FOR PUBLIC INSPECTION
** PUBLIC DISCLOSURE COPY
**
OMB No. 1545-0047
Return of Organization Exempt From Income Tax
Form 990
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.
2017
Department of the Treasury
Open to Public
Internal Revenue Service
Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
A For the 2017 calendar year, or tax year beginning
and ending
B Check if
C Name of organization
D Employer identification number
applicable:
Planned Parenthood New Hampshire
1Addresschange
Action Fund, Inc.
Name
'change
Doing business as
46-5554692
Initial
Ir
eturn
Number and street (or P.O. box if mail is not delivered to street address)
Room/suite E Telephone number
Fretu
inal
r n/
784 Hercules Drive, Suite
110
802-448-9700
termin-
ated
City or town, state or province, country, and ZIP or foreign postal code
G Gross receipts $
573,106.
1=1.:,Tided
Colchester, VT
05446
H(a) Is this a group return
1Applica-tion
F Name and address of principal officer:Meagan Gallagher
for subordinates?
=
Yes I X No
pending
same as C above
H(b) Are all subordinates included? ED Yes
=
No
I Tax-exempt status: LI 501(c)(3)
U
501
(c) (
4
)1
(insert no.)
4947
(a)(1) or LI 527
If "No," attach a list. (see instructions)
J Website:►WWW . ppafnh. org
H(c) Group exemption number
K Form of organization: I X I Corporation I
I Trust I
I Association
Other00,-
L Year of formation: 2 0141 M State of legal domicile: NH
Summary
1
Briefly describe the organization's mission or most significant activities: Reproductive Healthcare and
0
ccu
Education
E
2 Check this box PO. l
if the organization discontinued its operations or disposed of more than 25% of its net
assets.
3 Number of voting members of the governing body (Part VI, line la)
3
8
r8
4 Number of independent voting members of the governing body (Part VI, line 1b)
4
8
06
sc
5 Total number of individuals employed in calendar year 2017 (Part V, line 2a)
5
0
P>
6 Total number of volunteers (estimate if necessary)
6
214
..,0
7 a Total unrelated business revenue from Part VIII, column (C), line 12
7a
0
<
b Net unrelated business taxable income from Form 990-T, line 34
7b
0
Prior Year
Current Year
0)
8 Contributions and grants (Part VIII, line 1h)
528,792.
554,635.
m
c0
9 Program service revenue (Part VIII, line 2g)
6,702.
18,471.
8
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d)
0 .
0 .
et
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)
0 .
0 .
12 Total revenue • add lines 8 through 11 (must equal Part VIII, column (A), line 12)
535,494.
573,106.
13 Grants and similar amounts paid (Part IX, column (A), lines 1-3)
0 .
0 .
14 Benefits paid to or for members (Part IX, column (A), line 4)
0 .
0 .
u)
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
89,090.
98,444.
2
16a Professional fundraising fees (Part IX, column (A), line 11e)
0 .
0 .
9.
re
b Total fundraising expenses (Part IX, coiumn (D), line 25)
ri:-
n
4,
nlic
41J.
Uj
17 Other expenses (Part IX, column (A), lines 11 a-11 d, 1lf-24e)
434,734.
431,687.
18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
523,824.
530,131.
19 Revenue less expenses. Subtract line 18 from line 12
11,670.
42,975.
"cz,a,,
Beginning of Current Year
End of Year
m
20 Total assets (Part X, line 16)
100,469.
95,761.
4
c"
21 Total liabilities (Part X, line 26)
86,364.
38,431.
A
'E
22 Net assets or fund balances. Subtract line 21 from line 20
14,105.
57,330.
Part 11
J Signature Block
Under penalties of perju
, I leclare that I have e mined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and corn
'
• ""iiiigar
e
'
(oth• r t r n officer) is based on all information of which preparer has any knowiedg
n
iffirritili
t
k
i
l
W
i
e
n
Sign
gn ure o o Icer
late
Here
Heather Bush y, CF
Type or print name and title
Print/Type preparer's name
Preparer's signature
Date
Check I
PTIN
Paid
Barbara J. McGuan, CPA
Barbara J. McGuan, C06/21/18
sell-employed
P00219457
Preparer
Firm's name
',Berry Dunn McNeil & Parker
LLC
Firm's EIN
01-0523282
Use Only
Firm's address o, P.O. Box
1100
Portland, ME
04104-1100
Phone no. ( 207)
775-2387
May the IRS discuss this return with the preparer shown above? (see instructions)
LX] Yes
1_1 No
732001
11-28-17
LHA For Paperwork Reduction Act Notice, see the separate instructions
Form 990 (2017)
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692
Page2
I Part Ill Statement of Program Service Accomplishments
Check if Schedule 0 contains a response or note to any line in this Part III
lx1
-I
Briefly describe the organization's mission:
To encourage and protect informed individual choice regarding
reproductive health care.
To advocate public policies which guarantee
the right, as well as, full and nondiscriminatory access, to such
care.
To foster and preserve a social and political climate favorable
2
Did the organization undertake any significant program services during the year which were not listed on the
prior Form 990 or 990-EZ?
Yes
W
No
If "Yes," describe these new services on Schedule 0.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
I Yes I X I No
If "Yes," describe these changes on Schedule 0.
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.
4a
(Code:
) (Expenses $
522,105. including grants of $
)
(Revenue $
18,471.)
Pub
e
lic ducation and advocacy, education and electoral activities,
including public campaigns, online outreach, grassroots organizing, and
legislative advocacy.
Planned Parenthood New Hampshire Action Fund,
Inc. encourages and protects informed individual choices regarding
reproductive healthcare, advocates for public policy which guarantees
the right to choice, full and nondiscriminatory access to reproductive
health care, and fosters and preserves a social and political climate
favorable to the exercise of reproductive choice.
