Board of Selectmen - 444 (02/02/2021)
agenda center attachment
| Board/Commission | Board of Selectmen |
|---|---|
| Meeting Date | February 02, 2021 |
| Pages | 54 |
| File Size | 5.3 MB |
| OCR Status | Searchable (OCR processed) |
| Source URL | Original |
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FY22
BUDGET REQUEST
SACCEC
SACC ic C
90 South Park Street, P.O. Box 24, Willimantic, CT 06226 Telephone: 860-456-3595 Fox: 860-423-4461 www.saccec.org
January 13, 2021
Mr. Rob Brule
First Selectman
Town of Waterford
15 Rope Ferry Road
Waterford, CT 06385-2886
Dear Mr. Brule:
Attached please find our application requesting inclusion in your Town’s 2021-2022 Budget. While we
aware that towns have been greatly impacted by the pandemic and the unexpected costs, we hope that
you will be able to continue to support our services. Please consider that SACCEC has continued to provide
essential services to children, families, and individuals in your community throughout the pandemic. We
have continued in-person services at our Child Advocacy Centers and have continued to accompany
children and adults to the hospitals for medical assistance and evidence collection. We too have
experienced unforeseen expenses of PPEs and cleaning supplies to ensure the safety of our clients and
Staff.
Contributions to SACCEC enable our organization to provide 24-hour direct services to residents of your
town following sexual assault or abuse. Unfortunately, rates of sexual victimization continue to rise,
particularly among children. Families, children, and individuals are profoundly impacted by traumas of
this nature, experiencing distress and anxiety which can interfere with performance at work and school,
and negatively impact family functioning in significant ways.
In FY 2019-2020, SACCEC provided crisis response and trauma recovery services to 23 residents of the
town of Montville. At an approximate cost of $1,114 per client, this represented an expense of
approximately $25,622 to provide services to residents of the town of Waterford.
Municipal funding is a critical source of financial support for SACCEC, enabling the continued availability
of crisis response and trauma recovery services at no cost to community residents. Further, municipal
funding provides “matching funds” to the Federal Government grants which we receive.
Please call me at 860-456-3595 if you have any questions or would like to discuss our request, or email
me at hbotti@snet.net.
We thank you for your consideration of our request, and thank you for your ongoing support which we
greatly appreciate.
Very Truly Yours,
Hope A. Botti,
Executive Assistant
Georgette J. Katin,
Executive Director
SEXUAL ASSAULT CRISIS CENTER OF EASTERN CONNECTICUT, INC.
aes i
United Way ed Central
and Nertheastera
Cannes ticut
-_
Town of Waterford
Application for Funds
Fiscal Year 2021 - 2022
Agency: Sexual Assault Crisis Center of Eastern Connecticut, Inc.
906 South Park Street, P.O. Box 24, Willimantic, CT 06226
Name of Program: Sexual Assault Crisis Intervention Services
Fiscal Contact Person: Hope Botti, Executive Assistant
Statement of Need: The Sexual Assault Crisis Center of Eastern Connecticut, Inc. provided services to 732
victims of sexual assault/abuse in Eastern Connecticut during fiscal year 2016-2017. The Crisis Center
provides unduplicated, free & confidential services to victims, and works toward the prevention of sexual
violence through educational programs. The majority of the agency’s funding comes from federal and state
grants, the United Way and private donors. The support of municipalities helps us to cover our required
“match” for federal grants.
Services Provided: The Crisis Center offers 24-hour crisis intervention services through its hotline and
offices in Willimantic and New London. There are no fees for services. The agency provides immediate
response to victims, including crisis intervention and accompaniment to hospital exams and procedures,
police investigations, and court procedures. All staff persons are certified sexual assault crisis counselors.
Our staff assists victims with the filing of victim compensation forms, provides crisis intervention,
counseling, and support groups. We provide prevention and educational programs for children, parents,
human service personnel, educators, health care providers and the public. The Crisis Center is an active
participant of the Windham Multidisciplinary Team (MDT), the New London MDT, and the Tolland MDT.
The teams are a collaboration of the various agencies involved in the investigation of serious child abuse and
child sexual assault cases, and are comprised of members from law enforcement and child protection
agencies, hospital personnel, youth services, the State’s Attorney’s office, and mental health agencies. The
Crisis Center, in partnership with the Windham MDT, provides advocacy and support services to families
and children at Wendy’s Place, Windham County’s child advocacy center. In partnership with the New
London County MDT, the Crisis Center provides the advocacy and support services offered to families and
children at the New London County Child Advocacy Center located adjacent to our office in New London.
The Crisis Center is also a member of the Community Response Team at UConn, Connecticut College, the
College Consortium, the RAINN National Hotline and On-Line Hotline and the Welcome Center.
