NURSE-FAMILY PARTNERSHIP Form 990 (2012) Page 2

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3 Form 99 (212) Page 2 Part NURSE-FAMLY PARTNERSHP Statement of Program Service Accomplishments Check if Schedule O contains a response to any question in this Part m m m m m m m m m m m m m m m m m m m m m m m m 1 Briefly descrie the organization's mission: REPLCATE THE NURSE-FAMLY PARTNERSHP PROGRAM WHCH EMPOWERS FRST-TME MOTHERS LVNG N POVERTY TO SUCCESSFULLY CHANGE THER LVES AND THE LVES OF THER CHLDREN THROUGH EVDENCE-BASED NURSE HOME VSTNG. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," descrie these new services on Schedule O. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 99 or 99-EZ? Yes No m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," descrie these changes on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? Yes No 4 Descrie the organization's program service accomplishments for each of its three largest program services, as measured y expenses. Section 51(c)(3) and 51(c)(4) organizations 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 $ 1,475,629. including grants of $ 4,151. ) (Revenue $ 7,12,29. ) ATTACHMENT 1 4 (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4c (Code: ) (Expenses $ including grants of $ ) (Revenue $ ) 4d Other program services (Descrie in Schedule O.) (Expenses $ including grants of $ ) (Revenue $ ) 4e Total program service expenses 1,475,629. 2E12 2. Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 3

4 NURSE-FAMLY PARTNERSHP Form 99 (212) Page 3 Part V Checklist of Required Schedules a m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m s the organization required to complete Schedule B, Schedule of Contriutors (see instructions)? m m m m m m m m m Did the organization engage in direct or indirect political campaign activities on ehalf of or in opposition to candidates for pulic office? f "Yes," complete Schedule C, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m Section 51(c)(3) organizations. Did the organization engage in loying activities, or have a section 51(h) election in effect during the tax year? f "Yes," complete Schedule C, Part m m m m m m m m m m m m m m m m m m m m m m s the organization descried in section 51(c)(3) or 4947(a)(1) (other than a private foundation)? f "Yes," complete Schedule A 1 2 s the organization a section 51(c)(4), 51(c)(5), or 51(c)(6) organization that receives memership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? f "Yes," complete Schedule C, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distriution or investment of amounts in such funds or accounts? f "Yes," complete Schedule D, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? f "Yes," complete Schedule D, Part m m m m m m m m m m Did the organization maintain collections of works of art, historical treasures, or other similar assets? f "Yes," complete Schedule D, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization report an amount in Part, line 21, for escrow or custodial account liaility; serve as a custodian for amounts not listed in Part ; or provide credit counseling, det management, credit repair, or det negotiation services? f "Yes," complete Schedule D, Part V m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? f "Yes," complete Schedule D, Part V m m m m m m m 11 f the organization s answer to any of the following questions is "Yes," then complete Schedule D, Parts V, V, V,, or as applicale. a Did the organization report an amount for land, uildings, and equipment in Part, line 1? f "Yes," c d e f a a 2E complete Schedule D, Part V m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization report an amount for investments-other securities in Part, line 12 that is 5% or more of its total assets reported in Part, line 16? f "Yes," complete Schedule D, Part V m m m m m m m m m m m m m m m m m Did the organization report an amount for investments-program related in Part, line 13 that is 5% or more of its total assets reported in Part, line 16? f "Yes," complete Schedule D, Part V m m m m m m m m m m m m m m m m m Did the organization report an amount for other assets in Part, line 15 that is 5% or more of its total assets reported in Part, line 16? f "Yes," complete Schedule D, Part m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization report an amount for other liailities in Part, line 25? f "Yes," complete Schedule D, Part Did the organization s separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liaility for uncertain tax positions under FN 48 (ASC 74)? f "Yes," complete Schedule D, Part m m m m m m Did the organization otain separate, independent audited financial statements for the tax year? f "Yes," complete Schedule D, Parts and m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Was the organization included in consolidated, independent audited financial statements for the tax year? f "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts and is optional m m m m s the organization a school descried in section 17()(1)(A)(ii)? f "Yes," complete Schedule E Did the organization maintain an office, employees, or agents outside of the United States?m m m m m m m m m m m m m Did the organization have aggregate revenues or expenses of more than $1, from grantmaking, fundraising, usiness, investment, and program service activities outside the United States, or aggregate foreign investments valued at $1, or more? f "Yes," complete Schedule F, Parts and V m m m m m m m m m m m Did the organization report on Part, column (A), line 3, more than $5, of grants or assistance to any organization or entity located outside the United States? f "Yes," complete Schedule F, Parts and V m m m m m m m Did the organization report on Part, column (A), line 3, more than $5, of aggregate grants or assistance to individuals located outside the United States? f "Yes," complete Schedule F, Parts and V m m m m m m m m m m m Did the organization report a total of more than $15, of expenses for professional fundraising services on Part, column (A), lines 6 and 11e? f "Yes," complete Schedule G, Part (see instructions) m m m m m m m m m m m Did the organization report more than $15, total of fundraising event gross income and contriutions on Part V, lines 1c and 8a? f "Yes," complete Schedule G, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization report more than $15, of gross income from gaming activities on Part V, line 9a? f "Yes," complete Schedule G, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization operate one or more hospital facilities? f "Yes," complete Schedule H m m m m m m m f "Yes" to line 2a, did the organization attach a copy of its audited financial statements to this return? m m m m m m a 11 11c 11d 11e 11f 12a a a 2 Yes No Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 4

5 NURSE-FAMLY PARTNERSHP Form 99 (212) Page 4 Part V Checklist of Required Schedules (continued) a c d a a c a m m m m m m m m m m m m on Part, column (A), line 2? f "Yes," complete Schedule, Parts and m m m m m m m m m m m m m m m m m m m m m m Did the organization report more than $5, of grants and other assistance to any government or organization in the United States on Part, column (A), line 1? f "Yes," complete Schedule, Parts and 21 Did the organization report more than $5, of grants and other assistance to individuals in the United States 22 Did the organization answer "Yes" to Part V, Section A, line 3, 4, or 5 aout compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? f "Yes," complete Schedule J m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization have a tax-exempt ond issue with an outstanding principal amount of more than $1, as of the last day of the year, that was issued after Decemer 31, 22? f "Yes," answer lines 24 through 24d and complete Schedule K. f No, go to line 25 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization invest any proceeds of tax-exempt onds eyond a temporary period exception? m m m m m m m Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt onds? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization act as an "on ehalf of" issuer for onds outstanding at any time during the year? m m m m m m m Section 51(c)(3) and 51(c)(4) organizations. Did the organization engage in an excess enefit transaction with a disqualified person during the year? f "Yes," complete Schedule L, Part m m m m m m m m m m m m m m m m m m m s the organization aware that it engaged in an excess enefit transaction with a disqualified person in a prior year, and that the transaction has not een reported on any of the organization's prior Forms 99 or 99-EZ? f "Yes," complete Schedule L, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Was a loan to or y a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization's tax year? f "Yes," complete Schedule L, Part m Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, sustantial contriutor or employee thereof, a grant selection committee memer, or to a 35% controlled entity or family memer of any of these persons? f "Yes," complete Schedule L, Part m m m m m m m m m m m m m m m Was the organization a party to a usiness transaction with one of the following parties (see Schedule L, Part V instructions for applicale filing thresholds, conditions, and exceptions): A current or former officer, director, trustee, or key employee? f "Yes," complete Schedule L, Part V m m m m m m m m A family memer of a current or former officer, director, trustee, or key employee? f "Yes," complete Schedule L, Part V m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m An entity of which a current or former officer, director, trustee, or key employee (or a family memer thereof) was an officer, director, trustee, or direct or indirect owner? f "Yes," complete Schedule L, Part V m m m m m m m m m Did the organization receive more than $25, in non-cash contriutions? f "Yes," complete Schedule M Did the organization receive contriutions of art, historical treasures, or other similar assets, or qualified conservation contriutions? f "Yes," complete Schedule M m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization liquidate, terminate, or dissolve and cease operations? f "Yes," complete Schedule N, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? f "Yes," complete Schedule N, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization own 1% of an entity disregarded as separate from the organization under Regulations sections and ? f "Yes," complete Schedule R, Part m m m m m m m m m m m m m m m m m m m m m Was the organization related to any tax-exempt or taxale entity? f "Yes," complete Schedule R, Part,, or V, and Part V, line 1 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization have a controlled entity within the meaning of section 512()(13)? m m m m m m m m m m m m m m f "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512()(13)? f "Yes," complete Schedule R, Part V, line 2 m m m m m m Section 51(c)(3) organizations. Did the organization make any transfers to an exempt non-charitale related organization? f "Yes," complete Schedule R, Part V, line 2 m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? f "Yes," complete Schedule R, Part V m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization complete Schedule O and provide explanations in Schedule O for Part V, lines 11 and 19? Note. All Form 99 filers are required to complete Schedule O m m m m m m m m m m m m m m m m m m m m m m m m m 23 24a 24 24c 24d 25a a 28 28c a Yes No Form 99 (212) 2E DA K278 3/6/214 7:14:3 PM V PAGE 5

