 31, 2012 and 2011. Amortization expense will be $5,059,$2,554, $2,554, $2,554 and
$1,276 for December 31, 2013, 2014, 2015, 2016 and 2017, respectively.
R. Shipping and Handling Costs - The Association classifies freight billed to customers as
program revenue for the workshop and the related freight costs as program supplies.
S. Subsequent Events - The Association has evaluated events and transactions that occurred
between December 31, 2012 and March 25, 2013, which is the date the financial statements were available to
be issued, for possible disclosure and recognition in the financial statements.
NOTE 2- CASH AND CERTIFICATES OF DEPOSIT IN EXCESS OF FEDERALLY INSURED LIMITS
The Association maintains its cash in bank deposit and credit union accounts and certificates of
deposit that, at times, may exceed federally insured limits. The Association has not experienced any losses in
those accounts. As of December 31, 2012, the Association had on deposit $1,099,252 with local banks and
credit unions of which $730,764 was covered by either Federal Deposit or National Credit Union Insurance.
The remainder of the funds is subject to the general credit worthiness and financial stability of the financial
institutions.
11
CFIENANGO COUNTY CHAPTER
DECEMBER 31, 2012
NOTE 3- INVESTMENTS
Investment securities are exposed to various risks, such as interest rate, market and credit. Due to
the level of risk associated with certain investment securities and the level of uncertainties related to changes
in the fair value of investment securities, it is at least reasonably possible that changes in risks in the near
term would materially affect the net assets of the Association. At the current time the Association is unsure
of the potential investment risk on certain investments due to the changes in the current market conditions.
Investments consisted of the following at December 31:
U.S. Government Securities
Mutual Funds
Corporate Bonds
Equities
Cost
20122011
$- $
49,789
46,00086,000
282,523145,000
157,070157,070
838,151866,594
Fair Value
20122011
$- $
51,485
46,80787,433
284,436144,099
163,153149,780
1,204,7731,140,072
$ 1,323,744 $ 1,304,453 $ 1,699,169 $ 1,572,869
Investment return is summarized as follows for the years ended December 31:
20122011
Total Realized and Unrealized
Gain (Loss) on Investments
Investment Income:
Interest Income:
Checking and Savings Accounts
Investment Accounts
Dividend Income
Total Investment Income
Total Investment Return
$ 134,943 $
(21,163)
14,28612,068
9,64911,767
31,59923,853
55,53447,688
$ 190,477 $26,525
NOTE 4- DEBT RESERVE FUND
The financing agreements for the NYSARC, Inc DASNY Bond Series 2005A require the
Association to maintain debt reserve fund for the bonds. The Reserve Funds are a reserve that may be used
for the payment of principal and interest to the extent that other funds are not available. When the bonds
mature, monies in the Reserve Fund will be used to pay the final principal. As of December 31, 2012 and
2011, the debt reserve fund was $105,739.
12
* 12 1%
DECEMBER 31, 2012
NOTE 5- DEFERRED REVENUE
As of December 31, 2012 and 2011 included in deferred revenue is money received that is required
to be used on capital improvements to the various properties and had not been spent during 2012 and 2011.
NOTE 6- LONG-TERM DEBT
Current
Maturities Long-Term
Note Payable to a local bank, secured by investments. The note requires
monthly payments of $4,197, including interest at 6.5% per annum through
June 2017.
Note Payable to a local bank, secured by investments. Monthly installments
payable at $4,380 per month, including interest at 6.5% per annum through
October 2017 are required.
Note Payable to a local bank, secured by investments. Total loan available up
to $700,000 until October 1, 2013. Interest only payments until September 1,
2013. Then monthly payments are determined based on a 231 month
amortization. Final payment is due January 1, 2018. Note bears interest at
lender's corporate base lending rate plus 50 basis points with a minimum
interest rate of 3.75%. Interest rate as of December 31, 2012 was 3.75%.
Bonds Payable to NYSARC, Inc. Payable in monthly payments of $8,562,
including interest at 4.19% per annum through July 2013.
Bonds Payable to NYSARC, Inc. Payable in monthly principal payments of
$5,229, plus interest at 4.19% per annum through August 2017.
Total
$36,632 $ 192,367
33,7982741192
2,949328,149
49,632-
62,747219,615
$ 185,758 $ 1,014,323
At December 31, 2012, the future maturities of long-term debt consisted of the following:
2013
2014
2015
2016
2017
Thereafter
$185,758
149,968
155,461
161,309
250,961
296,624
$ 1,200,081
13
CI-IENANGO COUNTY CHAPTER
DECEMBER 31, 2012
NOTE 7- LINE OF CREDIT
The Association had established a $750,000 line of credit with a local bank. The line was increased
to $1,300,000 during 2012. Investments held with the bank secure the line of credit. The interest rate is prime
plus .5. At December 31, 2012 and 2011 the balance outstanding was $310,450 and $250,250, respectively.
The interest rate at December 31, 2012 was 3.75%.
NOTE 8- PENSION PLAN
The Association has a profit sharing plan with a deferred compensation matching feature for all
full-time staff with over one year of service. Contributions to the plan, net of forfeitures, totaled $177,232 and
$273,546 for the years ended December 31, 2012 and 2011, respectively.
NOTE 9- LEASE COMMITMENTS
In August 2006 the Association signed an agreement for nine copiers. Payments were $1,411 per
month until August 2011. During November 2011 the Association signed an agreement for five copiers.
Payments are $506 per month until October 2016. June 1, 2012 the Association signed an agreement to lease
warehouse/ storage space. The lease requires monthly rent of $5,750 that is month to month until
June 1, 2013. Rental expense for the leases totaled $47,592 and $12,300 for the years ended
December 31, 2012 and 2011, respectively.
Payments under the lease as of December 31 are as follows:
2013$6,072
20146,072
20156,072
20165,060
$23,276
NOTE 10- ECONOMIC DEPENDENCE
Historically, a significant amount of funding for the Association has been derived from New York
State government and government agencies. While this funding has been available in the past at a consistent
level, there is 110 guarantee that such funding will continue to be available in the future. Annually, the
Association must submit cost information to the State. Such information is subject to audit and review by the
New York State Oversight Agency. As such, subsequent audit adjustments are possible but are not expected
by management to be material to the Association's financial statements. Rates of reimbursement are subject
to appeal and subsequent adjustments.
During the years ending December 31, 2012 and 2011, the Association received subcontracting fees
of $4,674,552 and $5,257,233, or approximately 78% and 82% of total sales, from five and four companies,
respectively.
14
DECEMBER 31, 2012
NOTE 11- CONTINGENCIES AND COMMITMENTS
The Association is self-insured in regards to employee dental insurance. Under the plan, the
Association will provide a maximum dental care benefit of $1,500 per family per year for those employees
with dependents and a maximum benefit of $750 per employee per year for single employees with no
dependents. In addition, the Association will provide a lifetime maximum orthodontic care benefit of $500
per person with no annual limit per family. Under the plan, the Association's maximum liability could be
approximately $129,000. Management, based upon historical data on claims filed by its employee base, does
not expect that the Association's liability will approach this cap. During 2012 and 2011, $16,480 and $5,956 of
claims, net of employee premiums collected, were paid under the plan, respectively.
In a prior year, the Association signed a multi-year employment agreement with an employee
which is accounted for as a deferred compensation plan under FASB ASC 710. The agreement entitles the
employee to a longevity incentive which is equal to two weeks of the employee's base salary for every year
the employee is employed at the Association. The initial agreement was renegotiated with two renewal
terms. The first renewal extends the contract to January 1, 2012 and the second renewal extends the contract
until January 1, 2013 if exercised by the employee and approved by the board by specified dates. The first
renewal option has been exercised and approved by the board until January 1, 2012. During 2010 the board
approved a revised contract which expires June 4, 2013. The amount accrued as of December 31, 2010 in the
amount of $301,231 was paid during 2011. The amount accrued after December 31, 2010 until the end of the
contract is payable by the December of the year accrued for. The amount payable is two weeks of the base
salary for the year accrued times the portion of the months worked in the year. In addition, the employee
contract provides that if the Association cancels the agreement without cause the Association is required to
continue a yearly payment of approximately $220,000 including salary and benefits until June 4, 2013. As of
June 30, 2007 the employee became vested to continue to receive the current level of medical and dental
benefits for the lifetime of the employee and spouse. The cost of the medical and dental benefits was initially
recorded in 2007, which was the estimated liability to be paid out over the lifetime of the employee or spouse
discounted to present value. The actuarial calculation of the benefit discounted to present value is $191,764
and $176,395 as of December 31, 2012 and 2011, respectively. Total deferred compensation expense for the
years ending December 31, 2012 and 2011 is $58,831 and $39,078, respectively included on the statement of
functional expense as salary expense. The longevity portion of the contract of $8,461was recorded in accrued
expenses as of December 31, 2012 and 2011, respectively. The remaining balance of $259,764 and $176,395 is
shown as non-current in the statement of financial position as of December 31, 2012 and 2011, respectively.
During September 2011 the Association and Executive Director signed a new contract which took effect
January 1, 2012 with the same terms as above. The Executive Director is entitled to $35,000 based on signing
the new contract and extending his terms to March 1, 2014 which was accrued as of December 31, 2011 and
recorded in accrued expenses. The contract requires that he train a replacement for his position and is
entitled to $35,000 which was accrued as of December 31, 2012 and included in deferred compensation
payable.
The Association has implemented a health reimbursement plan. The contribution per employee is
determined annually by the Association. The estimated contribution for 2013 is immaterial.
The Board during 2010 authorized the Association to loan another nonprofit organization up to
$100,000. This money is to help the nonprofit cover costs until they can generate revenue. During 2010,
$10,000 was loaned to this Organization. No additional amounts were loaned during 2012 and 2011. No
repayment terms have been established at this time. The amount is classified as long term on the statement
of financial position since the Association does not expect repayment during 2013.
15
CHENANGO COUNTY CHAFFER
DECEMBER 31, 2012
NOTE 11- CONTINGENCIES AND COMMITMENTS (Continued)
The Association is an unincorporated association that is exempt from income tax as a Section
501(c)(3) charitable organization. The Association was issued a certificate of recognition as a chapter of
NYSARC, Inc., a not-for-profit corporation that is also exempt from income tax as a Section 501(c)(3)
charitable organization. NYSARC, Inc. has over 50 other chapters. The Association leases some property
from an affiliate, Chenango Community Residences, Inc., a 501(c)(2) not-for-profit corporation. Under the
provisions of some documents of NYSARC, Inc., other property of the Association might be deemed to be
held in trust by NYSARC, Inc. for the beneficial use of the Association. NYSARC, Inc. has stated that because
the chapters are not incorporated, there is a risk, in some circumstances, that individual chapters, or their
assets, may be exposed to liabilities of other chapters. Such liability, if any, cannot reasonably be estimated or
determinable at this time. To the Association's knowledge, no such liabilities have been asserted, or
threatened to be asserted, against the Association or its assets, and management of the Association does not
believe there is a valid basis on which any such liabilities could be imposed against the Association or its
assets. In individual cases, the Association has participated in financing with NYSARC, Inc. in which some of
the Association's assets are pledged for NYSARC, Inc.'s obligations to a third party, such as the Dormitory
Authority of the State of New York.
The Association has filed a lawsuit against NYSARC, Inc. seeking a judicial declaration that it is
autonomous. On October 20, 2011, the Appellate Division, Third Department confirmed that the Association
has, in fact, a sufficient separate existence from NYSARC, Inc. to be considered an unincorporated
association although it is bound by contract to retain its status as a chapter of NYSARC, Inc. NYSARC, Inc.
has counterclaimed based on legal theories of conversion and trespass and seeks damages claimed to exceed
$10,000,000. The Association believes the counterclaims lack merit, but because it is required to defend them,
it sought insurance coverage for both the defense and indemnification from insurance carrier Philadelphia
Insurance Company. The issue of indemnification of the Association likely will remain outstanding until the
NYSARC lawsuit is resolved. Management believes it is likely that the lawsuit in question will be resolved in
2013 without any damages assessed against the Association.
NOTE 12- ADMINISTRATIVE FEES PAID TO AFFILIATE
The Chenango County Chapter New York State Association for Retarded Children, Inc. is a
chapter of the New York State Association for Retarded Children, Inc. and fees are billed to the Chapter.
Fees are included in professional fees in the statement of functional expenses and totaled $21,745 and $21,669
in 2012 and 2011, respectively. In 2007 the Association ceased paying fees to NYSARC, Inc. Instead, the
equivalent of those fees were paid into and maintained in an escrow account pending resolution of the
litigation between these parties. During 2011 the escrow was liquidated and the money was paid to
NYSARC, Inc. and NYSARC, Inc. accepted them without comment. To the extent that the Association paid
service fees, they were for advocacy and education services provided by NYSARC, Inc.
NOTE 13- NON CASFI TRANSACTIONS
During the year ended December 31, 2012, the Association paid for building improvements with
loan proceeds of $331,097. The money was neither deposited nor disbursed from the Association's checking
account and therefore, not reflected in the Statement of Cash Flows.
16
CHENANGO COUNTY CHAFFER
DECEMBER 31, 2012
NOTE 14- FAIR VALUE OF FINANCIAL INSTRUMENTS
Fair values of assets measured utilizing the following levels of the fair value hierarchy:
Level 1: Quoted prices in active markets for identical assets
Level 2: Observable inputs other than the quoted prices included in Level 1
Level 3: Significant unobservable input
Fixed Income Securities
US Government Agencies
Corporate Bonds
Bank Certificate of Deposit
Equities Common Stock
Consumer Discretionary
Consumer Staples
Energy
Financials
Healthcare
Industrial
Information Technolgy
Materials
Telecommunications Services
Mutual Funds Fixed Income
Mutual Funds Equity
20122011
FairFair
ValueLevel 1ValueLevel I
$- $
- $ 51,485 $ 51,485
163,153163,153149,780149,780
46,80746,80787,43387,433
70,118
70,118
58,720
58,720
109,176
109,176
124,732
124,732
106,803
106,803
107,810
107,810
78,856
78,856
52,587
52,587
72,488
72,488
64,637
64,637
101,086
101,086
92,485
92,485
134,730
134,730
141,914
141,914
36,982
36,982
16,167
16,167
8,654
8,654
8,024
8,024
284,436
284,436
144,099
144,099
485,880
485,880
472,996
472,996
Total
$1,699,169 $1,699,169 $1,572,869 $1,572,869

