TOOLBANK USA, INC Form 990 (2014) Page 2

Transcription

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2 Form 99 (1) Pge Prt TOOLBANK USA, NC Sttement of Progrm Servie Aomplishments Chek if Shedule O ontins response or note to ny line in this Prt 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 desrie the orgniztion's mission: TOOLBANK USA STRENGTHENS COMMUNTES THROUGH THE COLLABORATVE ESTABLSHMENT OF TOOLBANKS ACROSS THE US AND THE PROVSONS OF NFRASTRUCTURE SUPPORT TO PROMOTE CONSSTENCY AND ECELLENCE FOR ALL LOCAL TOOLBANKS. m m m m m m m m m m m m m m m m m m m m m m m 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," desrie these new servies on Shedule 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 m m m m m m m m 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 orgniztion undertke ny signifint progrm servies during the yer whih were not listed on the prior Form 99 or 99-EZ? Yes No Did the orgniztion ese onduting, or mke signifint hnges in how it onduts, ny progrm servies? Yes No f "Yes," desrie these hnges on Shedule O. Desrie the orgniztion's progrm servie omplishments for eh of its three lrgest progrm servies, s mesured y expenses. Setion 51()() nd 51()() orgniztions re required to report the mount of grnts nd llotions to others, the totl expenses, nd revenue, if ny, for eh progrm servie reported. (Code: ) (Expenses $ 7,75. inluding grnts of $ ) (Revenue $ ) THE COMPANY NCORPORATED TS NNTH AFFLATE N CHCAGO, AND SUPPORTED THE GRAND OPENNG OF THE HOUSTON TOOLBANK. THE COMPANY PROVDED KEY OPERATONAL SUPPORT SERVCES TO TS NNE AFFLATES N ATLANTA, BALTMORE, CHCAGO, CHARLOTTE, CNCNNAT, HOUSTON, PHOEN, RCHMOND VA, AND PORTLAND OR. THE COMPANY LAUNCHED TOOLBANK DSASTER SERVCES, A MOBLE UNT TO AD DSASTER-AFFECTED COMMUNTES. (Code: ) (Expenses $ inluding grnts of $ ) (Revenue $ ) (Code: ) (Expenses $ inluding grnts of $ ) (Revenue $ ) d Other progrm servies (Desrie in Shedule O.) (Expenses $ inluding grnts of $ ) (Revenue $ ) e Totl progrm servie expenses 7,75. E1 1. Form 99 (1)

3 TOOLBANK USA, NC Form 99 (1) Pge Prt V Cheklist of Required Shedules m m m m m m m m m m m m m m m m m m 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 orgniztion required to omplete Shedule B, Shedule of Contriutors (see instrutions)? m m m m m m m m m Did the orgniztion engge in diret or indiret politil mpign tivities on ehlf of or in opposition to ndidtes for puli offie? f "Yes," omplete Shedule C, Prt m m m m m m m m m m m m m m m m m m m m m m m m m m m Setion 51()() orgniztions. Did the orgniztion engge in loying tivities, or hve setion 51(h) eletion in effet during the tx yer? f "Yes," omplete Shedule C, Prt m m m m m m m m m m m m m m m m m m m m m m s the orgniztion desried in setion 51()() or 97()(1) (other thn privte foundtion)? f "Yes," omplete Shedule A 1 s the orgniztion setion 51()(), 51()(5), or 51()() orgniztion tht reeives memership dues, ssessments, or similr mounts s defined in Revenue Proedure 98-19? f "Yes," omplete Shedule C, Prt m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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 orgniztion mintin ny donor dvised funds or ny similr funds or ounts for whih donors hve the right to provide dvie on the distriution or investment of mounts in suh funds or ounts? f "Yes," omplete Shedule D, Prt m m m m m m m m m m m m m m m m m m m m 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 orgniztion reeive or hold onservtion esement, inluding esements to preserve open spe, the environment, histori lnd res, or histori strutures? f "Yes," omplete Shedule D, Prt m m m m m m m m m m Did the orgniztion mintin olletions of works of rt, historil tresures, or other similr ssets? f "Yes," omplete Shedule D, Prt m m m m m m m m m m m m m m m m m m m m m m 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 orgniztion report n mount in Prt, line 1, for esrow or ustodil ount liility; serve s ustodin for mounts not listed in Prt ; or provide redit ounseling, det mngement, redit repir, or det negotition servies? f "Yes," omplete Shedule D, Prt 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 orgniztion, diretly or through relted orgniztion, hold ssets in temporrily restrited endowments, permnent endowments, or qusi-endowments? f "Yes," omplete Shedule D, Prt Vm m m m m m m m 11 f the orgniztion s nswer to ny of the following questions is "Yes," then omplete Shedule D, Prts V, V, V,, or s pplile. Did the orgniztion report n mount for lnd, uildings, nd equipment in Prt, line 1? f "Yes," d e f omplete Shedule D, Prt 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 orgniztion report n mount for investments-other seurities in Prt, line 1 tht is 5% or more of its totl ssets reported in Prt, line 1? f "Yes," omplete Shedule D, Prt V m m m m m m m m m m m m m m m m m Did the orgniztion report n mount for investments-progrm relted in Prt, line 1 tht is 5% or more of its totl ssets reported in Prt, line 1? f "Yes," omplete Shedule D, Prt V m m m m m m m m m m m m m m m m m Did the orgniztion report n mount for other ssets in Prt, line 15 tht is 5% or more of its totl ssets reported in Prt, line 1? f "Yes," omplete Shedule D, Prt m m m 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 orgniztion report n mount for other liilities in Prt, line 5? f "Yes," omplete Shedule D, Prt Did the orgniztion s seprte or onsolidted finnil sttements for the tx yer inlude footnote tht ddresses the orgniztion's liility for unertin tx positions under FN 8 (ASC 7)? f "Yes," omplete Shedule D, Prt m m m m m m Did the orgniztion otin seprte, independent udited finnil sttements for the tx yer? f "Yes," omplete Shedule D, Prts nd m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Ws the orgniztion inluded in onsolidted, independent udited finnil sttements for the tx yer? f "Yes," nd if the orgniztion nswered "No" to line 1, then ompleting Shedule D, Prts nd is optionl m m m s the orgniztion shool desried in setion 17()(1)(A)(ii)? f "Yes," omplete Shedule E Did the orgniztion mintin n offie, employees, or gents outside of the United Sttes? m m m m m m m m m m m m Did the orgniztion hve ggregte revenues or expenses of more thn $1, from grntmking, fundrising, usiness, investment, nd progrm servie tivities outside the United Sttes, or ggregte foreign investments vlued t $1, or more? f "Yes," omplete Shedule F, Prts nd V m m m m m m m m m m m Did the orgniztion report on Prt, olumn (A), line, more thn $5, of grnts or other ssistne to or for ny foreign orgniztion? f "Yes," omplete Shedule F, Prts nd V m m m m m m m m m m m m m m m m m m m m m m Did the orgniztion report on Prt, olumn (A), line, more thn $5, of ggregte grnts or other ssistne to or for foreign individuls? f "Yes," omplete Shedule F, Prts nd V m m m m m m m m m m m m m m m m Did the orgniztion report totl of more thn $15, of expenses for professionl fundrising servies on Prt, olumn (A), lines nd 11e? f "Yes," omplete Shedule G, Prt (see instrutions) m m m m m m m m m m m m m Did the orgniztion report more thn $15, totl of fundrising event gross inome nd ontriutions on Prt V, lines 1 nd 8? f "Yes," omplete Shedule G, Prt m m m m 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 orgniztion report more thn $15, of gross inome from gming tivities on Prt V, line 9? f "Yes," omplete Shedule G, Prt m m m m m 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 orgniztion operte one or more hospitl filities? f "Yes," omplete Shedule H m m m m m m m f "Yes" to line, did the orgniztion tth opy of its udited finnil sttements to this return? m m m m m m d 11e 11f Yes No Form 99 (1) E11 1.