6 Form 99 (212) Page 5 Part V Statements Regarding Other RS Filings and Tax Compliance Check if Schedule O contains a response to any question in this Part V m m m m m m m m m m m m m m m m m m m m m m m Yes 1a 1a 1 12 c Did the organization comply with ackup withholding rules for reportale payments to vendors and reportale gaming (gamling) winnings to prize winners? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1c 2a Enter the numer of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered y this return m 2a f at least one is reported on line 2a, did the organization file all required federal employment tax returns? 2 3 4a f Yes, enter the name of the foreign country: See instructions for filing requirements for Form TD F , Report of Foreign Bank and Financial Accounts. 5a Was the organization a party to a prohiited tax shelter transaction at any time during the tax year? m m m m m m m m Did any taxale party notify the organization that it was or is a party to a prohiited tax shelter transaction? c f "Yes" to line 5a or 5, did the organization file Form 8886-T? m m m m m m m m m m m m m m m m m m m m m m m m m m m m 6a Does the organization have annual gross receipts that are normally greater than $1,, and did the 7 a a c d e f g h a a a a c 14 a Enter the numer reported in Box 3 of Form 196. Enter -- if not applicale m Enter the numer of Forms W-2G included in line 1a. Enter -- if not applicale m m m m m m m m m Note. f the sum of lines 1a and 2a is greater than 25, you may e required to e-file (see instructions) Did the organization have unrelated usiness gross income of $1, or more during the year? f "Yes," has it filed a Form 99-T for this year? f "No," provide an explanation in Schedule O m m m m m m m m m m m m m 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 ank account, securities account, or other financial account)? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m organization solicit any contriutions that were not tax deductile as charitale contriutions? m m m m m m m m m m m f "Yes," did the organization include with every solicitation an express statement that such contriutions or gifts were not tax deductile? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Organizations that may receive deductile contriutions under section 17(c). Did the organization receive a payment in excess of $75 made partly as a contriution and partly for goods and services provided to the payor? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," did the organization notify the donor of the value of the goods or services provided? m m m m m m m m m m m m Did the organization sell, exchange, or otherwise dispose of tangile personal property for which it was required to file Form 8282? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," indicate the numer of Forms 8282 filed during the year m m m m m m m m m m m m m m m m 7d Did the organization receive any funds, directly or indirectly, to pay premiums on a personal enefit contract? m m m Did the organization, during the year, pay premiums, directly or indirectly, on a personal enefit contract? f the organization received a contriution of qualified intellectual property, did the organization file Form 8899 as required? m m m f the organization received a contriution of cars, oats, airplanes, or other vehicles, did the organization file a Form 198-C? Sponsoring organizations maintaining donor advised funds and section 59(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained y a sponsoring organization, have excess usiness holdings at any time during the year? m m m m m m m m m m m m m m m m m m m m m m m Sponsoring organizations maintaining donor advised funds. Did the organization make any taxale distriutions under section 4966? m m m m m m m Did the organization make a distriution to a donor, donor advisor, or related person? m m m m m m m m m m m m m m m m Section 51(c)(7) organizations. Enter: nitiation fees and capital contriutions included on Part V, line 12 m m m m m m m m m m 1a Gross receipts, included on Form 99, Part V, line 12, for pulic use of clu facilities m m m m 1 Section 51(c)(12) organizations. Enter: Gross income from memers or shareholders m m m m m m m m m m m m m m m m m m m m m m m m m m 11a Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) m m m m m m m m m m m m m m m m m m m m m m m m m m m 11 Section 4947(a)(1) non-exempt charitale trusts. s the organization filing Form 99 in lieu of Form 141? f "Yes," enter the amount of tax-exempt interest received or accrued during the year m m m m m 12 Section 51(c)(29) qualified nonprofit health insurance issuers. s the organization licensed to issue qualified health plans in more than one state? m m m m m m m m m m m m m m m m m m 13 a Note. See the instructions for additional information the organization must report on Schedule O. Enter the amount of reserves the organization is required to maintain y the states in which 2E14 1. NURSE-FAMLY PARTNERSHP the organization is licensed to issue qualified health plans 13 Enter the amount of reserves on hand m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 13c Did the organization receive any payments for indoor tanning services during the tax year? m m m m m m m f "Yes," has it filed a Form 72 to report these payments? f "No," provide an explanation in Schedule O m m m m m m 3a 3 4a 5a 5 5c 6a 6 7a 7 7c 7e 7f 7g 7h 8 9a 9 12a 13a 14a 14 No Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 6

7 Form 99 (212) Page 6 Part V Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7 elow, and for a "No" response to line 8a, 8, or 1 elow, descrie the circumstances, processes, or changes in Schedule O. See instructions. Check if Schedule O contains a response to any question in this Part V Section A. Governing Body and Management 1a a Enter the numer of voting memers of the governing ody at the end of the tax year. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f there are material differences in voting rights among memers of the governing ody, or if the governing ody delegated road authority to an executive committee or similar committee, explain in Schedule O. Enter the numer of voting memers included in line 1a, aove, who are independent m m m m m m 1 Did any officer, director, trustee, or key employee have a family relationship or a usiness relationship with any other officer, director, trustee, or key employee? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization delegate control over management duties customarily performed y or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? Did the organization make any significant changes to its governing documents since the prior Form 99 was filed? m m Did the organization ecome aware during the year of a significant diversion of the organization's assets? Did the organization have memers or stockholders? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization have memers, stockholders, or other persons who had the power to elect or appoint one or more memers of the governing ody? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Are any governance decisions of the organization reserved to (or suject to approval y) memers, stockholders, or persons other than the governing ody? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year y the following: a The governing ody? m m m m m m m m m m m m m m m m m m m m m m m m m m m m 8a Each committee with authority to act on ehalf of the governing ody? m m m m m m m m m m m m m m m m m m m m m m m 8 9 s there any officer, director, trustee, or key employee listed in Part V, Section A, who cannot e reached at the organization's mailing address? f "Yes," provide the names and addresses in Schedule O m m m m m m m m m m m m 9 Section B. Policies (This Section B requests information aout policies not required y the nternal Revenue Code.) 1a c a 16a Did the organization have local chapters, ranches, or affiliates? m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and ranches to ensure their operations are consistent with the organization's exempt purposes? m m Has the organization provided a complete copy of this Form 99 to all memers of its governing ody efore filing the form? m m 11a Descrie in Schedule O the process, if any, used y the organization to review this Form a Were officers, directors, or trustees, and key employees required to disclose annually interests that could give Did the organization have a written conflict of interest policy? f "No," go to line 13 m m m m m m m m m m m m m m m m m rise to conflicts? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Did the organization regularly and consistently monitor and enforce compliance with the policy? f "Yes," descrie in Schedule O how this was done m m m m m m m m Did the organization have a written whistlelower policy? m m m m m m m m m m m m Did the organization have a written document retention and destruction policy? m m m m m m m m m m m m m m m m m m m Did the process for determining compensation of the following persons include a review and approval y independent persons, comparaility data, and contemporaneous sustantiation of the delieration and decision? The organization's CEO, Executive Director, or top management official m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Other officers or key employees of the organization f "Yes" to line 15a or 15, descrie the process in Schedule O (see instructions). Did the organization invest in, contriute assets to, or participate in a joint venture or similar arrangement with a taxale entity during the year? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicale federal tax law, and take steps to safeguard the organization's exempt status with respect to such arrangements? m m m m m m m m m m m m m m m m m m m m m m m m m m List the states with which a copy of this Form 99 is required to e filed ATTACHMENT 2 Section C. Disclosure Section 614 requires an organization to make its Forms 123 (or 124 if applicale), 99, and 99-T (Section 51(c)(3)s only) availale for pulic inspection. ndicate how you made these availale. Check all that apply. Own wesite Another's wesite Upon request Other (explain in Schedule O) Descrie in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements availale to the pulic during the tax year. State the name, physical address, and telephone numer of the person who possesses the ooks and records of the organization: PAUL TOSETT 19 GRANT ST., SUTE 4 DENVER, CO Form 99 (212) 2E NURSE-FAMLY PARTNERSHP DA K278 3/6/214 7:14:3 PM V PAGE 7 1a a 7 1a 1 11a 12a 12 12c a 15 16a 16 Yes Yes No No

8 NURSE-FAMLY PARTNERSHP Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and ndependent Contractors Form 99 (212) Page 7 Part V Section A. Check if Schedule O contains a response to any question in this Part V m m m m m m m m m m m m m m m m m m m m Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1a Complete this tale for all persons required to e listed. Report compensation for the calendar year ending with or within the organization's tax year. % % % % List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -- in columns (D), (E), and (F) if no compensation was paid. List all of the organization's current key employees, if any. See instructions for definition of "key employee." List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportale compensation (Box 5 of Form W-2 and/or Box 7 of Form 199-MSC) of more than $1, from the organization and any related organizations. List all of the organization's former officers, key employees, and highest compensated employees who received more than $1, of reportale compensation from the organization and any related organizations. List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $1, of reportale compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this ox if neither the organization nor any related organization compensated any current officer, director, or trustee. (C) (A) (B) Position (D) (E) (F) Name and Title Average hours per week (list any (do not check more than one ox, unless person is oth an officer and a director/trustee) hours for related organizations elow dotted line) ndividual trustee or director nstitutional trustee Officer Key employee Highest compensated employee Former Reportale compensation from the organization (W-2/199-MSC) Reportale compensation from related organizations (W-2/199-MSC) Estimated amount of other compensation from the organization and related organizations (1) C. ROBN BRTT, SR 4. BOARD MEMBER (2) JOHN CASTLE 3. BOARD MEMBER (3) SUE HAGEDORN 3. BOARD MEMBER (4) BRETT HANSELMAN 3. BOARD MEMBER (5) KAREN HENDRCKS 2. BOARD MEMBER (6) ROBERT HLL 11. BOARD MEMBER (7) JOYCE KNG-THOMAS 2. BOARD MEMBER (8) PATRCK LBBEY 4. BOARD MEMBER (9) BEVERLY MALONE 3. BOARD MEMBER (1) PAT MORTZ 3. BOARD MEMBER (11) MCHELLE RDGE 2. BOARD MEMBER (12) ELENA ROS 2. BOARD MEMBER (13) CHRSTNE WASSERSTEN 2. BOARD MEMBER (14) THOMAS R. JENKNS, JR 4. PRESDENT & CEO 19,128. 2,12. 2E Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 8

9 NURSE-FAMLY PARTNERSHP Form 99 (212) Page 8 Part V Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued) (A) (B) (C) (D) (E) (F) Name and title Average hours per week (list any hours for related organizations elow dotted line) Position (do not check more than one ox, unless person is oth an officer and a director/trustee) ndividual trustee or director nstitutional trustee Officer Key employee Highest compensated employee Former Reportale compensation from the organization (W-2/199-MSC) Reportale compensation from related organizations (W-2/199-MSC) Estimated amount of other compensation from the organization and related organizations ( 15) PAUL TOSETT 4. SECRETARY & CFO 149, ,32. ( 16) NANCY BOTLLER 4. CHEF OPERATONS OFFCER ( 17) TAMAR BAUER 4. CHEF POLCY & GOVT AFFRS 163, ,161. ( 18) LAUREN BAKER 4. CHEF MARKETNG COMM OFFCER 145,64. 21,356. ( 19) KAREN HOWARD 4. DRECTOR, POLCY & GOVT AFFRS 129, ,298. ( 2) LAURENCE MLLER 4. DRECTOR, T 122, ,199. ( 21) DUNLAP WALLACE 32. CHEF PLANNNG & ADMN. OFFC 114, ,175. ( 22) ERKA BANTZ 4. DRECTOR, PROGRAM DEVELOPMENT 11, ,95. 1 Su-total m m m m m m m m m m m m m m m m m m m m m m m m m c Total from continuation sheets to Part V, Section A m m m m m m m m m m m m m m m m m m m m m m m m m m m m d Total (add lines 1 and 1c) 2 Total numer of individuals (including ut not limited to those listed aove) who received more than $1, of reportale compensation from the organization 8 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1a? f "Yes," complete Schedule J for such individual m m m m m m m m m m m m m m m m m m m m m m m m m m 3 4 For any individual listed on line 1a, is the sum of reportale compensation and other compensation from the organization and related organizations greater than $15,? f Yes, complete Schedule J for such individual m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 4 5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? f Yes, complete Schedule J for such person m m m m m m m m m m m m m m m m 5 Section B. ndependent Contractors 19,128. 2, , ,126. 1,124, , Complete this tale for your five highest compensated independent contractors that received more than $1, of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. Yes No ATTACHMENT 3 (A) Name and usiness address (B) Description of services (C) Compensation 2 Total numer of independent contractors (including ut not limited to those listed aove) who received more than $1, in compensation from the organization 8 2E Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 9