NOTE 15- PRIOR PERIOD ADJUSTMENT
During 2012, the Association discovered a liability was not recorded for amounts owed to employees
upon leaving the Association assuming certain criteria are met. Therefore, the December 31, 2011 beginning
uridesignated net assets has been restated by a reduction of $404,186 to correct the liability as of
December 31, 2010. The 2011 financial statements were restated due to this error and has resulted in an
increase of $13,344 to payroll taxes and fringe and a decrease of $13,344 to the ending undesignated net
assets as of December 31, 2011 and the change in net assets for the year ended December 31, 2011. As a result
of the change net assets for December 31, 2011 was restated to $698,463.
17
Piaker
imm
& Lyons
CERTIFIED PUBUC ACCOUNTANTS
Established in 19-5.5
(607) 336-8008
Fax: (607)336-622-t
\\ehstte: pnlcta.coni
Officers:
Roy E. I'iilhr, CM - lh'Si(!('Jll lXPCUh!','e
.l;ltli(s P. Lewis, (R/.\13V.
('\'S+
Alan D. Piakei, (1l\
Ronald L. SimonS, CR\
John R. May, CR
Angelo J. Gallo. CR\
Richard A. L\ neli. CR\
.\niy E. 13ioivn, (R\"
.Iaiwen E SuIi k, CR\'
Members be rs nfl
.l,nerbwn Institute of cerli/led Pubhe . Ieeountaiits
New Thrk Stale Sane/u of ('ertif ied Publie.leeountants
lhilipl. Piaker, (P.\
.\htaharn L. Piakei (R\
Of (ounsel:
Allan IL Lyons, CR
Keiitwtli L. Coleman, CPA
%%so Licensed in Pennsytuania
Atso Licensed in Marsland
.Ilso ,Il,',nber nfl
'NstiuniI .\ssoeiatioui if Certilieil ilnation Analysts
'l'eniisvluaiita Insliltite of Certified I'uhlic Accountants
INDEPENDENT AUDITORS' REPORT
ON SUPPLEMENTARY INFORMATION
To the Board of Directors
Chenango County Chapter
New York State Association
for Retarded Children, Inc.
We have audited of the consolidated basic financial statements of CHENANGO COUNTY
CHAFFER NEW YORK STATE ASSOCIATION FOR RETARDED CHILDREN, INC. AND RELATED
COMPANIES as of and for years ended December 31, 2012 and 2011, and our report thereon dated March
25, 2013, which expressed an unmodified opinion on those financial statements, appears on page 1 and 2.
Our audits were conducted for the purpose of forming an opinion on the consolidated financial statements
taken as a whole. The additional information included on Schedules I through 6 is presented for purposes of
additional analysis and is not a required part of the consolidated financial statements. Such information is
the responsibility of management and was derived from and relates directly to the underlying accounting
and other records used to prepare the consolidated financial statements. The information has been subjected
to the auditing procedures applied in the audit of the consolidated financial statements and certain
additional procedures, including comparing and reconciling such information directly to the underlying
accounting and other records used to prepare the consolidated financial statements or to the consolidated -
financial statements themselves, and other additional procedures in accordance with auditing standards
generally accepted in the United States of America. In our opinion, the information is fairly stated in all
material respects in relation to the consolidated financial statements as a whole.
/
MAKER & LYONS, P.C.
Norwich, New York
March 25, 2013
1$
586(ounlvRo;tilPD Box 190 X oi'wieh, New \ork 1:3815-0190
SUPPLEMENTAL SCHEDULE 1
CONSOLIDATING STATEMENT OF FINANCIAL POSITION
DECEMBER 31, 2012
Chenango ChenangoCWSConsolidated
CountyCommunity CharitableStatement of
Chapter NYS Residences, Foundation, Consolidation Financial
ARC, Inc.Inc.Inc.EliminationsPosition
ASSETS
Current Assets
Accounts Receivable - Net
Program Receivables
Medicaid Receivable - Net
Inventory
Investments
Fixed Assets
Net Fixed Assets
Other Assets
Debt Reserve Fund
Debt Acquisition Costs,
Net of Amortization of $59,689
Loan to Nonprofit Organization
Intercompany Receivable
Total Other Assets
$ 980,792 $
-$
97,581
837,749
488,166
448,943
366,117
103,763 -
3,323,111 -
1,462,786 -
403,11920,000
6,075,197940,936
3,674,924-
673,500-
577,871-
11,404,611960,936
6,792,265259,833
4,612,346701,103
105,739-
13,997-
10,000-
714,309-
844,045-
- $ 1,064,194
-97,581
-837,749
-488,166
-448,943
-366,117
103,763
3,406,513
=
1,699,169
-423,119
-7,016,133
-3,674,924
-673,500
=
577,871
-12,365,547
=
7,052,098
5,313,449
-105,739
-
-13,997
-
-10,000
6,482(720,791)-
6,482(720,791)
129,736
83,402 $
83,402
236,383
TOTAL ASSETS$ 10,242,288 $ 701,103 $ 326,267 $
(720,791) $ 10,548,867
19
DECEMBER 31, 2012
Current Liabilities
Line of Credit
Accounts Payable
Deferred Revenue
Accrued Expenses and Other Liabilities
$ 185,758 $
-$
- $ 185,758
310,450
-310,450
297,931
-297,931
123,832
-123,832
294,231
-4,000
-298,231
116,951
-116,951
200,487 -
200,487
1,529,640
=
4,000
=
1,533,640
Other Liabilities
1,014,323-
-
-1,014,323
Accrued Bank Hours
448,946-
-
-448,946
259,764-
-
-259,764
Intercompany Payable
-720,791
-(720,791)-
1,723,033720,791
-(720,791)1,723,033
Total Liabilities
3,252,673720,791
4,000(720,791)3,256,673
Total Net Assets
6,989,615(19,688)322,267-7,292,194
TOTAL LIABILITIES AND
NET ASSETS$ 10,242,288 $ 701,103 $ 326,267 $
(720,791) $10,548,867
PTO
, ,
DECEMBER 31, 2011
Restated
ASSETS
Current Assets
Accounts Receivable - Net
Program Receivables
Medicaid Receivable - Net
Inventory
Investments
$ 536, 723 $
609, 000
824, 598
160, 683
520, 741
371, 108
17, 942
3, 040, 795
1, 361, 526
72, 945$
=
72, 945
=
211, 343
- $
609, 668
-609, 000
-824, 598
-160, 683
-520, 741
-371, 108
=
17, 942
=
3, 113, 740
=
1, 572, 869
Fixed Assets
403, 11928, 908
-432, 027
5, 911, 614932, 028
-6, 843, 642

3, 462, 095-
-3, 462, 095

678, 623-
-678, 623
166, 371-
=
166, 371
10, 621, 822960, 936
-11, 582, 758

6, 349, 128252, 623
=
6, 601, 751
Net Fixed Assets
4, 272, 694708, 313
-4, 981, 007

Other Assets
Debt Reserve Fund105, 739---105, 739
Debt Acquisition Costs,
Net of Amortization of $52, 11921, 567---21, 567
Loan to Nonprofit Organization10, 000---10, 000
Intercompany Receivable
699, 082-19, 710(718, 792)-
Total Other Assets836, 388-19, 710(718, 792)137, 306
TOTAL ASSETS$ 9, 511, 403 $ 708, 313 $ 303, 998 $(718, 792) $9, 804, 922
21
1,544,926
868,998-
417,530-
176,395-
-718,792
1,462,923718,792
3,007,849718,792
=
1,549,926
-868,998
-417,530
-
-176,395
-(718,792)-
-(718,792)1,462,923
5,000(718,792)3,012,849
-5,000
DECEMBER 31, 2011
Restated
Current Liabilities
Line of Credit
Accounts Payable
Deferred Revenue
Accrued Expenses and Other Liabilities
Other Liabilities
Accrued Bank Hours
Intercompany Payable
Total Liabilities
$ 225,503 $
- $ 225,503
250,250
-250,250
362,381
-362,381
53,959
-53,959
261,885
5,000
-266,885
114,668
-114,668
276,280
276,280
Total Net Assets
6,907,740(10,479)298,998
-7,196,259
Prior Period Adjustment
(404,186)--
=
(404,186)
Restated Total Net Assets
6,503,554(10,479)298,998
=
6,792,073
TOTAL LIABILITIES AND
NET ASSETS$ 9,511,403 $ 708,313$ 303,998 $(718,792) $9,804,922
22
8,559,8167,433,767828,986
1,985,3631,789,600249,739
320,838256,39138,812
72,62673,27310,095
37,79333,8085,013
361,758226,00433,401
1,412,2721,128,477157,039
-8,262,753
-2,039,339
-295,203
-83,368
-38,821
-259,405
=
1,285,516
297,063
(53,976)
25,635
(10,742)
(1,028)
102,353
126,756
8,714,193
2,060,784
285,938
77,318
38,363
184,422
1,524,467
7,419,018989,361
1,667,545230,712
251,84137,658
69,0359,664
31,8174,751
159,81323,804
1,119,315156,121
-8,408,379305,814
-1,898,257162,527
-289,499(3,561)
-781699(1,381)
-36,5681,795
-183,617805
1,275,436249,031
CONSOLIDATING STATEMENTS OF ACTIVITIES
FOR THE YEARS ENDED DECEMBER 31,2012 AND 2011
Restated
2012
2011
Program
Increase
Program
Increase
Revenue
Management
(Decrease)
Revenue
Management
(Decrease)
and Other
Program and General FundraisingTotal
In Net
and Other
In Net
Support
ExpensesExpensesExpensesExpenses
Assets
Support
Assets
Chenango County Chapter New York State
Association for Retarded Children,Inc.
Workshop
Clinic
Respite Program
Total Chenango County Chapter New York State
Association for Retarded Children,Inc.
Chenango Community Residences,Inc.
CWS Charitable Foundation,Inc.
Combined Totals
Consolidation Eliminations*
Consolidated Totals
12,750,46610,941,3201,323,085
-12,264,405486,06112,885,48510,718,3841,452,071
-12,170,455715,030
10,12719,336-
-19,336(9,209)8,53518,986-
-18,986(10,451)
58,028-5,93728,82234,75923,26919,622-5,44420,29425,738(6,116)
12,818,62110,960,6561,329,02228,82212,318,500500,12112,913,64210,737,3701,457,51520,29412,215,179698,463
(15,407)(15,407)--(15,407)-(8,535)(8,535)--(8,535)-
$ 12,803,214$ 10,945,249$ 1,329,022$28,822$ 12,303,093 $500,121$ 12,905,107$ 10,728,835$ 1,457,515$20,294$ 12,206,644$ 698,463
* Consolidation Eliminations are Summarized as Follows:
Chenango County Chapter NYS ARC,Inc. Rent to
Chenango Community Residences,Inc.
Chenango County Chapter NYS ARC,Inc. Contribution to
CWS Charitable Foundation,Inc.
20122011
$10,127 $8,535
5,280-
$15,407 $8,535
23
CONSOLIDATING STATEMENTS OF ACTIVITIES
Restated
2012
2011
Program
IncreaseProgram
Increase
Revenue
Management
(Decrease)Revenue
Management
(Decrease)
and Other
In Netand Other
In Net
Support
AssetsSupport
Assets
Chenango County Chapter New York State
Association for Retarded Children, Inc.
Workshop
Clinic
Respite Program
8,559,8167,433,767828,986
1,985,3631,789,600249,739
320,838256,39138,812
72,62673,27310,095
37,79333,8085,013
361,758226,00433,401
1,412,2721,128,477157,039
-8,262,753297,063
-2,039,339(53,976)
-295,20325,635
-83,368(10,742)
-38,821(1,028)
-259,405102,353
-1,285,516126,756
8,714,193
2,060,784
285,938
77,318
38,363
184,422
1,524,467
7,419,018989,361
1,667,545230,712
251,84137,658
69,0359,664
31,8174,751
159,81323,804
1,119,315156,121
-8,408,379305,814
-1,898,257162,527
-289,499(3,561)
-78,699(1,381)
36,5681,795
-183,617805
=
1,275,436249,031
Total Chenango County Chapter New York State
Association for Retarded Children, Inc.
12,750,46610,941,3201,323,085
-12,264,405486,06112,885,48510,718,384
1,452,071
-12,170,455715,030
Chenango Community Residences, Inc.
10,127
19,336
--19,336(9,209)8,53518,986
-18,986(10,451)
CWS Charitable Foundation, Inc.
58,028-5,93728,82234,75923,26919,622-5,44420,29425,738(6,116)
Combined Totals
12,818,62110,960,6561,329,02228,82212,318,500500,12112,913,64210,737,3701,457,51520,29412,215,179698,463
Consolidation Eliminations*
(15,407)(15,407)--(15,407)-(8,535)(8,535)--(8,535)-
Consolidated Totals
$ 12,803,214 $ 10,945,249 $ 1,329,022 $28,822 $ 12,303,093 $ 500,121 $ 12,905,107 $ 10,728,835 $ 1,457,515 $20,294 $ 12,206,644 $ 698,463
* Consolidation Eliminations are Summarized as Follows:
Chenango County Chapter NYS ARC, Inc. Rent to
Chenango Community Residences, Inc.
Chenango County Chapter NYS ARC, Inc. Contribution to
CWS Charitable Foundation, Inc.
20122011
$10,127 $8,535
5,280-
$15,407 $8,535
23
-$ -$
1,150-
37,213184,4221,524,467 -
77,854 $
585,148
9,480
24,815
1,175
25,847
644,788
13,501
6,437,332
5,065,545
- $- $77,854
--585,148
8,535-18,015
-1,71026,525
-301,205
-17,88243,729
--644,788
--13,501
--6,437,332
-
-5,065,545
J
NEW YORK STATE ASSOCIATION FOR RETARDED CHILDREN,INC.
SCHEDULES OF TOTAL REVENUE
FOR THE YEAR ENDED DECEMBER 31,2012
ChenangoCWS
Medicaid HabilitationTotalCommunity Charitable
TotalSupervised Supportive
RespiteServiceDay andARCResidences,Foundation,Combined
WorkshopIRAApartments
Clinic
ProgramCoordination ResidentialInc.Inc.Inc.Totals
-$
155,844
164,994
-$
10,127
Revenue
Cafeteria Sales
Participant Fees
Rent Income*
Investment Return
Contributions*
Miscellaneous Income
Grants
New York State Direct Contract
ShelteredEmployment Program
Workshop Sales
MedicaidRevenue
Total Revenue
$71,995$- $
-454,188
10,872-
156,168-
1,304-
25,27830
250,000-
656,905-
13,438-
5,992,470-
1,381,3861,531,145-
- $- $- $- $71,995$
2252,100--612,357
----10,872
----156,168
----1,304
--46120025,969
----250,000
----656,905
----13,438
----5,992,470
72,40135,693361,2971,412,0724,958,988 -
- $71,995
-612,357
-20,999
34,309190,477
6,1807,484
17,53943,508
-250,000
-656,905
-13,438
-5,992,470
-4,958,988
$ 8,559,816 $ 1,985,363 $ 320,838 $72,626 $37,793 $ 361,758 $ 1,412,272 $ 12,750,466 $10,127 $58,028 $ 12,818,621
Restated
FOR THE YEAR ENDED DECEMBER 31,2011
$77,854 $$-$- $
-437,836145,972190
9,480---
24,815---
1,175---
25,847---
644,788---
13,501---
6,437,332---
1,479,4011,622,948139,96677,128 -
Cafeteria Sales
Participant Fees
Rent Income*
Investment Return
Contributions*
Miscellaneous Income
New York State Direct Contract
ShelteredEmployment Program
Workshop Sales
MedicaidRevenue
Total Revenue
$ 8,714,193 $ 2,060,784 $ 285,938 $77,318 $38,363 $ 184,422 $ 1,524,467 $ 12,885,485$8,535$19,622 $ 12,913,642
*Includes Intercompany Transactions as Summarizedin Supplemental Schedule 3.
24
. I
CONSOLIDATING STATEMENT OF FUNCTIONAL EXPENSES
FOR THE YEAR ENDED DECEMBER 31, 2012
*See Supplemental Schedule 3
Manage-ChenangoCWSConsolida-
Medicaid HabilitationmentTotalCommunity CharitabletionConsolida-

TotalSupervisedSupportiveRespiteServiceDay andTotalandExpensesResidences,Foundation,CombinedElimin-tion
WorkshopIRAApartmentsClinicProgram CoordinationResidentialProgramGeneralARC, Inc.Inc.Inc.Totalsations*Totals
$ 3,989,143$ 1,043,808$ 136,594$ 48,668$ 22,788$ 156,056$ 539,891 $ 5,936,948$ 762,739$6,699,687$-$3,047$ 6,702,734 $-$ 6,702,734
793,354389,37850,3249,8537,45464,346213,0721,527,781212,1211,739,902-1,4781,741,380-1,741,380
4,782,4971,433,186186,91858,52130,242220,402752,9637,464,729974,8608,439,589-4,5258,444,114-8,444,114
5,014-----2,5567,570-7,570--7,570-7,570
60------605,5595,619--5,619-5,619
69,058------69,058-69,058--69,058-69,058
5,280------5,280-5,280--5,280(5,280)-
120,03121,1441,228-2871,810223,186367,686-367,686--367,686-367,686
341,70563,6835,6023,812--47,161461,96356,142518,1057,210-525,315-525,315
-83,84025,188---3,464112,492-112,492--112,492-112,492
-13,3682,073---9,67725,118-25,118--25,118-25,118
28,7764,646208208--6,65640,49417,60958,1031,154-59,257-59,257
14,99137,820----12,75365,564-65,564--65,564-65,564
8,1031,59437--52340110,65850,97861,636--61,636-61,636
-58,61121,756----80,367-80,367--80,367-80,367
31,902------31,902110,204142,106-1,553143,659-143,659
7,99170701701--1,45210,915-10,915--10,915-10,915
9402,782263---8,19712,182-12,182--12,182-12,182
56,127------56,127-56,127--56,127(10,127)46,000
227,65311,4201,0551,222--20,269261,61915,859277,4782,998-280,476-280,476
----------22,74422,744-22,744
13,35055479255-2332,01716,4887,41823,906--23,906-23,906
2,33768-----2,40530,53232,937-5,93738,874-38,874
14,1345,8472,2081,084--2,97826,25130,62756,878--56,878-56,878
400------4002,4972,897--2,897-2,897
5,15357---347265,5838,11513,698--13,698-13,698
154,98533,4176,2541,332--20,428216,416-216,4167,974-224,390-224,390
27,0393,550850---10,70042,13912,68554,824--54,824-54,824
1,516,24113,9431,9716,1383,2792,6893,5931,547,854-1,547,854--1,547,854-1,547,854
2,651,270356,41469,47314,7523,5665,602375,5143,476,591348,2253,824,81619,33630,2343,874,386(15,407)3,858,979
$ 7,433,767$ 1,789,600$ 256,391$ 73,273$ 33,808$ 226,004$ 1,128,477$10,941,320$ 1,323,085$12,264,405 $ 19,336 $ 34,759 $12,318,500 $ (15,407) $12,303,093
Salaries, Temporary Services and
Participant Compensation
Other Expenses
Amortization
Bad Debt Expense (Recovery)
Cafeteria Purchases
Contributions
Depreciation
Food
Household Supplies
Insurance
Interest Expense
Office Supplies
Professional Fees
Real Estate Taxes
Recreation
Rent Expense
Staff Training
Sundry
Telephone
Travel
Utilities
Vehicle Expense
Program Supplies
TOTAL EXPENSES
25
CONSOLIDATING STATEMENT OF FUNCTIONAL EXPENSES
FOR THE YEAR ENDED DECEMBER 31, 2011
Restated
Manage-ChenangoCWSConsolida-
Medicaid HabilitationmentTotalCommunity CharitabletionConsolida-
TotalSupervised SupportiveRespiteServiceDay andTotalandExpenses Residences, Foundation, CombinedElimin-tion
WorkshopIRAApartmentsClinicProgram Coordination Residential ProgramGeneralARC, Inc.Inc.Inc.Totalsations*Totals