4 TOOLBANK USA, NC Form 99 (1) Pge Prt V Cheklist of Required Shedules (ontinued) 1 d m m m m m m m m m m Prt, olumn (A), line? f Yes, omplete Shedule, Prts nd 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 orgniztion report more thn $5, of grnts or other ssistne to ny domesti orgniztion or domesti government on Prt, olumn (A), line 1? f "Yes," omplete Shedule, Prts nd 1 Did the orgniztion report more thn $5, of grnts or other ssistne to or for domesti individuls on Did the orgniztion nswer Yes to Prt V, Setion A, line,, or 5 out ompenstion of the orgniztion s urrent nd former offiers, diretors, trustees, key employees, nd highest ompensted employees? f Yes, omplete Shedule 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 orgniztion hve tx-exempt ond issue with n outstnding prinipl mount of more thn $1, s of the lst dy of the yer, tht ws issued fter Deemer 1,? f "Yes," nswer lines through d nd omplete Shedule K. f No, go to line 5 m m m m m 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 orgniztion invest ny proeeds of tx-exempt onds eyond temporry period exeption?m m m m m m m Did the orgniztion mintin n esrow ount other thn refunding esrow t ny time during the yer to defese ny tx-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 Did the orgniztion t s n "on ehlf of" issuer for onds outstnding t ny time during the yer? m m m m m m Setion 51()(), 51()(), nd 51()(9) orgniztions. Did the orgniztion engge in n exess enefit trnstion with disqulified person during the yer? f Yes, omplete Shedule L, Prt m m m m m m m m m m m m s the orgniztion wre tht it engged in n exess enefit trnstion with disqulified person in prior yer, nd tht the trnstion hs not een reported on ny of the orgniztion's prior Forms 99 or 99-EZ? f "Yes," omplete Shedule L, Prt m m m m m m m m m m m m m m m m m m 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 orgniztion report ny mount on Prt, line 5,, or for reeivles from or pyles to ny urrent or former offiers, diretors, trustees, key employees, highest ompensted employees, or disqulified persons? f "Yes," omplete Shedule L, Prt m m m m m m 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 orgniztion provide grnt or other ssistne to n offier, diretor, trustee, key employee, sustntil ontriutor or employee thereof, grnt seletion ommittee memer, or to 5% ontrolled entity or fmily memer of ny of these persons? f "Yes," omplete Shedule L, Prt m m m m m m m m m m m m m m m Ws the orgniztion prty to usiness trnstion with one of the following prties (see Shedule L, Prt V instrutions for pplile filing thresholds, onditions, nd exeptions): A urrent or former offier, diretor, trustee, or key employee? f "Yes," omplete Shedule L, Prt V m m m m m m m A fmily memer of urrent or former offier, diretor, trustee, or key employee? f "Yes," omplete Shedule L, Prt 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 An entity of whih urrent or former offier, diretor, trustee, or key employee (or fmily memer thereof) ws n offier, diretor, trustee, or diret or indiret owner? f "Yes," omplete Shedule L, Prt Vm m m m m Did the orgniztion reeive more thn $5, in non-sh ontriutions? f "Yes," omplete Shedule M m m m m Did the orgniztion reeive ontriutions of rt, historil tresures, or other similr ssets, or qulified onservtion ontriutions? f "Yes," omplete Shedule M m m m m m m 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 orgniztion liquidte, terminte, or dissolve nd ese opertions? f "Yes," omplete Shedule N, Prt m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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 orgniztion sell, exhnge, dispose of, or trnsfer more thn 5% of its net ssets? f "Yes," omplete Shedule N, Prt m m m m m m m m m m m m m m m m m m m m m m 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 orgniztion own 1% of n entity disregrded s seprte from the orgniztion under Regultions setions nd ? f "Yes," omplete Shedule R, Prt m m m m m m m m m m m m m m m m m m m m Ws the orgniztion relted to ny tx-exempt or txle entity? f "Yes," omplete Shedule R, Prt,, or V, nd Prt 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 Did the orgniztion hve ontrolled entity within the mening of setion 51()(1)? m m m m m m m m m m m m m m f "Yes" to line 5, did the orgniztion reeive ny pyment from or engge in ny trnstion with ontrolled entity within the mening of setion 51()(1)? f "Yes," omplete Shedule R, Prt V, line m m m m m Setion 51()() orgniztions. Did the orgniztion mke ny trnsfers to n exempt non-hritle relted orgniztion? f "Yes," omplete Shedule R, Prt V, line m m 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 orgniztion ondut more thn 5% of its tivities through n entity tht is not relted orgniztion nd tht is treted s prtnership for federl inome tx purposes? f "Yes," omplete Shedule R, Prt 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 19? Note. All Form 99 filers re required to omplete Shedule 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 Did the orgniztion omplete Shedule O nd provide explntions in Shedule O for Prt V, lines 11 nd d Yes No Form 99 (1) E1 1.