10 NURSE-FAMLY PARTNERSHP Statement of Revenue Check if Schedule O contains a response to any question in this Part V Form 99 (212) Page 9 Part V Contriutions, Gifts, Grants and Other Similar Amounts Program Service Revenue Other Revenue 1a c d e 2a c d 6a 8a 9a 1a 11a c Federated campaigns Memership dues Fundraising events Related organizations m m m m m m m m m m Government grants (contriutions) f All other contriutions, gifts, grants, and similar amounts not included aove 1f 2,95,695. g Noncash contriutions included in lines 1a-1f: $ 36,325. h Total. Add lines 1a-1f m m m m m m m m m m m m m m m m m m m Business Code e f All other program service revenue g Total. Add lines 2a-2f m m m m m m m m m m m m m m m m m m m nvestment income (including dividends, interest, and other similar amounts) m m m m m m m m m m m m m m m m ncome from investment of tax-exempt ond proceeds Royalties m m m m m m m m m m m m m m m m m m m m m m m m m (i) Real (ii) Personal Gross rents m m m m m Less: rental expenses m c Rental income or (loss) m d Net rental income or (loss) m m m m m m m m m m m m m m m m m a Gross amount from sales of assets other than inventory Less: cost or other asis and sales expenses c Gain or (loss) m m d Net gain or (loss) m m m m m m m m m m m m m m m m m m m m m Gross income from fundraising events (not including $ of contriutions reported on line 1c). See Part V, line 18 m a Less: direct expenses m m m m m m m m m m c Net income or (loss) from fundraising events m m m m m m m m Gross income from gaming activities. See Part V, line 19 m a Less: direct expenses m m m m m m m m m m c Net income or (loss) from gaming activities m m m m m m m m m Gross sales of inventory, less returns and allowances a Less: cost of goods sold m m m m m m m m m c Net income or (loss) from sales of inventorym m m m m m m m m d All other revenue e Total. Add lines 11a-11d 12 Total revenue. See instructions m m m m m m m m m m m m m m 2E Miscellaneous Revenue 1a 1 1c 1d 1e (i) Securities 12, ,25. (ii) Other Business Code m m m m m m m m m m m m m m m m m m m m m (A) Total revenue 3,93,822. m m m m m m m m m m m m m m m m m m m m m m m m m (B) Related or exempt function revenue PROGRAM SUPPORT ,12,29. 7,12,29. 7,12,29. (C) Unrelated usiness revenue (D) Revenue excluded from tax under sections 512, 513, or , ,819. MSCELLANEOUS REVENUE 91 1,844. 1,844. 1,844. 1,455,775. 7,12,29. 1, ,819. Form 99 (212) 5574DA K278 3/6/214 7:14:3 PM V PAGE 1

11 NURSE-FAMLY PARTNERSHP Part Statement of Functional Expenses Section 51(c)(3) and 51(c)(4) organizations must complete all columns. All other organizations must complete column (A). Form 99 (212) Page 1 Check if Schedule O contains a response to any question in this Part m m m m m m m m m m m m m m m m m m m m m m m m m m Do not include amounts reported on lines 6, 7, 8, 9, and 1 of Part V. 1 2 m m m m m m m Grants and other assistance to governments and organizations in the United States. See Part V, line 21 Grants and other assistance to individuals in the United States. See Part V, line 22 3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part V, lines 15 and 16m 4 Benefits paid to or for memers m m m m m m m m m 5 Compensation of current officers, directors, trustees, and key employees m m m m m m m m m m 6 Compensation not included aove, to disqualified persons (as defined under section 4958(f)(1)) and persons descried in section 4958(c)(3)(B) 7 Other salaries and wages m m m m m m m m m m m m 8 Pension plan accruals and contriutions (include section 41(k) and 43() employer contriutions) 9 Other employee enefits Payroll taxes m m m m m m m m m m m m m m m m m m Fees for services (non-employees): a Management Legal m m m m m m m m m m m m m m m m m m m m m c Accounting d Loying m m m m m m m m m m m m m m m m m m m e Professional fundraising services. See Part V, line 17 f nvestment management fees m m m m m m m m m g Other. (f line 11g amount exceeds 1% of line 25, column (A) amount, list line 11g expenses on Schedule O.) Advertising and promotion Office expenses m m m nformation technology Royalties m m m m m m m m m m m m m m m m m m m m Occupancy Travel m m m m m m m m m m m m m m m m m m m m m a c d e Payments of travel or entertainment expenses for any federal, state, or local pulic officials Conferences, conventions, and meetings nterest Payments to affiliates Depreciation, depletion, and amortization nsurance m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Other expenses. temize expenses not covered aove (List miscellaneous expenses in line 24e. f line 24e amount exceeds 1% of line 25, column (A) amount, list line 24e expenses on Schedule O.) All other expenses 25 Total functional expenses. Add lines 1 through 24e 26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a comined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC ) m m m m m m m (A) (B) (C) (D) Total expenses Program service Management and Fundraising expenses general expenses expenses ,736. 3,736. Form 99 (212) 2E , , ,462. 4,459. 5,346,88. 4,434, , , , , ,98. 18,98. 48, , , , , ,24. 89,21. 14,78. 94, , ,429. 1,16. 12, , ,38. 52,64. 3,77. 27, , , ,51. 12, , ,5. 29,86. 17, , ,673. 6, , ,93. 25,82. 6, , , , , , ,43. 51, , , , ,51. 19, , ,26. 48,212. 3, , , ,7. 16, , ,445. 2, MEMBERSHPS, BOOKS, & SUBSCR 16, , , ,524. MODEL AUGUMENTATON 28, ,619. PROGRAM RESEARCH 39,36. 39,36. 12,778,464. 1,475,629. 1,923, , DA K278 3/6/214 7:14:3 PM V PAGE 11

12 Form 99 (212) Page 11 Part Balance Sheet Check if Schedule O contains a response to any question in this Part m m m m m m m m m m m m m m m m m m m m m (A) (B) Beginning of year End of year Assets Liailities Net Assets or Fund Balances m m m m m m m m m m m m m m m m m m m m m m m m m m m Cash - non-interest-earing Savings and temporary cash investments Pledges and grants receivale, net Accounts receivale, net m m m m m m m m m m m m m m m m m m m m m m m m m m m m Loans and other receivales from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part of Schedule L m m m m m m m m m m m m m m m m m m m m m m m m m Loans and other receivales from other disqualified persons (as defined under section 4958(f)(1)), persons descried in section 4958(c)(3)(B), and contriuting employers and sponsoring organizations of section 51(c)(9) voluntary employees' eneficiary organizations (see instructions). Complete Part of Schedule L Notes and loans receivale, net nventories for sale or use m m m m m m m m m m m m m m m m m m m m m m m m m m m m Prepaid expenses and deferred charges a Land, uildings, and equipment: cost or NURSE-FAMLY PARTNERSHP m m m m m m m m m m m m m m m m m m m m other asis. Complete Part V of Schedule D 1a Less: accumulated depreciation m m m m m 1 nvestments - pulicly traded securities m m m m m nvestments - other securities. See Part V, line 11 m nvestments - program-related. See Part V, line 11 ntangile assets m m m m m m m m m Other assets. See Part V, line 11 m m m m m m m m m m m m m m Total assets. Add lines 1 through 15 (must equal line 34) Accounts payale and accrued expenses Grants payale m m Deferred revenue m m m m m Tax-exempt ond liailities m m m m m m m m m m m m m m m m m m m m m m m Escrow or custodial account liaility. Complete Part V of Schedule D m m m m Loans and other payales to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part of Schedule L 1,865,869. 9,828,59. 1,34,55. 1,452, ,71. 7,867,12. 2,532,216. 1,436, , ,361. 2,865,373. 1,57,375. 1,258,53. 1c 1,357,998. 1,883, ,796,75. 1,458, ,372. 1,444, ,5, ,118,287. 1,327, ,685. 2,27,517. m m m m m m m m m m m m m m m m Secured mortgages and notes payale to unrelated third parties Unsecured notes and loans payale to unrelated third parties Other liailities (including federal income tax, payales to related third parties, and other liailities not included on lines 17-24). Complete Part of Schedule D m m m m m m m m m m m m m m Total liailities. Add lines 17 through 25 m m m m m m m m m m m m m m m m m m m m Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34. Unrestricted net assets m m m m m Temporarily restricted net assets Permanently restricted net assets m m m m m m m m m m m m m m m m m m m m m m m m Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 3 through 34. Capital stock or trust principal, or current funds m m m m m m m m Paid-in or capital surplus, or land, uilding, or equipment fund m m m m Retained earnings, endowment, accumulated income, or other funds Total net assets or fund alances m m m m m m Total liailities and net assets/fund alances m m m m m m m m m m m m m m m m m m ,918, ,763, ,452, ,348,895. 1,425, ,6, ,878,21. 17,796, ,355,91. 16,118,287. Form 99 (212) 2E DA K278 3/6/214 7:14:3 PM V PAGE 12

13 Form 99 (212) Page 12 Part Part Reconciliation of Net Assets Check if Schedule O contains a response to any question in this Part m m m m m m m m m m m Total revenue (must equal Part V, column (A), line 12) 1 Total expenses (must equal Part, column (A), line 25) 2 Revenue less expenses. Sutract line 2 from line 1 m m m m m m m m m m m m m m m m m m m m m 3 Net assets or fund alances at eginning of year (must equal Part, line 33, column (A)) 4 Net unrealized gains (losses) on investments 5 Donated services and use of facilities 6 nvestment expenses m m 7 Prior period adjustments m m m m m m m m m m m m m m m m m m m m m m m m 8 Other changes in net assets or fund alances (explain in Schedule O) m m m m m m m m m m m m m m m m 9 Net assets or fund alances at end of year. Comine lines 3 through 9 (must equal Part, line 33, column (B)) m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1 Financial Statements and Reporting Check if Schedule O contains a response to any question in this Part m m m m m m m m m m m m m m m m m 1 Accounting method used to prepare the Form 99: Cash Accrual Other f the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O. 2a Were the organization's financial statements compiled or reviewed y an independent accountant? m m m m m m 2a f "Yes," check a ox elow to indicate whether the financial statements for the year were compiled or reviewed on a separate asis, consolidated asis, or oth: Separate asis Consolidated asis Both consolidated and separate asis Were the organization's financial statements audited y an independent accountant? m m m m m m m m m m m m m m 2 f "Yes," check a ox elow to indicate whether the financial statements for the year were audited on a separate asis, consolidated asis, or oth: Separate asis Consolidated asis Both consolidated and separate asis c 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in NURSE-FAMLY PARTNERSHP f "Yes" to line 2a or 2, does the organization have a committee that assumes responsiility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? f the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. the Single Audit Act and OMB Circular A-133? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," did the organization undergo the required audit or audits? f the organization did not undergo the required audit or audits, explain why in Schedule O and descrie any steps taken to undergo such audits 1,455, ,778, ,322, ,878,21. -2,43. 12,355,91. 2c 3a 3 Yes No Form 99 (212) 2E DA K278 3/6/214 7:14:3 PM V PAGE 13