Number of Waterford residents provided victim services in fiscal year 07/01/19 — 06/30/20; 197%) %
Clients to be served: The Sexual Assault Crisis Center provides free services to men, women and children
of all ages, including services to those with physical or mental health disabilities. Services are provided
regardless of income status. All services are available in both English and Spanish. Translation services for
languages other than English and Spanish are available upon request, as are services for the hearing impaired,
Amount requested from the Town of Waterford for fiscal year 2021-2022: $1000
How Services can be accessed: Town residents can call our 24-hour, toll-free hotline at (888) 999-5545,
locally at 860-456-2789 or 860-437-7766, or
the toll-free RAINN national hotline at (800) 656-HOPE.
Counseling services are available at our Willimantic and New London offices; we also attempt to make
accommodations for clients who do not have access to transportation, whenever possible.
TOWN OF WATERFORD
15 Rope Ferry Road
Waterford, CT 06385
860-442-0553
SOCIAL SERVICES GRANT FUNDING REQUEST
ORGANIZATION NAME:
Sexual Assault Crisis Center of Eastern CT, Inc.
REQUEST DATE (FISCAL YEAR):
2021-2022
REQUESTED AMOUNT:
$1,000
BENEFIT STATEMENT (Describe how these funds will be used)
We provide crisis intervention, advocacy and trauma-focused counseling to victims of sexual
violence. Services, which are provided by certified sexual assault counselors, are free and
confidential. We provide immediate accompaniment to emergency rooms and provide legal and
judicial advocacy, accompanying victims to the police department and provide preparation,
accompaniment and advocacy throughout the Court process. We operate the N.L. County Child
Advocacy Center which is fully accredited through the National Children's Alliance.
We
provide evidence-based Trauma Focused CBT counseling to children who have been abused.
Per Town of Waterford Budget Guidelines: please attach a certified audit report of all funds
appropriated during the last completed fiscal year to your funding request.
DECLARATION
|, the requester, understand that | am requesting public funds from the Town of Waterford.
| declare that this request does not pose any potential conflict with the Town of Waterford
and | will provide any documentation requested by the Town of Waterford to authorize
funding this request or review the appropriateness of the request.
(!“torial J. Kalin
1/8/2021
Signature
Date
PAUPAU PAUP Alm see (el= Wm Sexual Assault Crisis Center of Eastern Connecticut, Inc.
SAGES
MDT/CAG} TONAL AGENCY
]
‘DCF MDT/CACGrant
en
ee
$148,270
$148,270
ce Income
|
;
$52
$52
United Way of Central @NECT
$1000
$11,000
United Way donor designations
$1,500
$1,500.
Total Prod ram REVERNES
Operating Expenses
TOTAL AGENCY
Accounting Fees
$3,720
$550
$4,270
‘Answering Service
i
$2,800 0
|
$2,800
Bank Fees
$50
seo
$50
Computers and Software
|
$900.
$800
$1,700
Employee Disability Insurance
$2,578
$221
$2,799
Employee Health
& Life Insurance
|
7
7
$33,370 $7,599
$40,969
Employer Medicare
}
$7,661
$1,200
$8,861.
Employer State Unemployment
i
$10,038 _
.
$1,572.
$11,610
Employer Social Security
$32,756
$5,130
$37,886
Employer Workers Comp
i
$4,279 |
$500.
$4,779
Emplymt Advertising&Background Cheeks
|
$837
$837
‘Equipment and repair
|
$1,000
i $1,000
‘Fees
$400
$400
Insurance
_|
|
i:
$9,900
$1,200
$14,100
‘Member Dues
{
$850
—
$1,200
$2,050}
‘Mileage & Parking
|
a
$23,000
$3,120
$26,120
Meetings and Refreshments
$700
$2,000
so
$2,700}
Office Supplies
/
$10,795
$4,474,
$15,269
Payroll Service
$4,500
$4,500
‘Postage
|
_
$350
$350
‘Rent (Facilities)
$43,000
$43,000
Rent CACs (N.L. & Wendy's Place
|
a
$28,840
$28,840
Telephone & Internet
$9,320
Fon.
$5,320.
Training
i
$3,738
$4,000.
.
$7,738
Utilities
ay
$770
$3,500
$4,270
Website
|
7
$300,
$300
Wages and Salaries
i
$528,316
$82,792,
0
$611,048
Total Program Expenses
ee
einen
Total Agency Expenses
6
Surplus/ (deficit)
7
-
$5,080
$368
4712
1074 09/15/2020 10:07 AM
Forms 990 / 990-EZ Return Summary
For calendar year 2019, or tax year beginning
07/01/19
,andending
06/30/20
Sexual Assault Crisis Center of
06-1033609
Eastern Connecticut,
Inc.