5 Form 99 (1) Pge 5 Prt V Sttements Regrding Other RS Filings nd Tx Compline Chek if Shedule O ontins response or note to ny line in this Prt V m m m m m m m m m m m m m m m m m m m m m Yes Did the orgniztion omply with kup withholding rules for reportle pyments to vendors nd reportle gming (gmling) 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 1 Enter the numer of employees reported on Form W-, Trnsmittl of Wge nd Tx Sttements, filed for the lendr yer ending with or within the yer overed y this return m 8 f t lest one is reported on line, did the orgniztion file ll required federl employment tx returns? See instrutions for filing requirements for FinCEN Form 11, Report of Foreign Bnk nd Finnil Aounts (FBAR). 5 Ws the orgniztion prty to prohiited tx shelter trnstion t ny time during the tx yer? m m m m m m m m Did ny txle prty notify the orgniztion tht it ws or is prty to prohiited tx shelter trnstion? f "Yes" to line 5 or 5, did the orgniztion file Form 888-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 Does the orgniztion hve nnul gross reeipts tht re normlly greter thn $1,, nd did the d e f g h 1 Enter the numer reported in Box of Form 19. Enter -- if not pplile m Enter the numer of Forms W-G inluded in line 1. Enter -- if not pplile m m m m m m m m m Note. f the sum of lines 1 nd is greter thn 5, you my e required to e-file (see instrutions) Did the orgniztion hve unrelted usiness gross inome of $1, or more during the yer? m m m f "Yes," hs it filed Form 99-T for this yer? f "No" to line, provide n explntion in Shedule O m m m m m m m At ny time during the lendr yer, did the orgniztion hve n interest in, or signture or other uthority over, finnil ount in foreign ountry (suh s nk ount, seurities ount, or other finnil ount)? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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 nme of the foreign ountry: orgniztion soliit ny ontriutions tht were not tx dedutile s hritle ontriutions? m m m m m m m m m m m f "Yes," did the orgniztion inlude with every soliittion n express sttement tht suh ontriutions or gifts were not tx dedutile? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Orgniztions tht my reeive dedutile ontriutions under setion 17(). Did the orgniztion reeive pyment in exess of $75 mde prtly s ontriution nd prtly for goods nd servies provided to the pyor? m m m m m m m 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 orgniztion notify the donor of the vlue of the goods or servies provided? m m m m m m m m m m m m Did the orgniztion sell, exhnge, or otherwise dispose of tngile personl property for whih it ws required to file Form 88? m m m m m m m 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," indite the numer of Forms 88 filed during the yer m m m m m m m m m m m m m m m m 7d Did the orgniztion reeive ny funds, diretly or indiretly, to py premiums on personl enefit ontrt? Did the orgniztion, during the yer, py premiums, diretly or indiretly, on personl enefit ontrt? m m m m m f the orgniztion reeived ontriution of qulified intelletul property, did the orgniztion file Form 8899 s required? f the orgniztion reeived ontriution of rs, ots, irplnes, or other vehiles, did the orgniztion file Form 198-C? Sponsoring orgniztions mintining donor dvised funds. Did donor dvised fund mintined y the sponsoring orgniztion hve exess usiness holdings t ny time during the yer? m m m m m m m m m m m m m m m m m Sponsoring orgniztions mintining donor dvised funds. Did the sponsoring orgniztion mke ny txle distriutions under setion 9? m m m m m m Did the sponsoring orgniztion mke distriution to donor, donor dvisor, or relted person? m m m m m m m m m m Setion 51()(7) orgniztions. Enter: nitition fees nd pitl ontriutions inluded on Prt V, line 1 m m m m m m m m m m 1 Gross reeipts, inluded on Form 99, Prt V, line 1, for puli use of lu filities m m m m 1 Setion 51()(1) orgniztions. Enter: Gross inome from memers or shreholders m m 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 Gross inome from other soures (Do not net mounts due or pid to other soures ginst mounts due or reeived 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 Setion 97()(1) non-exempt hritle trusts. s the orgniztion filing Form 99 in lieu of Form 11? f "Yes," enter the mount of tx-exempt interest reeived or rued during the yer m m m m m 1 Setion 51()(9) qulified nonprofit helth insurne issuers. s the orgniztion liensed to issue qulified helth plns in more thn one stte? m m m m m m m m m m m m m m m m m m 1 Note. See the instrutions for dditionl informtion the orgniztion must report on Shedule O. Enter the mount of reserves the orgniztion is required to mintin y the sttes in whih E1 1. TOOLBANK USA, NC the orgniztion is liensed to issue qulified helth plns 1 Enter the mount of reserves on hnd m m m m m 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 Did the orgniztion reeive ny pyments for indoor tnning servies during the tx yer? m m m m m m m f "Yes," hs it filed Form 7 to report these pyments? f "No," provide n explntion in Shedule O m m m m m m e 7f 7g 7h No Form 99 (1)