$4,739,676 $971,852 $134,032 $45,765$20,216 $110,909$540,040 $6,562,490 $806,559$7,369,049$- $9,799$7,378,848$- $7,378,848
673,842342,58148,2349,1046,53145,681186,0471,312,020221,2391,533,259-3,0191,536,278-1,536,278
5,413,5181,314,433182,26654,86926,747156,590726,0877,874,5101,027,7988,902,308-12,8188,915,126-8,915,126
5,014-----2,5567,570-7,570--7,570 - 7,570
2,966------2,9667,30310,269--10,269-10,269
1,427------1,427-1,427--1,427-1,427
77,822------77,822-77,822--77,822-77,822
92,60516,044757-1,725697222,956334,784-334,784--334,784-334,784
239,29467,2227,0674,089--47,488365,16057,468422,6288,002-430,630-430,630
-67,33219,996---7,26894,596-94,596--94,596-94,596
-13,9202,434---11,41627,770-27,770--27,770-27,770
24,9384,376193193--6,40436,10416,85952,9631,086-54,049-54,049
15,18444,107----15,24174,532-74,532--74,532-74,532
13,7032,458468---72517,35459,72377,077 - - 77,077 - 77,077
- 61,93321,147----83,080-83,080--83,080-83,080
34,993-2,700----37,693170,349208,042-1,396209,438-209,438
4,28736----8445,167-5,167--5,167-5,167
1,4212,872203---13,69018,186-18,186--18,186-18,186
8,535------8,535-8,535--8,535(8,535)-
181,60312,035378356--13,286207,6583,424211,0821,474-212,556-212,556
-----------6,0006,000-6,000
10,949------10,94911,85922,808--22,808-22,808
5,387746-365,41348,21453,627-5,44459,071-59,071
14,1865,2321,906817--2,49624,63726,28050,917--50,917-50,917
615120----1008352,4803,315--3,315-3,315
16,09916---262-16,3779,58025,957-8026,037-26,037
175,76037,8956,9381,493--27,736249,822-249,8228,424-258,246-258,246
29,0043,151892---12,05945,10610,73455,840--55,840-55,840
1,049,70814,3564,4927,2123,3452,2618,9571,090,331-1,090,331--1,090,331-1,090,331
2,005,500353,11269,57514,1665,0703,223393,2282,843,874424,2733,268,14718,98612,9203,300,053(8,535)3,291,518
$7,419,018$1,667,545$251,841 $69,035$31,817$159,813 $1,119,315$10,718,384$1,452,071 $12,170,455$18,986 $25,738$12,215,179$(8,535) $12,206,644
Salaries, Temporary Services and
Participant Compensation
Other Expenses
Amortization
Bad Debt Expense
Cafeteria Purchases
Contributions
Depreciation
Food
Household Supplies
Insurance
Interest Expense
Office Supplies
Professional Fees
Real Estate Taxes
Recreation
Rent Expense
Staff Training
Sundry
Telephone
Travel
Utilities
Vehicle Expense
Program Supplies
TOTAL EXPENSES
*See Supplemental Schedule 3
26
2,298,973.2,084,260.
8,770,773.8,738,799.
5,790,832. 6,036,749.
2,218,440.
8,009,272
761,501.
inn of Current Year
2,308, 574.
8,345, 323.
393,476.
End of Year
Form 990
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(aXl) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public
Inspection
A For the 2012 calendar year, or tax
,2012, and endi

B Check if applicable:
Address change
Name change
17 MIDLAND DRIVE
Initial return
NORWICH, NY 13815
Terminated
Amended return
[...j
Application pending I- Name and address of principal officer:
JOHN MCHALE
117 MIDLAND DRIVE NORWICH, NY 1381
ITax-exempt status
[]5O1(c)(3)
Li
501(c) (
)' (insert no.)[J4E

J Website:
CWSPACKAGING. COM
KForm of organizatii
I Corporation I I
Trust
I I AssociationI Other
Part I iSumrr
Employer Identification Number
16-0970103
Telephone number
(607) 334-5366
IG
Gross receipts $ 12,796,411.
H(a) Is this a group return for affiliates?
YesNo
H(b)
Are all affiliates included?YesNo
If No, attach a list. (see instructions)
H
)or
I 1527
H (c) Group exemption number
L Year of Formation: 1969I
M State of legal domicile: NY
1 Briefly describe the organizations mission or most significant activities:
THE MISSION OF THE CHENANGO COUNTY
ARC IS TO PROVIDE PROGRAMS THAT ARE SPECIFIC TO MEET A CONSUMER'S NEEDS IN THE
A_O_F QCIPL_ REHABILITATION,JOB READINESS TRAINING, EMPLOYMENT
ORTU OPPNITYJ RESIDENTIAL SERVICES SERVICEQTQNJ_ DATIAN
2eck this box Chif the organization discontinued its operations or disposed of more than 25% of its net assets.
3 Number of voting members of the governing body (Part VI, line la). ................................... .39
4 Number of independent voting members of the governing body (Part VI, line 1 b)
9
5 Total number of individuals employed in calendar year 2012 (Part V, line 2a)...........................5 217
6Total number of volunteers (estimate if necessary) ...................................................0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ...................................7a
0.
b Net unrelated business taxable income from Form 990-T, line 34 .......................................7b0.
Prior YearCurrent Year
8Contributions and grants (Part VIII, line ih) .........................................
1, 175251,304.
9Program service revenue (Part VIII, line 2g) ..........................................
6.412.683.6,339. 652.
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ........................________________________
11Other revenue (Part VIII, column (A), lines 5, Gd, Sc, 9c, lOc, and l le) ...............
12 Total revenue - add lines 8 through ii (must equal Part VIII, column (A), line 12).
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3) .....................
14 Benefits paid to or for members (Part IX, column (A), line 4) .........................
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10).....
16a Professional fundraising fees (Part IX, column (A), line lie) .........................
b Total fundraising expenses (Part IX, column (D), line 25)
17 Other expenses (Part IX, column (A), lines ha-lid, hif-24e) ........................
18Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) ............
19 Revenue less expenses. Subtract line 18 from line 12 ...............................
I20Total assets (Part X, line 16) .......................................................
o 21Total liabilities (Part X, line 26) .....................................................

Z%
22 Net assets or fund balances. Subtract line 21 from line 20
6. 921. 084.
6.989.615.
Part II
I
Signature Block
accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and
of which preparer has any knowledge.
Sign
Here
PRESIDENT
lype or print name and title.
Print/Type preparer's nameI Preparer s si at re Date
CheckLi if I PTIN
Paid
ROY E. FULLER, CPA
Preparer Firm's name PlANER &
self-employedP00005268
use uniy
Firm's address "
P0 BOX 190, 58,%2 COUNTY RD 32
Firm's EIN 11
16-1152552
NORWICH, NY 0815
Phoneno.
(607) 336-8908
May the IRS discuss this return with the preparef shown above? (see instructions) ..................................... [
Yes
Li
No
BAA For Paperwork Reduction Act Notice, see the separate instructions. TEEA01I3L 12/18/12Form 990 (2012)
a,
0
0
ad
Cl)
a,
cc
a)
a)
a)
Cl)
a,
(I)
C
0.
Ul
I ha
than
Form 990 (2012)
NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 2
I
Part Ill] Statement of ProgramService Accomplishments
Check if Schedule 0 contains a response to any question in this Part Ill ....................................................
1 Briefly describe the organizations mission:
SEESCHEDULE-0
2 Did the organization undertake any significant program services during the year which were not listed on the prior
Form 990 or 990-El' ......................................................................................... .YesRNo
If 'Yes,' describe these new services on Schedule 0.
3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? Yes RNo
If 'Yes,' describe these changes on Schedule 0.
4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.
Section 501 (c)(3) and 501 (c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to
others, the total expenses, and revenue, if any, for each program service reported.
4a (Code: )(Expenses $
3,774,497.
including grants of $) )(Revenue $
2,548,553.)
WORKSHOP
PROVIDES
TRAINING & EMPLOYMENT FOR DEVELOPMENTALLY DISABLED INDIVIDUALS.
THE
-
WORKSHOP
PROVIDES
SERVICES FOR APPROXIMATELY 124 INDIVIDUALS