14 SCHEDULE A (Form 99 or 99-EZ) Department of the Treasury nternal Revenue Service Pulic Charity Status and Pulic Support Complete if the organization is a section 51(c)(3) organization or a section 4947(a)(1) nonexempt charitale trust. Attach to Form 99 or Form 99-EZ. See separate instructions. OMB No À¾µ Open to Pulic nspection Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP Part Reason for Pulic Charity Status (All organizations must complete this part.) See instructions. The organization is not a private foundation ecause it is: (For lines 1 through 11, check only one ox.) A church, convention of churches, or association of churches descried in section 17()(1)(A)(i). A school descried in section 17()(1)(A)(ii). (Attach Schedule E.) A hospital or a cooperative hospital service organization descried in section 17()(1)(A)(iii). A medical research organization operated in conjunction with a hospital descried in section 17()(1)(A)(iii). Enter the hospital's name, city, and state: 5 An organization operated for the enefit of a college or university owned or operated y a governmental unit descried in section 17()(1)(A)(iv). (Complete Part.) A federal, state, or local government or governmental unit descried in section 17()(1)(A)(v). An organization that normally receives a sustantial part of its support from a governmental unit or from the general pulic descried in section 17()(1)(A)(vi). (Complete Part.) A community trust descried in section 17()(1)(A)(vi). (Complete Part.) An organization that normally receives: (1) more than 331/3 % of its support from contriutions, memership fees, and gross receipts from activities related to its exempt functions - suject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated usiness taxale income (less section 511 tax) from usinesses acquired y the organization after June 3, See section 59(a)(2). (Complete Part.) An organization organized and operated exclusively to test for pulic safety. See section 59(a)(4). An organization organized and operated exclusively for the enefit of, to perform the functions of, or to carry out the purposes of one or more pulicly supported organizations descried in section 59(a)(1) or section 59(a)(2). See section 59(a)(3). Check the ox that descries the type of supporting organization and complete lines 11e through 11h. a Type Type c Type -Functionally integrated d Type -Non-functionally integrated (A) e f g h By checking this ox, certify that the organization is not controlled directly or indirectly y one or more disqualified persons other than foundation managers and other than one or more pulicly supported organizations descried in section 59(a)(1) or section 59(a)(2). f the organization received a written determination from the RS that it is a Type, Type, or Type supporting organization, check this ox m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Since August 17, 26, has the organization accepted any gift or contriution from any of the following persons? (i) A person who directly or indirectly controls, either alone or together with persons descried in (ii) and (iii) elow, the governing ody of the supported organization? (ii) A family memer of a person descried in (i) aove? m m m m m m m (iii) A 35% controlled entity of a person descried in (i) or (ii) aove? m m m m m m m m m m m m m m m m m m m m m m Provide the following information aout the supported organization(s). (i) Name of supported organization (ii) EN (iii) Type of organization (descried on lines 1-9 aove or RC section (see instructions)) (iv) s the (v) Did you notify (vi) s the organization in the organization organization in col. (i) listed in in col. (i) of col. (i) organized your governing document? your support? in the U.S.? Yes No Yes No Yes No 11g(i) 11g(ii) 11g(iii) Yes No (vii) Amount of monetary support (B) (C) (D) (E) Total For Paperwork Reduction Act Notice, see the nstructions for Form 99 or 99-EZ. Schedule A (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 14

15 Schedule A (Form 99 or 99-EZ) 212 Page 2 Part Support Schedule for Organizations Descried in Sections 17()(1)(A)(iv) and 17()(1)(A)(vi) (Complete only if you checked the ox on line 5, 7, or 8 of Part or if the organization failed to qualify under Part. f the organization fails to qualify under the tests listed elow, please complete Part.) Section A. Pulic Support Calendar year (or fiscal year eginning in) 1 Gifts, grants, contriutions, and memership fees received. (Do not include any "unusual grants.") m m m m m m 2 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf m m m m m m m 3 The value of services or facilities furnished y a governmental unit to the organization without charge 4 Total. Add lines 1 through 3 m m m m m m m 5 The portion of total contriutions y each person (other than a governmental unit or pulicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) m m m m m m m 6 Pulic support. Sutract line 5 from line 4. Section B. Total Support Calendar year (or fiscal year eginning in) 7 Amounts from line 4 m m m m m m m m m m 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources m m m m m m m m m m m m m m m m m 9 Net income from unrelated usiness activities, whether or not the usiness is regularly carried on m m m m m m m m m m 1 Other income. Do not include gain or loss from the sale of capital assets (a) 28 () 29 (c) 21 (d) 211 (e) 212 (f) Total (a) 28 () 29 (c) 21 (d) 211 (e) 212 (f) Total (Explain in Part V.) m m m m m m m m m 11 Total support. Add lines 7 through 1 m m 12 Gross receipts from related activities, etc. (see instructions) m m m m m m m m m m m m m m m m m m m m m m m m m m First five years. f the Form 99 is for the organization's first, second, third, fourth, or fifth tax year as a section 51(c)(3) organization, check this ox and stop here m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Section C. Computation of Pulic Support Percentage 14 Pulic support percentage for 212 (line 6, column (f) divided y line 11, column (f)) Pulic support percentage from 211 Schedule A, Part, line 14 m m m m m m m m m m m m m m m m m m m 15 16a 33 1/3 % support test f the organization did not check the ox on line 13, and line 14 is 331/3 % or more, check this ox and stop here. The organization qualifies as a pulicly supported organization m m m m m m m m m m m m m m m m m m m m 33 1/3 % support test f the organization did not check a ox on line 13 or 16a, and line 15 is 331/3 % or more, check this ox and stop here. The organization qualifies as a pulicly supported organization m m m m m m m m m m m m m m m m m 17a NURSE-FAMLY PARTNERSHP ,591,3. 1,731,554. 4,215,528. 9,184,979. 1,214, ,937, ,591,3. 1,731,554. 4,215,528. 9,184,979. 1,214, ,937,176. 1%-facts-and-circumstances test f the organization did not check a ox on line 13, 16a, or 16, and line 14 is 1% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part V how the organization meets the "facts-and-circumstances test. The organization qualifies as a pulicly supported organization m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1%-facts-and-circumstances test f the organization did not check a ox on line 13, 16a, 16, or 17a, and line 15 is 1% or more, and if the organization meets the "facts-and-circumstances" test, check this ox and stop here. Explain in Part V how the organization meets the "facts-and-circumstances" test. The organization qualifies as a pulicly supported organization m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 18 Private foundation. f the organization did not check a ox on line 13, 16a, 16, 17a, or 17, check this ox and see instructions m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m % % Schedule A (Form 99 or 99-EZ) ,35, ,91, ,591,3. 1,731,554. 4,215,528. 9,184,979. 1,214, ,937, ,26. 72, , , , , ,763,67. 2E DA K278 3/6/214 7:14:3 PM V PAGE 15

16 Schedule A (Form 99 or 99-EZ) 212 Page 3 Part Support Schedule for Organizations Descried in Section 59(a)(2) (Complete only if you checked the ox on line 9 of Part or if the organization failed to qualify under Part. f the organization fails to qualify under the tests listed elow, please complete Part.) Section A. Pulic Support Calendar year (or fiscal year eginning in) 1 Gifts, grants, contriutions, and memership fees received. (Do not include any "unusual grants.") 2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose m m m m m m 3 Gross receipts from activities that are not an unrelated trade or usiness under section 513 m 4 Tax revenues levied for the organization's enefit and either paid to or expended on its ehalf m m m m m m m 5 The value of services or facilities NURSE-FAMLY PARTNERSHP (a) 28 () 29 (c) 21 (d) 211 (e) 212 (f) Total furnished y a governmental unit to the organization without charge 6 Total. Add lines 1 through 5 m m m m m m m 7a Amounts included on lines 1, 2, and 3 received from disqualified persons m m m m Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5, or 1% of the amount on line 13 for the year c Add lines 7a and 7 m m m m m m m m m m m 8 Pulic support (Sutract line 7c from line 6.) m m m m m m m m m m m m m m m m m Section B. Total Support Calendar year (or fiscal year eginning in) 9 Amounts from line 6 m m m m m m m m m m m 1 a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources m m m m m m m m m m m m m m m m m Unrelated usiness taxale income (less section 511 taxes) from usinesses acquired after June 3, 1975 c Add lines 1a and 1 m m m m m m m m m 11 Net income from unrelated usiness activities not included in line 1, whether or not the usiness is regularly carried on m m m m m m m m m m m m m m m 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part V.) m m m m m m m m m m m 13 Total support. (Add lines 9, 1c, 11, and 12.) m m m m m m m m m m m m m m m m 14 First five years. f the Form 99 is for the organization's first, second, third, fourth, or fifth tax year as a section 51(c)(3) organization, check this ox and stop here m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Section C. Computation of Pulic Support Percentage 15 Pulic support percentage for 212 (line 8, column (f) divided y line 13, column (f)) Pulic support percentage from 211 Schedule A, Part, line 15 m m m m m m m m m m m m m m m m m m m m m m m 16 Section D. Computation of nvestment ncome Percentage 17 nvestment income percentage for 212 (line 1c, column (f) divided y line 13, column (f)) nvestment income percentage from 211 Schedule A, Part, line 17 m m m m m m m m m m m m m m m m m m m m a 33 1/3 % support tests f the organization did not check the ox on line 14, and line 15 is more than 331/3 %, and line 17 is not more than 331/3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization 33 1/3 % support tests f the organization did not check a ox on line 14 or line 19a, and line 16 is more than 331/3 %, and line 18 is not more than 331/3 %, check this ox and stop here. The organization qualifies as a pulicly supported organization 2 Private foundation. f the organization did not check a ox on line 14, 19a, or 19, check this ox and see instructions (a) 28 () 29 (c) 21 (d) 211 (e) 212 (f) Total Schedule A (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 16 % % % %