6 Form 99 (1) Pge Prt V Governne, Mngement, nd Dislosure For eh "Yes" response to lines through 7 elow, nd for "No" response to line 8, 8, or 1 elow, desrie the irumstnes, proesses, or hnges in Shedule O. See instrutions. Chek if Shedule O ontins response or note to ny line in this Prt V Setion A. Governing Body nd Mngement Enter the numer of voting memers of the governing ody t the end of the tx yer m m m m m 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 re mteril differenes in voting rights mong memers of the governing ody, or if the governing ody delegted rod uthority to n exeutive ommittee or similr ommittee, explin in Shedule O. Enter the numer of voting memers inluded in line 1, ove, who re independent m m m m m 1 ny other offier, diretor, 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 supervision of offiers, diretors, or trustees, or key employees to mngement ompny or other person? Did the orgniztion mke ny signifint hnges to its governing douments sine the prior Form 99 ws filed? m m Did the orgniztion eome wre during the yer of signifint diversion of the orgniztion's ssets? Did the orgniztion hve memers or stokholders? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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 stokholders, or persons other thn 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 Did ny offier, diretor, trustee, or key employee hve fmily reltionship or usiness reltionship with Did the orgniztion delegte ontrol over mngement duties ustomrily performed y or under the diret Did the orgniztion hve memers, stokholders, or other persons who hd the power to elet or ppoint Are ny governne deisions of the orgniztion reserved to (or sujet to pprovl y) memers, 8 Did the orgniztion ontemporneously doument the meetings held or written tions undertken during the yer y the following: 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 8 Eh ommittee with uthority to t on ehlf 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 8 9 s there ny offier, diretor, trustee, or key employee listed in Prt V, Setion A, who nnot e rehed t the orgniztion's miling ddress? f "Yes," provide the nmes nd ddresses in Shedule O m m m m m m m m m m m 9 Setion B. Poliies (This Setion B requests informtion out poliies not required y the nternl Revenue Code.) Did the orgniztion hve lol hpters, rnhes, or ffilites? m m 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 orgniztion hve written poliies nd proedures governing the tivities of suh hpters, ffilites, nd rnhes to ensure their opertions re onsistent with the orgniztion's exempt purposes? m m m Hs the orgniztion provided omplete opy of this Form 99 to ll memers of its governing ody efore filing the form? m Desrie in Shedule O the proess, if ny, used y the orgniztion to review this Form 99. Did the orgniztion hve written onflit of interest poliy? f "No," go to line 1 m m m m m m m m m m m m m m m m rise to onflits? m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m desrie in Shedule O how this ws done m m m m m m m m Did the orgniztion hve written whistlelower poliy? m m m m m m m m m m m m Did the orgniztion hve written doument retention nd destrution poliy? m m m m m m m m m m m m m m m m m m Were offiers, diretors, or trustees, nd key employees required to dislose nnully interests tht ould give Did the orgniztion regulrly nd onsistently monitor nd enfore ompline with the poliy? f "Yes," Did the proess for determining ompenstion of the following persons inlude review nd pprovl y independent persons, omprility dt, nd ontemporneous sustntition of the deliertion nd deision? The orgniztion's CEO, Exeutive Diretor, or top mngement offiil m m m m m m m m m 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 offiers or key employees of the orgniztion f "Yes" to line 15 or 15, desrie the proess in Shedule O (see instrutions). Did the orgniztion invest in, ontriute ssets to, or prtiipte in joint venture or similr rrngement with txle entity during the yer? m m m m m m m m m m m m m m m m m 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 orgniztion follow written poliy or proedure requiring the orgniztion to evlute its prtiiption in joint venture rrngements under pplile federl tx lw, nd tke steps to sfegurd the orgniztion's exempt sttus with respet to suh rrngements? m 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 sttes with whih opy of this Form 99 is required to e filed GA, Setion C. Dislosure Setion 1 requires n orgniztion to mke its Forms 1 (or 1 if pplile), 99, nd 99-T (Setion 51()()s only) ville for puli inspetion. ndite how you mde these ville. Chek ll tht pply. Own wesite Another's wesite Upon request Other (explin in Shedule O) Desrie in Shedule O whether (nd if so, how) the orgniztion mde its governing douments, onflit of interest poliy, nd finnil sttements ville to the puli during the tx yer. Stte the nme, ddress, nd telephone numer of the person who possesses the orgniztion's ooks nd reords: TOOLBANK USA, NC. 5 BONAVENTURE AVE, NE ATLANTA, GA Form 99 (1) E1 1. TOOLBANK USA, NC Yes Yes No No

7 TOOLBANK USA, NC Compenstion of Offiers, Diretors, Trustees, Key Employees, Highest Compensted Employees, nd ndependent Contrtors Form 99 (1) Pge 7 Prt V Setion A. Chek if Shedule O ontins response or note to ny line in this Prt V m m m m m m m m m m m m m m m m m m m m m m Offiers, Diretors, Trustees, Key Employees, nd Highest Compensted Employees 1 Complete this tle for ll persons required to e listed. Report ompenstion for the lendr yer ending with or within the orgniztion's % tx yer. List ll of the orgniztion's urrent offiers, diretors, trustees (whether individuls or orgniztions), regrdless of mount of ompenstion. Enter -- in olumns (D), (E), nd (F) if no ompenstion ws pid. % List ll of the orgniztion's urrent key employees, if ny. See instrutions for definition of "key employee." List the orgniztion's five urrent highest ompensted employees (other thn n offier, diretor, trustee, or key employee) who reeived reportle ompenstion (Box 5 of Form W- nd/or Box 7 of Form 199-MSC) of more thn $1, from the orgniztion nd ny relted orgniztions. % List ll of the orgniztion's former offiers, key employees, nd highest ompensted employees who reeived more thn $1, of reportle ompenstion from the orgniztion nd ny relted orgniztions. % List ll of the orgniztion's former diretors or trustees tht reeived, in the pity s former diretor or trustee of the orgniztion, more thn $1, of reportle ompenstion from the orgniztion nd ny relted orgniztions. List persons in the following order: individul trustees or diretors; institutionl trustees; offiers; key employees; highest ompensted employees; nd former suh persons. Chek this ox if neither the orgniztion nor ny relted orgniztion ompensted ny urrent offier, diretor, or trustee. (C) (A) (B) Position (D) (E) (F) Nme nd Title Averge hours per week (list ny (do not hek more thn one ox, unless person is oth n offier nd diretor/trustee) hours for relted orgniztions elow dotted line) ndividul trustee or diretor nstitutionl trustee Offier Key employee Highest ompensted employee Former Reportle ompenstion from the orgniztion (W-/199-MSC) Reportle ompenstion from relted orgniztions (W-/199-MSC) Estimted mount of other ompenstion from the orgniztion nd relted orgniztions (1) NCK COSTDES PAST PRESDENT. () TM PERRA PAST VCE PRESDENT. () SHELLEY GOODMAN VCE PRESDENT. () RUPERT M. BARKOFF DRECTOR. (5) LES H. RELAND TREASURER. () ROBERT MASON DRECTOR. (7) ANDREW SOHN DRECTOR. (8) JOHN E. WALKER SECRETARY. (9) DAN WEBBER PRESDENT. (1) ERC BERNSTEN DRECTOR. (11) HED THOMPSON DRECTOR. (1) BOB TOUPN DRECTOR. (1) MARK BRODBECK CEO. 11,8. (1) Form 99 (1) E11 1.

