Attachments for IRS Form 1023
Page 2, Part II (1) – Copy of New York State Certificate of Corporation attached.
Page 2, Part II (5) – Copy of The New Life Foundation For Children Corporation Articles and By-Laws attached, with date of adoption.
Page 2, Part III (1) – Location of Purpose Clause in Articles and By-Laws; Page 1, Article 2, Paragraph 1.
Page 2, Part III (2b) – Location of Dissolution Clause in Articles and By-Laws; Page 2, Article 2, Paragraph 2.03 (c).
Attachment 1: Page 2, Part IV – Narrative description of activities –
The New Life Foundation For Children Corporation, herein referred to as The New Life Foundation, will be engaged in educational, charitable and research funding activities. The New Life Foundation will focus in the areas of premature and sick newborn support through education and charitable activities, including funding of research focused on the prevention, treatment and cure of maladies associated with premature and sick newborns. The New Life Foundation will utilize a web site, social media and fund raising activities to promote its activities.
Attachment 2: Page 3, Part V (2a) – Explain relationship of officers/directors –
Daniel Swartz – President/treasurer
Nina Swartz – Secretary, step-mother to Daniel Swartz
Anthony Clark – Vice-president, brother-in-law to Daniel Swartz
Attachment 3: Page 3, Part V (3a) – Explain officers/directors qualifications, hours worked and duties –
Daniel Swartz – President/treasurer, has worked in the field of biomedical research for premature and sick newborns for over 25 years, will work approximately 5-10 hrs per week to organize newsletters, fundraising functions, web site and interactive social media promotions. Oversee income/expense functions and maintain all financial records.
Nina Swartz – Secretary, has many years experience as secretary in several organizations, will work 1-2 hrs per week recording minutes and organizational changes.
Anthony Clark – Vice-president, has many years experience as an officer in several organizations and currently owns/operates a physical therapy business for children, will work 1-2 hrs per work as needed to facilitate running and restructuring the foundation as needed.
Page 4, Part V (5a) – Copy of Conflict of Interest Policy and Annual Statement is attached, policy was adopted by resolution of governing board at organizational meeting June1, 2015.
Attachment 4: Page 5, Part VI (1a) – Describe programs that provide funds to individuals –
The New Life Foundation will provide funds to individuals who apply for assistance based on programs set by the foundation to do so. These programs have yet to be developed but intend to provide individual assistance to families of premature and sick newborns under specific criteria and availability of funds.
Attachment 5: Page 5, Part VI (1b) – Describe programs that provide funds to organizations –
The New Life Foundation will provide funds to organizations who apply for assistance and support of their programs. Programs set by the foundation to do so have yet to be developed. These foundation programs intend to provide organizations who have research programs pertaining to prevention, treatment and cures for maladies of premature and sick newborns. These foundation programs will have specific criteria and application form. Funding will be determined by a needs determination and availability of funds. Sample application form attached.
Attachment 6: Page 5, Part VI (3) – Explain how related individuals are eligible to receive funds –
Due to the goals and objectives of The New Life Foundation, no individual or organization will be disallowed to receive funds. As well, individual foundation officers/directors/members are likely to be involved or have a relationship with some applicants. However, if a there is a relationship between an individual or organization with an individual who is part of the foundation, the foundation individual will not be allowed to vote, make decision or policy concerning foundation funding in that case.
Attachment 7: Page 6, Part VIII (4a) – Description of each fund raising activity –
Mail solicitation – donations will be requested from mailing list generated from various sources (foundation web site, other organizations, targeted potential donors).
Email solicitation – donations will be requested from emailing list generated from various sources (foundation web site, other organizations, targeted potential donors).
Personal solicitation – donations will be requested from individuals and organizations who attend fund raising events, other social events, or personal meeting.
Foundation grant solicitation – grants will be submitted to other foundations who support the type of work our foundation targets.
Phone solicitation – donations will be requested through phone calls from list acquired through the foundation web site, fund raising events or targeted calls.
Accept donations on website – the web site will be designed to accept donations directly through the web site.
Receive donations from another organization’s web site – with permission and arrangement with other organizations we will accept donations from their web sites.
Government grant solicitation – the foundation will submit grants to government grant agencies that support the work of the foundation.
Attachment 8: Page 6, Part VIII (4b) – contract with individuals or organizations to fund raise for the foundation –
The foundation does not currently employ any individual or organization to fund raise. It is a possibility to contract with individuals or organizations that are set up to provide this service (ex. Web based fund raising companies).