Net Asset / Fund Balance at Beginning of Year
370 A 710
Revenue
Contributions
936,070
Program service revenue
Investment income
6,422
Capital gain / loss
Fundraising / Gaming:
Gross revenue
Direct expenses
Net income
Other income
0
Total revenue
942,492
Expenses
:
Program services
901,938
Management and general
10,140
Fundraising
Total expenses
912,078
Excess / (deficit)
30,414
Changes
1,367
Net Asset / Fund Balance at End of Year
402 , 491
Reconciliation of Revenue
Reconciliation of Expenses
Total revenue per financial statements
943 r 859
Total expenses per financial statements
912 , 078
Less:
Less:
Unrealized gains
1 , 367
Donated services
Donated services
Prior year adjustments
Recoveries
Losses
Other
Other
Plus:
Plus:
Investment expenses
Investment expenses
Other
Other
Total revenue per return
942,492
Total expenses per return
912,078
Balance Sheet
Beginning
Ending
Differences
Assets
396,326
419,652
Liabilities
25,616
17,161
Net assets
370,710
402 ,491
31,781
Miscellaneous Information
Amended return
Return / extended due date
Failure to file penalty
11/16/20
1074 09/15/2020 10:07 AM
:
990
Return of Organization Exempt From Income Tax
orm
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
> Do not enter social security numbers on this form as it may be made public.
OMB No. 1545-0047
2019
Ober to Public
(Rev. January 2020)
Department of the Treasury
2
Internal Revenue Service
P Go to www.irs.gov/Form990_for instructions and the latest information.
2 Inspection
(C
A_For the 2019 calendar year, or tax year beginning
07/01/19 andending
06/30/20
:
B_
Check if applicable, J © Name of organization
Sexual Assault Crisis Center of
D Employer identification number
[] Address change
Eastern Connecticut, Inc.
C Name change
Doing business as
06-1033609
Number and street (or P.O. box if mail is not delivered to street address)
Room/suite
E Telephone number
Initial return
PO Box 24
860-456-3595
Final return/
City or town, state or province, country, and ZIP or foreign postal code
terminated
.
.
.
.
0 Amended retum
Willimantic
CT 06226
G Gross receipts $
942,492
F
Name and address of principal officer:
[] Application pending
Geor g ette Katin
H(a) Is this a group return for subordinates? [| Yes fx] No
PO Box 24
H(b) Are all subordinates included?
[| Yes [] No
Willimantic
CT 06226
If "No," attach a list. (see instructions)
|
Tax-exempt status:
[x] 501(c)(3)
|
501 (c)
(
) < (insert no.)
[| 4947(a)(1) or
|
527
J
Website:
P
SAaccec. oe
K__Form of organization:
|x| Corporation
Trust |] Association |] Other >
in Year of formation: 1974
M_
State of legal domicile: CT
Part|
Summary
H(c} Group exemption number >
Part li
Signature Block
Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign
» Signature of officer
| Date
Here
»
Georgette Katin
Executive Director
Type or print name and title
PrintType preparer's name
Preparers signature
Date
Check [Je PTIN
Paid
Michael Rubin
09/15/20 | sel-employed | PO1037664
Preparer | rimsname
>
SHANE, NAVRATIL & CO., CPA'S
Fimsend>
_06-0916777 \__
Use Only
20 WALNUT ST.
Firm's address
>
WILLIMANTIC,
CT
06226
Phone no.
860-456-2297
May the IRS discuss this return with the preparer shown above? (see instructions) cece
cece reece cece cence Tx] Yes
No
For Paperwork Reduction Act Notice, see the separate instructions.
Form 990 (2019)
DAA
1
Briefly describe the organization's mission or most significant activities: bbb
bbb bbb bbb bbb beeen:
g
‘The organization was formed to provide counseling and education to sexual
Fs
assault victims, their families, and the community.
cee
Bf
tn
ni
8
2 Check this box >» | if the organization discontinued its operations or disposed of more than 25% of its net assets.
03 | 3 Number of voting members of the governing body (Part VI, line tay eee
eee
3
7
# | 4 Number of independent voting members of the governing body (Part Vi, fine 1b) eee, 4
7
=
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ©
5
16
3
6 Total number of volunteers (estimate ifnecessaryy:
ca get
ee 6
6
7a Total unrelated business revenue from Part
olurt
a
oe
oe A 8 OF eee
7a
0
b Net unrelated business taxable income: from:Fat
in
hon.
a
eee
7b
QO
Hee
es
.