8 TOOLBANK USA, NC Form 99 (1) Pge 8 Prt V Setion A. Offiers, Diretors, Trustees, Key Employees, nd Highest Compensted Employees (ontinued) (A) (B) (C) (D) (E) (F) Nme nd title Averge hours per week (list ny hours for relted orgniztions elow dotted line) Position (do not hek more thn one ox, unless person is oth n offier nd diretor/trustee) ndividul trustee or diretor nstitutionl trustee Offier Key employee Highest ompensted employee Former Reportle ompenstion from the orgniztion (W-/199-MSC) Reportle ompenstion from relted orgniztions (W-/199-MSC) Estimted mount of other ompenstion from the orgniztion nd relted orgniztions 1 Su-totl m m m m m m m m m m m m m m m m m m m m m m m m m Totl from ontinution sheets to Prt V, Setion 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 Totl (dd lines 1 nd 1) Totl numer of individuls (inluding ut not limited to those listed ove) who reeived more thn $1, of reportle ompenstion from the orgniztion 1 Did the orgniztion list ny former offier, diretor, or trustee, key employee, or highest ompensted employee on line 1? f "Yes," omplete Shedule J for suh individul m m 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 ny individul listed on line 1, is the sum of reportle ompenstion nd other ompenstion from the orgniztion nd relted orgniztions greter thn $15,? f Yes, omplete Shedule J for suh individul m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 5 Did ny person listed on line 1 reeive or rue ompenstion from ny unrelted orgniztion or individul for servies rendered to the orgniztion? f Yes, omplete Shedule J for suh person m m m m m m m m m m m m m m m m 5 Setion B. ndependent Contrtors 11,8. 11,8. 1 Complete this tle for your five highest ompensted independent ontrtors tht reeived more thn $1, of ompenstion from the orgniztion. Report ompenstion for the lendr yer ending with or within the orgniztion's tx yer. Yes No (A) Nme nd usiness ddress (B) Desription of servies (C) Compenstion Totl numer of independent ontrtors (inluding ut not limited to those listed ove) who reeived more thn $1, in ompenstion from the orgniztion E Form 99 (1)

9 TOOLBANK USA, NC Sttement of Revenue Form 99 (1) Pge 9 Prt V Contriutions, Gifts, Grnts nd Other Similr Amounts Progrm Servie Revenue Other Revenue 1 Chek if Shedule O ontins response or note to ny line in this Prt 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 Federted mpigns Memership dues m m m m m m m m m m Fundrising events d Relted orgniztions e Government grnts (ontriutions)m m f All other ontriutions, gifts, grnts, nd similr mounts not inluded ove m 1f g Nonsh ontriutions inluded in lines 1-1f: $ h Totl. Add lines 1-1f m m m m m m m m m m m m m m m m m m d d 1e Business Code e f All other progrm servie revenue g Totl. Add lines -f m m m m m m m m m m m m m m m m m m nd other similr mounts) m m m m m m m m m m m m m m m nome from investment of tx-exempt ond proeeds Roylties 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) Rel (ii) Personl Gross rents m m m m m Less: rentl expenses m Rentl inome or (loss) m m d Net rentl inome or (loss) m m m m m m m m m m m m m m nvestment inome (inluding dividends, interest, 5 7 Gross mount from sles of ssets other thn inventory m m m m m m m Less: ost or other sis (i) Seurities (ii) Other nd sles expenses Gin or (loss) d Net gin or (loss) m m m m m m m m m m m m m m m m m m m m 8 of ontriutions reported on line 1). See Prt V, line 18 m Less: diret expenses m m m m m m m m m m Net inome or (loss) from fundrising events m m m m m m m Gross inome from gming tivities. See Prt V, line 19 m Less: diret expenses m m m m m m m m m m Net inome or (loss) from gming tivities m m m m m m m Gross sles of inventory, less returns nd llownes Less: ost of goods sold m m m m m m m m m Net inome or (loss) from sles of inventorym m m m m m m m Gross inome from fundrising events (not inluding $ Misellneous Revenue d All other revenue e Totl. Add lines 11-11d 1 Totl revenue. See instrutions m m m m m m m m m m m m m E ,9,78. 8,5. Business Code m m m m m m m m m m m m m m m m m m m m (A) Totl revenue 1,9,78. (B) Relted or exempt funtion revenue (C) Unrelted usiness revenue (D) Revenue exluded from tx under setions ,9,7. 8. Form 99 (1)

10 TOOLBANK USA, NC Prt Sttement of Funtionl Expenses Setion 51()() nd 51()() orgniztions must omplete ll olumns. All other orgniztions must omplete olumn (A). Form 99 (1) Pge 1 Chek if Shedule O ontins response or note to ny line in this Prt 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 inlude mounts reported on lines, 7, 8, 9, nd 1 of Prt V. 1 Grnts nd other ssistne to domesti orgniztions nd domesti governments. See Prt V, line 1 m m m m Grnts nd other ssistne to domesti individuls. See Prt V, line m m m m m m m m m Grnts nd other ssistne to foreign orgniztions, foreign governments, nd foreign individuls. See Prt V, lines 15 nd 1 m m m m m Benefits pid to or for memers m m m m m m m m m 5 Compenstion of urrent offiers, diretors, trustees, nd key employees m m m m m m m m m m Compenstion not inluded ove, to disqulified persons (s defined under setion 958(f)(1)) nd persons desried in setion 958()()(B) m m m m m m 7 Other slries nd wges m m m m m m m m m m m m 8 Pension pln ruls nd ontriutions (inlude 9 setion 1(k) nd () employer ontriutions) Other employee enefits Pyroll txes m m m m m m m m m m m m m m m m m m 1 11 Fees for servies (non-employees): Mngement Legl Aounting d Loying e Professionl fundrising servies. See Prt V, line 17 m f g d m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m nvestment mngement fees m m m m m m m m m Other. (f line 11g mount exeeds 1% of line 5, olumn (A) mount, list line 11g expenses on Shedule O.) Advertising nd promotion m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m Offie expenses nformtion tehnology Roylties Oupny Trvel Pyments of trvel or entertinment expenses for ny federl, stte, or lol puli offiils Conferenes, onventions, nd meetings nterest Pyments to ffilites Depreition, depletion, nd mortiztion nsurne m m m m m m m m m m m 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 overed ove (List misellneous expenses in line e. f line e mount exeeds 1% of line 5, olumn (A) mount, list line e expenses on Shedule O.) e All other expenses 5 Totl funtionl expenses. Add lines 1 through e Joint osts. Complete this line only if the orgniztion reported in olumn (B) joint osts from omined edutionl mpign nd fundrising soliittion. Chek here if following SOP 98- (ASC 958-7) m m m m m m m (A) (B) (C) (D) Totl expenses Progrm servie Mngement nd Fundrising expenses generl expenses expenses 71,9. 71,9. Form 99 (1) E ,8. 71,7. 17,5. 1,18. 7,9. 17,57.,15.,7. 5,1., ,89. 9,8.,95. 1,8. 8,. 19,81.,81.,8. 8,75. 8,75. 1,. 1,.,. 1,. 1.,98.,98.,79., ,. 18, ,9. 5,9. DRECT PROGRAM EPENSES 51,58. 51,58. MSCELLANEOUS ADMNSTRATVE 9,55.,78.,. 1,5. REPAR & MANTENANCE,.,. SUPPLES,9.,9. 8,77.,75.,. 8,79. 7,75. 1,55. 5,99.