4b
(Code:
)
(Expenses $
including grants of $
)
(Revenue $
4c
(Code:
)
(Expenses $
including grants of $
)
(Revenue $
4d Other program services (Describe in Schedule 0.)
(Expenses $
including grants of $
)
(Revenue $
4e Total program service expenses li.
5 2 2 ,10 5 .
Form 990 (2017)
732002
11-28-17
2
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692
page3
Part IVI Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
If 'Yes," complete Schedule A
1
X
2
Is the organization required to complete Schedule B, Schedule of ContributorV
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, Part I
3
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, Part II
4
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? if "Yes," complete Schedule C, Part Ill
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? If "Yes," complete Schedule D, Part I
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, Part II
X
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete
Schedule D, Part Ill
8
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, Part IV
9
X
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V
10
X
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? If "Yes," complete Schedule 0,
Part VI
11a
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? If "Yes," complete Schedule D, Part VII
11b
X
c
Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII
11c
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 IX
11d
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X
1 'le
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, Part X
11f
X
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
12a
X
b
Was the organization included in consolidated, independent audited financial statements for the tax year?
If "Yes," and if the organization answered °No" to line 12a, then completing Schedule D, Parts Xl and XII is optional
12b
X
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
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, Parts 1 and IV
14b
X
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization? If "Yes," complete Schedule F, Parts ll and IV
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? If "Yes," complete Schedule F, Parts Ill and IV
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 e? If "Yes," complete Schedule G, Part I
17
X
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
lc and 8a? if "Yes," complete Schedule G, Part ll
18
X
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If 'Yes,"
complete Schedule G, Part M
19
X
Form 990 (2017)
732003
11-28-17
3
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692
Page 4
Part IV Checklist of Required Schedules (continued)
Yes
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H
20a
X
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
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!, Parts ! and II
21
X
22
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 1, Parts I and III
X
23
Did the organization answer "Yes" to Part VII, 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 J
23
X
24a
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? If "Yes," answer lines 24b through 24d and complete
Schedule K. If "No", go to line 25a
24a
X
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
24b
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
24c
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
24d
25a
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, Part I
25a
X
b
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 Fomis 990 or 990-EZ? If "Yes," complete
Schedule L, Part 1
25b
X
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes,"
complete Schedule L, Part I!
26
X
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial
contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member
of any of these persons? If "Yes," complete Schedule L, Part
27
X
28
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
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV
28a
X
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV
28b
X
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,
director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV
28c
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M
29
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions? If "Yes," complete Schedule M
30
X
31
Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Part 1
31
X
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?If "Yes, " complete
Schedule N, Part 11
32
X
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part 1
33
X
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, Ill, or IV, and
Part V, line 1
34
X
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
b
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)? If "Yes," complete Schedule R, Part V, line 2
35b
36
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
36
37
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? If "Yes," complete Schedule R, Part VI
37
X
38
Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 b and 19?
Note. All Form 990 filers are required to complete Schedule 0
38
Form 990 (2017)
732004
11-28-17
4
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990(2017)
Action Fund, Inc.
46-5554692
Page 5
Part V Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule 0 contains a response or note to any line in this Part V
is
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable
is
b
Enter the number of Forms W-2G included in line la. Enter -0- if not applicable
lb
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners?
2a
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
2a
b
If at least one is reported on line 2a, did the organization file all required federal employment tax retu ns?
Note. If the sum of lines la and 2a is greater than 250, you may be required to e-file (see instructions)
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?
b
If "Yes," has it filed a Form 990-T for this year? If "No," to line 3b, provide an explanation in Schedule 0
4a
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)?
b
If "Yes," enter the name of the foreign country: Ow
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
If "Yes," to line 5a or 5b, did the organization file Form 8886-T?
6a
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?
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payer?
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
d
If "Yes," indicate the number of Forms 8282 filed during the year
7d
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
9
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
8
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?
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12
10a
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders
lla
b
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
llb
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year
12b
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
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 0.
b
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
c
Enter the amount of reserves on hand
13c
14a
Did the organization receive any payments for indoor tanning services during the tax year?
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule 0
14b
Form 990 (2017)
732005
11-28-17
5
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692
pagE6
FP-art VI
I Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and fora
"No" response
to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule 0. See instructions.
Check if Schedule 0 contains a response or note to any line in this Part VI
Section A. Governing Body and Management
Yes
is Enter the number of voting members of the governing body at the end of the tax year
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 in Schedule 0.
b Enter the number of voting members included in line la, above, who are independent
lb
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?
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision
of officers, directors, or trustees, or key employees to a management company or other person?
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
5
Did the organization become aware during the year of a significant diversion of the organization's assets?
5
6
Did the organization have members or stockholders?
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?
b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
7b
X
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a The governing body?
8a
X
b 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? If "Yes," provide the names and addresses in Schedule 0
Section B. Policies (This Section B requests information about policies not required by the internal Revenue Code.)
Yes
No
10a Did the organization have local chapters, branches, or affiliates?
10a
X
b If "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?
lla
X
b Describe in Schedule 0 the process, if any, used by the organization to review this Form 990.
12a Did the organization have a written conflict of interest policy? If "No," go to line 13
12a
X
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
12b
c Did the organization regularly and consistently monitor and enforce compliance with the policy? if "Yes,' describe
in Schedule 0 how this was done
12c
13
Did the organization have a written whistleblower policy?
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?
a The organization's CEO, Executive Director, or top management official
15a
b Other officers or key employees of the organization
15b
If "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions).
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?
16a
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 arrangements?
16b
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed ►NI-1
18
Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-1 (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
lx1Own website
NI Another's website
El Upon request
I Other (explain in Schedule 0)
19
Describe in Schedule 0 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:0o-
Heather Bushey, CPA
-
802-448-9728
784 Hercules Drive,
Suite
110, Colchester, VT
05446
732006
11-28-17
Form 990 (2017)
6
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990(2017)
Action Fund, Inc.