Prior Year
Current Year
\
|
8 Contributions and grants (Part VI, fe THY cceseeresentesesseveeeee
849,113
936,070 ~
2|
9 Program service revenue (Part Vill Ine 2)
0
$
10 Investment income (Part VII, column (A), lines 3,4,and 7d)
5,213
6,422
“|
41 Other revenue (Part VIH, column (A), lines 5, 6d, 8c, 9c, 10c,and11e)
0
42 Total revenue — add lines 8 through 11 (must equal Part Vill, column (A), line 12)...
854,326
942,492
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)
0
14 Benefits paid to or for members (Part IX, column (A), line 4) ee,
0
» | 15 Salaries, other compensation, employee benefits (Part [X, column (A), lines 5-10)
627,358
711,341
a
16a Professional fundraising fees (Part IX, column (A), line 11e)
‘
0
3
b Total fundraising expenses (Part IX, column (D), line 25)h
0
8
|
|
47 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
208,829
200,737
18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
836,187
912 ,078
19 Revenue less expenses. Subtract line 18 fromline 12.
18,139
30,414
5g
Beginning of Current Year
End of Year
BS 20 Total assets (Part X, lime 18)
ccc cececevesevesvsvevevesvsesetveveavevevee
396,326
419,652
25) 24 Total liabliies (Part X,line 28)
25,616
17,161
35 22 Net assets or fund balances. Subtract line 21 from line 20. ..tti‘C:CTMCSC*SCSCCCCCCC
370,710
402,491
1074 09/15/2020 10:07 AM
Form
990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 2
Part Ill
Statement of Program Service Accomplishments
ro
Check if Schedule O contains a response or note to any line inthis Partlll.
O
\
1
Briefly describe the organization's mission:
The organization was formed to provide counseling and education to sexual
2
Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 of 990-FZ?
eee ber nnn
ner b cent
n tb
tte bb btt bbe ei eine eres
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services?
[J Yes [x] No
If "Yes," describe these changes on Schedule O.
4
Describe the organization's program service accomplishments for each of its three largest program services, as measured by
expenses. Section 501(c)(3) and 501(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.
4d Other program services (Describe on Schedule O.)
(Expenses
$
including grants of $
) (Revenue $
)
4e Total program service expenses >
901,938
DAA
Form 990 (2019)
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 3
Part IV
_—sCheccklist of Required Schedules
Yes | No;
>
1.
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? /f “Yes,”
LO
complete Schedule A ttt
tnt nttetetcbnnns
1|
x
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)?
2|
x
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to
candidates for public office? if “Yes,” complete Schedule C, Path
3
x
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h)
election in effect during the tax year? If "Yes," complete Schedule C, Pat He
4
x
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues,
assessments, or similar amounts as defined in Revenue Procedure 98-19? /f “Yes,” complete Schedule C, Patil
5
x
6
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 distribution or investment of amounts in such funds or accounts? /f
"Yes," complete Schedule D, Party
eee
ebb
tebe bbb bbe t bb bbtiticbitttttstetetecn
6
x
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? if “Yes,” complete Schedule D, Path
7
x
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? /f “Yes,”
complete Schedule D, Part cen
ete ebb be bb te bb bttbetitvctttttntteecnniey
8
x
9
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a
custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or
debt negotiation services? if “Yes,” complete Schedule D, Pat V
9
x
10
Did the organization, directly or through a related organization, hold assets in donor-restricted endowments
or in quasi endowments? /f “Yes,” complete Schedule D, Part eevee
ceetee crete tttetttenene:
11
If the organization's answer to any of the following questions is “Yes,” then complete Schedule D, Parts VI,
VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? /f “Yes,”
complete Schedule D, Part VE
eevee cbc eect bbb bette bbbetetccbttttcbetttteennees
‘a| X
b
Did the organization report an amount for investments—other securities in Part X, line 12, that is 5% or more
_
of its total assets reported in Part X, line 16? /f "Yes," complete Schedule D, Pat VI
11b
x a
c_
Did the organization report an amount for investments—program related in Part X, line 13, that is 5% or more
Ne
of its total assets reported in Part X, line 16? /f "Yes," complete Schedule D, Part VIE
11c
x
d_
Did the organization report an amount for other assets in Part X, line 15, that is 5% or more of its total assets
reported in Part X, line 16? if "Yes," complete Schedule D, Part cee
ete ceecttttttetttetteeen
11d
x
e
Did the organization report an amount for other liabilities in Part X, line 25? if "Yes," complete Schedule D, PartX
te|
X
f
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, PartX
11f
x
12a
Did the organization obtain separate, independent audited financial statements for the tax year? if “Yes,” complete
Schedule D, Parts XI and XM
oo
nebo
b boob
bbb bet lbtttbttitetinnetnes
12a|
X
b
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 Xland Xilis optional
12b
x
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete ScheduleE
13
x
14a
Did the organization maintain an office, employees, or agents outside of the United States?