11 Form 99 (1) Pge 11 Prt Blne Sheet Chek if Shedule O ontins response or note to ny line in this Prt 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 yer End of yer Assets Liilities Net Assets or Fund Blnes m m m m m m m m m m m m m m m m m m m m m m m m m m m Csh - non-interest-ering Svings nd temporry sh investments Pledges nd grnts reeivle, net Aounts reeivle, 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 Lons nd other reeivles from urrent nd former offiers, diretors, trustees, key employees, nd highest ompensted employees. Complete Prt of Shedule 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 Lons nd other reeivles from other disqulified persons (s defined under setion 958(f)(1)), persons desried in setion 958()()(B), nd ontriuting employers nd sponsoring orgniztions of setion 51()(9) voluntry employees' enefiiry orgniztions (see instrutions). Complete Prt of Shedule L Notes nd lons reeivle, net nventories for sle 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 Prepid expenses nd deferred hrges Lnd, uildings, nd equipment: ost or TOOLBANK USA, NC m m m m m m m m m m m m m m m m m m m m other sis. Complete Prt V of Shedule D 1 Less: umulted depreition m m m m m 1 nvestments - pulily trded seurities m m m m m nvestments - other seurities. See Prt V, line 11 m nvestments - progrm-relted. See Prt V, line 11 ntngile ssets m m m m m m m m m Other ssets. See Prt V, line 11 m m m m m m m m m m m m m m Totl ssets. Add lines 1 through 15 (must equl line ) Aounts pyle nd rued expenses Grnts pyle m m Deferred revenue m m m m m Tx-exempt ond liilities m m m m m m m m m m m m m m m m m m m m m m m Esrow or ustodil ount liility. Complete Prt V of Shedule D m m m m Lons nd other pyles to urrent nd former offiers, diretors, trustees, key employees, highest ompensted employees, nd disqulified persons. Complete Prt of Shedule L m m m m m m m m m m m m m m m m Seured mortgges nd notes pyle to unrelted third prties Unseured notes nd lons pyle to unrelted third prties Other liilities (inluding federl inome tx, pyles to relted third prties, nd other liilities not inluded on lines 17-). Complete Prt of Shedule D m m m m m m m m m m m m m m Totl liilities. Add lines 17 through 5 m m m m m m m m m m m m m m m m m m m m Orgniztions tht follow SFAS 117 (ASC 958), hek here nd omplete lines 7 through 9, nd lines nd. Unrestrited net ssets m m m m m Temporrily restrited net ssets Permnently restrited net ssets m m m m m m m m m m m m m m m m m m m m m m m m Orgniztions tht do not follow SFAS 117 (ASC 958), hek here nd omplete lines through. Cpitl stok or trust prinipl, or urrent funds m m m m m m m m Pid-in or pitl surplus, or lnd, uilding, or equipment fund m m m m Retined ernings, endowment, umulted inome, or other funds Totl net ssets or fund lnes m m m m m m Totl liilities nd net ssets/fund lnes m m m m m m m m m m m m m m m m m m 1,9. 1, ,75. 15,9. 18, ,1. 1, ,78. 5, , ,8. 9,7. 1,97. 99,., ,1,55. 7,8. 5,58. 7,8. 79, ,157,17., , ,. 1 1,157,17. 1,1,55. Form 99 (1) E15 1.

12 Form 99 (1) Pge 1 Prt Prt TOOLBANK USA, NC Reonilition of Net Assets Chek if Shedule O ontins response or note to ny line in this Prt m m m m m m m m m m m m m m Totl revenue (must equl Prt V, olumn (A), line 1) 1 Totl expenses (must equl Prt, olumn (A), line 5) Revenue less expenses. Sutrt line from line 1 m m m m m m m m m m m m m m m m m m m m m Net ssets or fund lnes t eginning of yer (must equl Prt, line, olumn (A)) Net unrelized gins (losses) on investments 5 Donted servies nd use of filities nvestment expenses m m 7 Prior period djustments 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 hnges in net ssets or fund lnes (explin in Shedule O) m m m m m m m m m m m m m m m m 9 Net ssets or fund lnes t end of yer. Comine lines through 9 (must equl Prt, line, olumn (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 Finnil Sttements nd Reporting Chek if Shedule O ontins response or note to ny line in this Prt m m m m m m m m m m m m m m m m m m m 1 Aounting method used to prepre the Form 99: Csh Arul Other f the orgniztion hnged its method of ounting from prior yer or heked "Other," explin in Shedule O. Were the orgniztion's finnil sttements ompiled or reviewed y n independent ountnt? m m m m m m f "Yes," hek ox elow to indite whether the finnil sttements for the yer were ompiled or reviewed on seprte sis, onsolidted sis, or oth: Seprte sis Consolidted sis Both onsolidted nd seprte sis Were the orgniztion's finnil sttements udited y n independent ountnt? m m m m m m m m m m m m m m f "Yes," hek ox elow to indite whether the finnil sttements for the yer were udited on seprte sis, onsolidted sis, or oth: Seprte sis Consolidted sis Both onsolidted nd seprte sis f "Yes" to line or, does the orgniztion hve ommittee tht ssumes responsiility for oversight of the udit, review, or ompiltion of its finnil sttements nd seletion of n independent ountnt? f the orgniztion hnged either its oversight proess or seletion proess during the tx yer, explin in Shedule O. As result of federl wrd, ws the orgniztion required to undergo n udit or udits s set forth in the Single Audit At nd OMB Cirulr A-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 f "Yes," did the orgniztion undergo the required udit or udits? f the orgniztion did not undergo the required udit or udits, explin why in Shedule O nd desrie ny steps tken to undergo suh udits. 1,9,7. 8,79. 15,57. 99,115. 1,157,17. Yes No Form 99 (1) E15 1.