17 SCHEDULE C Political Campaign and Loying Activities OMB No (Form 99 or 99-EZ) For Organizations Exempt From ncome Tax Under section 51(c) and section 527 À¾µ Complete if the organization is descried elow. Attach to Form 99 or Form 99-EZ. Open Department of the Treasury nternal Revenue Service See separate instructions. nspection % % f the organization answered "Yes," to Form 99, Part V, line 3, or Form 99-EZ, Part V, line 46 (Political Campaign Activities), then Section 51(c)(3) organizations: Complete Parts -A and B. Do not complete Part -C. Section 51(c) (other than section 51(c)(3)) organizations: Complete Parts -A and C elow. Do not complete Part -B. Section 527 organizations: Complete Part -A only. to Pulic f the organization answered "Yes," to Form 99, Part V, line 4, or Form 99-EZ, Part V, line 47 (Loying Activities), then % Section 51(c)(3) organizations that have filed Form 5768 (election under section 51(h)): Complete Part -A. Do not complete Part -B. Section 51(c)(3) organizations that have NOT filed Form 5768 (election under section 51(h)): Complete Part -B. Do not complete Part -A. f the % organization answered "Yes," to Form 99, Part V, line 5 (Proxy Tax) or Form 99-EZ, Part V, line 35c (Proxy Tax), then Section 51(c)(4), (5), or (6) organizations: Complete Part. Name of organization Employer identification numer NURSE-FAMLY PARTNERSHP Part -A Complete if the organization is exempt under section 51(c) or is a section 527 organization. 1 Provide a description of the organization's direct and indirect political campaign activities in Part V. 2 Political expenditures m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ 3 Volunteer hours m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Part 4 -B Complete if the organization is exempt under section 51(c)(3). 1 Enter the amount of any excise tax incurred y the organization under section 4955 $ 2 Enter the amount of any excise tax incurred y organization managers under section 4955 $ 3 f the organization incurred a section 4955 tax, did it file Form 472 for this year? Yes No 4 a Was a correction made? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes No f "Yes," descrie in Part V. Part -C Complete if the organization is exempt under section 51(c), except section 51(c)(3). 1 Enter the amount directly expended y the filing organization for section 527 exempt function activities m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ 2 Enter the amount of the filing organization's funds contriuted to other organizations for section 527 exempt function activities m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ 3 Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 112-POL, line 17 m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ 4 Did the filing organization file Form 112-POL for this year? m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes No 5 Enter the names, addresses and employer identification numer (EN) of all section 527 political organizations to which the filing organization made payments. For each organization listed, enter the amount paid from the filing organization's funds. Also enter the amount of political contriutions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). f additional space is needed, provide information in Part V. (1) (a) Name () Address (c) EN (d) Amount paid from filing organization's funds. f none, enter --. (e) Amount of political contriutions received and promptly and directly delivered to a separate political organization. f none, enter --. (2) (3) (4) (5) (6) For Paperwork Reduction Act Notice, see the nstructions for Form 99 or 99-EZ. Schedule C (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 22

18 Schedule C (Form 99 or 99-EZ) 212 NURSE-FAMLY PARTNERSHP Part -A Complete if the organization is exempt under section 51(c)(3) and filed Form 5768 (election under section 51(h)). A Check if the filing organization elongs to an affiliated group (and list in Part V each affiliated group memer's name, address, EN, expenses, and share of excess loying expenditures). B Check if the filing organization checked ox A and "limited control" provisions apply. 1 a c d e f g h i j Limits on Loying Expenditures (The term "expenditures" means amounts paid or incurred.) m m m m m m Total loying expenditures to influence pulic opinion (grass roots loying) Total loying expenditures to influence a legislative ody (direct loying) Total loying expenditures (add lines 1a and 1) Other exempt purpose expenditures m m m m m m m m m m m Total exempt purpose expenditures (add lines 1c and 1d) m m m m m m m m m m m m m m m m Loying nontaxale amount. Enter the amount from the following tale in oth columns. f the amount on line 1e, column (a) or () is: The loying nontaxale amount is: Not over $5, Over $5, ut not over $1,, Over $1,, ut not over $1,5, Over $1,5, ut not over $17,, Over $17,, 2% of the amount on line 1e. $1, plus 15% of the excess over $5,. $175, plus 1% of the excess over $1,,. $225, plus 5% of the excess over $1,5,. $1,,. Grassroots nontaxale amount (enter 25% of line 1f) Sutract line 1g from line 1a. f zero or less, enter -- Sutract line 1f from line 1c. f zero or less, enter -- m m m m m m m m m m m m m m m m m m (a) Filing organization's totals m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m () Affiliated group totals f there is an amount other than zero on either line 1h or line 1i, did the organization file Form 472 reporting section 4911 tax for this year? Yes No 4-Year Averaging Period Under Section 51(h) (Some organizations that made a section 51(h) election do not have to complete all of the five columns elow. See the instructions for lines 2a through 2f on page 4.) Loying Expenditures During 4-Year Averaging Period 19, , , ,47, ,778, ,923. Page 2 197,231. Calendar year (or fiscal year eginning in) (a) 29 () 21 (c) 211 (d) 212 (e) Total 2 a Loying nontaxale amount Loying ceiling amount (15% of line 2a, column (e)) 736, , , ,923. 3,6,913. 4,51,37. c d e f Total loying expenditures Grassroots nontaxale amount Grassroots ceiling amount (15% of line 2d, column (e)) Grassroots loying expenditures 27, , , ,799. 1,279, , , , , ,729. 1,127, , ,39. 82, , ,734. Schedule C (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 23

19 Schedule C (Form 99 or 99-EZ) 212 Part -B NURSE-FAMLY PARTNERSHP Complete if the organization is exempt under section 51(c)(3) and has NOT filed Form 5768 (election under section 51(h)). For each "Yes," response to lines 1a through 1i elow, provide in Part V a detailed (a) () description of the loying activity. Yes No Amount Page 3 1 a c d e f g h i j During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence pulic opinion on a legislative matter or referendum, through the use of: Volunteers? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? Media advertisements? m m m m m m m m m m m m m Mailings to memers, legislators, or the pulic? m m m Pulications, or pulished or roadcast statements? Grants to other organizations for loying purposes? m m m m m m m m m m m m m m m m m m Direct contact with legislators, their staffs, government officials, or a legislative ody? m m Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? Other activities? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Total. Add lines 1c through 1i m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," enter the amount of any tax incurred under section 4912 m m m m m m m m m m m m m m c f "Yes," enter the amount of any tax incurred y organization managers under section 4912 d f the filing organization incurred a section 4912 tax, did it file Form 472 for this year? m m m m m 2 a Did the activities in line 1 cause the organization to e not descried in section 51(c)(3)? Part -A Part -B Complete if the organization is exempt under section 51(c)(4), section 51(c)(5), or section 51(c)(6). m 1 m m m m m m m m 2 m m m m m m m m m m 3 Complete if the organization is exempt under section 51(c)(4), section 51(c)(5), or section Were sustantially all (9% or more) dues received nondeductile y memers? Did the organization make only in-house loying expenditures of $2, or less? Did the organization agree to carry over loying and political expenditures from the prior year? 51(c)(6) and if either (a) BOTH Part -A, lines 1 and 2, are answered "No," OR () Part -A, line 3, is answered "Yes." 1 Dues, assessments and similar amounts from memers m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1 2 Section 162(e) nondeductile loying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid). a Current year m m m m m m m Carryover from last year c Total m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 3 Aggregate amount reported in section 633(e)(1)(A) notices of nondeductile section 162(e) dues m m m m 4 f notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonale estimate of nondeductile loying and political expenditure next year? m m m m m m m m m m m m m m m m m m m m 5 Taxale amount of loying and political expenditures (see instructions) m m m m m m m m m m m m m m m m m m m Part V Supplemental nformation Complete this part to provide the descriptions required for Part -A, line 1; Part -B, line 4; Part -C, line 5; Part -A (affiliated group list); Part -A, line 2; and Part -B, line 1. Also, complete this part for any additional information. 2a 2 2c Yes No 2E Schedule C (Form 99 or 99-EZ) DA K278 3/6/214 7:14:3 PM V PAGE 24

20 NURSE-FAMLY PARTNERSHP Schedule C (Form 99 or 99-EZ) 212 Page 4 Part V Supplemental nformation (continued) Schedule C (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 25

21 SCHEDULE D OMB No Supplemental Financial Statements (Form 99) Complete if the organization answered "Yes," to Form 99, À¾µ Part V, line 6, 7, 8, 9, 1, 11a, 11, 11c, 11d, 11e, 11f, 12a, or 12. Department of the Treasury Open to Pulic nternal Revenue Service Attach to Form 99. See separate instructions. nspection Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP Part Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 99, Part V, line (a) Donor advised funds () Funds and other accounts Total numer at end of year m m m m m m m Aggregate contriutions to (during year) Aggregate grants from (during year) Aggregate value at end of year m m m m m m m m m m Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization s property, suject to the organization's exclusive legal control? m m m m m m m m m m m Yes No Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can e used only for charitale purposes and not for the enefit of the donor or donor advisor, or for any other purpose conferring impermissile private enefit? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes No Part Conservation Easements. Complete if the organization answered "Yes" to Form 99, Part V, line 7. 1 Purpose(s) of conservation easements held y the organization (check all that apply) a c d Preservation of land for pulic use (e.g., recreation or education) Protection of natural haitat Preservation of open space Preservation of an historically important land area Preservation of a certified historic structure Complete lines 2a through 2d if the organization held a qualified conservation contriution in the form of a conservation easement on the last day of the tax year. Held at the End of the Tax Year m m m m m m m m m m m m m m m m m m m m m m m m m m m m Total numer of conservation easements 2a Total acreage restricted y conservation easements 2 Numer of conservation easements on a certified historic structure included in (a) m m m m m m 2c Numer of conservation easements included in (c) acquired after 8/17/6, and not on a historic structure listed in the National Register m m m m m m m m m m m m m m m m m m m m m m m m m 2d Numer of conservation easements modified, transferred, released, extinguished, or terminated y the organization during the tax year Numer of states where property suject to conservation easement is located Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year m m m m m m m m m m m m m m m m m m m m m m m Yes No 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) aove satisfy the requirements of section 17(h)(4)(B) (i) and section 17(h)(4)(B)(ii)? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Yes 9 n Part, descrie how the organization reports conservation easements in its revenue and expense statement, and alance sheet, and include, if applicale, the text of the footnote to the organization s financial statements that descries the organization s accounting for conservation easements. Part Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered "Yes" to Form 99, Part V, line 8. 1a f the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and alance sheet works of art, historical treasures, or other similar assets held for pulic exhiition, education, or research in furtherance of pulic service, provide, in Part, the text of the footnote to its financial statements that descries these items. f the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and alance sheet works of art, historical treasures, or other similar assets held for pulic exhiition, education, or research in furtherance of pulic service, provide the following amounts relating to these items: (i) Revenues included in Form 99, Part V, line 1 $ (ii) Assets included in Form 99, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ 2 f the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to e reported under SFAS 116 (ASC 958) relating to these items: a Revenues included in Form 99, Part V, line 1 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ Assets included in Form 99, Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ For Paperwork Reduction Act Notice, see the nstructions for Form 99. Schedule D (Form 99) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 26 No