4 6 - 5 5 5 4 692
page 7
I Part VIII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
Check if Schedule 0 contains a response or note to any line in this Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
is 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.
• 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.
• List all of the organization's current key employees, if any. See instructions for definition of "key employee."
• List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received report-
able 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.
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.
• 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.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees;
and former such persons.
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(do not check more than one
Reportable
Reportable
Estimated
hours per
box imiessoersonisboMan
compensation
compensation
amount of
week
officer and a director/trus ee)
from
from related
other
(list any
.‘.1*
e
the
organizations
compensation
hours for
organization
(W2/1099-MISC)
from the
related
14
(W-2/1099-MISC)
organization
organizations t
7---;
a;
,,R
E
,,
and related
below
,T,
2
- g
1-4 -
.,.-.
organizations
line)
0
',.
fo2
..-
0,2
.i
E-E
(1)
Iris Estabrook
0.50
Chair
3.00
X
X
O.
O.
0.
(2)
Matthew Houde
0.50
Vice Chair
3.00
X X
0.
O.
O.
(3)
Lucy Karl, Esq.
0.50
Treasurer
3.00
X X
0.
O.
O.
(4)
Rashida Mohamed
0.50
Past Trustee
3.00
X
O.
0.
O.
(5)
Linda Patchett
0.50
Trustee
3.00
X
O.
O.
O.
(6)
Leah Plunkett
0.50
Secretary
X X
0.
0.
0.
(7)
Benjamin Siracusa Hillman
0.50
Trustee
3.00
X
O.
O.
O.
(8)
Leonard Small
0.50
Trustee
X
0 .
0 .
0 .
(9)
Regan Theiler
0.50
Past Trustee
X
0.
0.
0.
(10) Anita Springer
0.50
Trustee
3.00
X
O.
O.
O.
(11) Meagan Gallagher
2.00
CEO
37.50
X
548.
220,423.
25,426.
(12) Heather Bushey
2.00
CFO
37.50
X
0.
140,814.
11,019.
(13) Jennifer Frizzell
13.00
VP of Public Policy
24.50
X
96,243.
27,481.
6,776.
732007
11-28-17
Form 990 (2017)
7
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 TO17)
Action Fund, Inc.
46-5554692
Page8
PartVII Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees continued
(A)
(B)
(C)
(D)
(E)
(F)
Name and title
Average
Poslion
Reportable
Reportable
(do not check more than one
Estimated
hours per
box unless pe son is both an
compensation
compensation
amount of
week
officer and a director/trustee)
from
from related
other
(list any
:T,.
the
organizations
compensation
hours for
4
organization
(W-2/1099-MISC)
from the
related
1
(W-2/1099-MISC)
organization
organizations
§
f
§'
,,
1E1
and related
below
I
-a
.Pal
organizations
line)
''
Z
13.f,.0s
E
E
E o
= ..,
,E
lb Sub-total
ill'
96,791.
388,718.
43,221.
c Total from continuation sheets to Part VII, Section A
il•
0 .
0 .
0 .
d Total (add lines lh and le)
110-
96,791.
388,718.
43,221.
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
corn ensation from the or. anization PPD.
0
Yes No
Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on
line 1 a? If "Yes," complete Schedule J for such individual
3
x
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? If "Yes," complete Schedule J for such individual
4
X
5
Did any person listed on line la receive or accrue compensation from any unrelated organization or individual for services
rendered to the or anization? If "Yes," complete Schedule J for such person
5
X
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)
(B)
(C)
Name and business address
NONE
Description of services
Compensation
2
Total number of independent contractors (including but riot limited to those listed above) who received more than
$100,000 of compensation from the organization OPP-
0
Form 990 (2017)
732008
11-28-17
8
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692
Page 9
1 Part VIII
Statement of Revenue
Check if Schedule 0 contains a response or note to any line in this Part VIII
(A)
(9)
(C)
(D)
Total revenue
Related or
Unrelated
Revenue excluded
exempt function
fro
x under
business
es
sct
ections
revenue
revenue
512 - 514
.rEl
1 a
Federated campaigns
is
mm6 o
b
Membership dues
lb
m<<
c
Fundraising events
is
(54
d
Related organizations
id
422,193.
u5'Ecii).
e
Government grants (contributions)
le
..?... ,
f
All other contributions, gifts, grants,
and
m 2r04-.
similar amounts not included above
If
132,442.
c0Z. /3
g
Noncash contributions included in lines
la-1f: $
0 c
0
h
Total. Add lines la-1 f
554,635.
business Code
0u
2a
Consulting Services
621990
18,471.
18
,
471.
b
5 1,
)0
C
C
eat
g!
d
o2
e
a.
f
All other program service revenue
Total. Add lines 2a-2f
18,471.
3
Investment income (including
dividends, interest, and
other similar amounts)
4
Income from investment of tax-exempt
bond proceeds
1110-
5
Royalties
1110-
(i) Real
(ii) Personal
6 a
Gross rents
b
Less: rental expenses
c
Rental income or (loss)
d
Net rental income or (loss)
OP-
7 a
Gross amount from sales of
(i) Securities
(ii) Other
assets other than inventory
b
Less: cost or other basis
and sales expenses
c
Gain or (loss)
d
Net gain or (loss)
1110.
0
8 a
Gross income from fundraising
events
(not
=
c
including $
of
>ru
contributions reported on line 1c). See
cc
a)
Part IV, line 18
a
.c
b
Less: direct expenses
b
5
c
Net income or (loss) from fundraising events
IP'
9 a
Gross income from gaming activities.
See
Part IV, line 19
a
b
Less: direct expenses
b
c
Net income or (loss) from gaming activities
00.
10 a
Gross sales of inventory, less returns
and allowances
a
b
Less: cost of goods sold
b
c
Net income or (loss) from sales of inventory
lo.
