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ALEX LEE INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ALEX LEE INC (EIN 57-0742607)
Tax period
2010-10-03 to 2011-10-01
Filed
2012-08-14
IRS object ID
201222279349300437
Schema version
2010v3.4
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)
Timestamp2012-08-14T08:36:17-05:00Timestamp
Tax Period End Date2011-10-01TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-10-03TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN570742607EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ALEX LEE INC VOLUNTARY EMPLOYEESBusinessNameLine1
Business Name Line2BENEFICIARY ASSOCIATIONBusinessNameLine2
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)
NameRONALD W KNEDLIKName
TitleTREASURERTitle
Phone8287254424Phone
Date Signed2012-08-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRENEE CLARKName
Phone3368895156Phone
Date Prepared2012-08-03DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRONALD W KNEDLIKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 800AddressLine1
CityHICKORYCity
StateNCState
ZIP Code28603ZIPCode
FieldValueIRS element (for citing)
Gross Receipts36305801GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1982YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE MEDICAL & DENTAL BENEFITS TO PARTICIPATING & FORMER EMPLOYEES & DEPENDENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body0NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI19202TotalGrossUBI
Net Unrelated Business Txbl Income16605NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year36878286ProgramServiceRevenuePriorYear
Program Service Revenue CY36286599ProgramServiceRevenueCY
Investment Income Prior Year46127InvestmentIncomePriorYear
Investment Income Current Year19202InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year36924413TotalRevenuePriorYear
Total Revenue Current Year36305801TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year35451479BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY33851671BenefitsPaidToMembersCY
Salaries Etc Prior Year29621SalariesEtcPriorYear
Salaries Etc Current Year27998SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2782941OtherExpensePriorYear
Other Expenses Current Year2413183OtherExpensesCurrentYear
Total Expenses Prior Year38264041TotalExpensesPriorYear
Total Expenses Current Year36292852TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1339628RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12949RevenuesLessExpensesCY
Total Assets BOY13104289TotalAssetsBOY
Total Assets EOY13117238TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY13104289NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY13117238NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE MEDICAL AND DENTAL BENEFITS TO PARTICIPATING EMPLOYEES AND THEIR DEPENDENTS, AND TO RETIRED FORMER EMPLOYEES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense36292852Expense
Revenue36305801Revenue
DescriptionPROVIDED MEDICAL AND DENTAL BENEFITS TO PARTICIPATING EMPLOYEES AND THEIR DEPENDENTS, AND RETIRED FORMER EMPLOYEES.Description
Total Program Service Expense36292852TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
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
Transaction Related Entity0TransactionRelatedEntity
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
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 Organization27998ReportableCompFromOrganization
Reportable Comp From Related Orgs0ReportableCompFromRelatedOrgs
Other Compensation0OtherCompensation
FieldValueIRS element (for citing)
Total Reportable Comp From Org27998TotalReportableCompFromOrg
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
Compensation2582297Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPAYMENTS FROM PARTICIPDescription
Business Code900001BusinessCode
Total Revenue Column36286599TotalRevenueColumn
Related Or Exempt Function Income36286599RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue36286599TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19202TotalRevenueColumn
Unrelated Business Revenue19202UnrelatedBusinessRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column36305801TotalRevenueColumn
Related Or Exempt Function Income36286599RelatedOrExemptFunctionIncome
Unrelated Business Revenue19202UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total33851671Total
Program Services33851671ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total27998Total
Program Services27998ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13590Total
Program Services13590ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2582297Total
Program Services2582297ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
POSTAGE1729617296
FEDERAL TAX REFUND-200000-200000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36292852Total
Program Services36292852ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY320327BOY
EOY194405EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12783962BOY
EOY12922833EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13104289BOY
EOY13117238EOY

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)
BOY13104289BOY
EOY13117238EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13104289BOY
EOY13117238EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13104289BOY
EOY13117238EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses12949ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue36305801TotalRevenue
Total Expenses36292852TotalExpenses
Excess Or Deficit For Year12949ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS12949ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt36306373TotRevenueEtcAuditedFinclStmt
Other Revenues572OtherRevenues
Revenue Not Rptd F990572RevenueNotRptdF990
Revenue Subtotal36305801RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99036305801TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt36616017TotExpensesEtcAuditedFinclStmt
Other Expenses Included323165OtherExpensesIncluded
Expenses Not Rptd F990323165ExpensesNotRptdF990
Expenses Subtotal36292852ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99036292852TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE PLAN SPONSOR HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLICATIONS AS OF SEPTEMBER 30, 2011.
PART XII, LINE 2D - ACCRUED INTERST RECEIVABLE NOT INLCUDED ON CASH BASIS FORM 990 - $377; DIFFERENCE DUE TO CALENDAR YEAR CUT OFF FOR AUDITED FINANCIAL STATEMENTS AND FISCAL CUT OFF FOR FORM 990 - $195 . PART XIII, LINE 2D - NET TAX REFUND AND CORRECTION OF AN ERROR NOT INCLUDED ON CASH BASIS FORM 990 - $206,048; BENEFIT PAID ON 10/1/2011 INCLUDED ON PRIOR YEAR 990.- $117,117.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
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. SUBSEQUENT TO FILING, FORM 990 AND ALL SUPPORTING SCHEDULES ARE REVIEWED AND APPROVED BY THE CORPORATE CONTROLLER OF ALEX LEE, INC. AS A FINAL APPROVAL PROCESS, FORM 990 IS SIGNED BY THE TREASURER OF ALEX LEE, INC.
AS A VOLUNTARY EMPLOYEES BENEFIT ASSOCIATION (VEBA) NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETCWELLS FARGO - 401 S. TRYON ST., CHARLOTTE, NC 28202.FORM 990, PART VII
NO CHANGE FROM PRIOR YEARFORM 990, PART XII LINE 2B