4b (Code: ) (Expenses $
2, 045, 991.
including grants of $ ) (Revenue $
2,306, 201. )
RESIDENTIAL PROGRAMS PROVIDE VARIOUS LEVELS OF ASSISTANCE TO DEVELOPMENTALLY DISABLED
INDIVIDUALS. 39 INDIVIDUALS 365 DAYS A YEAR.
4c (Code:)(Expenses $1,128,477.
including grants of $
) (Revenue $1,412,272.
THE RESIDENTIAL/DAY HABILITATION PROGRAM PROVIDES
ACTIVITIES
IN A COMMUNITY AND
OIAL ENVIRONMENT FOR DEVELOPMENTALLY DISABLED INDIVIDUALS. 24 423 UNITS OF SERVICE--
4d Other program services.(Describe in Schedule 0.)
SEE SCHEDULE 0
(Expenses
$73,273.
including grants of $
) (Revenue $
72,626.
4e Total programservice expenses
P
7, 022, 238.
BAAmaoioa 08108/12
Form 990 (2012)
S
Form 990 (2012) NYS ARC, INC. CHENANGO COUNTY CHAPTER
16-0970103Page 3
es
I Yes I No
1 I s the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If 'Yes,' complete
ScheduleA.........................................................................................................
2 I s the organization required to complete Schedule B, Schedule of Contributors (see instructions)7......................
3Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates
for public office? If 'Yes,' complete Schedule C, Part /................................................................
4Section 501(c)(3) organizations Did the organization engage in lobbying activities, or have a section 501(h) election
in effect during the tax year? If 'Yes,' complete Schedule C, Part II...................................................
5 I s the organization a section 501 (c)(4), 501 (c)(5), or 501 (c)(6) organization that receives membership dues,
assessments, or similar amounts as defined in Revenue Procedure 98-19? If 'Yes,' complete Schedule C, Part Ill.......
EMM
MME
II,
I.,
I.,
6Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right
to provide advice on the distribution or investment of amounts in such funds or accounts? If 'Yes,' complete Schedule D,
Patti.............................................................................................................6
7Did the organization receive or hold a conservation easement, including easements to preserve open space, the
environment, historic land areas or historic structures? If 'Yes,' complete Schedule D, Part II...........................7
8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If 'Yes,'
complete Schedule D, Part Ill....................................................................................... 8
9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian
for amounts not listed in Part X; or provide credit counseling, debt management credit repair, or debt negotiation
services? If 'Yes, 'complete Schedule D, Part IV .................................................................... .9
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments,
permanent endowments, or quasi-endowments? If 'Yes,' complete Schedule D, Part V.................................10
11 I f the organization's answer to any of the following questions is 'Yes', then complete Schedule D, Parts VI , VI I , VI I I , I X,
or X as applicable.
a Did the organization report an amount for land, buildings and equipment in Part X, line 10? If 'Yes,' complete Schedule
D, Part VI ........................................................................................................
b Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total
assets reportedin Part X, line 16? If 'Yes,' complete Schedule D, Part VII............................................
c Did the organization report an amount for investments - program related in Part X, line 13that is 5% or more of its total
assets reportedin Part X, line 16? If 'Yes,' complete Schedule D, Part VIII...........................................
d Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported
in Part X, line 16? If 'Yes,' complete Schedule D, Part IX............................................................
e Did the organization report an amount for other liabilities in Part X, line 25? If 'Yes,' complete Schedule D, Part X......
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FI N 48 (ASC 740)? If 'Yes,' complete Schedule 0, Part X....
12a Did the organization obtain separate, independent audited financial statements for the tax year? If 'Yes,' complete
Schedule D, Parts XI, andXII.......................................................................................
11
11
ii
X
X
X
X
X
X
X
X
X
X
lid X
lie X
iii
12a
b Was the organization included in consolidated, independent audited financial statements for the tax year? If 'Yes,' and
if the organization answered 'No' to line 12a, then completing Schedule 0, Parts XI and XII is optional.................
13 I s the organization a school described in section 170(b)(1)(A)(ii)? If 'Yes,' complete Schedule E.......................
14a Did the organization maintain an office, employees, or agents outside of the United States? ...........................
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising,
business, investment, and program service activities outside the United States, or aggregate foreign investments valued
at $100,000 or more? If 'Yes,' complete Schedule F, Parts I andIV..................................................
15 Did the organization report on Part I X, column (A), line 3, more than $5,000 of grants or assistance to any organization
or entity located outside the United States? If 'Yes,' complete Schedule F, Parts II andIV.............................
16 Did the organization report on Part I X, column (A), line 3, more than $5,000 of aggregate grants or assistance to
individuals located outside the United States? If 'Yes,' complete Schedule F, Parts Ill andIV..........................
17Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part I X,
column (A), lines 6andlie? If 'Yes,' complete Schedule G, Part I (see instructions)..................................
18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VI I I ,
lines 1 c and8a? If 'Yes,' complete Schedule G, Part II..............................................................
i2b X
13X
14aX
i4bX
15 X
16X
17X
18X
19 Did the organization report more than $15,000 of gross income from gaming activities on Part VI I I , line 9a? If 'Yes,'
complete Schedule G, Part Ill. ..................................... . ............................................... .19X
20 a Did the organization operate one or more hospital facilities? If 'Yes,' complete Schedule H.............................20X
b I f 'Yes' to line 20a, did the organization attach a copy of its audited financial statements to this return? .................. 20 b
BAATEEA0103L 12/13112 Form 990 (2012)
Form 990 (2012) NYS ARC, INC. CHENANGO COUNTY CHAPTER
16-0970103
Page
Checklist of Required Schedules
I I YesI No
21 Did the organization report more than $5,000 of grantsand other assistance to governmentsand organizationsin the
United States on Part I X, column (A), line 1? If 'Yes,' complete Schedule I, Parts I and II. ............................. .21
22 Did the organization report more than $5,000 of grantsand other assistance to individualsin the United Stateson Part
IX, column(A), line 2? If 'Yes,' complete Schedule!, Parts /and Ill .................................................. .22
23Did the organization answer 'Yes' to Part VI I , Section A, line 3, 4, or 5 about compensation of the organization'scurrent
and former officers, directors, trustees, key employees, and highest compensated employees? If 'Yes,' complete
ScheduleJ...........................................................................................................23X
24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 asof
the last day of the year, and that was issued after December 31, 2002? If 'Yes,' answerlines 24b through 24d and
complete Schedule K.If 'No, 'go to line 25 ............................................................................24aX
b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception7 ...................24b
c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
anytax-exempt bonds' .............................................................................................24c
d Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year' ...................24d
25a Section 501 (cX3) and 501
(cX4)
organizations. Did the organization engage in an excess benefit transaction with a
disqualified person during the year? If 'Yes,' complete Schedule L, Part I.............................................
b I sthe organization aware that it engaged in an excessbenefit transaction with a disqualified person in a prior year, and
that the transaction hasnot been reported on any of the organization'sprior Forms990 or 990 . EZ? If 'Yes,' complete
ScheduleL, Part I. ................................................................................................ . 25b
26 Wasa loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or
disqualified person outstanding as of the end of the organization's tax year? If 'Yes,' complete Schedule L, Part II...... 26
27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If 'Yes,' complete Schedule L, Part Ill.......................................................
27
28 Wasthe organization a party to a businesstransaction with one of the following parties(see Schedule L, Part I V
instructions for applicable filing thresholds, conditions, and exceptions): -
a A current or former officer, director, trustee, or key employee? If 'Yes,' complete Schedule L, Part IV.................. .28a
b A family member of a current or former officer, director, trustee, or key employee? If 'Yes,' complete
Schedule L, Part IV.................................................................................................. 28b
c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) wasan
I
officer, director, trustee, or direct or indirect owner? If 'Yes,' complete Schedule L, Part IV............................
29 Did the organization receive more than $25,000 in non-cash contributions? If 'Yes,' complete Schedule M..............
30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? If 'Yes,' complete Schedule M .......................................................................
31 Did the organization liquidate, terminate, or dissolve and cease operations? If 'Yes,' complete Schedule N, Part I.......
32 Did the organization sell, exchange, dispose of, or transfer more than 25% of itsnet assets? If 'Yes,' complete
ScheduleN, Part II. .......... . .................................................................................... . 32
33 Did the organization own 100% of an entity disregarded asseparate from the organization under Regulationssections
301.7701-2 and 301.7701-3? If 'Yes,' complete Schedule R, Part I.....................................................33X
34 Was the organization related to any tax-exempt or taxable entity? If 'Yes,' complete Schedule F?, Parts II, Ill, IV,
andV, line l.........................................................................................................34X
35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? ................................. 35aX
b I f 'Yes' to line 35a, did the organization receive any payment from or engage in any transaction with a controlled
entity withinthe meaning of section512(b)(13)? If 'Yes,' complete Schedule F?, Part V, line 2........................... 35bX
36 Section 501 (cX3) organizations. Did the organization make any transfers to an exempt non-charitable related
organization? If 'Yes,' complete Schedule R, Part V, line 2............................................................ 36
37 Did the organization conduct more than 5% of itsactivitiesthrough an entity that isnot a related organization and that is
treated as a partnership for federal income tax purposes? If 'Yes,' complete Schedule R, Part VI ....................... 37
X
!
!
I
X
X
38 Did the organization complete Schedule 0 and provide explanationsin Schedule 0 for Part VI , lines1 lb and 19?
Note. All Form 990 filers are required to complete Schedule 0 ............ ...........................................
BAA
381 XI
Form 990 (2012)
TEEA01 041 08108112
Form 99O(2012) NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page
I
PjjJ Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule 0 contains a response to any question in this Part V .......................................................
Yes I No
1 a Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ............. I lal
136
b Enter the number of Forms W-2G included in line 1 a. Enter -0- if not applicable ........... .1 b0
c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners? .............................................................................. . 1 c
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax State-
ments, filed for the calendar year ending with or within the year covered by this return.... I 2a217 *
b If at least one is reported on line 2a, did the organization file all required federal employment tax returns'. ............. . 2b X-
Note. If the sum of lines la and 2a is greater than 250, you may be required toe-file. (see instructions)
3 a Did the organization have unrelated business gross income of $1,000 or more during the year? ........................ .3a -X
b If 'Yes' has it filed a Form 990-T for this year? If 'No, 'provide an explanation in Schedule 0............................3b - -
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a
financial account in a foreign country (such as a bank account, securities account, or other financial account)' ........... 4aX
b If 'Yes,' enter the name of the foreign country:
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5 a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year' ....................
b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction' ............
c If 'Yes,' to line 5a or 5b, did the organization file Form 8886-T' ......................................................
6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization
I
solicit any contributions that were not tax deductible as charitable contributions? ...................................... .6aX
b If 'Yes,' did the organization include with every solicitation an express statement that such contributions or gifts were
I
not tax deductible' .................................................................................................
7 Organizations that may receive deductible contributions under section 170(c).
a Did the organization receive apayment in excess of $75 made partly as a contribution and partly for and and
services provided to the payor' ......................................................................................
b If 'Yes,' did the organization notify the donor of the value of the goods or services provided' ...........................
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file
Form8282'..........................................................................................................
d If 'Yes,' indicate the number of Forms 8282 filed during the year .........................I 7d
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract' ..........
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract' ..............
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8399
asrequired' ........................................................................................................
h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a
Form1098-C'.....................................................................................................
8 Sponsoring organizations maintaining donor advised funds and section 509(aX3) supporting organizations. Did the
supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business
holdings at any time during the year' ................................................................................
9 Sponsoring organizations maintaining donor advised funds.
a Did the organization make any taxable distributions under section 4966' ..............................................
b Did the organization make a distribution to a donor, donor advisor, or related person' .................................
10 Section 501(c)(7) organizations. Enter:
a Initiation fees and capital contributions included on Part VIII, line 12 ............ ......... .lOa
b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities...,lOb
11 Section 501(cX12) organizations. Enter:
a Gross income from members or shareholders ........................................... .11 a
b Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them.) ........................................... .11 b
12 a Section 4947(aXl) non . exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041' .............
b If 'Yes,' enter the amount of tax-exempt interest received or accrued during the year ...... . 12b
13 Section 501 (cX29) qualified nonprofit health insurance issuers.
a Is the organization licensed to issue qualified health plans in more than one state' ....................................
Note. See the instructions for additional information the organization must report on Schedule 0.
b Enter the amount of reserves the organization is required to maintain by the states in
which the organization is licensed to issue qualified health plans .........................
c Enter the amount of reserves on hand .................................................. HI
14a Did the organization receive any payments for indoor tanning services during the tax year' ............................
b If 'Yes,' has it filed a Form 720 to report these payments? If 'No, 'provide an explanation in Schedule 0 ................
X
7e1IX
7h
12a
BAATEEA0I05L 08/08112Form 990 (2012)
Form 990 (2012) NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103
Page 6
F P -
art 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 lOb below, describe the circumstances, processes, or changes in
Schedule 0. See instructions.
Check if Schedule 0 contains a response to any question in this Part VI .....................................................
rn
Yes I No
1 a Enter the number of voting members of the governing body at the end of the tax year .....rl
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 0.
b Enter the number of voting members included in line la, above, who are independent.....
2 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? ..........................................................................2
3 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' .......................3
4 Did the organization make any significant changes to its governing documents
since the prior Form 990 was filed 7 ..................................................................................4
5 Did the organization become aware during the year of a significant diversion of the organization's assets?...............5
6 Did the organization have members or stockholders?..... SEE. SCHED UL E. . 0....................................... 6
7 a Did the organization have members, stockhol .ers or other persons who had the power to elect or appoint one or more
bod members of the governingy?..SEE. .bC.UEDULE . Q............................................................
b Are any governance decisions of the organization reserved to (or subject to approval by) members,
stockholders, or other persons other than the governing body' .......................................................
8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by
the following:
alhegoverning body?...............................................................................................8aX
b Each committee with authority to act on behalf of the governing body' ................................................8 bX
Is there any officer, director or 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 0 ..............................9 -X
B. P olicies (This Section B reciuests
/ the Internal Revenue Code

7a1 X
7b
I
I
Yes No
lOaX
lOb
haX
12a X
12b X
lOa Did the organization have local chapters, branches, or affiliates' .....................................................
b If Y es,' 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'..................................................................
11a H as the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form' ......................
b Describe in Schedule 0 the process, if any, used by the organization to review this Form 990.
SEE SCHED UL E o
12a Did the organization have a written conflict of interest policy?If 'No,' go to line 13 ....................................
b Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise
toconflicts' .......................................................................................................
c Did the organization regularly and consistent (y monitor and enforce compliance with the policy?If 'Yes,' describe in
Schedule 0 how this is done...... SEE. CHED UL E . 0.............................................................12cX
13Did the organization have a written whistleblower policy? .............................................................13X
14 Did the organization have a written document retention and destruction policy' ........................................14X
15 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?
a The organization's CEO, Executive Director, or top management official ..............................................15aX
b Other officers of key employees of the organization ...SEE. SCHED UL E. U ..........................................15b X
If 'Y es' to line 15a or 15b, describe the process in Schedule 0.(See instructions.)
16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year' .....................................................................................
b If 'Y es,' 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 taken steps to safeguard the
organization's exempt status with respect to such arrangements' ....................................................
on
17 List the states with which a copy of this Form 990 is required to be filed
NY
18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-1 (501 (c)(3)s only) available for public
inspection.Indicate how you make these available.Check all that apply.
Own websiteAnother's website
R
Upon request
F1
Other (explain in Schedule 0)
19 Describe in Schedule 0 whether (and if so, how) the organization makes its governing documents, conflict of interest policy, and financial statements available to
the public during the tax year.
SEE SCHED UL E 0
20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
D EBRA CARL IN 17 MID L INE D RIVE NORWICH NY 13815 (607) 334-5366
BAAmoiom 0ei08n2Form 990 (2012)
X
Form 990 (2012)
NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page
I
Part VII
I
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and
Independent Contractors
Check if Schedule0contains aresponseto any question in this Part VII
LI
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1aCompletethis tablefor all persons required to belisted. Report compensation for thecalendar year endingwith or within the
organization's tax year.
List all of theorganization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of
compensation. Enter -U- in columns (D), (E), and (F) if no compensation was paid.
List all of theorganization's current key employees, if any. Seeinstructions for definition of key employee.'
List theorganization's fivecurrent highest compensated employees (other than an officer, director, trustee, or key employee)
who received reportablecompensation (Box 5 of Form W-2and/or Box 7 of Form 1099-MISC) of morethan $100,000from the
organization and any related organizations.
List all of theorganization's former officers, key employees, and highest compensated employees who received morethan $100,000
of reportablecompensation from theorganization and any related organizations.
List all of theorganization's former directors or trustees that received, in thecapacity as aformer director or trusteeof the
organization, morethan $10,000of reportablecompensation from theorganization and any related organizations.
List persons in thefollowingorder: individual trustees or directors; institutional trustees; officers; key employees; highest compensated
employees; and former such persons.
[1
Check this box if neither theorganization nor any related organization compensated any current officer, director, or trustee.
(A)
Nameand Title
(C)I
I
(B)
Position (do not check morethan I(D)I(E)
onebox, unless person i s both an I
Average
officer and adirector/trustee)
I
ReportableIReportable
ours per
week (list
any hours
for related
organiza-
co 'ions
below
dotted
<5
line)to-
(5
0
(F)
Estimated
amount of other
compensation
from the
organization
and related
organizations
theO rQ aflizatiO flrelated organizations
(w-2I199.Mlsc)(w.211o99-Misc)
(1)WILLIAM C. CRAINE0.5
BOARD MEMBER0
(2)KIM PARKER0.5
BOARD MEMBER0
(3)ANTHONY SAVITSKY0.5
BOARD MEMBER0
(4)ANGELA ARCIDIACONO0.5
BOARD MEMBER0
(5)JAMES FERTIG ESQ.0.5
BOARD MEMBER0
(6)WILLIAM WHITAKER JR1
PRESIDENT0
(7)SALLY MERRILL0.5
BOARD MEMBER0
(8)ROBYN KING1
VICE PRESIDENT0
(9)WILLIAM WENTZ1
SECRETARY/TREAS0
(10)JOHN MCHALE40
EXECUTIVE DIREC0
(11)DEBRA CARLIN40
VP iifN FINA0
(12)JASON LASICKI40
SALES MANAGER0
(13)
X
X
X
0.
X
0.
0.0.
X
0.
0.0.
XX
0.
0.0.
X
0.
0.0.
XX
0.
0.0.
XX
0.
0.0.
X
347,441.
0.62,955.
X
136,612.
0.23,694.
X249,881.
0.20,538.
(14) -- - -
BAA-rA0107L 12117/12Form 990(2012)
(E)
Reportable
compensation from
related orcianizations
(W_2/]o9.MlSC)
(F)
Estimated
amount of other
compensation
from the
organization
and related
organizations
Form 990 (2012)
(B)(C)
Position
(A)Average (do not check more than one
(D)
Name and title
hoursbox, unless person is both an

Reportable
perofficer and a director/trustee) compensation from

week
(list any
5lI ics--
the oraanization
hours o.. I
0 I i
(W2/th99MlSC)
'
for
i related CCD
organiza
j,I I
-tions
I
below
i
0
dotted
I
I
I MI line)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
i b Sub-total .................................................................733,934.0.107,187.
c Total from conti nuati on sheets to Part VII, Secti on A ........................0.

0.0.
d Total (add li nes lb and lc) ................................................733,934.0.107,187.