Miscellaneous Revenue
business Code
11 a
b
c
d
All other revenue
e
Total. Add lines 11a-11d
00'
12
Total revenue. See instructions.
00.
573
,
106.
18,
471.
O.
O.
732009
11-28-17
Form 990 (2017)
9
18450621
757052
07605.AF-10
2017.03050
Planned
Parenthood
New
Hamp
07605_01
Planned Parenthood New Hampshire
Form 990(2(:17 )
Action Fund , Inc .
46-5554692 Page
l
Part IX IStatement 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 0 contains a response or note to any line in this Part IX
Do not include amounts reported on lines 6b,
(A)
(B)
(C)
(D)
Total expenses
Program service
Management and
Fundraising
7b, 8b, 9b, and 106 of Part VIII.
expenses
general expenses
expenses
i
Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
2
Grants and other assistance to domestic
individuals. See Part IV, line 22
3
Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16
4
Benefits paid to or for members
5
Compensation of current officers, directors,
trustees, and key employees
98,
444.
98,
444.
6
Compensation not included above, to disqualified
persons (as defined under section 4958(0(1)) and
persons described in section 4958(c)(3)(B)
7
Other salaries and wages
8
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
9
Other employee benefits
10
Payroll taxes
11
Fees for services (non-employees):
a
Management
226,
076.
224,
728.
466.
882.
b
Legal
926.
180.
746.
c
Accounting
d
Lobbying
e
Professional fundraising services. See Part IV, line 17
f
Investment management fees
g
Other. (If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch 0 )
27,
436.
26,
236.
1,
200.
12
Advertising and promotion
35,
930.
35,
930.
13
Office expenses
37,
369.
36,
137.
134.
1,098.
14
Information technology
15
Royalties
16
Occupancy
34,
913.
34,
771.
4 9.
93.
17
Travel
11,
865.
11,
817.
18
Payments of travel or entertainment expenses
for any federal, state, or local public officials
19
Conferences, conventions, and meetings
20
Interest
24.
21
Payments to affiliates
22
Depreciation, depletion, and amortization
23
Insurance
320.
24
Other expenses. Itemize expenses not covered
above. (List miscellaneous expenses in line 24e. If line
24e amount exceeds 10% of line 25, column (A)
amount, list line 24e expenses on Schedule 0.)
a
Miscellaneous
53,
366.
52,049.
1,
175.
142.
b
Dues & Subscriptions
3,
462.
1,813.
1,
649.
c
d
e
All other expenses
25
Total functional expenses. Add lines 1 through 24e
530,
131.
522,105.
5,
811.
2,215.
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
,
I if following SOP 98-2 (ASC 958-720)
732010
11-28-17
Form 990 (2017)
10
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood
New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692 Page 'I 1
I Part X I Balance Sheet
Check if Schedule 0 contains a response or note to any line in this Part X
(A)
(B)
Beginning of year
End of year
1
Cash - non-interest-bearing
100,119.
1
90,188.
2
Savings and temporary cash investments
2
3
Pledges and grants receivable, net
100.
3
5,323.
4
Accounts receivable, net
4
5
Loans and other receivables from current and former
officers,
directors,
trustees, key employees, and highest compensated
employees.
Complete
Part II of Schedule L
5
6
Loans and other receivables from other disqualified
persons
(as defined under
section 4958(f)(1)), persons described in section
4958
(c)(3)(B),
and contributing
employers and sponsoring organizations of section
501
(c)(9)
voluntary
4u)
employees' beneficiary organizations (see instr)
Complete
Part II of Sch L
6
w
(-1
7
Notes and loans receivable, net
7
8
Inventories for sale or use
8
9
Prepaid expenses and deferred charges
9
10a
Land, buildings, and equipment: cost or other
basis. Complete Part VI of Schedule D
10a
b
Less: accumulated depreciation
10b
10c
11
Investments - publicly traded securities
11
12
Investments - other securities. See Part IV, line 11
12
13
Investments - program-related. See Part IV, line 11
13
14
Intangible assets
14
15
Other assets. See Part IV, line 11
250.
15
250.
16
Total assets. Add lines 1 through 15 (must equal
line 34)
100,469.
16
95,761.
17
Accounts payable and accrued expenses
8,525.
17
5,231.
18
Grants payable
18
19
Deferred revenue
71 ,910 .
19
31,053.
20
Tax-exempt bond liabilities
20
21
Escrow or custodial account liability. Complete Part IV of Schedule D
21
ci)a
22
Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
I:3
c
Complete Part II of Schedule L
22
7J
23
Secured mortgages and notes payable to unrelated third parties
23
24
Unsecured notes and loans 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 D
5,929.
25
2,147.
26
Total liabilities. Add lines 17 through 25
86,364.
26
38,431.
Organizations that follow SFAS 117 (ASC 958), check here Il■
X
and
2
complete lines 27 through 29, and lines 33 and 34.
ua
27
Unrestricted net assets
14,105.
27
57,330.
c
o
Tom
28
Temporarily restricted net assets
28
-a
29
Permanently restricted net assets
29
c
1.E
Organizations that do not follow SFAS 117 (ASC 958), check here Po-
t
and complete lines 30 through 34.
Le)
ri;
30
Capital stock or trust principal, or current funds
30
0co
31
Paid-in or capital surplus, or land, building, or equipment fund
31
ct
ii;
32
Retained earnings, endowment, accumulated income, or other funds
32
Z
33
Total net assets or fund balances
14,105.
33
57,330.
34
Total liabilities and net assets/fund balances
100,469.
34
95,761.
Form 990 (2017)
732011
11-28-17
11
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757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Planned Parenthood New Hampshire
Form 990 (2017)
Action Fund, Inc.
46-5554692 Page 12
I Part XI I Reconciliation of Net Assets
Check if Schedule 0 contains a response or note to any line in this Part XI
1
Total revenue (must equal Part VIII, column (A), line 12)
1
573,106.