14a
x
b_
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking,
fundraising, business, investment, and program service activities outside the United States, or aggregate
foreign investments valued at $100,000 or more? if “Yes,” complete Schedule F, PartslandIV
14b
x
15
Did the organization report on Part 1X, column (A), fine 3, more than $5,000 of grants or other assistance to or
,
for any foreign organization? /f “Yes,” complete Schedule F, Parts and
15
x
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other
assistance to or for foreign individuals? ff “Yes,” complete Schedule F, Parts Ifand VO
16
x
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on
Part IX, column (A), lines 6 and 11¢? ff “Yes,” complete Schedule G, Part i(see instructions)
17
x
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on
Part VIll, lines 1¢ and 8a? if "Yes," complete Schedule G, Part ccc
e este ct tteettttevtnteeceney
18
x
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, tine 9a?
if "Yes," complete Schedule G, Parti occ
ccc ccc cece cece eee eeeevvenvvnrnreteeenerens
19
xX
20a
Did the organization operate one or more hospital facilities? /f “Yes,” complete Schedule H
20a
x LL
b_
if “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this retumn?
==
20b
21 ~~ Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line-1? if “Yes,” complete Schedule | Partstand il...
21
Xx
DAA
Form 990 (2019)
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
_ Part lV
Checklist of Required Schedules (continued)
23
24a
25a
26
27
28
29
30
31
32
33
34
35a
36
37
38
Page 4
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on
Part IX, column (A), line 2? if “Yes,” complete Schedule |, Partstandtf
Did the organization answer “Yes” to Part Vil, Section A, line 3, 4, or 5 about compensation of the
organization's current and former officers, directors, trustees, key employees, and highest compensated
employees? if "Yes," complete Schedule Jvc
ccc ce cee b tte bebe teeth bbb tb bbb tt beeen ey
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than
$100,000 as of the last day of the year, that was issued after December 31, 2002? /f “Yes,” answer lines 24b
through 24d and complete Schedule K. If “No,” go to line 25a
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit
transaction with a disqualified person during the year? if “Yes,” complete Schedule L, Path
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior
year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?
If "Yes," complete Schedule b, Party
no
eevveceecceceseueeseeeseeeteete
bette eee reeteittettrettteeereceeens
Did the organization report any amount on Part X, line 5 or 22, for receivables from or payables to any current
or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35%
controlled entity or family member of any of these persons? /f “Yes,” complete Schedule L, Path
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key
employee, creator or founder, substantial contributor or employee thereof, a grant selection committee
member, or to a 35% controlled entity (including an employee thereof) or family member of any of these
persons? if “Yes,” complete Schedule L, Part Meee
verte cretevvettetttevcrteeetttevevteeres
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part
IV instructions, for applicable filing thresholds, conditions, and exceptions):
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? if
"Yes,” complete Schedule L, Part IV
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? /f
“Yes,” complete Schedule L, Part IV
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified
conservation contributions? /f “Yes,” complete Schedule M
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? /f “Yes,”
complete Schedule N, Part Il
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-37 if “Yes,” complete Schedule R, Part {
Was the organization related to any tax-exempt or taxable entity? /f “Yes,” complete Schedule R, Part If, Il
or IV, and Part V, line 7
If "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(b)(13)? /f “Yes,” complete Schedule R, Part V, line 2
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable
related organization? if “Yes,” complete Schedule R, Part V, line 2
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, Pat VE
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and
19? Note: All Form 990 filers are required to complete Schedule O.
Yes
No
22
23
24a
24b
24c
24d
25a
25b
26
28a
28b
28c
29
30
31
32
33
34
35a
le
ee i
a
a
i
ad a)
35b
36
37
Part V.
- Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V
C 1a
b
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable
1a
2
Did the organization comply with backup withholding rules for reportable payments to vendors and
reportable gaming (gambling) winnings to prize winners? .. cece
cece cece cee eres
DAA
Form 990 (2019)
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 5
_ Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
3a
4a
5a
6a
To
» oO
12a
13
14a
15
16
Enter the number 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 by this return
Note: If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
Did the organization have unrelated business gross income of $1,000 or more during the year?
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 bank account, securities account, or other financial account)?
if “Yes,” enter the name of the foreign country cece
ccc ett e cnt e tebe eetbtettiteecttttitereenseey
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
If “Yes” to line 5a or 5b, did the organization file Form 8886-T?
Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions?
6a
x
If “Yes,” did the organization include with every solicitation an express statement that such contributions or
gifts were not tax deductiolg?
cc
ecceccveeuseceeeeeccevevuvevsseeeecevtvesssteevevtvtvsvtitevevevivereceeseees
Organizations that may receive deductible contributions under section 170(c).
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods
and services provided to the payor?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was
required to file Form 8282?
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year?
Sponsoring organizations maintaining donor advised funds.
Did the sponsoring organization make any taxable distributions under section 4966?
Initiation fees and capital contributions included on Part Vill, line 12000
10a
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
= ==
10b
Section 501(c)(12) organizations. Enter:
Gross income from members or shareholders De
ee ia
Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them.)
ci
cesecserevevvsvevveveesvseies
1b
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year
| 12b |
Section 501(c)(29) qualified nonprofit health insurance issuers.