2 Total number of i ndi vi duals (i ncludi ng but not li mi ted to those li sted above) who recei ved more than $100,000 of reportable compensati on
from the organi zati on 01,
3
Yes I No
3 Di d the organi zati on li st any former offi cer, di rector or trustee, key employee, or hi ghest compensated employee
on line 1 a? I f 'Yes,' complete Schedule J for such individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 For any i ndi vi dual li sted on li ne la, i s the sum of reportable compensati on and other compensati on from
the organi zati on and related organi zati ons greater than $150,000? I f 'Yes' complete Schedule J for
suchindividual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 Di d any person li sted on li ne la recei ve or accrue compensati on from any unrelated organi zati on or i ndi vi dual
for services rendered to the organization? I f 'Yes,' complete Schedule J for such person
action B. Indeendent Contractors
WMW
U..
IM F
I uompi ete tni s tame tor your ti ve ni gnest compensateci i ndependent contractors that recei vea more tnan I uu,uuu
compensati on from the organi zati on.Report compensati on for the calendar year endi ng wi th or wi thi n the organi zati on's tax
(A)(B)
Name and busi ness addressDescri pti on of servi ces
D HILLMAN & SONS LLC 3190 WESTLAND DR BOUCKVILLE, NY 13310 CONSTRUCTION
GREENTECH COMPANY 519 ROBERT WILLIAMS ROAD UNADILLA, NY 13849 CONSTRUCTION
2 Total number of i ndependent contractors (i ncludi ng but not li mi ted to those li sted above) who recei ved more than
$100,000 i n compensati on from the organi zati on
2
(C)
Compensati on
331, 097.
122.025.
BAATEEA0108L 01/24113Form 990 (2012)
Form 990 (2012) NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 9
Part
VIli
l
Statement of Revenue
Check if Schedule 0 contains a response to any question in this Part VIII. ...................................................
LI
(A)(B)(C)(D)
Total revenueRelated orUnrelatedRevenue
exemptbusinessexcluded from tax
functionrevenueunder sections
revenue512, 513, or 514
1 a Federated campaigns ......... .l a
............. b Membership dues.1 b
(5
c Fundraising events .............ic
d Related organizations ......... .id
e Government grants (contributions)......l e
2 5 0, 000
UJ
2
I-
=f All other contributions, gifts, grants, and
I-
o
similar amounts not included above ...if
1,304.
g Noncash contributions included in Ins la-if: $___________________
h Total . Add lines la-if...............................
Business Code
2a
FEES & CONTRACTS GOV AGENCIES 62 42 006,2 41,688. 6,2 41,688.
Ujb
CAFETERIASALES812 90071,995 71,995
C ELLANEOtJSPROGRANINC62 42 002 5 ,969.2 5 ,969.
LU
u d
e
f All other program service revenue.
-g Total. Add lines 2a-2f...............................
6, 339, 65 2 .
3 Investment income (including dividends, interest and
other similar amounts) ..............................
..49, 796.
4 Income from investment of tax-exempt bond proceeds. .
5Royalties ..........................................
(I) Real
I
(ii) Personal-
I 6a Gross rents ..........
.10,872 .1
b Less: rental expenses
c Rental income or (loss). . .
10,872 .
I d Net rental income or (loss)..........................
7a Gross amount from sales of
(I) Securities
1
(ii) Other
assets other than inventory.
15 2 ,317.1
b Less: cost or other basis
and sales expenses .......
.138, 5 30
c Gain or (loss) ........
.13, 787.
d Net gain or (loss)...................................
8a Gross income from fundraising events
(not including. $
of contributions reported on line ic).
Uj
See Part IV, line l8 ................ a__________
b Less: direct expenses .............. b
0
c Net income or (loss) from fundraising events.........
9a Gross income from gaming activities.
See Part IV, line 19................ a
b Less: direct expenses ..............b
c Net income or (loss) from gaming activities..........
iOa Gross sales of inventory, less returns
and allowances .................... a _
5 , 992 , 470.
b Less: cost of goods sold ............ b _
3, 919, 082 .
c Net income or (loss) from sales of inventory .........
Miscellaneous RevenueIBusiness Code
11a
b
C
d All other revenue...................
e Total. Add lines ha-lid ............................ ..________
12 Total revenue. See instructions .....................
8,738,
BAATEEA0109L 12/17/12 Form 990(2012)
1.
I
Part IX
I
Statement of Functional Expenses
Section 501(c) (3) and 501(c) (4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule 0contains a response to any question in this Part IX .............................................
.IT
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and lOb of Part VIII.
1Grants and other assistance to governments
and organizations in the United States. See
Part IV, line 21.............................
2Grants and other assistance to individuals in
the United States. See Part IV, line 22......
3 Grants and other assistance to governments,
organizations, and individuals outside the
United States. See Part IV, lines 15 and 16..
4 Benefits paid to or for members ............
Compensation of current officers, directors,
trustees, and key employees................
6 Compensation not included above, to
disqualified persons (as defined under
section 4958(i(1)) and persons described
in section 4958(c)(3)(B).....................
7 Other salaries and wages...................
8 Pension plan accruals and contributions
(include section 401(k) and section 403(b)
employer contributions).....................
9 Other employee benefits ...................
10Payroll taxes ..............................
11Fees for services (non-employees):
a Management ..............................
bLegal ......................................
c Accounting ................................
dLobbying..................................
e Professional fundraising services. See Part IV, line 17.
f Investment management fees...............
g Other. (If line hg amt exceeds 10% of line 25, col-
umn (A) amt, list line 119 expenses on Sch 0) ........
12Advertising and promotion..................
13Office expenses ...........................
14 Information technology.....................
15Royalties..................................
16Occupancy ................................
17Travel.....................................
18 Payments of travel or entertainment
expenses for any federal, state, or local
public officials .............................
19 Conferences, conventions, and meetings....
20Interest ...................................
21Payments to affiliates......................
22Depreciation, depletion, and amortization.
23Insurance .................................
24 Other expenses. Itemize expenses not
covered above (List miscellaneous expenses
in line 24e. If line 24e amount exceeds 10%
of line 25, column (A) amount, list line 24e
expenses on Schedule 0.)..................
a
PARTICIPANT TRANSPORTATION
b
FOOD
C
PARTICIPANT EXPENSES
d
CAFETERIA COST
e All other expenses.........................
25 Total functional expenses. Add lines 1through 24e.
26 Joint costs. Complete this line only if
the organization reported in column (B)
joint costs from a combined educational
campaign and fundraising solicitation.
Check hereif following
SOP 98-2(ASC 958-720)...................
Total dxoenses
Program service
Management and
570,702.
7,392
563.310.
0.
0.10.
3,989,484.
3,755,021.1234.463.
130,936.
125,729.5,207.
986, 021.
864,361.121,660.
359, 606.
309.389.50.217.
27,825.
5,358.122,467.
33,850.
33,850.
7,629.
7,629.
72,802.
93,249.
2
16.488.17.418.
564.
112,492.1112.492.
195.734.
TEEA0110L12/18112
Form 990(2012)
6
7
371,108. ii
17,942.
9
4,272,694. lOc
1,361,526. 11
12
13
14
1,517,812,
15
9,511,403.
1,015,214.
17
18
53,959.
19
492,396.
21
22
852,355. 23
24
176,395.
25
2,590,319.
26
6,877,230.
27
43,854.
28
366,117.
103. 763.
4,612,346.
1,781,154.
1.358.546.
331.994.
1,178,537.
3,252. 673.
43,854.
30
31
32
6,921,084.
9.511.403.
6,989,615.
10,242, 288.
Form 990 (2012)
Form 990 012) NYS ARC, INC. CHENANGO COUNTY CHAPTER
16-0970103Page 11
FP-art X Balance Sheet
Check if Schedule 0 contains a response to any question in this Part X .....................................................
(A)(B)
Beginning of yearEnd of year
Cash - non-interest . bearing ............................................... ....
2,60512,605.
Savings and temporary cash investments ......................................
.1, 143,118
2
1,075,768.
Pledges and grants receivable, net ............................................3
Accounts receivable, net .......................................................
824,598
41837,749.
1
2
3
4
A
$
S
E
T
$
A
T
E
S
N
E
T
N
0
B
A
L
C
BAA
5 Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L .....................................................
6 Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501 (c)(9) voluntary employees'
beneficiary organizations (see instructions). Complete Part II of Schedule L. . . . . .
7Notes and loans receivable, net ...............................................
8Inventories for sale or use ....................................................
9Prepaid expenses and deferred charges .......................................
iQa Land, buildings, and equipment: cost or other basis.
Complete Part VI of Schedule D .................... .lOa
11,404, 611.
b Less: accumulated depreciation .....................lOb
6,792,265.
11Investments - publicly traded securities .......................................
12Investments - other securities. See Part IV, line 11 ............................
13Investments - program-related. See Part IV, line 11 ............................
14Intangible assets .............................................................
15Other assets. See Part IV, line 11 .............................................
16 Total assets. Add lines 1 through 15 (must equal line 34) .......................
17Accounts payable and accrued expenses ......................................
18Grants payable...............................................................
19Deferred revenue.............................................................
20Tax-exempt bond liabilities ...................................................
21 Escrow or custodial account liability. Complete Part IV of Schedule D ...........
22 Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L................................................
23 Secured mortgages and notes payable to unrelated third parties ................
24Unsecured notes and loans payable to unrelated third parties ...................
25 Other liabilities (including federal income tax, payables to related third parties,
and other liabilities not included on lines 17-24). Complete Part X of Schedule D.
26Total liabilities. Add lines 17 through 25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Organizations that follow SFAS 117 (ASC 958), check hereFvl and complete
lines 27 through 29, and lines 33 and 34.
27Unrestricted net assets .......................................................
28Temporarily restricted net assets ..............................................
29Permanently restricted net assets .............................................
Organizations that do not follow SFAS 117 (ASC 958), check here
and complete lines 30 through 34.
30Capital stock or trust principal, or current funds ................................
31Paid-in or capital surplus, or land, building, or equipment fund ..................
32 Retained earnings, endowment, accumulated income, or other funds ............
33Total net assets or fund balances .............................................
34Total liabilities and net assets/fund balances ...................................
TEEA011IL 01103/13
I
-Part XI
I
Reconciliation of Net Assets
Check if Schedule 0 contains a response to any question in this Part Xl .....................................................
U
1Total revenue (must equal Part VIII, column (A), line 12) .................................................
2 Total expenses (must equal Part IX, column (A), line 25) .................................................
3Revenue less expenses. Subtract line 2 from line 1.......................................................
4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..................
5Net unrealized gains (losses) on investments ............................................................
2 .585.
6Donated services and use of facilities ...................................................................
7Investment expenses...................................................................................
8Prior period adjustments ...............................................................................
417,530.
9 Other changes in net assets or fund balances (explain in Schedule 0) .....................................
10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column(B))...............................................................................................
Reporting
Check if Schedule 0 contains a resoonse to an y auestion in this Part XII ....................................................
Yes I No
Accounting method used to prepare the Form 990: [CashAccrual[Other
If the organization changed its method of accounting from a prior year or checked 'Other,' explain
in Schedule 0.
2 a Were the organization's financial statements compiled or reviewed by an independent accountant? ..................... .2 aX
If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
F1
Separate basis[Consolidated basis[Both consolidated and separate basis
b Were the organization's financial statements audited by an independent accountant? ...................................2 bX

If 'Yes,' check a box below to indicate whether the financial statements for the year were audited on a separate
basis, consolidated basis, or both:
Consolidated basis
F1
Separate basis[Both consolidated and separate basis*-
c If 'Yes' to line 2a or
?b,
does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant7 ..........................2cX
If the organization changed either its oversight process or selection process during the tax year, explain
in Schedule 0.
3 a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single
Audit Act and OMB Circular A-133' .................................................................................. 3aX
b If 'Yes,' did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain why in Schedule 0 and describe any steps taken to undergo such audits ..............................
BAA
Form 990 (2012)

TEEA0112L 08109111
SCHEDULE A
(Form 990 or 990-EZ)
Public Charity Status and Public Support
Complete if the organization is a section 501 (cX3) organization or a section
4947(aXl) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. 1, See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
I
Employer identification number
NYS ARC, I NC. CHENANGO COUNTY CHAPTER 116-0970103
Part I
J
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1A church, convention of churches or association of churches described in section 170(bX1XAXi).
2A school described in section 170(bX1XAXii). (Attach Schedule E.)
3A hospital or a cooperative hospital service organization described in section 170(bXlXAXiii).
4A medical research organization operated in conjunction with a hospital described in section 170(bXlXAXiii). Enter the hospital's
name, city, and state:
5An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section
170(bX1XAXiv). (Complete Part II.)
6A federal, state, or local government or governmental unit described in section 170(bX1XAXv).
7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public described
in section 170(bX1XAXvi). (Complete Part II.)
8 [A community trust described in section 170(bX1XAXvi). (Complete Part II.)
9 [M organization that normally receives: (1) more than 33-1/3% of its support from contributions, membership fees, and gross receipts from activities
related to its exempt functions - subject to certain exceptions, and (2) no more than 33-1/3% of its support from gross investment income and
unrelated business taxable income (less section 511 tax) from businesses acqired by the organization after June 30, 1975. See section 509(aX2).
(Complete Part Ill.)
10 H An organization organized and operated exclusively to test for public safety. See section 509(aX4).
11An organization organized and operated exclusively for the benefit of, to perform the functions of, or carry out the purposes of one or more publicly
supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(aX3). Check the box that describes the type of
supporting organization and complete lines lie through 11 h.
a [Type Ib [Type IIc [Type Ill - Functionally integratedd [] Type Ill - Non-functionally integrated
e []By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons
other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or
section 509(a)(2).
If the organization received a written determination from the IRS that is a Type I, Type II or Type III supporting organization,
checkthis box ............................................................................................................
gSince August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
Yes No
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii)
below, the governing body of the supported organization' ...............................................119 O) -
(ii) A family member of a person described in (i) above? ....................................................11 g (ii)
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ........................................
11 g (Iii) -
Provide the following information about the supported organization(s). -
(i) Name of supported(ii) EIN(iii) Type of organization(iv) Is the
organization(described on lines .9organization in
above or IRC sectioncolumn (I) listed in
(see instructions))your governing
document?
Yes I No
(A)
(B)
(C)
(D)
(E)
Total
IIII
BAA For Paperwork Reduction Ad Notice, see the Instructions for Form 990 or 990-EZ.
g
) Did you notify(vi) Is the(vii) Amount of monetary
e organization inorganization insupport
column (I) of yourcolumn (i)

support?organized in the
U.S.?
Yes I No I Yes I No
Schedule A (Form 990 or 990. EZ) 2012
TEEA0401L 08/09/12
Schedule A (Form 990 or 990-EZ) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER16-0970103
Page 2
I
-Part II ISupport Schedule for Organizations Described in Sections 170(bX1XAXiv) and 170(bX1XAXvi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part Ill. If the
organization fails to qualify under the tests listed below, please complete Part Ill.)
Section A. Public Support
Calendar year (or fiscal year
(a) 2008(b) 2009(c) 2010(d) 2011(e) 2012
(9
Total
beginning in) I-
1G ifts, grants, contributions, and
membership fees receiv ed. D o not
include any ' unusual grants.) ........
.6,061,109. 6,514,850. 6,473,217. 6,336,004. 6,518,961. 31,904,141.
2 Tax rev enues lev ied for the
organization' s benefit and
either paid to or expended
on its behalf .................. 0.
3 The v alue of serv ices or
facilities furnished by a
gov ernmental unit to the
organization without charge.... 0.
4 TotaLAdd lines l through 3... 6,061,109. 6,514,850. 6,473,217. 6,336,004. 6,518,961. 31,904,141.
5 The portion of total
contributions by each person
(other than a gov ernmental
unit or publicly supported
organization) included on line 1
that exceeds 2% of the amount
shown on line 11, column (f).. 0.
6Public support. Subtract line 5
from line 4. ................... 3
Section B. Total Support
Calendar year (or fiscal year
(a) 2008(b)2009(c) 2010(d) 2011(e) 2012
(9
Total
beginning in) 1 ,
7 Amounts from line 4 ..........
.6,061,109. 6,514,850. 6,473,217. 6,336,004.T6,518,961. 31,904,141.
8 G ross income from interest,
div idends, payments receiv ed
on securities loans, rents,
royalties and income from
similar sources ...............
9 Net income from unrelated
business activ ities, whether or
not the business is regularly
carried on ....................
10 Other income. D o not include
gain or loss from the sale of
capital assets (Explain in
Part lv.)......................
72,616.173,631.146,951.143,801.149,796.1286,795.
[ii
11 Total support. Add lines 7
through 10132,190,936.
12 G ross receipts from related activ ities, etc (see instructions) ..................................................
I
12
124,425,200.
13 First fiv e years. If the Form 990 is for the organization' s first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
organization, check this box and stop here
LI
ection C. Computation of Public Support Percentage
14 Public support percentage for 2012 (line 6, column (f) div ided by line 11, column (f)) ...........................14
99.11%
15 Public support percentage from 2011 Schedule A, Part II, line 14 .............................................15
99.05%
16a 33-113% support test 2012. If the organization did not check the box on line 13, and the line 14 is 33-1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ..................................................
b33-113% support test 2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33-1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................................................
17a 10%-facts-and-circumstances test 2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10%
or more, and if the organization meets the ' facts-and-circumstances' test, check this box and stop here. Explain in Part IV how
the organization meets the ' facts-and-circumstances' test. The organization qualifies as a publicly supported organization ......... .
LI
b 10%-facts-and-circumstances test - 2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10%
or more, and if the organization meets the facts-and-circumstances' test, check this box and stop here. Explain in Part IV how the
organization meets the ' facts-and-circumstances' test. The organization qualifies as a publicly supported organization-------------
18 Priv ate foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions..
BAASchedule A (Form 990 or 990-EZ) 2012
TEEA0402L 08/091 1 2
Schedule A (Form 990 or 990-EZ) 2012
Part Ill Support Schedule for Organizations Described in Section 509(aX2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails
to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal yr beginning in) (a) 2008(b) 2009(c) 2010(d) 2011(e) 2012(1) Total
1 Gifts, grants, contributions
and membership fees
received. (Do not include
any unusual grants.') .........
2 Gross receipts from admis-
sions, merchandise sold or
services performed, or facilities
furnished in any activity that is
related to the organization's
tax-exempt purpose ...........
3 Gross receipts from activities
that are not an unrelated trade
or business under section 513.
4 Tax revenues levied for the
organization's benefit and
either paid to or expended on
its behalf
5 The value of services or
facilities furnished by a
governmental unit to the
organization without charge....
6 Total. Add lines 1 through 5
7 a Amounts included on lines 1,
2, and 3 received from
disqualified persons ...........
b Amounts included on lines 2
and 3 received from other than
disqualified persons that
exceed the greater of $5,000 or
1% of the amount on line 13
for the year ...................
cAdd lines 7a and 7b...........
8 Public support (Subtract line
7c from line 6.)
ection B. Total Suonort
Calendar year (or fiscal yr beginning in)
9 Amounts from line s ..........
lOa Gross income from interest,
dividends, payments received
on securities loans, rents,
royalties and income from
similar sources ...............
b Unrelated business taxable
income (less section 511
taxes) from businesses
acquired after June 30, 1975...
cAdd lines lOa and lOb.........
11 Net income from unrelated business
activities not included in line lob,
whether or not the business is
regularly carried on ...............
12 Other income. Do not include
gain or loss from the sale of
capital assets (Explain in
Part IV.) ......................
13 Total Support (Add ins 9, lOc, 11, and 12.)
2008
I
(b) 2009
I
(c) 2010
I
(d) 20111(e) 2012
I
(f) Total
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
organization, check this box and stop here .................................................................................
eciion . tomputation OT ruoiic buppori rerceniage
15 Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .......................... L.!!
16Public support percentage from 2011 Schedule A, Part III, line 15 ............................................
I
16
on
nvestment Income
17 Investment income percentage for 2012 (line lOc, column (f) divided by line 13, column (f)) ....................17
18 Investment income percentage from 2011 Schedule A, Part III, line 17 .........................................18
19a 33-1/3% support tests 2012. If the organization did not check the box on line 14, and line 15 is more than 33-1/3%, and line 17
is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........... 01
F1
b 33-1/3% support tests - 2011. If the organization did not check a box on line 14 or line 19a, and line 16is more than 33-1/3%, and
line 18 is not more than 33-1/3%, check this box and stop here. The organization qualifies as a publicly supported organization....
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .............
BAATEEA0403L08/09/12Schedule A (Form 990 or 990 . EZ) 2012
T
Schedule A (Form 990 or 990-EZ) 2012NYS ARC, INC. CHENANGO COUNTY CHAPTER16-0970103Page 4
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10;
Part II, line 17a or 17b; and Part Ill, line 12. Also complete this part for any additional information.
(See instructions).
BAA
Schedule A (Form 990 or 990-EZ) 2012

