2011-12-13T13:42:19-06:00 2011-01-31 SPROLES WOODARD LLP 777 MAIN STREET SUITE 3250 FORT WORTH TX 761025304 990 2010-02-01 752267609 JEWEL CHARITY BALL INCORPORATED JEWE 8178709064 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 OLIVIA KEARNEY 8178709064 2011-12-06 1 ROBERT W DUKE 8173321328 2010 2016-02-24 21:20:13Z X OLIVIA KEARNEY 5020 COLLINWOOD AVENUE NO 400 FORT WORTH TX 76107 4390612 0 X WWW.JEWELCHARITY.ORG X 1988 TX RAISE FUNDS TO PROVIDE HEALTH CARE FOR CHILDREN AT COOK CHILDREN'S MEDICAL CENTER 55 55 0 400 0 0 3535105 3586757 0 0 9768 24287 -720192 -538067 2824681 3072977 2784953 2839261 0 0 0 0 0 0 30966 62520 71139 2847473 2910400 -22792 162577 3034620 3211108 0 0 3034620 3211108 PROVIDE FINANCIAL SUPPORT TO FORT WORTH COOK CHILDREN'S MEDICAL CENTER 0 0 2839261 2839261 19227 JEWEL CHARITY BALL RAISES FUNDS FOR UNCOMPENSATED HEALTHCARE FOR CHILDREN AT COOK CHILDREN'S MEDICAL CENTER. FUNDRAISING IS ACCOMPLISHED BY SOLICITING DONATIONS FROM LOCAL, NATIONAL, AND INTERNATIONAL INDIVIDUALS, BUSINESSES AND FOUNDATIONS. ALL PROCEEDS ARE DONATED TO COOK CHILDREN'S MEDICAL CENTER FOR THE UNCOMPENSATED CARE FUND AND OTHER SPECIFIC FIELDS OF INTEREST AS DESIGNATED ANNUALLY BY THE JEWEL CHARITY BALL BOARD OF DIRECTORS. JEWEL CHARITY BALL'S 2010 DONATION TO COOK CHILDREN'S MEDICAL CENTER WAS OVER $2.83 MILLION. 2839261 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 36 28 1 0 0 0 0 0 0 1 1 0 0 0 0 X 55 55 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X JONELLE O'NEILL 8177329333 5020 COLLINWOOD AVENUE SUITE 400 FORT WORTH TX 76107 X DEBBY BROWN 40.00 X X 0 0 0 OLIVIA KEARNEY 5.00 X X 0 0 0 FAITH MALLORY 1.00 X X 0 0 0 MELISSA KIRTLEY 0.50 X X 0 0 0 CAROL DUNAWAY 0.30 X 0 0 0 ANGIE DONAHUE 3.00 X 0 0 0 PAM PIGMAN 3.00 X 0 0 0 NENETTA TATUM 2.00 X 0 0 0 LINDA FIERKE 1.00 X 0 0 0 KIM DARDEN 1.00 X 0 0 0 TERRI SEXTON 1.00 X 0 0 0 ELAINE DAVIS 1.00 X 0 0 0 JANE YORK 0.30 X 0 0 0 SANDRA TILLEY 5.00 X 0 0 0 LISA QUERALT 1.00 X 0 0 0 DEBBIE REYNOLDS 1.00 X 0 0 0 SUSIE FINLEY 2.00 X 0 0 0 JOY ANN HAVRAN 2.00 X 0 0 0 PATTI AMBROSE 7.00 X 0 0 0 ANN BIGGS 7.00 X 0 0 0 KATHY WOMACK 7.00 X 0 0 0 ANNE BASS 1.00 X 0 0 0 SHEILA JOHNSON 1.00 X 0 0 0 LINDA BATTON 1.00 X 0 0 0 CINDY LAWRENCE 1.00 X 0 0 0 CAROLE PETTY 1.00 X 0 0 0 ANN GREENHILL 3.00 X 0 0 0 MARSHA WRIGHT 3.00 X 0 0 0 ANN FLORSHEIM 2.00 X 0 0 0 ANNE PAUP 2.00 X 0 0 0 ANN CLINKSCALES 1.00 X 0 0 0 LISA LOWRY 1.00 X 0 0 0 SHARON CORCORAN 2.00 X 0 0 0 JAN SCULLY 2.00 X 0 0 0 BONNIE EPSTEIN 1.00 X 0 0 0 JAN SMITH 1.00 X 0 0 0 CINDY HAWKINS 1.00 X 0 0 0 ERAN WEST 1.00 X 0 0 0 KIM BERKOWITZ 3.00 X 0 0 0 YANCY FLEMING 3.00 X 0 0 0 BOB MITCHELL 3.00 X 0 0 0 NANCY MITCHELL 3.00 X 0 0 0 LINDA CHRISTIE 1.00 X 0 0 0 MARY ANNE POLSON 1.00 X 0 0 0 PEGGY SIMS 1.00 X 0 0 0 LESLIE JOHNSON 1.00 X 0 0 0 KAYDEE BAILEY 2.00 X 0 0 0 JULIE KLEBERG 2.00 X 0 0 0 PAT LORIMER 2.00 X 0 0 0 PATTI MCCONNELL 2.00 X 0 0 0 JOEL SAWYER 2.00 X 0 0 0 JOAN KATZ 1.00 X 0 0 0 ANN KORMAN 1.00 X 0 0 0 CINDY SIMON 1.00 X 0 0 0 KAREN SIMON 1.00 X 0 0 0 0 0 0 0 0 0 0 MARRIOTT BUSINESS SERVICES PO BOX 