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ALEX LEE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ALEX LEE INC (EIN 57-0742607)
Tax period
2012-09-30 to 2013-09-28
Filed
2014-05-12
IRS object ID
201401329349300430
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-12T08:33:00-05:00Timestamp
Tax Period End Date2013-09-28TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560747981EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2646AddressLine1
CityHIGH POINTCity
StateNCState
ZIP Code27261ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-30TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN570742607EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALEX LEE INCBusinessNameLine1
Business Name Line2VOLUNTARY EMPLOYEES BENEFICIARY ASSOCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlALEXNameControl
Phone8287254424Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 800AddressLine1
CityHICKORYCity
StateNCState
ZIP Code28603ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOYCE RETOName
TitleCHIEF FINANCIAL OFFICERTitle
Phone8287254424Phone
Date Signed2014-04-28DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRENEE CLARKName
PTINP00202944PTIN
Phone3368895156Phone
Date Prepared2014-04-28DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOYCE RETONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 800AddressLine1
CityHICKORYCity
StateNCState
ZIP Code28603ZIPCode
FieldValueIRS element (for citing)
Gross Receipts30491138GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1982YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MEDICAL, DENTAL AND VISION BENEFITS TO PARTICIPATING & FORMER EMPLOYEES & DEPENDENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body0NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI13892TotalGrossUBI
Net Unrelated Business Txbl Income11230NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year35351962ProgramServiceRevenuePriorYear
Program Service Revenue CY30477246ProgramServiceRevenueCY
Investment Income Prior Year11598InvestmentIncomePriorYear
Investment Income Current Year13892InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year35363560TotalRevenuePriorYear
Total Revenue Current Year30491138TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year32992426BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY28763204BenefitsPaidToMembersCY
Salaries Etc Prior Year20720SalariesEtcPriorYear
Salaries Etc Current Year25575SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2855625OtherExpensePriorYear
Other Expenses Current Year2504487OtherExpensesCurrentYear
Total Expenses Prior Year35868771TotalExpensesPriorYear
Total Expenses Current Year31293266TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-505211RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-802128RevenuesLessExpensesCY
Total Assets BOY12612027TotalAssetsBOY
Total Assets EOY11809899TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12612027NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11809899NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE MEDICAL, DENTAL AND VISION BENEFITS TO PARTICIPATING EMPLOYEES AND THEIR DEPENDENTS, AND TO RETIRED FORMER EMPLOYEES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense31293266Expense
Revenue30477246Revenue
DescriptionPROVIDED MEDICAL, DENTAL AND VISION BENEFITS TO PARTICIPATING EMPLOYEES AND THEIR DEPENDENTS, AND RETIRED FORMER EMPLOYEES.Description
Total Program Service Expense31293266TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members0NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body0MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1WELLS FARGOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7043744042TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1401 S TRYON STAddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28202ZIPCode

Form990 Part VII Section A Form990PartVIISectionA

FieldValueIRS element (for citing)
Name PersonWELLS FARGONamePerson
TitleTRUSTEETitle
Average Hours Per Week1.00AverageHoursPerWeek
Institutional TrusteeXInstitutionalTrustee
Reportable Comp From Organization25575ReportableCompFromOrganization
Reportable Comp From Related Orgs0ReportableCompFromRelatedOrgs
Other Compensation0OtherCompensation
FieldValueIRS element (for citing)
Total Reportable Comp From Org25575TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CIGNABusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ROUTE C3FINAddressLine1
CityHARTFORDCity
StateCTState
ZIP Code06152ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCLAIMS PROCESSING FEEDescriptionOfServices
Compensation2315032Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPAYMENTS FROM PARTICIPANTSDescription
Business Code900001BusinessCode
Total Revenue Column30477246TotalRevenueColumn
Related Or Exempt Function Income30477246RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue30477246TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13892TotalRevenueColumn
Unrelated Business Revenue13892UnrelatedBusinessRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column30491138TotalRevenueColumn
Related Or Exempt Function Income30477246RelatedOrExemptFunctionIncome
Unrelated Business Revenue13892UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total28763204Total
Program Services28763204ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total25575Total
Program Services25575ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total18300Total
Program Services18300ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2315032Total
Program Services2315032ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
OTHER ADMIN. EXPENSES146419146419
ACTUARIAL FEE1612316123
12 B-1 FEES86138613

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total31293266Total
Program Services31293266ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY399772BOY
EOY119689EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12212255BOY
EOY11690210EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12612027BOY
EOY11809899EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY12612027BOY
EOY11809899EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12612027BOY
EOY11809899EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12612027BOY
EOY11809899EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-802128ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt30490460TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal30490460RevenueSubtotal
Other Revenues Not Included678OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt678RevenueNotRptdOnFinStmt
Total Revenue Per Form99030491138TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt32282679TotExpensesEtcAuditedFinclStmt
Other Expenses Included989413OtherExpensesIncluded
Expenses Not Rptd F990989413ExpensesNotRptdF990
Expenses Subtotal31293266ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99031293266TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE PLAN SPONSOR HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF OCTOBER 1, 2013.
PART XI, LINE 4B - OTHER ADJUSTMENTS:INTEREST RECEIVABLE
PART XII, LINE 2D - OTHER ADJUSTMENTS:BENEFITS PAID AFTER YEAR END ACCRUED TAXES
PART XII, LINE 2D - ACCRUED INTERST RECEIVABLE NOT INLCUDED ON CASH BASIS FORM 990 - $94; PRIOR YEAR ACCRUED INTEREST RECEIVABLE INCLUDED ON CASH BASIS FORM 990 - ($772). PART XIII, LINE 2D - BENEFIT PAYMENTS RECORDED ON FINANCIAL STATEMENTS NOT INCLUDED ON CASH BASIS FORM 990 IN CURRENT YEAR - $985,719.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 8ATHE ORGANIZATION IS A VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION (VEBA) AND AS SUCH DOES NOT HAVE A GOVERNING BODY
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION IS A VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION (VEBA) AND AS SUCH DOES NOT HAVE A GOVERNING BODY OR COMMITTEES.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION IS A VOLUNTARY EMPLOYEES BENEFICIARY ASSOCIATION (VEBA) AND AS SUCH DOES NOT HAVE A GOVERNING BODY. FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM IS COMPLETED USING DATA RECEIVED FROM THE TRUSTEE FOR THE SPECIFIC FISCAL YEAR. FORM 990 AND ALL SUPPORTING SCHEDULES ARE REVIEWED AND APPROVED BY THE CORPORATE CONTROLLER OF ALEX LEE, INC.
FORM 990, PART VI, SECTION C, LINE 19AS A VOLUNTARY EMPLOYEES BENEFIT ASSOCIATION (VEBA) NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART VIIWELLS FARGO - 401 S. TRYON ST., CHARLOTTE, NC 28202.CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC
FORM 990 PART XII, LINE 2CTHERE HAVE BEEN NO CHANGES FROM PRIOR YEAR.