22 NURSE-FAMLY PARTNERSHP Schedule D (Form 99) 212 Page 2 Part Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued) 3 a c 4 5 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): Pulic exhiition Scholarly research d e Loan or exchange programs Other Preservation for future generations Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part. Part V 1a During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to e sold to raise funds rather than to e maintained as part of the organization's collection? m m m m m m Yes No Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 99, Part V, line 9, or reported an amount on Form 99, Part, line 21. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m s the organization an agent, trustee, custodian or other intermediary for contriutions or other assets not included on Form 99, Part? f "Yes," explain the arrangement in Part and complete the following tale: Amount m m m m 1c m 1d 1e m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1f m m m m m m m m m m m m m m m m m m m m m m m m m m m c Beginning alance d Additions during the year e Distriutions during the year f Ending alance 2a Did the organization include an amount on Form 99, Part, line 21? Part V 1a c d e f g Yes No f "Yes," explain the arrangement in Part. Check here if the explanation has een provided in Part Endowment Funds. Complete if the organization answered "Yes" to Form 99, Part V, line 1. (a) Current year () Prior year (c) Two years ack (d) Three years ack (e) Four years ack Beginning of year alance Contriutions m m m m m m m m m m m Net investment earnings, gains, and losses m m m m m m m Grants or scholarships m m m m m m Other expenditures for facilities and programs m m m m m m Administrative expenses m m m m m End of year alance m m m m m m m m 2 Provide the estimated percentage of the current year end alance (line 1g, column (a)) held as: a Board designated or quasi-endowment % Permanent endowment % c Temporarily restricted endowment % The percentages in lines 2a, 2, and 2c should equal 1%. 3a Are there endowment funds not in the possession of the organization that are held and administered for the organization y: (i) unrelated organizations (ii) related organizations f "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? 4 Descrie in Part the intended uses of the organization's endowment funds. Part V Land, Buildings, and Equipment. See Form 99, Part, line 1. Description of property m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 3a(i) m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 3a(ii) m m m m m m m m m m m m m m m m m m 3 (a) Cost or other asis (investment) () Cost or other asis (other) (c) Accumulated depreciation Yes Yes (d) Book value 1a c d e Land Buildings Leasehold improvements Equipment Other 294, ,835. 1,798, , , , , , ,677. Total. Add lines 1a through 1e. (Column (d) must equal Form 99, Part, column (B), line 1(c).) 1,357,998. m m m m m m No No Schedule D (Form 99) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 27

23 NURSE-FAMLY PARTNERSHP Schedule D (Form 99) 212 Page 3 Part V nvestments - Other Securities. See Form 99, Part, line 12. (a) Description of security or category (including name of security) (1) Financial derivatives (2) Closely-held equity interests (3) Other (A) (B) (C) (D) (E) (F) (G) (H) () m m m m m m m m m m m m m m m m m Total. (Column () must equal Form 99, Part, col. (B) line 12.) Part V (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) () Book value nvestments - Program Related. See Form 99, Part, line 13. (c) Method of valuation: Cost or end-of-year market value (a) Description of investment type () Book value (c) Method of valuation: Cost or end-of-year market value Total. (Column () must equal Form 99, Part, col. (B) line 13.) Part (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) Other Assets. See Form 99, Part, line 15. (a) Description Total. (Column () must equal Form 99, Part, col. (B) line 15.) m m m m m m m m m m m m m m m m m m m m m m m m m m Part Other Liailities. See Form 99, Part, line (a) Description of liaility () Book value (1) Federal income taxes (2) (3) (4) (5) (6) (7) (8) (9) (1) (11) Total. (Column () must equal Form 99, Part, col. (B) line 25.) () Book value liaility for uncertain tax positions under FN 48 (ASC 74). Check here if the text of the footnote has een provided in Part m m m m m m m m m m m 2. FN 48 (ASC 74) Footnote. n Part, provide the text of the footnote to the organization's financial statements that reports the organization's 2E Schedule D (Form 99) DA K278 3/6/214 7:14:3 PM V PAGE 28

24 Schedule D (Form 99) 212 Page 4 Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Part 1 Total revenue, gains, and other support per audited financial statements 2 Amounts included on line 1 ut not on Form 99, Part V, line 12: a c d e 3 4 a c 5 Net unrealized gains on investments Donated services and use of facilities Recoveries of prior year grants m m m m m m m m m m m m m m m m m 2a 2 2c 2d m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Other (Descrie in Part.) Add lines 2a through 2d 2e Sutract line 2e from line 1 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 3 Amounts included on Form 99, Part V, line 12, ut not on line 1: nvestment expenses not included on Form 99, Part V, line 7 4a Other (Descrie in Part.) 4 Add lines 4a and 4 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 4c Total revenue. Add lines 3 and 4c. (This must equal Form 99, Part, line 12.) m m m m m m m m m m m m m m 5 Part Reconciliation of Expenses per Audited Financial Statements With Expenses per Return 1 Total expenses and losses per audited financial statements m m m m m m m m m m m m m m m m m m m m m m m m 1 2 Amounts included on line 1 ut not on Form 99, Part, line 25: a Donated services and use of facilities 2a 565,36. Prior year adjustments 2 c Other losses m m m m m m m m m 2c d Other (Descrie in Part.) 2d e Add lines 2a through 2d m m 2e 3 Sutract line 2e from line 1 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 3 4 Amounts included on Form 99, Part, line 25, ut not on line 1: a nvestment expenses not included on Form 99, Part V, line 7 4a Other (Descrie in Part.) 4 c Add lines 4a and 4 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 4c 5 Total expenses. Add lines 3 and 4c. (This must equal Form 99, Part, line 18.) m m m m m m m m m m m m m m 5 Part Supplemental nformation Complete this part to provide the descriptions required for Part, lines 3, 5, and 9; Part, lines 1a and 4; Part V, lines 1 and 2; Part V, line 4; Part, line 2; Part, lines 2d and 4; and Part, lines 2d and 4. Also complete this part to provide any additional information. SEE PAGE 5 NURSE-FAMLY PARTNERSHP , , ,82, ,93. 1,455,775. 1,455, ,343, ,36. 12,778, ,778,464. Schedule D (Form 99) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 29

25 NURSE-FAMLY PARTNERSHP Part Supplemental nformation (continued) Schedule D (Form 99) 212 Page 5 PART, LNE 2 NURSE-FAMLY PARTNERSHP (NFP) S EEMPT FROM FEDERAL NCOME TAES UNDER SECTON 51(C)(3) OF THE NTERNAL REVENUE CODE (RC); ACCORDNGLY, NO PROVSON FOR NCOME TAES S NCLUDED N THE ACCOMPANYNG FNANCAL STATEMENTS. NFP RECEVED FNAL DETERMNATON AS A PUBLC CHARTY UNDER SECTON 51(C)(3) OF THE RC N DECEMBER OF 27. NFP ASSESSES THE LKELHOOD OF THE FNANCAL STATEMENT EFFECT OF A TA POSTON THAT SHOULD BE RECOGNZED WHEN T S MORE LKELY THAN NOT THAT THE POSTON WLL BE SUSTANED UPON EAMNATON BY A TANG AUTHORTY BASED ON THE TECHNCAL MERTS OF THE TA POSTON, CRCUMSTANCES, AND NFORMATON AVALABLE AS OF THE REPORTNG DATE. MANAGEMENT DOES NOT BELEVE THAT THERE ARE ANY TA POSTONS THAT WOULD RESULT N AN ASSET OR LABLTY FOR TAES BENG RECOGNZED N THE FNANCAL STATEMENTS. NFP'S POLCY S TO RECOGNZE NTEREST AND PENALTES ACCRUED ON ANY UNRECOGNZED TA POSTONS AS A COMPONENT OF NCOME TA EPENSE. AS OF SEPTEMBER 3, 213 AND 212, NFP DD NOT HAVE ANY ACCRUED NTEREST OR PENALTES ASSOCATED WTH ANY UNRECOGNZED TA POSTONS, NOR WERE ANY NTEREST EPENSE OR PENALTES RECOGNZED DURNG THE YEARS ENDED SEPTEMBER 3, 213 AND 212. THERE ARE OPEN STATUTES OF LMTATONS FOR TANG AUTHORTES TO AUDT NFP'S TA RETURNS FOR 21 THROUGH THE CURRENT PEROD. Schedule D (Form 99) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 3

26 SCHEDULE J (Form 99) Compensation nformation OMB No For certain Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees Complete if the organization answered "Yes" to Form 99, Part V, line 23. Department of the Treasury nternal Revenue Service Attach to Form 99. See separate instructions. Name of the organization À¾µ Open to Pulic nspection Employer identification numer NURSE-FAMLY PARTNERSHP Part Questions Regarding Compensation 1a Check the appropriate ox(es) if the organization provided any of the following to or for a person listed in Form 99, Part V, Section A, line 1a. Complete Part to provide any relevant information regarding these items. First-class or charter travel Travel for companions Tax indemnification and gross-up payments Discretionary spending account Housing allowance or residence for personal use Payments for usiness use of personal residence Health or social clu dues or initiation fees Personal services (e.g., maid, chauffeur, chef) Yes No f any of the oxes on line 1a are checked, did the organization follow a written policy regarding payment or reimursement or provision of all of the expenses descried aove? f "No," complete Part to explain m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 2 Did the organization require sustantiation prior to reimursing or allowing expenses incurred y all officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? m m m m m m m m m m m 3 ndicate which, if any, of the following the filing organization used to estalish the compensation of the organization's CEO/Executive Director. Check all that apply. Do not check any oxes for methods used y a related organization to estalish compensation of the CEO/Executive Director, ut explain in Part. Compensation committee ndependent compensation consultant Form 99 of other organizations Written employment contract Compensation survey or study Approval y the oard or compensation committee 4 During the year, did any person listed in Form 99, Part V, Section A, line 1a, with respect to the filing organization or a related organization: a Receive a severance payment or change-of-control payment? Participate in, or receive payment from, a supplemental nonqualified retirement plan? c Participate in, or receive payment from, an equity-ased compensation arrangement? f "Yes" to any of lines 4a-c, list the persons and provide the applicale amounts for each item in Part. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 1 2 4a 4 4c a a Only section 51(c)(3) and 51(c)(4) organizations must complete lines 5-9. For persons listed in Form 99, Part V, Section A, line 1a, did the organization pay or accrue any compensation contingent on the revenues of: The organization? m m m m Any related organization? m m m m m m m m m m m f "Yes" to line 5a or 5, descrie in Part. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m For persons listed in Form 99, Part V, Section A, line 1a, did the organization pay or accrue any compensation contingent on the net earnings of: The organization? m m m m Any related organization? m m m m m m m m m m m m m f "Yes" to line 6a or 6, descrie in Part. m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m For persons listed in Form 99, Part V, Section A, line 1a, did the organization provide any non-fixed payments not descried in lines 5 and 6? f "Yes," descrie in Part m m m m m m m m m m m m m m m m m m m m m m m m Were any amounts reported in Form 99, Part V, paid or accrued pursuant to a contract that was suject to the initial contract exception descried in Regulations section (a)(3)? f "Yes," descrie in Part m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Regulations section (c)? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 9 f "Yes" to line 8, did the organization also follow the reuttale presumption procedure descried in For Paperwork Reduction Act Notice, see the nstructions for Form 99. Schedule J (Form 99) 212 5a 5 6a E DA K278 3/6/214 7:14:3 PM V PAGE 31