402642 ATLANTA GA 30384 CATERING FOR THE BALL 238772 PARTY DESIGNS AND PRODUCTION 1921 OLD ANNETTA ROAD ALEDO TX 76008 DESIGN AND PRODUCTION OF THE BALL 177961 2 335200 3206307 45250 501071 3586757 18088 18088 6199 6199 6199 6199 579073 3206307 1139287 -560214 -560214 197575 178348 19227 19227 CALENDAR & CARD SALES 453000 2920 2920 2920 3072977 19227 0 -533007 2839261 2839261 446 446 66152 35211 30941 330 330 1000 1000 OTHER ADMINISTRATIVE EX 3186 3186 REFUNDS: DONATION 25 25 2910400 2839261 40173 30966 2867842 3022083 1000 1000 0 0 121602 153809 45176 35216 3034620 3211108 0 0 X 2840433 2951008 92052 157165 102135 102935 3034620 3211108 3034620 3211108 X 162577 13911 X X 0 1 1 X 0 X 3102570 3499365 3270018 3535105 3586757 16993815 3102570 3499365 3270018 3535105 3586757 16993815 145107 16848708 58239 58451 21467 12015 18088 168260 416476 497044 765050 614782 779568 3072920 20234995 0.83270 0.82580 X 166778 800 22017 570 189025 141509 200 31891 6747 166853 200333 245 -48471 10598 141509 0.54000 0.46000 1 0 1000 1000 0 0 3072977 2910400 162577 13911 13911 176488 4801756 13911 355038 117258 486207 4315549 446 -1243018 -1242572 3072977 4728292 355038 4302561 4657599 70693 446 2839261 2839707 2910400 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE JEWEL CHARITY BALL (THE BALL) ENDOWMENT WAS FORMED TO PROVIDE ADDITIONAL OPERATING FUNDS FOR THE BALL SHOULD MEMBERSHIP DUES FAIL TO COVER THE COSTS OF ADMINISTRATION AND CONDUCTING THE BALL. THIS IS DONE SO THAT MORE (OFTEN ALL) OF THE FUNDS RAISED BY MEMBERS OF THE BALL AND THE BALL'S SPECIAL EVENTS CAN BE USED TO SUPPORT COOK CHILDREN'S MEDICAL CENTER. PART XII, LINE 2D - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/11 117,258. PART XII, LINE 4B - OTHER ADJUSTMENTS: ACCRUED REVENUE AT 1/31/10 COLLECTED IN FYE 2011 58,139. PREPAID DUES 1,200. FUNDRAISING EXPENSES PER AUDITED FINANCIAL STATEMENTS -1,129,605. GAMING EXPENSES PER AUDITED FINANCIAL STATEMENTS -168,998. REIMBURSEMENTS INCLUDED WITH EXPENSES -3,754. PART XIII, LINE 2D - OTHER ADJUSTMENTS: OTHER ACCRUED EXPENSES AT 1/31/11 3,000,204. FUNDRAISING EXPENSES PER AUDITED FINANCIAL STATEMENTS 1,129,605. GAMING EXPENSES PER AUDITED FINANCIAL STATEMENTS 168,998. REIMBURSEMENTS INCLUDED WITH EXPENSES 3,754. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ACCRUED EXPENSES AT 1/31/10 PAID IN FYE 2011 2,839,261. JEWEL CHARITY BALL 2531095 2323722 207373 14878 239222 23500 316423 AUCTION 436764 293563 143201 293563 17853 7 817521 589022 228499 24890 208958 3785380 3206307 579073 318453 14878 239222 23500 543234 1139287 -560214 197575 167200 11148 1 1.00000 197575 167200 11148 178348 19227 TX 0 THE STATE OF TEXAS DOES NOT REQUIRE AN EXEMPT ORGANIZATION TO HAVE A GAMING LICENSE FOR THE PURPOSES OF HOLDING A RAFFLE. 