TEEA0404L 08/10/12
- (
Schedule B
( Form 990, 990- EZ,
or 990- PF)
Schedule of Contributors
Attach to Form 990, Form 990- EZ, or Form 990- PF
OMB No. 1545-0047
2012
Employer Identitication number
16-0970103 NYS ARC, INC. CHENANGO COUNTY CHAPTER
Organization type (check one):
Filers of:
Form 990 or 990-EZ
Section:
501 (c)(
3)
(enter number) organization
U4947(a)(1) nonexempt charitable trust not treated as a private foundation
U
527 political organization
Form 990. PF501 (c)(3) exempt private foundation
U4947(a)(1) nonexempt charitable trust treated as a private foundation
501 (c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule
Note. Only a section 501 (c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
UFor an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or property) from any one
contributor. (Complete Parts I and II.)
Special Rules
rXj For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33. 1/3% support test of the regulations under sections
509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the greater of (1) $5,000 or
(2)2% of the amount on (i) Form 990, Part VIII, line lh or (ii) Form 990-EZ, line 1. Complete Parts land II.
UFor a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990. EZ that received from any one contributor, during the year,
total contributions of more than $1,000 for use exclusively for religious, charitable, scientific, literary, or educational purposes, or
the prevention of cruelty to children or animals. Complete Parts I, II, and Ill.
UFor a section 501 (c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor, during the year,
contributions for use exclusively for religious, charitable, etc, purposes, but these contributions did not total to more than $1 ,000.
If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc,
purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc, contributions of $5,000 or more during the year..................................... $
Caution: An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B form 990, 990-EZ, or 990 . PF) but it must
answer No on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not
meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990EZ,
or 990- PF.
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
TEEA0701L 11/30/12
(a)-----------(b)
NumberName, address, and ZIP + 4
(c)(d)
TotalType of contribution
contributions
(a)----------(b)
NumberName, address, and ZIP + 4
(c)(d)
TotalType of contribution
contributions
\.
Schedule B (Form 990, 990-EZ, or 990-PF)(2012)
Page
1 of
1 of Part
Employer identificatic
16-0970103
Part IContributors (see i nstructi ons). U se dupli cate copi es ofPart I i faddi ti onal space i s needed.
(a)(b)(c)
NumberName, address, and ZIP +4Total

contributions
(d)
Type of contribution
1
(a)
Number
DORMITORY AUTHORITY OF THE STATE OF
Person
--------------------------------------
-Payroll [
515 BROADWAY
-----------------------------$5.0L00.0.
Noncash
LI
(Complete Part I I i f there i s
anoncash contri buti on.)
(b)(C)(d)
Name, address, andZIP +4TotalType of contribution
contributions
Person
LI
Payroll
LI
Noncash
-- I s
Person
Payroll
[
Noncash
--------------------------Is ----------
Person
Payroll
LI
Noncash
---------------------------5__________
(a)r-
NumberName, address, and ZI P +4
(a)(b)(c)
NumberName, address, and ZI P + 4Total
contri buti ons
(d)
Type of contribution
(c)(d)
TotalType of contri buti on
contri buti ons
Person .
LI
Payroll
LI
Noncash
LI
Person
LI
Payroll
LI
$Noncash
LI
TEEA0702L 11/30112Schedule B (Form 990, 990-EZ, or 990-PF)(2012)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Page
1
to1 of Part II
Name of organization. Employer identification number
NYS ARC, INC. CHENANGO COUNTY CHAPTER116-0970103
I
Part II
I
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. (b)(c)(d)
fromDescription of noncash property givenFMV (or estimate)Date received
Part I(see instructions)
(a) No.
from
Part I
N/A
(b)
Description of noncash property given
(C)(d)
FMV (or estimate)Date received
(see instructions)
(a)No.
from
Part I
(b)
(c)(d)
(see instructions)
$
(a)No.
from
Part I
(b)
(c)(d)
(see instructions)
(a)No.
from
Part I
(b)
(c)(d)
(see instructions)
(a)No.
from
Part I
(b)
(c)(d)
(see instructions)
BAA
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

TEEA0703L 11/30/12
(a)
No. from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
Description of how gift is held
(a)
No. from
Part I
(b)
Purpose of gift
(c)
Use of gift
(d)
(a)
No. from
Part I
(b)
Purpose of gift
(C)
Use of gift
(d)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012) Page
1
to1 of Part III
Name of organization
NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103
Part I ll
I Exclusively religious, charitable, etc, individual contributions to section 501(c)(7), (8) or (10)
organizations that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part Ill, enter total of exclusively religious, charitable, etc,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.)............ 01
$N/A
Use duplicate copies of Part Ill if additional space is needed.
(a)(b)(c)(d)
No. fromPurpose of giftUse of giftDescription of how gift is held
Part
N/A
(e)
Transfer of gift
Transferees name, address, and ZI P +4 Relationship of transferor to transferee
(e)
Transfer of gift
Transferee's name, address, and ZIP +4
Relationship of transferor to transferee

(e)
Transfer of gift
Transferee's name, address, and ZIP +4 Relationship of transferor to transferee
(e)
Transfer of gift
Transferee's name, address, and ZIP + 4
Relationship of transferor to transferee

BAA
Schedule B (Form 990, 990-EZ, or
TEEA0704L 11/30/12
SCHEDULE D
(Form 990)
internal Revenue Service
Supplemental Financial Statements
Complete if the organization answered 'Yes,' to Form990,
Part IV, lines 6, 7, 8, 9, 10, ha, lib, lic, lid, lie, iif, 12a, or 12b.
Attach to Form990. 1, See separate instructions.
OMB No. 1545-0047
2012
Open to Public
NYS ARC, INC. CHENANGO COUNTY CHAPTER 116-0970103
Paqj_j Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Comp
the organization answered 'Yes' to Form 990, Part IV, line 6.
(a) Donor advised funds(b) Funds and other accounts
1 Total number at end of year ................
2 Aggregate contributions to (during year) .....
3 Aggregate grants from (during year).........
4 Aggregate value at end of year..............
5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control? ........................... [Yes
[
No
6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only
for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring
impermissible private benefit' ..............................................................................
fl
Yes
art II
I
Conservation Easements. Complete if the organization answered 'Yes' to Form 990, Part IV, line 7.
1 Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)Preservation of an historically important land area
Protection of natural habitatPreservation of a certified historic structure
Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the
last day of the tax year.
Held at the End of the Tax Year
a Total number of conservation easements ...................................................
[_!
b Total acreage restricted by conservation easements .........................................
[_
c Number of conservation easements on a certified historic structure included in (a) ............
I
2 c
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic
structure listed in the National Register ................................. .................... .2d
3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year
4 Number of states where property subject to conservation easement is located
5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations,
and enforcement of the conservation easements it holds' .................................................... [Yes
6 Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
7 Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(13)(i)
and section 170(h)(4)(B)(ii)' ................................................................................
[Yes
[ No
9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and
include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for
conservation easements.
Part
Ill
I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered 'Yes' to Form 990, Part IV, line 8.
1 a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held forpublic exhibition, education, or research in furtherance of public service, provide,
in Part XIII, the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the
following amounts relating to these items:
(i) Revenues included in Form 990, Part VIII, line 1 ........................................................ ..
(ii) Assets included in Form 990, Part X................................................................... $
2 If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following
amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a Revenues included in Form 990, Part VIII, line 1 ........................................................... $
b Assets included in Form 990, Part X ......................................................................$
BAA For Paperwork Reduction Act Notice, see the Instructions for Form990. TEEA3301L 09/18/12Schedule D (Form 990) 2012
No
[No
. .
Schedule (Form 990) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 2
Part Ill Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection
items (check all that apply):
aPublic exhibitiondLoan or exchange programs
bScholarly researcheOther
CPreservation for future generations
4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in
Part XIII.
5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets
to be sold to raise funds rather than to be maintained as part of the organization's. . . . . . . . . . . . . . . . . . . . [YesN o
Part IV Escrow and Custodial Arrangements. Complete if the organization answered 'Yes' to Form 990, Part IV, line 9, or
reported an amount on Form 990, Part X, line 21.
1 a Is the organization an agent, trustee, custodian, or other intermediary for contributions or other assets not included
onForm 990, Part X' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [Yes[N o
b If 'Yes,' explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ic
d Additions during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . id
e Distributions during the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . le
Endingbalance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . if
2a Did the organization include an amount on Form 990, Part X, line 21' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [ YesN o
b If 'Yes,' explain the arrangement in Part XIII. Check here if the explantion has been provided in Part XIII . . . . . . . . . . . . . . . . . . . . . . .
H
ent Funds. Complete if the organization answered 'Yes' to Form 990, Part IV, line 10.
I
(a) Current
I
(b) Prior year
I
(C) Two years
I
(d) Three yearsI (e) Four years
1 a Beginning of year balance. . . . .
b Contributions . . . . . . . . . . . . . . . . .
c Net investment earnings, gains,
and losses
d Grants or scholarships . . . . . . . .
e Other expenditures for facilities
and programs. . . . . . . . . . . . . . . . .
f Administrative expenses. . . . . . .
g End of year balance . . . . . . . . . . . . _________________
2 Provide the estimated percentage of the current year end balance (line lg, column (a)) held as:
a Board designated or quasi-endowment%
b Permanent endowment 0,%
c Temporarily restricted endowment%
The percentages in lines 2a, 2b, and 2c should equal 100% .
3 a Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:
YesN o
(i) unrelated organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a(u)
(ii) related organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 a(ii)
b If 'Yes' to 3a(ii), are the related organizations listed as required on Schedule R' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 b
I
4 Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI I
Land,
Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property(a) Cost or other basis(b) Cost or other(c) Accumulated(d) Book value
(investment)basis (other)depreciation
la Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403,119. 403,119.

b Buildings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,075,197.3,499,3192,575,878.
c Leasehold improvements . . . . . . . . . . . . . . . . . . .
dEquipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,348,424.3,292,9461,055,478.
e Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
577,871.1 577,871.
Total. Add lines 1 a through 1 e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).) .................. 0 1 4, 612, 346.
BAASchedule D (Form 990) 2012
TEEA33006107/12
Schedule D
P a r t V 1 1 7
201 2 NYS ARC, INC. CHENANGO COUNTY CHAP TER
Investments - Other Securities. See Form 990, Part X, line 12. N/A
a) Description of security or category(b) Book value(C)
(including name of security)
1 6-097 01 03Page
of valuation: Cost or
'ear market value
(1) Financial derivatives ................................ ._________________
(2) Closely-held equity interests.........................
(3) Other
(A)
(B)
(C)
(D)
(G)
Total. (Column (b)must equal Form 990, Partx, column (B)line 1 2 . 7 . 7
Part VIII I
Investments
- Program Related. See Form 990, Part X
(a) Description of investment type
I
(b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b)must eaual Form 990. Part X, column (B)line
(a) Description
(1)
(2)
(3)CONTRACTS RECEIV ABLE
(4)DEBT ACQUISITION COSTS
(5)DEBT RESERV E FUND
(6)DUE FROM CHENANGO COMMUNITY RESID., INC
(7 )LOAN TO NONP ROFIT ORGANIZATION
(8)MEDICAID RECEIV ABLE
(9)
(10)
Total. (Column (b)must equal Form 990, Part X, column (B), line 1 5. )
(C) Method of valuation: Cost or
end-of-year market value
Book value
488,1 66.
1 3,997 .
1 05,7 39.
7 1 4,309.
1 0,000.
448, 943.
1 ,7 81 ,1 54.
(a) Description of liability(b) Book value
(1) Federal income taxes
(2)DEFERRED COMP ENSATION P AYABLE 259,7 64.
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11) ___
Total. (Column (b)must equal Form 990, Part X, column (B)line 2 5. ). . . . . 259, 7 64
2. FI N 48 (ASC 740) Footnote. I n Part XI I I , provide the text of the footnote to the organization' s financial statements that reports the organization' s liability for uncertain tax positions
under FI N 48 (ASC 740). Check here if the text of the footnote has been provided in Part XI I I ................................................................ [1
BAArE303L12123112Schedule D (Form 990) 2012
Schedule D (Form 990) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 4
Part Xl I Reconciliation of Revenue per Audited Financial Statements With Revenue per Return N/A
1 Total revenue, gains, and other support per audited financial statements ...................................1
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments ..........................................2a
b Donated services and use of facilities .........................................2b
c Recoveries of prior year grants ...............................................2c
d Other (Describe in Part XIII.) ..................................................2d
e Add lines 2a through 2d .................................................................................2e
3Subtract line 2e from line 1 ..............................................................................3
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .............. .4a
b Other (Describe in Part XIII.)..................................................4b
c Add lines 4a and 4b .................................................................................... .4c
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) .............................5
Part Xli I Reconciliation of Expenses per Audited Financial Statements With Expenses per Return N/A
1Total expenses and losses per audited financial statements ...............................................1
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .........................................2a
b Prior year adjustments .......................................................21,
cOther losses .................................................................2c
d Other (Describe in Part XIII.) ..................................................2d
e Add lines 2a through 2d .................................................................................2e
3Subtract line 2e from line 1 ..............................................................................3
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b
..............
.4a
b Other (Describe in Part XIII.)................................................. .
cAdd lines 4a and 4b ..................................................................................... 4c
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part!, line 18.) ............................5
Part XIII I Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part Ill, lines la and 4; Part IV, lines lb and 2b; Part V
line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XI I, lines 2d and 4b. Also complete this part to provide any additional information.
BAA
Schedule D (Form 990) 2012

TEEA3304L. 11/30/12
Employer Identificati
16-0970103
SCHEDULEJ
(Form 990)
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered 'Yes to Form 990, Part IV, line 23.
Attach to Form 990. 0, See separate instructions.
OMB No. 1545.0047
Open:to Public
-Inspection
Part II Questions Regarding Compensation
Yes No
1a Check the appropriate box(es) if the organization provided any of the following to or for a person listed in Form 990, Part
VII, Section A, line la. Complete Part Ill to provide any relevant information regarding these items.
[First-class or charter travel[Housing allowance or residence for personal use
[Travel for companions[Payments for business use of personal residence
[Tax indemnification and gross-up payments[Health or social club dues or initiation fees
[Discretionary spending account [Personal services (e.g., maid, chauffeur, chef)
b If any of the boxes on line 1a are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If 'No,' complete Part Ill to explain ................ .1b
2 Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers, directors,
trustees, and the CEO/Executive Director, regarding the items checked in line la?....................................
3Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part Ill.
[Compensation committee[Written employment contract
EJ
Independent compensation consultant [Compensation survey or study
[Form 990of other organizationsApproval by the board or compensation committee
4 During the year, did any person listed in Form 990, Part VII, Section A, line la with respect to the filing organization
or a related organization:
a Receive a severance payment or change-of-control payment? ........................................................ 4a
b Participate in, or receive payment from, a supplemental nonqualified retirement plan? .................................4b
c Participate in, or receive payment from, an equity-based compensation arrangement7..................................4c
If 'Yes' to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part Ill. PART III
2
X
Only section 501(cX3) and 501(cX4) organizations must complete lines 5-9.
5 For persons listed in Form 990, Part VII, Section A, line la, did the organization pay or accrue any compensation
contingent on the revenues of:
aThe organization7.................................................................................................
b Any related organization? .........................................................................................
If 'Yes' to line 5a or 5b, describe in Part Ill
PART III
6For persons listed in Form 990, Part VII, Section A, line la, did the organization pay or accrue any compensation
contingent on the net earnings of:
aThe organization7.................................................................................................
b Any related organization? .........................................................................................
If 'Yes' to line 6a or 6b, describe in Part Ill.
5a X
5bX
6aX
6b
X
7For persons listed in Form 990, Part VII, Section A, line la, did the
ART III
organization provide any non-fixed
P
payments not described in lines 5 and 6? If 'Yes,' describe in Part Ill ..............................................7X -
8 Were any amounts reported in Form 990, Part VII, paid or accrued pursuant to a contract that was subject,
to the initial contract exception described in Regulations section 53.4958-4(a)(3)?
If 'Yes,' describe in Part Ill .........................................................................................8 -X
9If 'Yes' to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations
section53.4958-6(c) 7 ............................................................................................. 9
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Schedule J (Form 990) 2012