2 Total expenses (must equal Part IX, column (A), line 25)
2
530,131.
3
Revenue less expenses. Subtract line 2 from line 1
3
42,9757
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
4
14,105.
5
Net unrealized gains (losses) on investments
5
6
Donated services and use of facilities
6
7
Investment expenses
7
8
Prior period adjustments
8
250.
9 Other changes in net assets or fund balances (explain in Schedule 0)
9
0.
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
10
57,330.
I Part XII I Financial Statements and Reporting
Check if Schedule 0 contains a response or note to any line in this Part XII
F-1
Yes
No
1
Accounting method used to prepare the Form 990:
0
Cash
I X I Accrual
I Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule 0.
2a Were the organization's financial statements compiled or reviewed by an independent accountant?
2a
X
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
Separate basis
Consolidated basis
0
Both consolidated and separate basis
b Were the organization's financial statements audited by an independent accountant?
2b X
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis, or both:
Separate basis
Lxi Consolidated basis
Ell Both consolidated and separate basis
c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant?
2c
X
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule 0.
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit
TT-
Act and OMB Circular A-133?
X
b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain wh in Schedule 0 and describe an ste•s taken to undergo such audits
3b
Form 990 2017)
732012
11-28-17
12
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
** PUBLIC DISCLOSURE COPY
**
Schedule B
Schedule of Contributors
OMB No. 1545-0047
(Form 990, 990-EZ,
Attach to Form 990, Form 990-EZ, or Form 990-PF.
or 990-PF)
Department of the Treasury
Bo. Go to www.irs.gov/Form990 for the latest information.
Internal Revenue Service
2017
Name of the organization
Employer identification number
Planned Parenthood New Hampshire
Action Fund, Inc.
46-5554692
Organization type(check one):
Filers of:
Section:
Form 990 or 990-EZ
lx1
501
(c)(
4 ) (enter number) organization
4947
(a)(1) nonexempt charitable trust not treated as a private foundation
527 political organization
Form 990-PF
501
(c)(3) exempt private foundation
4947
(a)(1) nonexempt charitable trust treated as a private foundation
501
(c)(3) taxable private foundation
Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
LXJ For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
Special Rules
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 113% support test of the regulations under
sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from
any one contributor, during the year, total contributions of the greater of (1) $5,000; or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h;
or (i) Form 990-EZ, line 1. Complete Parts I and li.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
Ci For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box
is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc.,
purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively
religious, charitable, etc., contributions totaling $5,000 or more during the year
$
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990-EZ, or 990-PF),
but it must answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to
certify that it doesn't meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA For Paperwork Reduction Act Notice, see the instructions for Form 990, 990-EZ, or 990-PF. Schedule B (Form 990, 990-EZ, or 990-PF) (2017)
723451
11-01-17
Schedule B (Form 990, 990-EZ, or 990-PF) (2017)
Page2
Name of organization
Employer identification number
Planned Parenthood New Hampshire
Action Fund, Inc.
46-5554692
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
1
Person
I X I
Payroll
$
64,750.
Noncash
I I
(Complete Part II for
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
2
Person
I X
Payroll
$
422,193.
Noncash
(Complete Part II for
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
I I
$
Noncash
I—I
(Complete Part II for
noncash contributions)
(a)
(b)
(0
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
El
$
Noncash
(Complete Part II for
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
I-1
$
Noncash
I I
(Complete Part II for
noncash contributions.)
(a)
(b)
(c)
(d)
No.
Name, address, and ZIP + 4
Total contributions
Type of contribution
Person
Payroll
$
Noncash ri
(Complete Part II for
noncash contributions.)
771459 i1_n1-17
Schedule B (Form 990. 990-EZ. or 990-PF1 (20171
14
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Schedule B (Form 990, 990-EZ, or 990-PF) (2017)
Page3
Name of organization
Employer identification number
Planned Parenthood New Hampshire
Action Fund, Inc.
46-5554692
Part It
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.
(b)
(c)
(d)
FMV (or estimate)
from
Description of noncash property given
Date received
(See instrtructions.)
Part I
$
(a)
No.
(b)
(c)
(d)
FMV (or estimate)
from
Description of noncash property given
Date received
Part I
(See instructions.)
$
(a)
(c)
No.
(I)
(d)
from
Description of noncash property given
FMV (or estimate)
Date received
(See instructions.)
Part I
(a)
(c)
No.
(b)
(di
from
Description of noncash property given
FMV (or estimate)
Date received
(See instructions.)
Part I
(a)
(c)
FMV (or estimate)
from
Description of noncash property given
Date received
Part I
(See instrtructions.)
(a)
No.
(b)
(c)
(d)
FMV (or estimate)
from
Description of noncash property given
Date received
(See insttrructions.)
Part I
723453
11-01-17
Schedule B (Form 990. 990-EZ. or 990-PFI (2017)
15
18450621
757052
07605.AF-10
2017.03050 Planned Parenthood New Hamp
07605_01
Schedule B (Form 990, 990-EZ, or 990-P F) (2017)
Page 4
Name of organization
Employer identification number
Planned Parenthood New Hampshire
Action Fund, Inc.
46-5554692
a
c usive y re igloos, c
e, e c., con r
ons
0 organiza ions escr
in sec Ion r c
, or
l
aro7 a1 -767
M
17$1711
M
or
the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations
completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this infa. once.)
10. $
Use duplicate copies of Part Ill if additional space is needed.
(a) No.
from
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
Relationship of transferor to transferee
(a) No.
from
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
Relationship of transferor to transferee
N
(a) o.
from
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
Relationship of transferor to transferee
(a) No.
from
(b) Purpose of gift
(c) Use of gift
(d) Description of how gift is held
Part I
(e) Transfer of gift
Transferee's name, address, and ZIP + 4
Relationship of transferor to transferee
723454
11-01-17
Schedule B (Form 990, 990-EZ, or 990-PF) (2017)
16
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2017.03050 Planned Parenthood New Hamp
07605_01
SCHEDULE C
Political Campaign and Lobbying Activities
OMB No. 1545-0047
(Form 990 or 990-EZ)
For Organizations Exempt From Income Tax Under section 501(c) and section 527
2017
Department of the Treasury
Complete if the organization is described below. II" Attach to Form 990 or Form 990-EZ.