0 1 0 0.00000 1.00000 JONELLE O'NEIL 5020 COLLINWOOD AVENUE SUITE 400 FORT WORTH TX 76107 0 LISA QUERALT DEBBIE REYNOLDS LISA QUERALT AND DEBBIE REYNOLDS ARE THE CHANCE TICKET ACCOUNTABILITY CO-CHAIRS. THEY FOLLOW ALL ACCOUNTABILITY PROCEDUES SET FORTH IN JEWEL CHARITY BALL'S POLICIES AND PROCEDURES HANDBOOK TO ENSURE AN ACCURATE ACCOUNTING OF CHANCE TICKETS AND CHANCE TICKET REVENUE FOR THE ANNUAL AUDIT. THEY ALSO INSTRUCT ALL TICKET SELLERS IN THEIR RESPONSIBILITIES AND ACCOUNTABILITY PROCEDURES. X 1 197575 1 COOK CHILDREN'S MEDICAL - FORT WORTH 801 SEVENTH AVENUE FORT WORTH TX 76104 752051646 501(C)(3) 2839261 UNCOMPENSATED CARE AND GENERAL SUPPORT 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS ARE GIVEN TO COOK CHILDREN'S MEDICAL - FORT WORTH FOR UNCOMPENSATED CARE AND GENERAL SUPPORT. COOK CHILDREN'S MEDICAL PROVIDES JEWEL CHARITY BALL WITH PERIODIC REPORTS REGARDING THE USE OF THE FUNDS. X 16 66714 RETAIL COST X 77728 RETAIL COST X 5 71100 RETAIL COST X 3 885 RETAIL COST X 4 3420 RETAIL COST X FLOWERS 5 8300 RETAIL COST X TRAVEL & ENTERTAINMENT PACKAGES 62 184339 RETAIL COST X GIFT CERTIFICATES 40 83167 RETAIL COST X PRINTED MATERIALS 3 5418 RETAIL COST 0 0 0 SCHEDULE B, LIST OF CONTRIBUTORS: FORM 990, PART IV, LINE 2 JEWEL CHARITY BALL IS A 501(C)(3) ORGANIZATION THAT MET THE 33 1/3% SUPPORT TEST UNDER SECTIONS 509(A)(1)/170(B)(1)(A)(VI). IT DID NOT RECEIVE ANY CONTRIBUTIONS OVER 2% OF THE AMOUNT ON FORM 990 PART VIII, LINE 1H ($71,735). THEREFORE, JEWEL CHARITY BALL IS NOT REQUIRED TO FILE SCHEDULE B. FORM 990, PART VI, SECTION A, LINE 2 BOB MITCHELL (AUCTION CO-CHAIR) AND NANCY MITCHELL (AUCTION CO-CHAIR) - FAMILY RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 THERE ARE FOUR CLASSIFICATIONS OF MEMBERS: ACTIVE, NON-RESIDENT, LIFE, AND HONORARY. ACTIVE MEMBERS MAINTAIN THEIR PHYSICAL RESIDENCE WITHIN FIFTY MILES OF COOK CHILDREN'S MEDICAL CENTER SO AS TO ALLOW FOR ACTIVE PARTICIPATION IN JEWEL CHARITY BALL ACTIVITIES THROUGHOUT THE YEAR. NON-RESIDENT MEMBERS ARE THOSE ACTIVE MEMBERS WHOSE PHYSICAL RESIDENCE IS BEYOND A FIFTY MILE RADIUS OF COOK CHILDREN'S MEDICAL CENTER. LIFE MEMBERS ARE PREVIOUS ACTIVE MEMBERS IN GOOD STANDING WHO NO LONGER WISH TO ACCEPT THE OBLIGATIONS OF ACTIVE MEMBERSHIP, BUT WISH TO REMAIN INVOLVED WITH THE JEWEL CHARITY BALL. HONORARY MEMBERS ARE THOSE MEMBERS WHO HAVE BEEN PRESIDENT OF THE JEWEL CHARITY BALL. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS ELECT THE BOARD OF DIRECTORS AND COMMITTEE CHAIRS. FORM 990, PART VI, SECTION B, LINE 11 THE PRESIDENT REVIEWS FORM 990 BEFORE IT IS SIGNED AND FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE SIGNED ANNUALLY BY THE BOARD OF DIRECTORS AND FILED IN THE JEWEL CHARITY BALL OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY CONTACTING THE JEWEL CHARITY BALL OFFICE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 13,911. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C JEWEL CHARITY BALL'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. ENDOWMENT FUNDS ADMINISTERED BY AN UNRELATED PARTY FORM 990, SCHEDULE D, PART V, LINE 3A(I) JEWEL CHARITY BALL HAS PLACED ITS ENDOWMENT FUNDS WITH COOK CHILDREN'S MEDICAL CENTER TO BE ADMINISTERED AS A PART OF THE MEDICAL CENTER'S ENDOWMENT FUNDS. THIS KEEPS ADMINISTRATIVE AND INVESTMENT COSTS TO A MINIMUM. JEWEL CHARITY BALL CAN WITHDRAW FUNDS AT WILL SHOULD IT NEED TO.