TEEA4101L 12/10112
Schedule J (Form 990) 2012 NYS ARC, INC. CHENANGO
CHAPTER
16-0970103
2
Directors, Trustees, Key Employees, and
ensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation fromthe organization on row (i) and fromrelated organizations, described in the instructions on
row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sumof columns (B)(i)-(iii) for each listed individual must equal the total amount of Form990, Part VII, Section A, line la, applicable columns (D) and (E) amounts for that individual.
(B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement (D) Nontaxable(E) Total of(F) Compensation
and otherbenefitscolumns(B)(i)-(D)reported as
(A) Name and TitleBonus and
deferreddeferred in prior compensationincentivereportable
compensationcompensationcompensation Form990
JOHN MCHALE(i)
_2L2.
385O0.9Qt539.410,396. -0.
1 EXECUTIVE DIREC)0.0.0.0.0.0.0.
DEBRA CARLIN(I)
9OO.
2 672 7. .
7_5L9
160,306. -0.
2 VP ADMIN & FINA(h )
0.0.0.0.0.0.0.
JASON LASICKIM
64 553. 18532 8. -Q.54638 2 70,419. -

3 SALES MANAGER
7
8(
(i)
0.
)0.0.0.0.0.0.0.
(I)
4
W 5
(i)
6(h )
M
u )
V)
9
V)
10(ii)
V)
11
()
(i)
12 (u) ________________________
M
13
()
M
14 (u )
W
15(h )
V)
16(ii)
BAA TEEA4102L12/11(12
Schedule J (Form990) 2012
Schedule J (Form 990) 2012
NYS ARC, INC. CHENANGO COUNTY CHAPTER16-0970103
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines la, ib, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, for
Part H. Also complete this part for any additional information.
- - YARIL .LLN
CEDSVAS
LEMETAQILRJIIENT, QVIIY-BENAT1QN________________________
THE EXECUTIVE DIRECTOR RECEIVED TAXABLE AMOUNTS UNDER SEVERAL ARRANGEMENTS
MAINTAINEDIN CONNECTION WITH PRIOR SERVICES AND CURRENT SERVICES. THESE INCLUDED:
. . . LI)_ANLIPLCENTIVE PAYMENT THAT WAS DEFERRED
-
AND
-
EARNEDIN A
-
PRIOR
YEAR R^3 ,1 22QPIL ___________________________
(II) A
-
RETENTION PAYMENT PAIDFOR HIS AGREEMENT TO
-
STAY ON
-
WITH THE AGENCY
-
PAST HIS
-------------------------
RETIREMENT AGE ($35,(LO.Q)
NON-QUALIFIEDPLAN
-
L^.8,4j^2)_AND_(Iy)_OTHER
-
MISCELLANEOUS PAYMENTS-E.G.,
-
IMPUTED
_____________________________
- - -
INCOME
-
FROMAUTOMOBILE
-
Q^.E, TAXABLE PARTICIPATION IN AGENCY EMPLOYEE PLANS,ETC
----------------------------
___Q27L________________________________________________________________________________
PART 1. LINE 5 - COMPENSATION CONTINGENT ON REVENUES OR RELATED ORGANIZATION
THE SALES MANAGER RECEIVES
COMMISSIONS
AS A PERCENTAGE OF NET CONTRACT SALES

PROCEEDS. THE PERCENTAGES RANGE FROM 1% TO 5% OF NET CONTRACT SALES PROCEEDS. ALL
OTHER COMPENSATION IS SALARY AND NO COMPENSATION IS BASED ON A PERCENTAGE OF AGENCY
REVENUE OR AGENCY PROFITS.
PART LI NE J NON-FI XED PAYME NTS NO T LISTE D
THE EXECUTIVE DIRECTOR IS ELIGIBLE
FOR
AN INCENTIVE PAYMENT BASED ON PERSONAL AND

ORGANIZATIONAL
-
PERFORMANCE
-
GOALS ESTABLISHEDBY THE BOARD,
-
IF ANDTO THE EXTENT
----------------------------
THOSE GOALSARE SATISFIED. BASEDON SATISFACTION/EXCEEDING GOALSIN 20:Ll,
INCENTIVE PAYMENT OF $35,000 WAS PAID IN 2012.
BAASchedule J (Form 990) 2012
TEEA4103L 12/11/12
SCHEDULE K
I
(Form 990)
Supplemental Information on Tax Exempt Bonds
Complete if the organization answered 'Yes' to Form 990, Part I V, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
Attach to Form 990.01See separate instructions.
Part I
I
Bond Issues
(a) I ssuer Name(b) I ssuer EI N
I
(c) CUSI P
# I
(d) Date issued
I
(e) I ssue price
OMB No. 545-0047
2012-
Open to Public
Inspection
16-0970103
(1) Description of purpose(g)(h) On(i) Pooled
Defeased behalf of financing
issuer
Yes I No Yes I No Yes I No
A DORMITORY AUTHORITY OF THE 14-6000293 1649
1, 466.124.IREFINANCE
B
C
D
A
1 Amount of bonds retired.................................................................
2Amount of bonds legallydefeased........................................................
3Total proceeds of issue..................................................................
4Gross proceeds in reserve funds.........................................................
5 Capitalized interest from proceeds
6Proceeds in refunding escrows...........................................................
7I ssuance costs from proceeds............................................................
8 Credit enhancement from proceeds
9 Working capital expenditures from proceeds
1 0Capital expenditures from proceeds ......................................................
1 1 Other spent proceeds ...................................................................
1 2Other unspent proceeds.................................................................
B
C
1 3Year of substantial completion...........................................................
YesNoYesNoYesNoYesNo
14Were the bonds issued as part of a current refunding issue?
1 5 Were the bonds issued as part of an advance refunding issue'.............................
1 6 Has the final allocation of proceeds been made'..........................................
1 7 Does the organization maintain adequate books and records to support the final allocation
ofproceeds'.............................................................................
Part HI
I
Private Business Use
A
Yes INo
1 Was the organization a partner in a partnership, or a member of an LLC, which owned
propertyfinanced bytax-exempt bonds'..................................................
2 Are there anylease arrangements that mayresult in private business use of
bond-financed property'..................................................................
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
BCD
Yes I NoI Yes F NoI Yes INo
Schedule K (Form 990) 201 2
TEEA4401L 01104/13
Schedule K (Form 990) 2012NYS ARC, INC
1 n97nln Paae2
Part HI
I
Private Business Use (Continued)
CID
Yes INo
3a Are there any management or service contracts that may result in private business use of
bond-financed property7 .................................................................
b If 'Yes to line 3a, does the organization routinely engage bond counsel or other outside
counsel to review any management or service contracts relating to the financed property?...
c Are there any research agreements that may result in private business use of
bond-financed property' .................................................................
d If 'Yes to line 3c, does the organization routinely engage bond counsel or other outside counsel
to review any research agreements relating to the financed property' .......................
4 Enter the percentage of financed property used in a private business use by entities other
than a section 501 (c)(3) organization or a state or local government ......................
5 Enter the percentage of financed property used in a private business use as a result of
unrelated trade or business activity carried on by your organization, another section 501 (c)(3
organization, or a state or local government ..............................................
6Total of lines 4 and 5....................................................................
7 Does the bond issue meet the private security or payment test' ............................
8 a Has there been a sale or disposition of any of the bond-financed property to a nongoven-
mental person other than a 501 (c)(3) organization since the bonds were issued' ............
b If 'Yes', to line 8a, enter the percentage of bond-financed property sold or disosed of........
c If 'Yes' to line 8a, was any remedial action taken pursuant to Regulations sections
1.141-12 and 1.145-2' ...................................................................
9 Has the organization established written procedures to ensure that all nonqualified bonds of
the issue are remediated in accordance with the requirements under Regulations sections
1.141-12 and 1.145-2' ...................................................................
Part IV I Arbitrage
In
9- I 9-I
01
0I
%.5
010
1
0
.51.5-5
1Has the issuer filed Form 8038-1' ........................................................
2 If 'No to line 1, did the following apply?
a Rebate not due yet' .....................................................................
b Exception to rebate' ....................................................................
cNo rebate due' .........................................................................
If you checked 'No rebate due' in line 2c, provide in Part VI the date the rebate computation
was performed.
3Is the bond issue a variable rate issue' ...................................................
4a Has the organization or the governmental issuer entered into a qualified hedge with respect
to the bond issue' .......................................................................
b Name of provider........................................................................
cTerm of hedge ..........................................................................
d Was the hedge superintegrated? .........................................................
e Was the hedge terminated' ..............................................................
BAASchedule K (Form 990) 2012
TEEA4401L01/04/13
Schedule K (Form 990) 2012
NYS ARC, INC. CHENANCO COUNTY CHAPTER 16-0970103Page 3
Part IV I Arbitage (Continued)
AB D____
5a Were gross proceeds invested in a guaranteed investment contract (GIC)' ..................
b Name of provider........................................................................
c Term of GIC
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied'.....________
6 Were any gross proceeds invested beyond an available temporary period' ..................
7 Has the organization established written procedures to monitor the requirements of
section148' ...........................................................................
Part V I Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax A
BCD
requirements are timely identified and corrected through the voluntary closing agreement program
if self -remediation is not available under applicable regulations' .................................
[Part VI
I
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
BAATEEA4401L01/04113Schedule K (Form 990) 2012
SCHEDULE 0
(Form 990 or 990-EZ)
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.
Attach to Form 990 or 990-EZ.
OMB No. 15450047
2012
Open to Public
Inspection
16-0970103
FORM 990, PART III, LINE 1 - ORGANIZATION MISSION
THE MISSION OF THE CHENANGO COUNTY ARC IS TO PROVIDE PROGRAMS THAT ARE SPECIFIC TO
MEET A CONSUMER'S NEEDS
-
IN
-
THE
-
AREAS OF VOCATIONAL REHABILITATION, JOB READINESS
TRAINING, EMPLOYMENT OPPORTUNITY, RESIDENTIAL SERVICES,
-
SERVICE
-
COORDINATION,
-
DAY
HABILITATION AND OTHER SUPPORT
-
SERVICES
-
THAT WOULD ALLOW PARTICIPANTS THE
OPPORTUNITY
-
TO
-
MEET
-
THEIR OPTIMUM LEVEL
-
OF
-
SUCCESS
-
AND
-
INDEPENDENCE. THESE MEASURES
WILL BE DESIGNED TO ENSURE
-
THAT
-
PROGRAM
-
PARTICIPANTS ARE NOT ONLY INVOLVED IN, BUT
ARE MAKING
-
POSITIVE
-
CONTRIBUTIONS TO THEIR RESPECTIVE COMMUNITIES.
FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES DESCRIPTION

THE
-
CLINIC
-
PROGRAM
-
PROVIDES
-
DENTAL
-
CARE
-
FOR DEVELOPMENTALLY DISABLED INDIVIDUALS.
621 UNITS OF SERVICE WERE PROVIDED.
FORM 990, PART VI, LINE 6- EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDER
THE ORGANIZATION HAS FOUR CLASSES OF MEMBERS,
-
ACTIVE,
-
LIFE, AT-LARGE AND HONORARY.
NONE OF
-
THE
-
CLASSES
-
OF
-
MEMBERS
-
GIVE
-
THE MEMBERS
-
THE
-
RIGHTS
-
TO APPROVE SIGNIFICANT
DECISIONS OF THE GOVERNING BODY OR SHARE OF THE ORGANIZATION'S
-
PROFITS
-
OR EXCESS
DUES OR A SHARE
-
OF
-
THE
-
ORGANIZATION'S NET ASSETS UPON THE ORGANIZATION'S
DISSOLUTION.
ACTIVE
-
MEMBERS
-
ARE
-
THOSE MEMBERS WHO PAY ANNUAL DUES AND ARE IN GOOD STANDING
DETERMINED
-
ONE
-
MONTH PRIOR TO THE ACT WHICH GOOD STANDING IS REQUIRED. THESE
MEMBERS HAVE THE RIGHT TO VOTE
-
AND
-
HOLD OFFICE EXCEPT THAT NO PERSON WHO IS A PAID
_-
EMPLOYEE OF EITHER
-
THE
-
ASSOCIATION
-
OR ONE OF ITS CHAPTERS IS MAY BE AN
-
OFFICER -
GOVERNOR OR DIRECTOR OF THE ASSOCIATION OR
-
SUCH
-
CHAPTER -
LIFE MEMBERS ARE THOSE WHO CONTRIBUTE WITHIN A PERIOD OF ONE YEAR AN AMOUNT FIXED BY
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. TEEA4901L 12/8112Schedule 0 (Form 990 or 990-EZ) 2012
Schedule 0 (Form 990 or 990-EZ) 2012
16-0970103
---
FORM990,IO PART Vl,_. ki E^^-_g^PLANATN -
_F9yI9!Q, lollccER
ivc -----------
THE BOARD OF GOVERNORS
-
AND
-
WHO
-
REQUESTS
-
SUCH STATUS.
-
LIFE
-
MEMBERS
-
SHALL THEREAFTER
BE EXEMPT FROM
-
THE
-
PAYMENT
-
OF DUES
-
AND
-
SHALL RETAIN ALL RIGHTS AND PRIVILEGES OF
MEMBERSHIP INCLUDING THE RIGHT TO VOTE
-
AND
-
HOLD
-
OFFICE -
MEMBERSATLARGE ARE PERSONS WHO WOULD
BE ELIGIBLE TO BE ACTIVE
OR
LIFE MEMBERS WHO
RESIDE IN A TERRITORY IN WHICH THERE IS NO CHAPTER AND
ADMITTED
TO
MEMBERSHIP UPON
APPLICATION
IN
WRITING.
THEY RETRAIN ALL PRIVILEGES OF MEMBERSHIP EXCEPT THE RIGHT

TO VOTE AND HOLD OFFICE AND SHALL PAY THE SANE DUES AS AN ACTIVE MEMBER.
HONORARY MEMBERS ARE PERSON WHO HAVE DISTINGUISHED THEMSELVES BY THEIR ATTAINMENTS
IN
THE
FIELD OF DEVELOPMENTALLY DISABLED AND HAVE BEEN
ELECTED
TO SUCH MEMBERSHIP BY
THE BOARD OF GOVERNORS OR BOARD
OF
DIRECTORS OF
THE
CHAPTER. HONORARY MEMBERS DO NOT

PAY DUES AND SHALL
NOT
HAVE
THE RIGHT TO VOTE OR HOLD OFFICE.

FORM 990, PART VI, LINE 7A - HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY
ACTIVE
AND
LIFE MEMBERS ARE ABLE TO VOTE AND ELECT
MEMBERS
TO THE GOVERNING BODY.

FORM 990, PART VI, LINE 11B - FORM 990 REVIEW PROCESS
MANAGEMENT
AND
THE
BOARD OF DIRECTORS WILL REVIEW THE FORM

-
990
PRIOR TO SUBMISSION.
ANY QUESTIONS OR COMMENTS WILL BE DIRECTED TO THE ACCOUNTING FIRM THATPREPARESTHE---
RETURN. THE FORM 990 IS MADE AVAILABLE, FOR REVIEW AFTER FILING, TO THOSE BOARD
MEMBERS WHO WERE UNABLE
TO
ATTEND THE MEETING AT WHICH
THE
FORM WAS PRESENTED.