Attachment 9: Page 6, Part VIII (4d) – List states and local jurisdictions and fund raining mechanism –
Fund raising is expected to occur in all states and local jurisdictions through internet web site and social media by our foundation. If we contract to have fund raising done, then it is expected again that all states and local jurisdictions will be included inn the scope of contracted fund raising.
Attachment 10: Page 7, Part VIII (13b) – How does the grant application and awards further the foundation exempt purposes.
The grant application and awards further the foundations exempt purposes by providing funding to individuals and organizations which propose projects to prevent, treat and cure medical ailments of premature babies and sick newborns.
Attachment 11: Page 7, Part VIII (13d) – Identify each recipient and relationship between the recipient and the foundation.
Each recipient will apply for funding utilizing the grant funding application. Any individual or organization is allowed to apply if their goal is within the exempt purpose of the foundation. There is no limitation to applying for funding due to any relationship with the foundation, director, employee or member of the foundation. Any conflict of interest will be addressed, and any individual of the foundation associated with a funding decision, who may have a conflict of interest, will not be allowed to vote upon that decision of funding.
Attachment 12: Page 7, Part VIII (13e) – Describe the records kept for with respect to any grants, loans or other distributions made by the foundation.
All applications, disbursements and recipient reports will be recorded and maintained according the Articles and Bylaws of the foundation. As well, any conflicts of interest will be noted with the results of any votes in favor of disbursements, listing each voting member.
Attachment 13: Page 7, Part VIII (13f) – Describe the selection process and if it requires (i) an application form and (ii) grant proposal.
The selection process will vary depending upon the specific request for funding. Each application will be reviewed by the directors of the foundation or sent to selected experts for their input on the quality of the proposed project. Applications for funding will be funded based upon the availability of funds and the quality of the proposed project with respect to the exempt purposes of the foundation.
- An application form is required. A sample of the application form is attached.
- A grant proposal is required. A sample of the application and request for a grant proposal is attached. Part 7 of the application addresses the requirements of the grantor and the grantee associated with the funding of the proposed project (below).
- Requirements if Funded:
- a) Requirements of the Grantee – use the grant funds only for the purposes for which the grant was made, provides for periodic written reports (due within 1 week of each 6 month period) concerning the use of grant funds, requires a final written report of research conducted with the results of that research and an accounting of how grant funds were used for granting period.
- b) Requirements of the Grantor – the grantor will provide awarded funding at 6 month intervals within one week of receipt of periodic written report accounting the use of previous 6 months of funding
- c) The Grantor has the authority to withhold and/or recover grant funds in case such funds are, or appear to be, misused as per the approved use and exempt purposes of The New Life Foundation.
Attachment 14: Page 7, Part VIII (13g) – Describe procedures for oversight of distributions to assure the resources are used in accordance with the foundations exempt purposes.
As described in part (ii) of attachment 13 above, procedures for oversight of resources are described in part 7 of the application and restated above.
Attachment 15: Page 8, Part VIII (15) – Do you have a close connection with any organizations?
As the founder of the foundation, I Daniel Swartz, am currently a faculty member of the State University of New York at Buffalo, Departments of Pediatrics and Physiology/Biophysics and work closely with neonatologist at Women’s and Children’s Hospital of Buffalo. This group is a primary example of an organization that supports the exempt goals of the foundation and would be a possible recipient of funding. I would exempt myself from voting on any funding applications from this group.
Attachment 16: Page 9, Part IX (A23) – Expenses not otherwise classified.
Books and records are kept on the cash receipts and disbursement basis as stated in the articles and bylaws of the foundation, page 10, Article VIII, section 8.01.
Year 2014 expenses – $75, NYS Corp application fee
Year 2015 expenses – $1000, Web design and maintenance; $500, Office supplies.
Year 2016 expenses – $1500, Web design and maintenance; $700, Office supplies.
Attachment 17: Page 10, Part X (1b) – Statement describing organizing documents to support as a private foundation, section 508(e).
The New Life Foundation For Children Corporation is organized under full compliance with regulations provided for by the Department of State of the State of New York, and it further certifies that it is in full compliance with the provisions set forth under Internal Revenue Code section 508 (e) as stated in the foundation Articles and Bylaws, page 2, Article II, section 2.03(a).