Open to Public
Internal Revenue Service
PI- Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
If the organization answered "Yes," on Form 990, Part IV, line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
• Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part /-C.
• Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
• Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes," on Form 990, Part IV, line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
• Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
• Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes," on Form 990, Part IV, line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy
Tax) (see separate instructions), then
• Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of organization
Planned Parenthood New Hampshire
Employer identification number
Action Fund, Inc.
46-5554692
Part )-A
omplete if the organization is exempt under section 501 c or is a section 527 organization.
1 Provide a description of the organization's direct and indirect political campaign activities in Part IV.
2 Political campaign activity expenditures
► $
3 Volunteer hours for political campaign activities
I Part 1-6 I Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955
► $
2 Enter the amount of any excise tax incurred by organization managers under section 4955
► $
3 If the organization incurred a section 4955 tax, did it file Form 4720 for this year?
r_l Yes
L_J No
4a Was a correction made?
=
Yes
[
1 No
b If "Yes," describe in Part IV.
PartI-
omplete if the organization is exempt un a er section 501 c , except section 501 c
3
Enter the amount directly expended by the filing organization for section 527 exempt function activities
► $
0 .
2 Enter the amount of the filing organization's funds contributed to other organizations for section 527
exempt function activities
► $
0 .
3 Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL,
line 17b
110.: $
4 Did the filing organization file Form 1120-POL for this year?
Yes
No
5 Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing organization
made payments. For each organization listed, enter the amount paid from the filing organization's funds. Also enter the amount of political
contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a
political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name
(b) Address
(c) EIN
(d) Amount paid from
(e) Amount of political
filing organization's
contributions received and
funds. If none, enter -0-.
promptly and directly
delivered to a separate
political organization.
If none, enter -0-.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Schedule C (Form 990 or 990-EZ) 2017
LHA
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Planned Parenthood New Hampshire
Schedule C (Form 990 or 990-EZ) 2017 Action Fund, Inc.
46-5554692 Page 2
Part II-A I Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under
section 501(h)).
A Check 111" I
I if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, El N,
expenses, and share of excess lobbying expenditures).
B Check
► I
I if the filing organization checked box A and "limited control" provisions apply.
Limits on Lobbying Expenditures
(a) Filing
(b) Affiliated group
organization's
totals
(The term "expenditures" means amounts paid or incurred.)
totals
la
Total lobbying expenditures to influence public opinion (grass roots lobbying)
b
Total lobbying expenditures to influence a legislative body (direct lobbying)
c
Total lobbying expenditures (add lines la and 1b)
d
Other exempt purpose expenditures
e
Total exempt purpose expenditures (add lines 1c and 1d)
f
Lobbying nontaxable amount. Enter the amount from the following table in both columns
If the amount on line le, column (a) or (b) is:
The lobbying nontaxable amount is:
Not over $500,000
20% of the amount on line 1e.
Over $500,000 but not over $1,000,000
$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000
$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000
$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000
$1,000,000.
g
Grassroots nontaxable amount (enter 25% of line 1f)
h
Subtract line 1 g from line 1 a. If zero or less, enter -0-
i
Subtract line 1f from line 1 c. If zero or less, enter -0-
j
If there is an amount other than zero on either line 1 h or line 1i, did the organization file Form 4720
reporting section 4911 tax for this year?
Yes
I
No
4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five columns below.
See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year
(a) 2014
(b) 2015
(c) 2016
(d) 2017
(e) Total
(or fiscal year beginning in)
2a
Lobbying nontaxable amount
b
Lobbying ceiling amount
(150% of line 2a, column(e))
c
Total lobbying expenditures
d
Grassroots nontaxable amount
e
Grassroots ceiling amount
(150% of line 2d, column (e))
f
Grassroots lobbying expenditures
Schedule C (Form 990 or 990-EZ) 2017
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Planned Parenthood New Hampshire
Schedule C (Form 990 or 990-EZ) 2017 Action Fund , Inc .
46-5554692 Page 3
I Part 11431 Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768
(election under section 501(h)).
For each "Yes, " response on lines la through 1 i below, provide in Part lV a detailed description
(a)
(b)
of the lobbying activity.
Yes
No
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or
local legislation, including any attempt to influence public opinion on a legislative matter
or referendum, through the use of:
a Volunteers?
b Paid staff or management (include compensation in expenses reported on lines 1c through 1i)?
c Media advertisements?
d Mailings to members, legislators, or the public?
e Publications, or published or broadcast statements?
f Grants to other organizations for lobbying purposes?
g Direct contact with legislators, their staffs, government officials, or a legislative body?
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means?
i Other activities?
j Total. Add lines 1c through 1i
2a Did the activities in line 1 cause the organization to be not described in section 501(c)(3)?
b If "Yes," enter the amount of any tax incurred under section 4912
c If "Yes," enter the amount of any tax incurred by organization managers under section 4912
d If the filin or anization incurred a section 4912 tax, did it file Form 4720 for this ear?
Part III-A , Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section
501
(c)(6).
Yes
No
'I
Were substantially all (90% or more) dues received nondeductible by members?
1
X
2
Did the organization make only in-house lobbying expenditures of $2,000 or less?
2
3
Did the or anization a ree to car over lobb "n arid .olitical cam •ai.n activit expenditures from the rior ear?
3
Part Ill-B Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section
501
(c)(6) and if either (a) BOTH Part Ill-A, lines 1 and 2, are answered "No," OR (b) Part III-A,
line 3, is
answered "Yes."