Is the organization licensed to issue qualified health plans in more than one state?
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 by the states in which
the organization is licensed to issue qualified health plans
13b
Enter the amount of reserves on hand
13¢
Is the organization subject to the section 4960 tax on paymeni(s) of more than $1,000,000 in remuneration or
excess parachute payment(s) during the year
icc
cerueeeeeeveeveteeeeeeteeectbttttitttetetererrees
ff "Yes," see instructions and file Form 4720, Schedule N.
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
{f "Yes," complete Form 4720, Schedule O.
DAA
Fom 990 (2019)
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response fo lines 2 through 7b below, and for a "No"
response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes on Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI
Section A. Governing Body and Management
[x]
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
7
If there are material differences in voting rights among members of the governing body, or
if the governing body delegated broad authority to an executive committee or similar
committee, explain on Schedule O.
b
Enter the number of voting members included on line 1a, above, who are independent
= ==
1b | 7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with
any other officer, director, trustee, or key employee?
ccc
ecu eece cece ceeetereeeeteeetietitetetereeeeeey
Xx
3
Did the organization delegate control over management duties customarily performed by or under the direct
supervision of officers, directors, trustees, or key employees to a management company or other person?
3
x
4
Did the organization make any significant changes to its goveming documents since the prior Form 990 was filed?
4
xX
5
Did the organization become aware during the year of a significant diversion of the organization’s assets?
5
x
6
— Did the organization have members or stockholders?
occ ccc eccccsu ete eceeteesceetecetevereveriteeereeeren,
6
x
7a__
Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body? cece
cbt bt tb bette ccttevrttenenriee,
7a
x
b
Are any governance decisions of the organization reserved to (or subject to approval by) members,
stockholders, or persons other than the governing body?
icc
ccc ccc eese eter eseeeeeeesteveseeeetteveresens
7b
x
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
_ a
a
The governing ody?
cece ccc ecb
ee vcr
te cnet eenatedtitecrtievtitivrrivertitertiessrs
8a | X
Each committee with authority to act on behalf of the governing body?
8b | X
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at
the organization’s mailing address? /f “Yes,” provide the names and addresses on Schedule O....
0... eee 9
xX
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
ee.
Yes | No
C “10a
Did the organization have local chapters, branches, or affiliates?
10a
x
—" bf “Yes,” did the organization have written policies and procedures governing the activities of such chapters,
affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? _............................
10b
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a|
X
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Lo
12a
Did the organization have a written conflict of interest policy? if “No,”gotoline?3
12a|_
X
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
12b|
X
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? /f “Yes,”
describe in Schedule O how this was done ee
eee Eee ee
eee
12c
x
13
Did the organization have a written whistleblower policy? cette
cette ce ttt tettentntennnen
13 | X
14
Did the organization have a written document retention and destruction policy?
14
|X
15
Did the process for determining compensation of the following persons include a review and approval by
independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
:
The organization’s CEO, Executive Director, or top management official
15a|
X
Other officers or key employees of the organization. cece
ect eet e tect ttetttetteneeies
x
If “Yes” to line 15a or 15b, describe the process in Schedule O (see instructions).
SS
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement
with a taxable entity during the year?
i
eevcveveveeeueveeeescreeceeeteuuvevestvirieveteservevetserevesees
b_
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its
participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the
organization’s exempt status with respect to such arrarigements? Wee,
Section C. Disclosure
17
_List the states with which a copy of this Form 990 is required to be filed >
cT
18
Section 6104 requires an organization to make its Forms 1023 (1024 or 1024-A, if applicable), 990, and 990-T (Section 501(c)
(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
[| Own website [| Another's website [x] Upon request
[| Other (explain on Schedule OQ)
(C
19
Describe on Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and
financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records »
Georgette Katin
PO Box 24
Willimantic
CT 06226
860-456-3595
DAA
Form 990 (2019)
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 7
Part VI|_
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and
Independent Contractors
C
~
Check if Schedule O contains a response or note to any line inthis Part Vil,
L]
Section A. _ Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the
organization's tax year.
e List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of
compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
e List all of the organization's current key employees, if any. See instructions for definition of "key employee."
e List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.
e List all of the organization's former officers, key employees, and highest compensated employees who received more than
$100,000 of reportable compensation from the organization and any related organizations.
e 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 $10,000 of reportable compensation from the organization and any related organizations.
See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
{A)
(B)
{(C)
{D)
{E)
(F)
Name and title
Average
Position
Reportable
Reportable
Estimated amount
hours
(do not check more than one
compensation
compensation
of other
per week
box, unless person is both an
from the
from related
compensation
(list any
officer and a director/trustee)
organization
organizations
from the
hours for
esl
s
fs)
x
Toa) 7
{W-2/1099-MISC)
(W-2/1099-MISC)
organization and
related
a a/213)/28
=C-%
g
related organizations
organizations
ge)
5]
8
g
cy Bl
o
below
gz
3
B®e
dotted line)
a]
.