FORM 990, PART VI, LINE 12C - EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS
EACH YEAR ALL BOARD MEMBERS AND EXECUTIVE MANAGEMENT STAFF COMPLETE CONFLICT OF
INTEREST STATEMENTS. STATEMENTS ARE REVIEWED BY EXECUTIVE COMMITTEE AND EXECUTIVE

DIRECTOR.
--
ALL
PARTIES
WITH
CONFLICTS ABSTAIN FROM VOTING AND DISCUSSIONS ON MATTERS

WHERE THEY
HAVE
CONFLICT OF
INTEREST -
BAASchedule 0 (Form 990 or 990-EZ) 2012
TEEA4902L 1218/12
Schedule 0 (Form 990 or
2012
Page 2

16-0970103
FORM 990, PART VI, LINE 15B - COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES
ANNUALLY THE BOARD OF DIRECTORS WILL REVIEW AND APPROVE THE EXECUTIVE DIRECTOR'S
SALARY THE OTHER SALARIES ARE APPROVED BY THE BOARD WHEN THEY APPROVE THE OVERALL
BUDGET. PERIODICALLY THE BOARD WILL REVIEW COMPARABILITY DATA FOR-THE-EXECUTIVE
DIRECTOR'S
-
AND
-
MANAGEMENT EMPLOYEE'S SALARY. MANAGEMENT EMPLOYEES ARE DEBRA CARLIN
AND LISA BERARD.
-
THIS
-
WAS
-
LAST
-
DONE IN 2011.
FORM 990, PART VI, LINE 19-OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE
AVAILABLE UPON
-
REQUEST
-
AT THE ORGANIZATION'S OFFICE.
BAA
Schedule 0 (Form 990 or 990-EZ) 2012

TEEA4902L 12/8/12
OMB No. 1545-0047
2012
Open to Public
Inspection
16-0970103
SCHEDULER
(Form 990)
Related Organizations and Unrelated Partnerships
Depament of the Treasury
Complete if the organization answered ' Yes' to Form 990, Part IV, line 33, 34, 35, 36, or 37.
Internal Revenue ServiceAttach to Form 990. - See separate instructions.
[PartIdentification of Disregarded Entities (Complete if the organization answered ' Yes to Form 990, Part IV, line 33.)
(b)(c)(d)(e)(f)
Primary activityLegal domicile (stateTotal incomeEnd-of-year assetsDirect controlling
or foreign country)
I I
entity
(a)
Name, address, and EIN (if applicable) of disregarded entity
(1)
(2)
(3)
JJ Identification of Related Tax-Exempt
one or more related tax-exempt orgar
(a)
Name, address, and EIN of related organization
ations (Complete if the organization answered ' Yes' to Form 990, Part IV, line 34 because it had
during the tax year.)
(b)(c)(d)(e)(1)(g)
Primary activityLegal domicile (stateExempt CodePublic charity statusDirect controllingSec 512(bX13)
or foreign country)section(if section 501 (c)(3))entitycontrolled entity?
Yes I No
(1)CWS CHARITABLE FOUNDATION, INC
- 17 MIDLAND DRIVE
NORWICH, NY 13815
16-1531603
(2)CHENANGO COMMUNITY RESIDENCES, INC
17 MIDLAND DRIVE
NORWICH, NY 13815
51-0239210
(3)
PROVIDE
NYS ARC, INC

SCHOLARSHIPS TO
CHENANGO
HIGH SCHOOL
COUNTY
NYSARC, INC
CHENANGO
COUNTY
LEASES PROPERTY
NY
501(C) (2
CHAPTERX
BAA For Paperwork Reduction Act Notice, see the Instructions for Form 990.TEEA5001L 12/28/12Schedule R (Form 990) 2012
Schedule R (Form 990) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 2
I
Part iii
I
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered Yes to Form 990, Part IV, line 34
because it had one or more related organizations treated as a partnership during the tax year.)
(a)(b)(c)(d)(e)(f)(g)(h)(i)(j) (k)
Name, address, and EIN of Primary activity Legal Direct Predominant income Share of total Share of Dispropor- Code V-UBI General or Percentage
related organization domicile controlling (related, unrelated, income end-of-year tionate amount in box managing ownership 'x
(state or entity excluded from tax assets allocations? 20 of Schedule partner?
foreign under sections______________K-i (Form
country) 512-514)
Yes I No
1065)
___
Yes
_____
-No-
(1)
(2)
(3)
Part IV Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered 'Yes' to Form 990, Part IV,
line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(g)(h)(i
cen
)
Share of end-of- Pertage Sec 512(b)(13)
year assets ownership controlled entity?
Yes I No
(a)(b)(c)(d)(e)(f)
Name, address, and EIN of related organization Primary activity Legal domicile Direct Type of entity Share of
(state or foreign controlling (C corp, S corp, total income
country) entity or trust)
(1)
(2)
(3)
BAATEEA5002L 12/28112 Schedule R (Form 990) 2012
Name of other organization TransactionIAmo
type (a-s)
Method of cletermin
amount involved
Schedule R (Form 990) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 3 -
Part V
I
Transactions With Related Organizations (Complete if the organization answered 'Yes' to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, lii, or IV of this schedule.
No
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity ...............................................................................
x
b Gift, grant, or capital contribution to related organization(s)......................................................................................................
X
c Gift, grant, or capital contribution from related organization(s)...................................................................................................
X
d Loans or loan guarantees to or for related organization(s).......................................................................................................
e Loans or loan guarantees by related organization(s) ............................................................................................................
fDividends from related organization(s) .........................................................................................................................
X
g Sale of assets to related organization(s) .......................................................................................................................
X
h Purchase of assets from related organization(s) ................................................................................................................
X
iExchange of assets with related organization(s) ................................................................................................................
X
Lease of facilities, equipment, or other assets to related organization(s)..........................................................................................
X
kLease of facilities, equipment, or other assets from related organization(s) .......................................................................................
IPerformance of services or membership or fundraising solicitations for related organization(s).....................................................................
m Performance of services or membership or fundraising solicitations by related organization(s) .....................................................................
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) .........................................................................
o Sharing of paid employees with related organization(s)..........................................................................................................
p Reimbursement paid to related organization(s) for expenses ....................................................................................................
qReimbursement paid by related organization(s) for expenses....................................................................................................
r Other transfer of cash or property to related organization(s).....................................................................................................
X
s Other transfer of cash or property from related organization(s)...................................................................................................
X
2 If the answer to any of the above is 'Yes,' see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
CHENANGO COMMUNITY RESIDENCES, INC
714,309.
CHENANGO COMMUNITY RESIDENCES, INC
10,127
T
BAATEEA5003L12/28112Schedule R (Form 990) 2012
Schedule R (Form 990) 2012 NYS ARC, INC. CHENANGO COUNTY CHAPTER 16-0970103Page 4
I
Part VI
j
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered 'Yes to Form 990, Part IV, line 37.) -
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross
revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)(b) (b)(c)(d)(e)(f)(g)(h)(i)( j ) (k)
Name, address, and EIN of entity Primary activity Legal domicilePredominant Are all partnersShare ofShare ofDispropor- Code V- UBlGeneral or Percentage
(state or foreignincomesectiontotal incomeend- of- yeartionateamount in box managing ownership

country)(related, unre- 501(cX3)assetsallocations? 20 of Schedulepartner?
lated, excluded organizations?K- i
from tax under__________ Form (1065)_ _____
section 512- 514) Yes
I NoYes I No
______
Yes I No
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
BAATEEA5004L 12/28/12
Schedule R (Form 990) 2012Page 5
Part VII I Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R
(see instructions).
BAATEEA5005L 12/28/12Schedule R (Form 990) 2012
-
Form868
(Rev January 2013)
Application for Extension of Time To File an
Exempt Organization Return
File a separate application for each return.
OMB No. 1545-1709
If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box......................................
If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).
Do not complete Part!l unless you have already been granted an automatic 3-month extention on a previously filed Form8868.
Electronic filing (e-file). You can electronically file Form8868 if you need a 3-month automatic extension of time to file (6 months for a
corporation required to file Form990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form8868 to
request an extension of time tofile any of the forms listed in Part I or Part II with the exception of Form8870, Information Return for Transfers
Associated With Certain Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the
electronic filing of this form, visit www.irs.gov/e file and click on e-file for Charities & Nonprofits.
Part II Automatic 3-Month Extension of Time. Only submit original (no copies needed).
A corporation required to file Form990-1 and requesting an automatic 6-month extension - check this box and complete Part I only.....
All other corporations (including 1120-C filers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of time to file
income tax returns.
Enter filer's identifying number, see instructions
or other filer, see
I Employer identification number (EIN) or

Type or
print
16-0970103
File by the
Number, street, and room or suite number. If a P.O. box, see instructions.
due date for
filing your
return. See
or
a foretan address, see

instructions.
Enter the Return code for the return that this application is for (file a separate application for each return) ..........................
ApplicationReturn ApplicationReturn
Is ForICodeIs ForICode
07
08
09
10
11
12
Form990 or Form990-EZ
Form990-BL
Form4720 (individual)
Form990-PF
Form990-T (section 401(a) or 408(a) trust)
Form990-T (trust other than above)
The books are in the care of
DEBRA CARLIN
01Form990-T (corporation)
02Form1041-A
03Form4720
04Form5227
05Form6069
06Form8870
Telephone No.'
Q71_334536-
FAX No.
If the organization does not have an office or place of business in the United States, check this box .................................
U
If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN). If this is for the whole group,
check this box......[ . If it is for part of the group, check this box.... 1, [and attach a list with the names and EINs of all members
the extension is for.
1 I request an automatic 3-month (6 months for a corporation required to file Form990-1) extension of time
until
8/15
, 20
13 ,
to file the exempt organization return for the organization named above.
The extension is for the organization's return for:
calendar year 20
12
or
F1 tax beginning20and ending-,20
2 If the tax year entered in line 1 is for less than 12 months, check reason: [Initial return [Final return
[Change in accounting period
3a If this application is for Form990-BL, 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions .................................................................
b If this application is for Form990-PF, 990-1, 4720, or 6069, enter any refundable credits and estimated tax
payments made. Include any prior year overpayment allowed as a credit ................................
c Balance due. Subtract line 3b fromline 3a. Include your payment with this form, if required, by using
EFTPS (Electronic Federal Tax Payment System). See instructions .....................................
Caution. If you are going tomake an electronic fund withdrawal with this Form8868, see Form8453-EO and Form8879-EO for
payment instructions.
BAA For Privacy Act and Paperwork Reduction Act Notice, see instructions.Form8868 (Rev 1-2013)
FIFZ0501L 01/21/13
am
"
Form 8868 (Rev 1-2013)Page 2
If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box .....................
Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.
If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).
Part ItAdditional (Not Automatic) 3-Month Extension of Time. Only file the original (no copies needed).
Enter filer's identifying number, see instructions
Name of exempt organization or other filer, see instructions.
identification number (EIN) or

Type or
print
Number, street, and room or suite number.If a P.O.box, see instructions.
File by the
extended
due date for
filing your
return.See
instructions.
PIAKER & LYONS, PC
City, town or post office, state, and ZIP code.For a address, see instructions.
13815
Enter the Return code for the return that this application is for (file a separate application for each return) ..........................
ApplicationReturn ApplicationReturn
Is ForCodeIs ForI Code
Form 990 or Form 990-E7
01
Form 990-BL
02Form 1041-A
08
Form 4720 (individual)
03Form 4720
09
Form 990-PF
04Form 5227
10
Form 990-T (section 401(a) or 408(a) trust)
05Form 6069
11
Form 990-T (trust other than above)
06Form 8870
12
STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.
The books are in care of
DEBRA CARLIN
Telephone No. 1,
J6Q7 334-5366
FAX No.
If the organization does not have an oftice or place of business in the United States, check this box ................................
If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN) ... . If this is for the
whole group, check this box.... -
. If it is for part of the group, check this boxFland attach a list with the names and EINs of all
members the extension is for.
4 I request an additional 3-month extension of time until
11/15
, 20
13.
5 For calendar year 2012 , or other tax year beginning, 20
,and ending, 20
6 If the tax year entered in line 5 is for less than 12 months, check reason: Initial returnFinal return
Change in accounting period
7 State in detail why you need the extension.. -
ADDITIONAL TIME IS REQUIRED TO G ATH ERTHE
INFORMAT ION
--.
NECESSARY TO FILE A COMPLETE
AND
ACCURATE
RETURN -
8a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions ...............................................................
b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax
payments made. Include any prior year overpayment allowed as a credit and any amount paid previously
withForm 8868 ......................................................................................
c Balance due. Subtract line Sb from line Ba. Include your payment with this form, if required, by using
EFTPS (Electronic Federal Tax Payment System). See instructions ....................................
Signature and Verification must be completed for Part II only.
Under penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct, and complete, and that I am authorized to prepare this form.
SignatureTitle 0,
PRESIDENT
Date 10,
BAAFIFZ0502L 01/21/13Form 8868 (Rev 1-2013)
COPY OF WITHIN PAPER
RECEIVED
NOV 22 2013
NYS OFFICE OF THE ATTORtL' J E
CHARITIES BUREAU

28 Chenango County Chapter ARC

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I

Total Government Contributions (Grants) $250, 000.

$ 5,936,948$ 762,739$3,047$ 6,702,734$ 6,562,490$ 806,559$9,799$ 7,378,848

$ 10,945,249$ 1,329,022$28,822$ 12,303,093$10,728,835$ 1,457,515$20,294$ 12,206,644

$1,699,169 $1,699,169 $1,572,869 $1,572,869

403, 11928, 908

5, 911, 614932, 028

-6, 843, 642

-3, 462, 095

10, 621, 822960, 936

-11, 582, 758

6, 349, 128252, 623

4, 272, 694708, 313

-4, 981, 007

Program and General FundraisingTotal

Program and General FundraisingTotal

Program and General FundraisingTotal

Program and General FundraisingTotal

Medicaid HabilitationmentTotalCommunity CharitabletionConsolida-

WorkshopIRAApartmentsClinicProgram CoordinationResidentialProgramGeneralARC, Inc.Inc.Inc.Totalsations*Totals

WorkshopIRAApartmentsClinicProgram Coordination Residential ProgramGeneralARC, Inc.Inc.Inc.Totalsations*Totals

13,7032,458468---72517,35459,72377,077 - - 77,077 - 77,077

,2012, and endi

)' (insert no.)[J4E

o 21Total liabilities (Part X, line 26) .....................................................

TRAINING & EMPLOYMENT FOR DEVELOPMENTALLY DISABLED INDIVIDUALS.

SERVICES FOR APPROXIMATELY 124 INDIVIDUALS

/ the Internal Revenue Code

hoursbox, unless person is both an

perofficer and a director/trustee) compensation from

c Total from conti nuati on sheets to Part VII, Secti on A ........................0.

d Total (add li nes lb and lc) ................................................733,934.0.107,187.

b Were the organization's financial statements audited by an independent accountant? ...................................2 bX

Form 990 (2012)

e organization inorganization insupport

column (I) of yourcolumn (i)

Schedule A (Form 990 or 990-EZ) 2012

NumberName, address, and ZIP +4Total

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Relationship of transferor to transferee

Relationship of transferor to transferee

la Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403,119. 403,119.

Schedule D (Form 990) 2012

Schedule J (Form 990) 2012

ensated Employees. Use duplicate copies if additional space is needed.

64 553. 18532 8. -Q.54638 2 70,419. -

AS A PERCENTAGE OF NET CONTRACT SALES

AN INCENTIVE PAYMENT BASED ON PERSONAL AND

THEY RETRAIN ALL PRIVILEGES OF MEMBERSHIP EXCEPT THE RIGHT

FIELD OF DEVELOPMENTALLY DISABLED AND HAVE BEEN

CHAPTER. HONORARY MEMBERS DO NOT

THE RIGHT TO VOTE OR HOLD OFFICE.

LIFE MEMBERS ARE ABLE TO VOTE AND ELECT

TO THE GOVERNING BODY.

BOARD OF DIRECTORS WILL REVIEW THE FORM

ATTEND THE MEETING AT WHICH

FORM WAS PRESENTED.

CONFLICTS ABSTAIN FROM VOTING AND DISCUSSIONS ON MATTERS

Employer identification number

Schedule 0 (Form 990 or 990-EZ) 2012

NYS ARC, INC

(state or entity excluded from tax assets allocations? 20 of Schedule partner?

foreign under sections______________K-i (Form

r Other transfer of cash or property to related organization(s).....................................................................................................