1
Dues, assessments and similar amounts from members
2 Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a Current year
2a
b Carryover from last year
2b
c Total
2c
3 Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess
does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political
expenditure next year?
5 Taxable amount of lobbying and political expenditures (see instructions)
Part IV I
Supplemental Information
Provide the descriptions required for Part I-A, line 1; Part I-B, line 4; Part I-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see
instructions); and Part II-B, line 1. Also, complete this part for any additional information.
Schedule C (Form 990 or 990-EZ) 2017
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OMB No. 1545-0047
SCHEDULE D
Supplemental Financial Statements
(Form 990)
No- Complete if the organization answered "Yes" on Form 990,
I
2
01
7
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
Department of the Treasury
PI' Attach to Form 990.
Open to Public
Internal Revenue Service
1►Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
Name of the organization
Planned Parenthood New Hampshire
Employer identification number
Action Fund, Inc.
46-5554692
1157
at
—I
I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.comprete if the
organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds
(b) Funds and other accounts
1
Total number at end of year
2 Aggregate value of contributions to (during year)
3 Aggregate value of grants from (during year)
4 Aggregate value at end of year
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control?
Yes
I No
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only
for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring
im ermissible rivate benefit?
L
I
Yes
I No
[Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
I Preservation of a historically important land area
Protection of natural habitat
I Preservation of a certified historic structure
Preservation of open space
2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year.
Heldat theEndof the Tax Year
a Total number of conservation easements
2a
b Total acreage restricted by conservation easements
2b
c Number of conservation easements on a certified historic structure included in (a)
2c
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure
listed in the National Register
2d
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax
year►
4 Number of states where property subject to conservation easement is located IP-
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds?
I Yes
I No
6 Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
110.-
7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
$
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)()
and section 170(h)(4)(8)(i)?
Yes
No
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and
include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for
conservation easements.
I Part HI
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII,
the text of the footnote to its financial statements that describes these items.
b If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical
treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts
relating to these items:
(i) Revenue included on Form 990, Part VIII, line 1
► $
(ii) Assets included in Form 990, Part X
0► $
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide
the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a Revenue included on Form 990, Part VIII, line 1
$
b Assets included in Form 990, Part X
$
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Schedule 13 (Form 990) 2017
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Planned Parenthood New Hampshire
Schedule D
(Form 990) 2017
Action Fund, Inc.
46-5554692 Pae2
Par
I Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets(continued)
3
Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items
(check all that apply):
a
Public exhibition
d
I Loan or exchange programs
b
I Scholarly research
e
Other
c I
=
Preservation for future generations
4
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets
to be sold to raise funds rather than to be maintained as part of the organization's collection?
El Yes
1 Part IV J Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or
reported an amount on Form 990, Part X, line 21.
is Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X?
Yes
I No
b If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance
is
d Additions during the year
id
e Distributions during the year
le
f Ending balance
if
2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
U
Yes
LI No
b If "Yes" explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII
1 Part V
Endowment Funds. Complete
a Current ear
(b) Prior ear '
(c) Two years back
(d) Three years back
(e) Four years back
is
Beginning of year balance
b
Contributions
c
Net investment earnings, gains, and losses
d
Grants or scholarships
e
Other expenditures for facilities
and programs
f
Administrative expenses
g
End of year balance
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment 0
b
Permanent endowment
c
Temporarily restricted endowment IP-
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the organization'
by:
(i) unrelated organizations
(ii) related organizations
b
If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R?
4
Describe in Part XIII the intended uses of the or anization's endowment funds.
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property
(a) Cost or other
(b) Cost or other
(c) Accumulated
(d) Book value
basis (investment)
basis (other)
depreciation
la
Land
b
Buildings
c
Leasehold improvements
d
Equipment
e
Other
Total. Add lines la throu. h 1 e. Column (d must equal Form 990, Part X, column B line 10c.
0 .
Schedule D (Form 990) 2017
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2017.03050 Planned Parenthood New Hamp
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Planned Parenthood New Hampshire
Schedule D (Form 990) 2017
Action Fund, Inc.
46-5554692 Page 3
I Pad VII] Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category (including name of security)
(b) Book value
(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives
(2) Closely-held equity interests
(3) Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Col. (b) must equal Form 990, Part X, col. (B) line 12.)1►
Part VIII Investments - Program Related.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment
(b) Book value
(c) Method of valuation: Cost or end-of•year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Col. (b must equal Form 990, Part X, col. B line 13. II.
Part IX Other Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description
(b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 15.)
Part X I Other Liabilities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11 e or 11f. See Form 990, Part X, line 25.
1.
(a) Description of liability
(b) Book value
(1) Federal income taxes
(2) Due to Related Parties
2,147.
(3)
(4)
(5)
(6
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 25)
110-
2,147.
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the
organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XII! I
1
Schedule D (Form 990) 2017
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Planned Parenthood New Hampshire
Schedule D Form 990
2017
Action Fund, Inc.
46-5554692
Page 4
iPart XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
1
Total revenue, gains, and other support per audited financial statements
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments
2a
b Donated services and use of facilities
2b
c Recoveries of prior year grants
2c
d Other (Describe in Part XIII.)
2d
e Add lines 2a through 2d
2e
3 Subtract line 2e from line 1
3
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b
4a I
b Other (Describe in Part XIII.)
4b
c Add lines 4a and 4b
4c
5 Total revenue. Add lines 3 and 4c. (This must e ual Form 990, Part I, line 12.
5
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Complete if the organization answered "Yes" on Form 990, Part IV, line 12a.
1
Total expenses and losses per audited financial statements
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities
2a
b Prior year adjustments
2b
c Other losses
1
2c
d Other (Describe in Part XIII.)
2d
e Add lines 2a through 2d
2e
3
Subtract line 2e from line 1
3
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b
4a
b Other (Describe in Part XIII.)