3s | 2
g|
&
“|
8
oO
o
g
&
(1)Georgette Katin
ee
oe 40.00.
Executive Director
0.00
4
88,791
0
0
(22)Enevia Baidoo
C
Cotte
fes 1.00.
Member
0.00
|X
0
0
0
3)Susan Beauregard
ree
ee 1.00 _
Member
0.00
|X
0
0
fe]
(4)Christopher Burke
ere
ee 1.00
Member
0.00
|X
0
0
0
(5) Timothy Davis
foc ttt
fees 1.00 _
Treasurer
0.00
|X
x
0
0
0
()Marc Scrivener
Cott
fees 1.00 _
President
0.00
|X
x
0
0
¢)
(7)Ellen
Sostman~Laramie
eens
Gees 1.00 _
Vice President
0.00
|X
x
0
0
0
(3)Rachel B.
Tambliing
Sof
1.00 _
Secretary
0.00
|X
x
0
0
0
(9)
(10)
a
(11)
XU
Fom 990 (2019)
DAA
1074 09/15/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
Page 8
“Part VIL. _— Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(a)
®)
(c)
i)
)
a)
~,
Name and title
Average
Position
Reportable
Reportable
Estimated amount
hours
(do not check more than one
compensation
compensation
of other
~
per week
box, unless Person is both an
from the
from related
compensation
(list any
officer and a directoritrustee)
organization
organizations
from the
hours for
os]
5/0
wR
|@al
7
(W-2/1099-MISC)
(W-2/1099-MISC)
organization and
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8
aa
related
az]
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related organizations
og
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a
a
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1b Subtotal 20000
eee eeeeees
>
88,791
c
Total from continuation sheets to Part VII, Section A
>
d_Total(addlines 1band1c).
>
88,791
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of
reportable compensation from the organization >
3.
Did the organization list any former officer, director, trustee, key employee, or highest compensated
employee on line 1a? if “Yes,” complete Schedule J for such individual
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the
organization and related organizations greater than $150,000? /f “Yes,” complete Schedule J for such
ANGIE EEE
DEED DEE ene Dente t eee cect ees ne eres
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
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of
compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year.
(A)
Name and business address
_, (B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who
received more than $100,000 of compensation from the organization >
DAA
Fom 990 ois)
4074 09/16/2020 10:07 AM
Form 990 (2019) Sexual Assault Crisis Center of
06-1033609
_-
Page 9
Part Vill
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIN.
[|e
(A)
Total revenue
(Cc)
Unrelated
business revenue
(D)
Revenue excluded
from tax under
sections 512-514
(B)
Related or exempt
function revenue
2 #)
1a Federated campaigns
1a
5 3,
b Membership dues
1b
7
c Fundraising events
1c
ey
d Related organizations
id
|
©
Government grants (contibutions)
1e
867,026
6°
f All other contributions, gifts, grants,
Bs
and similar amounts not included above.........
1f
#°
g Noncash contributions included in lines ta-1f |... .
1g
|S
S&|__h Total. Addlines ta~tf.
2a
evenue
Program
Service
|
co
a
> a
co
id
3.
Investment income (including dividends, interest, and
other similar amounts)
>
6,422
6,422
4
Income from investment of tax-exempt bond proceeds
5
Royalties 0.00000
ee
{il) Real
6a Gross rents
6a
b
Less: rental expenses |_ 6b
c
Rental inc. or (loss)
6c
d
Net rental income or (loss) ........
7a Gross amount from
() Securities
(i) Other
sales of assets
other than inventory |_ 7a
b
Less: cost or other
basis and sales exps. | 7b
Gain or (loss)
7c
d
Net gain or (loss) 000...
8a Gross income from fundraising events
(not including
S$
of contributions reported on line 1c).
See Part lV, line 18
8a
Less: direct expenses
8b
Net income or (loss) from fundraising events .................
9a Gross income from gaming activities.