27 NURSE-FAMLY PARTNERSHP Schedule J (Form 99) 212 Page 2 Part Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed. For each individual whose compensation must e reported in Schedule J, report compensation from the organization on row (i) and from related organizations, descried in the instructions, on row (ii). Do not list any individuals that are not listed on Form 99, Part V. Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 99, Part V, Section A, line 1a, applicale column (D) and (E) amounts for that individual E (A) Name and Title (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (i) (ii) (B) Breakdown of W-2 and/or 199-MSC compensation (i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportale compensation (C) Retirement and other deferred compensation (D) Nontaxale enefits (E) Total of columns (B)(i)-(D) (F) Compensation reported as deferred in prior Form 99 THOMAS R. JENKNS, JR PRESDENT & CEO PAUL TOSETT SECRETARY & CFO TAMAR BAUER CHEF POLCY & GOVT AFFRS LAUREN BAKER (i) (ii) (i) (ii) (i) (ii) (i) 165, , , ,64. 25,. 11,. 11,. 1,. 19, , , , ,37. 21, , , ,42. CHEF MARKETNG COMM OFFCER Schedule J (Form 99) DA K278 3/6/214 7:14:3 PM V PAGE 32

28 NURSE-FAMLY PARTNERSHP Schedule J (Form 99) 212 Page 3 Part Supplemental nformation Complete this part to provide the information, explanation, or descriptions required for Part, lines 1a, 1, 3, 4a, 4, 4c, 5a, 5, 6a, 6, 7, and 8, and for Part. Also complete this part for any additional information. PART 1, LNE 7 BONUSES TOTALNG $57, WERE AWARDED TO NDVDUALS LSTED N PART. Schedule J (Form 99) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 33

29 SCHEDULE L (Form 99 or 99-EZ) Department of the Treasury nternal Revenue Service Transactions With nterested Persons Complete if the organization answered "Yes" on Form 99, Part V, line 25a, 25, 26, 27, 28a, 28, or 28c, or Form 99-EZ, Part V, line 38a or 4. Attach to Form 99 or Form 99-EZ. See separate instructions. OMB No À¾µ Open To Pulic nspection Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP Part Excess Benefit Transactions (section 51(c)(3) and section 51(c)(4) organizations only). Complete if the organization answered "Yes" on Form 99, Part V, line 25a or 25, or Form 99-EZ, Part V, line 4. () Relationship etween disqualified person 1 (a) Name of disqualified person and organization (c) Description of transaction (1) (2) (3) (4) (5) (6) 2 3 Enter the amount of tax incurred y the organization managers or disqualified persons during the year under section 4958 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m $ Enter the amount of tax, if any, on line 2, aove, reimursed y the organization m m m m m m m m m m m m m m $ (d) Corrected? Yes No Part Loans to and/or From nterested Persons. Complete if the organization answered "Yes" on Form 99-EZ, Part V, line 38a or Form 99, Part V, line 26; or if the organization reported an amount on Form 99, Part, line 5, 6, or 22. (a) Name of interested person () Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) n default? (h) Approved y oard or committee? (i) Written agreement? (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Total $ Part Grants or Assistance Benefiting nterested Persons. Complete if the organization answered "Yes" on Form 99, Part V, line 27. (a) Name of interested person () Relationship etween interested person and the organization To From Yes No Yes No Yes No (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) For Paperwork Reduction Act Notice, see the nstructions for Form 99 or 99-EZ. Schedule L (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 34

30 NURSE-FAMLY PARTNERSHP Schedule L (Form 99 or 99-EZ) 212 Page 2 Part V Business Transactions nvolving nterested Persons. Complete if the organization answered "Yes" on Form 99, Part V, line 28a, 28, or 28c. (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) Part V (a) Name of interested person () Relationship etween interested person and the organization (c) Amount of transaction (d) Description of transaction Supplemental nformation Complete this part to provide additional information for responses to questions on Schedule L (see instructions). (e) Sharing of organization's revenues? ROBERT HLL BOARD CHAR 74,79. SEE SCHEDULE L, PART V SUE HAGEDORN BOARD MEMBER 6,. SEE SCHEDULE L, PART V BEVERLY MALONE BOARD VCE CHAR 3,. SEE SCHEDULE L, PART V ROBN BRTT BOARD MEMBER 29,55. SEE SCHEDULE L, PART V SCHEDULE L, PART V, BUSNESS TRANSACTONS NVOLVNG NTERESTED PERSONS NVEST N KDS (K) ASSSTS N THE MPLEMENTATON OF THE PROGRAM BY PERFORMNG CERTAN CONSULTNG AND TECHNCAL ASSSTANCE FUNCTONS ON BEHALF OF NFP TO MPLEMENTNG AGENCES N COLORADO. FOR THE YEAR ENDED SEPTEMBER 3, 213 PAYMENTS TO K WERE $74,79. ROBERT HLL, NFP BOARD CHAR, S RELATED TO THE K EECUTVE DRECTOR. Yes No NFP HAS ATTENDED AND PARTCPATED N CERTAN CONFERENCE EVENTS SPONSORED BY THE NATONAL LEAGUE OF NURSNG (NLN) FOR A FEE. FOR THE YEAR ENDED SEPTEMBER 3, 213, NFP NCURRED EPENSE OF $3,. BEVERLY MALONE, NFP BOARD VCE-CHAR, ALSO SERVED AS THE NLN CEO DURNG THE 213 FSCAL YEAR. NFP PAD SEEDWORKS FLMS $6, N 213 TO DEVELOP VDEO CLPS AND DSCUSSON GUDES THAT WLL BE USED FOR NFP EDUCATON. SUE HAGEDORN, NFP BOARD MEMBER, ALSO WAS THE OWNER OF SEEDWORKS FLMS DURNG THE 213 FSCAL YEAR. NFP RECORDED STE REVENUES OF $29,55 FROM GULFORD CHLD DEVELOPMENT, AN 2E Schedule L (Form 99 or 99-EZ) DA K278 3/6/214 7:14:3 PM V PAGE 35

31 NURSE-FAMLY PARTNERSHP Schedule L (Form 99 or 99-EZ) 212 Page 2 Part V Business Transactions nvolving nterested Persons. Complete if the organization answered "Yes" on Form 99, Part V, line 28a, 28, or 28c. (a) Name of interested person () Relationship etween interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues? (1) (2) (3) (4) (5) (6) (7) (8) (9) (1) Part V Supplemental nformation Complete this part to provide additional information for responses to questions on Schedule L (see instructions). Yes No MPLEMENTNG AGENCY N NORTH CAROLNA, FOR PROGRAM SERVCES PROVDED N 213. ADDTONALLY, NFP PAD $133,333 TO GULFORD N 213 AS PART OF A PASS THROUGH GRANT. ROBN BRTT, NFP BOARD MEMBER, ALSO SERVED AS THE EECUTVE DRECTOR OF GULFORD CHLD DEVELOPMENT DURNG THE 213 FSCAL YEAR. 2E Schedule L (Form 99 or 99-EZ) DA K278 3/6/214 7:14:3 PM V PAGE 36

32 OMB No SCHEDULE M (Form 99) Noncash Contriutions Complete if the organizations answered "Yes" on Form À¾µ 99, Part V, lines 29 or 3. Open To Pulic Department of the Treasury nternal Revenue Service Attach to Form 99. nspection Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP Part Types of Property (a) () (c) (d) Check if Numer of contriutions or Noncash contriution Method of determining amounts reported on applicale items contriuted Form 99, Part V, line 1g noncash contriution amounts m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Art - Works of art Art - Historical treasures Art - Fractional interests Books and pulications Clothing and household goods Cars and other vehicles Boats and planes ntellectual property Securities - Pulicly traded Securities - Closely held stock Securities - Partnership, LLC, or trust interests Securities - Miscellaneous Qualified conservation contriution - Historic structures Qualified conservation contriution - Other Real estate - Residential Real estate - Commercial Real estate - Other Collectiles Food inventory Drugs and medical supplies Taxidermy Historical artifacts Scientific specimens Archeological artifacts Other ( ATCH 1 Other ( Other ( Other ( m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m ) ) ) ) m m m m m m m m m 29 Numer of Forms 8283 received y the organization during the tax year for contriutions for which the organization completed Form 8283, Part V, Donee Acknowledgement 29 3 a ,325. During the year, did the organization receive y contriution any property reported in Part, lines 1-28 that it must hold for at least three years from the date of the initial contriution, and which is not required to e used for exempt purposes for the entire holding period? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m f "Yes," descrie the arrangement in Part. Does the organization have a gift acceptance policy that requires the review of any non-standard contriutions? 31 m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 32 a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash contriutions? f "Yes," descrie in Part. 33 f the organization did not report an amount in column (c) for a type of property for which column (a) is checked, descrie in Part. For Paperwork Reduction Act Notice, see the nstructions for Form 99. Schedule M (Form 99) (212) 3a 32a Yes No 2E DA K278 3/6/214 7:14:3 PM V PAGE 37

33 Schedule M (Form 99) (212) Page 2 Part Supplemental nformation. Complete this part to provide the information required y Part, lines 3, 32, and 33, and whether the organization is reporting in Part, column (), the numer of contriutions, the numer of items received, or a comination of oth. Also complete this part for any additional information. ATTACHMENT 1 SCHEDULE M, PART - OTHER NONCASH CONTRBUTONS NURSE-FAMLY PARTNERSHP (B) NUMBER OF (C) REVENUES (D) METHOD OF DESCRPTON (A) CHECK CONTRBUTONS REPORTED DETERMNNG MCROSOFT VSUAL STUDO ,725. FAR MARKET VALUE ART CARDS FOR BABY FAR MARKET VALUE TOTALS 6. 36,325. Schedule M (Form 99) (212) 2E DA K278 3/6/214 7:14:3 PM V PAGE 38

34 SCHEDULE O (Form 99 or 99-EZ) Department of the Treasury nternal Revenue Service Name of the organization Supplemental nformation to Form 99 or 99-EZ Complete to provide information for responses to specific questions on Form 99 or 99-EZ or to provide any additional information. Attach to Form 99 or 99-EZ. OMB No À¾µ Open to Pulic nspection Employer identification numer NURSE-FAMLY PARTNERSHP FORM 99, PART V, SECTON B, LNE 11B A COPY OF FORM 99 S PROVDED TO THE ORGANZATON'S FNANCE & AUDT COMMTTEE FOR REVEW, AND THEN A COPY S DSTRBUTED TO EACH BOARD MEMBER PROR TO FLNG. FORM 99, PART V, SECTON B, LNE 12C THE ORGANZATON REGULARLY AND CONSSTENTLY MONTORS AND ENFORCES COMPLANCE WTH THE CONFLCT OF NTEREST POLCY BY REQURNG ANNUAL DSCLOSURE OF ANY CONFLCTS BY DRECTORS, OFFCERS AND KEY EMPLOYEES N A SGNED STATEMENT. FORM 99, PART V, SECTON B, LNE 15A THE COMPENSATON OF THE PRESDENT & CEO S DETERMNED BY THE GOVERNANCE COMMTTEE OF THE BOARD OF DRECTORS USNG MARKET BASED COMPARABLE DATA AND OTHER RELEVANT NFORMATON. COMPENSATON OF OTHER OFFCERS AND KEY EMPLOYEES ARE DETERMNED BY SENOR MANAGEMENT USNG THE SAME TYPE OF NFORMATON. FORM 99, PART V, SECTON C, LNE 19 THE ORGANZATON MAKES TS GOVERNNG DOCUMENTS AND CONFLCT OF NTEREST POLCY AVALABLE TO THE PUBLC UPON REQUEST. THE ORGANZATON MAKES TS FNANCAL STATEMENTS AND 99 AVALABLE TO THE PUBLC ON TS WEBSTE, OTHER CHARTABLE ORGANZATON WEBSTES, AND UPON REQUEST. For Privacy Act and Paperwork Reduction Act Notice, see the nstructions for Form 99 or 99-EZ. Schedule O (Form 99 or 99-EZ) (212) 2E DA K278 3/6/214 7:14:3 PM V PAGE 39