13 SCHEDULE A Puli Chrity Sttus nd Puli Support OMB No (Form 99 or 99-EZ) Complete if the orgniztion is setion 51()() orgniztion or setion 97()(1) nonexempt hritle trust. À¾µ Deprtment of the Tresury Atth to Form 99 or Form 99-EZ. Open to Puli nternl Revenue Servie nformtion out Shedule A (Form 99 or 99-EZ) nd its instrutions is t nspetion Nme of the orgniztion Employer identifition numer TOOLBANK USA, NC Prt Reson for Puli Chrity Sttus (All orgniztions must omplete this prt.) See instrutions. The orgniztion is not privte foundtion euse it is: (For lines 1 through 11, hek only one ox.) 1 A hurh, onvention of hurhes, or ssoition of hurhes desried in setion 17()(1)(A)(i). A shool desried in setion 17()(1)(A)(ii). (Atth Shedule E.) A hospitl or oopertive hospitl servie orgniztion desried in setion 17()(1)(A)(iii). A medil reserh orgniztion operted in onjuntion with hospitl desried in setion 17()(1)(A)(iii). Enter the hospitl's nme, ity, nd stte: 5 An orgniztion operted for the enefit of ollege or university owned or operted y governmentl unit desried in setion 17()(1)(A)(iv). (Complete Prt.) 7 A federl, stte, or lol government or governmentl unit desried in setion 17()(1)(A)(v). An orgniztion tht normlly reeives sustntil prt of its support from governmentl unit or from the generl puli desried in setion 17()(1)(A)(vi). (Complete Prt.) A ommunity trust desried in setion 17()(1)(A)(vi). (Complete Prt.) An orgniztion tht normlly reeives: (1) more thn 1/ % of its support from ontriutions, memership fees, nd gross reeipts from tivities relted to its exempt funtions - sujet to ertin exeptions, nd () no more thn 1/ % of its support from gross investment inome nd unrelted usiness txle inome (less setion 511 tx) from usinesses quired y the orgniztion fter June, See setion 59()(). (Complete Prt.) An orgniztion orgnized nd operted exlusively to test for puli sfety. See setion 59()(). An orgniztion orgnized nd operted exlusively for the enefit of, to perform the funtions of, or to rry out the purposes of one or more pulily supported orgniztions desried in setion 59()(1) or setion 59()(). See setion 59()(). Chek the ox in lines 11 through 11d tht desries the type of supporting orgniztion nd omplete lines 11e, 11f, nd 11g. (A) d e f g Type. A supporting orgniztion operted, supervised, or ontrolled y its supported orgniztion(s), typilly y giving the supported orgniztion(s) the power to regulrly ppoint or elet mjority of the diretors or trustees of the supporting orgniztion. You must omplete Prt V, Setions A nd B. Type. A supporting orgniztion supervised or ontrolled in onnetion with its supported orgniztion(s), y hving ontrol or mngement of the supporting orgniztion vested in the sme persons tht ontrol or mnge the supported orgniztion(s). You must omplete Prt V, Setions A nd C. Type funtionlly integrted. A supporting orgniztion operted in onnetion with, nd funtionlly integrted with, its supported orgniztion(s) (see instrutions). You must omplete Prt V, Setions A, D, nd E. Type non-funtionlly integrted. A supporting orgniztion operted in onnetion with its supported orgniztion(s) tht is not funtionlly integrted. The orgniztion generlly must stisfy distriution requirement nd n ttentiveness requirement (see instrutions). You must omplete Prt V, Setions A nd D, nd Prt V. Chek this ox if the orgniztion reeived written determintion from the RS tht it is Type, Type, Type funtionlly integrted, or Type non-funtionlly integrted supporting orgniztion. Enter the numer of supported orgniztions m m m m m m m m m m m m m m m m m m 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 informtion out the supported orgniztion(s). (i) Nme of supported orgniztion (ii) EN (iii) Type of orgniztion (desried on lines 1-9 ove or RC setion (see instrutions)) (iv) s the orgniztion listed in your governing doument? Yes No (v) Amount of monetry support (see instrutions) (vi) Amount of other support (see instrutions) (B) (C) (D) (E) Totl For Pperwork Redution At Notie, see the nstrutions for Form 99 or 99-EZ. E11. Shedule A (Form 99 or 99-EZ) 1