See Part lV, line 19
9a
b
Less: direct expenses
9b
Other
Revenue
oO
10a Gross sales of inventory, less
returns and allowances
10a
Miscellaneous
Revenue
12
Total revenue. See instructions... id
942,492
6,422
Form 990 (2019)
DAA
1074 09/15/2020 10:07 AM
Form 990 (2019)
_ Part IX
Sexual Assault Crisis Center of
06-1033609
Statement of Functional Expenses
~- Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX
Do not include amounts rep orted on lines 6b,
Total oe enses
Progra enics
Management and
Fundreg
7b, 8b, 9b, and 10b of Part VIil.
expenses
general expenses
expenses
1
Grants and other assistance to domestic organizations
:
and domestic governments. See Part V, line 2400
2
Grants and other assistance to domestic
individuals. See Part V, line 22)
3
Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 1600
4
Benefits paid to orformembers
5
Compensation of current officers, directors,
trustees, and key employees
6
Compensation not included above to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
7
Othersalariesandwages
609,355
604,355
5,000
8
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
9
Other employee benefits
51,923
51,673
250
10
Payrlitaxes
50,063
49,813
250
11
Fees for services (nonemployees):
a Management
ee
© Accounting
4,269
4,269
d Lobbying
e
Professional fundraising services. See Part lV, line 17
f
Investment management fees
g
Other. (If line 14g amount exceeds 10% of line 25, column
(A} amount, list line 11g expenses on Schedule 0.)
7 r 101
7 y 101
12
Advertising and promotion
1,109
1,109
13°
Office expenses,
10,571
10,200
371
14
Information technology
1,886
1,886
158
Royalties.
16
Occupancy
85,915
85,915
VTA eceececeeeseeeeeeeees
21,540
21,540
18
Payments of travel or entertainment expenses
for any federal, state, or local public officials
19
Conferences, conventions, and meetings
38 L 000
38 L 000
20
Interest eee eee eee
21
Payments to affiliates
=
22
Depreciation, depletion, and amortization a
23
Insurance a
aay
24
Other expenses. ltemize expenses not covered
above (List miscellaneous expenses on line 24e. If
line 24e amount exceeds 10% of line 25, column
(A) amount, list line 24e expenses on Schedule O.)
.
—
ae
a
In-Kind Donations
7,776
7,776
b
5,150
5,150
c
1,569
1,569
d
e
25
Total functional expenses. Add lines 1 through 24e
912,078
901,938
10,140
0
.
26
Joint costs. Complete this line only if the
organization reported in column (B) joint costs
from a combined educational campaign and
fundraising solicitation. Check here > [| if
following SOP 98-2 (ASC 958-720)...
DAA
Fom 990 ots)
1074 09/15/2020 10:07 AM
Form 990 (2019)
Sexual Assault Crisis Center of
06-1033609
Page 11
Part X —- Balance Sheet
Check if Schedule O contains a response or note to any line in this PartX
Oe .
(A)
(B)
-_
Beginning of year
End of year
1
Cashnonsinterest beating nnn
109,203]
1
107,583
2
Savings and temporary cash investments
2
3
Pledges and grants receivable, net
156,886|
3
175,369
4
Accounts receivable, Met ccc
cette tteeeeecttetteeees
2,500|
4
2,500
5
Loans and other receivables from any current or former officer, director,
:
:
:
trustee, key employee, creator or founder, substantial contributor, or 35%
controlled entity or family member of any of these persons
6
Loans and other receivables from other disqualified persons (as defined
7)
under section 4958(f)(1)), and persons described in section 4958(c)(3)(B)
B|
7
Notes and loans receivable, net
ccc asssttnenvaniennne
<
8
Inventories for sale OF USC
ccc rece eeu eeeeeeveeeteernevetettvevetererenes
9
Prepaid expenses and deferred charges
cc cececeveveveveveeeeenes
10a Land, buildings, and equipment: cost or other
basis. Complete Part Vi of ScheduleD
10a
8,491
b Less: accumulated depreciation
=
10b
8,491
10c
11
Investments—publicly traded securities
117,223)
411
124,949
12
Investments—other securities. See Part lV, line 11
0
12
13
Investments—program-related. See Part IV, fine 1400
13
14
Intangible assets cece
ee cette ete tect tnen
14
15
Other assets. See Part lV, line 14 eects
3,222|
15
3,222
16
Total assets. Add lines 4 through 15 (must equal line 33) ......000..
396,326]
16
419,652
17
Accounts payable and accrued expenses eee
25,616|
17
10,357
18
Grants payable cette
ttt beet ttttteneennnees
19
Deferred cc
20
Tax-exempt bond liabilities ccc
ett ecettec eres
21
Escrow or custodial account liability. Complete Part V of ScheduleD
» | 22
Loans and other payables to any current or former officer, director,
=
trustee, key employee, creator or founder, substantial contributor, or 35%
4
controlled entity or family member of any of these persons
1}
23
Secured mortgages and notes payable to unrelated third parties
24
25
Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X
OF Schedule Di
eeccececcevevvveveveveseevevecvevtstetereveveveree:
25
6,804
26
Total liabilities. Add lines 17 through 25...
Organizations that follow FASB ASC 958, check here > [X|
3
and complete lines 27, 28, 32, and 33.
a
:
S
o
:
&
|27
Net assets without donor restrictions
370,710|
27
402,491
a
|28
Net assets with donor restrictions cc
ceccee ve epee etn eeeeevees
z
Organizations that do n