35 Schedule O (Form 99 or 99-EZ) 212 Page 2 Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP FORM 99, PART V, LNE 2A THE ORGANZATON HAS AN AGREEMENT WTH A PROFESSONAL EMPLOYMENT ORGANZATON (PEO) AND LEASES EMPLOYEES FROM THE PEO, THEREFORE NO W-3 WAS SSUED BY THE ORGANZATON. FORM 99, PART, LNE 5 UNREALZED GANS ON NVESTMENTS -2,43 ATTACHMENT 1 FORM 99, PART - PROGRAM SERVCE, LNE 4A NURSE-FAMLY PARTNERSHP S A COMMUNTY BASED HEALTH PROGRAM THAT SERVES FRST-TME, LOW-NCOME PARENTS LVNG N POVERTY, HELPNG THEM TO SUCCESSFULLY CHANGE THER LVES AND THE LVES OF THER CHLDREN THROUGH EVDENCE-BASED NURSE HOME VSTNG. EVERY YEAR, APPROMATELY 845, CHLDREN ARE BORN TO LOW-NCOME FRST-TME MOTHERS N THE U.S. WHO ARE AT THE GREATEST RSK OF SUFFERNG HEALTH, EDUCATON AND ECONOMC DSPARTES. BY OFFERNG SUPPORT TO THS VULNERABLE POPULATON, NURSE-FAMLY PARTNERSHP HELPS PREGNANT WOMEN AND THER FAMLES TO MPROVE THER HEALTH, EDUCATON, AND ECONOMC SELF-SUFFCENCY. EACH MOTHER N OUR PROGRAM S PARTNERED WTH A REGSTERED NURSE EARLY N HER PREGNANCY AND RECEVES ONGONG NURSE HOME VSTS THROUGH HER CHLD'S SECOND BRTHDAY. THE PROGRAM'S THREE MAN GOALS ARE TO 1) MPROVE PREGNANCY OUTCOMES, 2) MPROVE CHLD HEALTH AND DEVELOPMENT, AND 3) MPROVE Schedule O (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 4

36 Schedule O (Form 99 or 99-EZ) 212 Page 2 Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP ATTACHMENT 1 (CONT'D) THE ECONOMC SELF-SUFFCENCY OF THE FAMLY. THREE RANDOMZED CONTROLLED TRALS OVER THRTY FVE YEARS, AND CONTNUNG LONGTUDNAL FOLLOW-UP STUDES HAVE AMASSED AN UNSURPASSED LEVEL OF EVDENCE ABOUT THE PROGRAM'S EFFECTVENESS. THESE TRAL OUTCOMES DEMONSTRATE THAT NURSE-FAMLY PARTNERSHP DELVERS AGANST TS THREE PRMARY GOALS - MAKNG MEASURABLE MPACT ON THE LVES OF CHLDREN, FAMLES AND THE COMMUNTES N WHCH THEY LVE. FOR EAMPLE, THE FOLLOWNG OUTCOMES HAVE BEEN OBSERVED AMONG PARTCPANTS N AT LEAST ONE OF THE TRALS OF THE PROGRAM: 48% REDUCTON N CHLD ABUSE AND NEGLECT; 56% REDUCTON N EMERGENCY ROOM VSTS FOR ACCDENTS AND POSONNGS; 59% REDUCTON N ARREST AT CHLD AGE 15; 67% REDUCTON N BEHAVORAL AND NTELLECTUAL PROBLEMS AT CHLD AGE 6; AND 72% FEWER CONVCTONS OF MOTHERS AT CHLD AGE 15. THE NURSE-FAMLY PARTNERSHP NATONAL SERVCE OFFCE (NSO) S A 51(C)(3) ORGANZATON THAT PROVDES LEADERSHP, EDUCATON AND EPERTSE TO MPLEMENT AND SUSTAN THE NURSE-FAMLY PARTNERSHP PROGRAM NATONWDE. AS OF SEPTEMBER 3, 213, THE NSO WAS SUPPORTNG PROGRAM MPLEMENTATON N 529 COUNTES N 43 STATES, S TRBAL ENTTES AND ONE TERRTORY, SERVNG 26,35 FAMLES. SNCE REPLCATON OF THE PROGRAM BEGAN N 1996, NURSE-FAMLY PARTNERSHP HAS SERVED MORE THAN 188, VULNERABLE FAMLES. Schedule O (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 41

37 Schedule O (Form 99 or 99-EZ) 212 Page 2 Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP ATTACHMENT 1 (CONT'D) THE NON-PROFT NSO S SUPPORTED THROUGH EARNED REVENUE FOR TS SERVCES TO MPLEMENTNG AGENCES AND DONATONS FROM NDVDUALS, CORPORATONS AND PHLANTHROPC FOUNDATONS. AGENCES MPLEMENTNG THE NURSE-FAMLY PARTNERSHP PROGRAM AND SERVED BY NSO TYPCALLY NCLUDE COUNTY HEALTH DEPARTMENTS, HOSPTALS AND NONPROFT ORGANZATONS. FORM 99, PART V, LNE 17 - STATES ATTACHMENT 2 AL,AK,AR,CA,CT, FL,GA,L,KS,KY,MD,MA,M, MN,MS,NH,NJ,NM,NY,NC,OH,OK,OR,PA, R,SC,TN,UT,VA,WV,W, 99, PART V- COMPENSATON OF THE FVE HGHEST PAD ND. CONTRACTORS ATTACHMENT 3 NAME AND ADDRESS DESCRPTON OF SERVCES COMPENSATON SOCAL SOLUTONS T CONSULTNG 235, WLLAMS COURT, SUTE 1 BALTMORE, MD 2122 UNVERSTY OF COLORADO PROGRAM RESEARCH 316,926. PO BO DENVER, CO GRANT, LTD. LANDLORD 267, GRANT STREET, SUTE 84 DENVER, CO 823 UCD PRNTNG SERVCES PRNTNG 198,362. MAL STOP A85, 131 EAST 17TH PLACE AURORA, CO 845 Schedule O (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 42

38 Schedule O (Form 99 or 99-EZ) 212 Page 2 Name of the organization Employer identification numer NURSE-FAMLY PARTNERSHP ATTACHMENT 3 (CONT'D) 99, PART V- COMPENSATON OF THE FVE HGHEST PAD ND. CONTRACTORS NAME AND ADDRESS DESCRPTON OF SERVCES COMPENSATON ADP TOTALSOURCE PAYROLL PROCESSNG 15, EAST LFF AVENUE, SUTE 31 AURORA, CO 814 Schedule O (Form 99 or 99-EZ) 212 2E DA K278 3/6/214 7:14:3 PM V PAGE 43

39 Form 99-T Department of the Treasury nternal Revenue Service A Check ox if address changed Exempt Organization Business ncome Tax Return (and proxy tax under section 633(e)) For calendar year 212 or other tax year eginning 1/1, 212, and ending 9/3, See separate instructions. Name of organization ( Check ox if name changed and see instructions.) OMB No À¾µ Open to Pulic nspection for 51(c)(3) Organizations Only D Employer identification numer (Employees' trust, see instructions.) B Exempt under section NURSE-FAMLY PARTNERSHP 51( C )( 3 ) Print Numer, street, and room or suite no. f a P.O. ox, see instructions or 48(e) 22(e) E Type 48A 53(a) 19 GRANT STREET 4 529(a) C Book value of all assets at end of year F City or town, state, and ZP code Group exemption numer (see instructions) Unrelated usiness activity codes (see instructions.) G Check organization type 51(c) corporation 51(c) trust 41(a) trust Other trust H Descrie the organization's primary unrelated usiness activity. m m m m m m m During the tax year, was the corporation a susidiary in an affiliated group or a parent-susidiary controlled group? Yes No f "Yes," enter the name and identifying numer of the parent corporation. J The ooks are in care of Telephone numer Part Unrelated Trade or Business ncome (A) ncome (B) Expenses (C) Net 1a Gross receipts or sales 1,844. Less returns and allowances c Balance 1c 1, Cost of goods sold (Schedule A, line 7) 2 3 4a c Part ,118,287. m Gross profit. Sutract line 2 from line 1c m m Capital gain net income (attach Schedule D) m m m m m m Net gain (loss) (Form 4797, Part, line 17) (attach Form 4797) Capital loss deduction for trusts m m m m m m m m m m m m m m ncome (loss) from partnerships and S corporations (attach statement) Rent income (Schedule C) m m m m m m m m m m Unrelated det-financed income (Schedule E) m m m m m m m nterest, annuities, royalties, and rents from controlled organizations (Schedule F) m m m m m m m m m m m m m m m m m nvestment income of a section 51(c)(7), (9), or (17) organization (Schedule G) m m m m m m m m m m Exploited exempt activity income (Schedule ) Advertising income (Schedule J) m m m m m m m m Other income (see instructions; attach statement) Total. Comine lines 3 through 12 m m m m m m m m m m m m m 3 4a 4 4c ,844. 1,844. Deductions Not Taken Elsewhere (see instructions for limitations on deductions) (except for contriutions, deductions must e directly connected with the unrelated usiness income) Compensation of officers, directors, and trustees (Schedule K) Salaries and wages Repairs and maintenance Bad dets nterest (attach statement) Taxes and licenses Charitale contriutions (see instructions for limitation rules) Depreciation (attach Form 4562) Less depreciation claimed on Schedule A and elsewhere on return Depletion m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 21 22a m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Contriutions to deferred compensation plans Employee enefit programs Excess exempt expenses (Schedule ) Excess readership costs (Schedule J) Other deductions (attach statement) Total deductions. Add lines 14 through 28 DENVER, CO PAUL TOSETT Unrelated usiness taxale income efore net operating loss deduction. Sutract line 29 from line 13 Net operating loss deduction (limited to the amount on line 3) Unrelated usiness taxale income efore specific deduction. Sutract line 31 from line 3 Specific deduction (generally $1,, ut see line 33 instructions for exceptions) Unrelated usiness taxale income. Sutract line 33 from line 32. f line 33 is greater than line 32, enter the smaller of zero or line For Paperwork Reduction Act Notice, see instructions. 2E Form 99-T (212) 1,844. 1, ,. 5574DA K278 3/6/214 7:14:3 PM V PAGE 44

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