14 Shedule A (Form 99 or 99-EZ) 1 Pge Prt Support Shedule for Orgniztions Desried in Setions 17()(1)(A)(iv) nd 17()(1)(A)(vi) (Complete only if you heked the ox on line 5, 7, or 8 of Prt or if the orgniztion filed to qulify under Prt. f the orgniztion fils to qulify under the tests listed elow, plese omplete Prt.) Setion A. Puli Support Clendr yer (or fisl yer eginning in) 1 Gifts, grnts, ontriutions, nd memership fees reeived. (Do not inlude ny "unusul grnts.") m m m m m m Tx revenues levied for the orgniztion's enefit nd either pid to or expended on its ehlf m m m m m m m The vlue of servies or filities furnished y governmentl unit to the orgniztion without hrge Totl. Add lines 1 through m m m m m m m 5 The portion of totl ontriutions y eh person (other thn governmentl unit or pulily supported orgniztion) inluded on line 1 tht exeeds % of the mount shown on line 11, olumn (f) m m m m m m m Puli support. Sutrt line 5 from line. 7 Amounts from line m m m m m m m m m m 8 Gross inome from interest, dividends, pyments reeived on seurities lons, rents, roylties nd inome from similr soures m m m m m m m m m m m m m m m m m Setion B. Totl Support Clendr yer (or fisl yer eginning in) 9 Net inome from unrelted usiness tivities, whether or not the usiness is regulrly rried on m m m m m m m m m m 1 Other inome. Do not inlude gin or loss from the sle of pitl ssets () 1 () 11 () 1 1 (e) 1 (f) Totl () 1 () 11 () 1 1 (e) 1 (f) Totl (Explin in Prt V.) m m m m m m m m m 11 Totl support. Add lines 7 through 1 m m 1 Gross reeipts from relted tivities, et. (see instrutions) m m 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 orgniztion, hek this ox nd 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 Setion C. Computtion of Puli Support Perentge 15 m m m m m m m m m m m m m m m m m m m 1 First five yers. f the Form 99 is for the orgniztion's first, seond, third, fourth, or fifth tx yer s setion 51()() 1 Puli support perentge for 1 (line, olumn (f) divided y line 11, olumn (f)) Puli support perentge from 1 Shedule A, Prt, line / % support test - 1. f the orgniztion did not hek the ox on line 1, nd line 1 is 1/ % or more, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion m m m m m m m m m m m m m m m m m m 1/ % support test - 1. f the orgniztion did not hek ox on line 1 or 1, nd line 15 is 1/ % or more, 17 TOOLBANK USA, NC hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion m m m m m m m m m m m m m m m 1%-fts-nd-irumstnes test - 1. f the orgniztion did not hek ox on line 1, 1, or 1, nd line 1 is 1% or more, nd if the orgniztion meets the "fts-nd-irumstnes" test, hek this ox nd stop here. Explin in Prt V how the orgniztion meets the "fts-nd-irumstnes test. The orgniztion qulifies s pulily supported orgniztion m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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%-fts-nd-irumstnes test - 1. f the orgniztion did not hek ox on line 1, 1, 1, or 17, nd line 15 is 1% or more, nd if the orgniztion meets the "fts-nd-irumstnes" test, hek this ox nd stop here. Explin in Prt V how the orgniztion meets the "fts-nd-irumstnes" test. The orgniztion qulifies s pulily supported orgniztion m m m m m m m m m m m m m m m m m m m m m m m m m m m m m 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 Privte foundtion. f the orgniztion did not hek ox on line 1, 1, 1, 17, or 17, hek this ox nd see instrutions m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m % % Shedule A (Form 99 or 99-EZ) 1 E1.

15 Shedule A (Form 99 or 99-EZ) 1 Pge Prt Support Shedule for Orgniztions Desried in Setion 59()() (Complete only if you heked the ox on line 9 of Prt or if the orgniztion filed to qulify under Prt. f the orgniztion fils to qulify under the tests listed elow, plese omplete Prt.) Setion A. Puli Support Clendr yer (or fisl yer eginning in) 1 Gifts, grnts, ontriutions, nd memership fees reeived. (Do not inlude ny "unusul grnts.") Gross reeipts from dmissions, merhndise sold or servies performed, or filities furnished in ny tivity tht is relted to the orgniztion's tx-exempt purpose m m m m m m Gross reeipts from tivities tht re not n unrelted trde or usiness under setion 51 m Tx revenues levied for the orgniztion's enefit nd either pid to or expended on its ehlf m m m m m m m 5 The vlue of servies or filities TOOLBANK USA, NC () 1 () 11 () 1 1 (e) 1 (f) Totl 51,177. 1,15,77.,979. 1,15,95. 7,198.,8,. furnished y governmentl unit to the orgniztion without hrge Totl. Add lines 1 through 5 m m m m m m m 7 Amounts inluded on lines 1,, nd reeived from disqulified persons m m m m Amounts inluded on lines nd reeived from other thn disqulified persons tht exeed the greter of $5, or 1% of the mount on line 1 for the yer Add lines 7 nd 7 m m m m m m m m m m m 8 Puli support (Sutrt line 7 from line.) m m m m m m m m m m m m m m m m m Setion B. Totl Support Clendr yer (or fisl yer eginning in) 9 Amounts from line m m m m m m m m m m m 1 Gross inome from interest, dividends, pyments reeived on seurities lons, rents, roylties nd inome from similr soures m m m m m m m m m m m m m m m m m Unrelted usiness txle inome (less setion 511 txes) from usinesses quired fter June, 1975 Add lines 1 nd 1 m m m m m m m m m 11 Net inome from unrelted usiness tivities not inluded in line 1, whether or not the usiness is regulrly rried on m m m m m m m m m m m m m m m 1 Other inome. Do not inlude gin or loss from the sle of pitl ssets (Explin in Prt V.) m m m m m m m m m m m 1 Totl support. (Add lines 9, 1, 11, nd 1.) m m m m m m m m m m m m m m m m 1 First five yers. f the Form 99 is for the orgniztion's first, seond, third, fourth, or fifth tx yer s setion 51()() orgniztion, hek this ox nd 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 Setion C. Computtion of Puli Support Perentge 15 Puli support perentge for 1 (line 8, olumn (f) divided y line 1, olumn (f)) 15 1 Puli support perentge from 1 Shedule A, Prt, 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 1 Setion D. Computtion of nvestment nome Perentge 17 nvestment inome perentge for 1 (line 1, olumn (f) divided y line 1, olumn (f)) nvestment inome perentge from 1 Shedule A, Prt, line 17 m m m m m m m m m m m m m m m m m m m m / % support tests - 1. f the orgniztion did not hek the ox on line 1, nd line 15 is more thn 1/ %, nd line 17 is not more thn 1/ %, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion 1/ % support tests - 1. f the orgniztion did not hek ox on line 1 or line 19, nd line 1 is more thn 1/ %, nd line 18 is not more thn 1/ %, hek this ox nd stop here. The orgniztion qulifies s pulily supported orgniztion Privte foundtion. f the orgniztion did not hek ox on line 1, 19, or 19, hek this ox nd see instrutions 51,177. 1,15,77.,979. 1,15,95. 7,198.,8,. () 1 () 11 () 1 1 (e) 1 (f) Totl Shedule A (Form 99 or 99-EZ) 1 E11. % % % %,8,. 51,177. 1,15,77.,979. 1,15,95. 7,198.,8, , ,7. 51,. 1,1,5.,. 1,1,9. 7,.,85,