4b
c Add lines 4a and 4b
4c
5 Total expenses. Add lines 3 and 4c
his must equal Form 990, Part I, line 18.L
5
Part XIII Supplemental Information.
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines la and 4; Part IV, lines 1 b and 2b; Part V, line 4; Part X, line 2; Part XI,
lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
732054
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Schedule D (Form 990) 2017
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2017.03050 Planned Parenthood New Hamp
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SCHEDULE J
Compensation Information
OMB No. 1545-0047
(Form 990)
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
2017
111.- Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Department of the Treasury
►Attach to Form 990.
Open to Public
Internal Revenue Service
II.. Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
Name of the organization
Planned Parenthood New Hampshire
Employer identification number
Action Fund, Inc.
46-5554692
1
11
1
Questions Regarding Compensation
Yes
No
1a
Check the appropriate box(es) if the organization provided any of the following to or for a person listed on Form 990,
Part VII, Section A, line 1 a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
1
Payments for business use of personal residence
Tax indemnification and gross-up payments
Health or social club dues or initiation fees
L
.] Discretionary spending account
Personal services (such as, maid, chauffeur, chef)
b
If any of the boxes on line la are checked, did the organization follow a written policy regarding payment or
reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
lb
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all directors,
trustees, and officers, including the CEO/Executive Director, regarding the items checked on line la?
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the organization's
CEO/Executive Director. Check all that apply. Do not check any boxes for methods used by a related organization to
establish compensation of the CEO/Executive Director, but explain in Part III.
1x1 Compensation committee
Ix!
Written employment contract
LA Independent compensation consultant
IX'
Compensation survey or study
Form 990 of other organizations
lx1
Approval by the board or compensation committee
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1 a, with respect to the filing
organization or a related organization:
a
Receive a severance payment or change-of-control payment?
a
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
4b
c
Participate in, or receive payment from, an equity-based compensation arrangement?
4c
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Fart Ill.
Only section 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1 a, did the organization pay or accrue any compensation
contingent on the revenues of:
a
The organization?
5a
b
Any related organization?
5b
If "Yes" on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1 a, did the organization pay or accrue any compensation
contingent on the net earnings of:
a
The organization?
6a
b
Any related organization?
6b
If "Yes" on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed payments
not described on lines 5 and 6? If "Yes," describe in Part III
8
Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject to the
initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe in Part III
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53.4958.6(c)?
9
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Schedule J (Form 990) 2017
732111
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24
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Planned Parenthood New Hampshire
Schedule J (Form 990) 2017
Action Fund, Inc.
46-5554692
Page 2
Part 11 Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the instructions, on row (ii).
Do not list any individuals that aren't listed on Form 990, Part VII.
Note: The sum of columns (B)(1)-(11i) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line la, applicable column (D) and (E) amounts for that individual.
(B) Breakdown of W-2 and/or 1099-MISC compensation
(C) Retirement and
in' Nontaxable
(E) Total of columns
(F) Compensation
other deferred
benefits
(B)(i)-(D)
in column (B)
(i) Base
(ii) Bonus &
(iii) Other
compensation
reported as deferred
(A) Name and Title
compensation
incentive
reportable
compensation
compensation
on prior Form 990
(1)
Meagan Gallagher
(I)
548.
O.
O.
O.
35.
583.
0.
CEO
(ii)
207,649.
5,875.
6,899.
4,300.
21,091.
245,814.
O.
(2)
Heather Bushey
(i)
0 .
0 .
0 .
0 .
0 .
0 .
0 .
CFO
00
130,997.
3,780.
6,037.
2,624.
8,395.
151,833.
O.
(i)
(ii)
(I)
(ii)
(i)
(ii)
(I)
(ii)
(I)
(ii)
(i)
(ii)
(i)
(ii)
(i)
(ii)
(I)
(ii)
(i)
(ii)
(I)
(ii)
(i)
(ii)
(I)
(ii)
(i)
(ii)
Schedule J (Form 990) 2017
732112
10-17-17
25
Planned Parenthood New Hampshire
Schedule J (Form 990) 2017
Action Fund, Inc.
46-5554692
Page 3
Part Ill I Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1 a, 1 b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Schedule J, Part II
Meagan Gallagher, CEO, Heather Bushey, CFO, and Jennifer Frizzel, VP of
Public Policy, are compensated by Planned Parenthood of Northern New
England, Inc., a related organization.
Schedule J (Form 990) 2017
732113
10-17-17
26
OMB No. 1545-0047
SCHEDULE 0
Supplemental Information to Form 990 or 990-EZ
(Form 990 or 990-EZ)
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
2017
Department of the Treasury
Po- Attach to Form 990 or 990-EZ.
Open to Public
Internal Revenue Service.
IIlo- Go to www.irs.qov/Form990 for the latest information.
Inspection
Name of the organization
Planned Parenthood New Hampshire
Employer identification number
Action Fund, Inc.
46-5554692
Form
990, Part III, Line
1, Description of Organization Mission:
to the exercise of reproductive choice.
Form
990, Part VI, Section A, line
2:
Lucy Karl, Esq., Board Treasurer and Benjamin Siracusa Hillman, Board
Trustee, have a business relationship.
Form
990, Part VI, Section A, line
6:
The Organization has two classes of members: Regular and Associate.
Form
990, Part VI, Section B, line lib:
The Form
990 is reviewed in detail by the Controller and Chief Financial
Officer prior to the return being filed. In addition, the Form
990 is
shared electronically through a secure portal with the Action Fund Board or
a copy is provided to the Action Fund Board for discussion, review, and
approval at a board meeting prior to the return being filed.
Form
990, Part VI, Section C, Line
19:
The Organization does not make its governing documents, conflict of
interest policy, or its financial statements available to the public.
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Schedule 0 (Form 990 or 990-EZ) (2017)
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OMB No. 1545-0047
SCHEDULE R
Related Organizations and Unrelated Partnerships
(Form 990)
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
2017
Po. Attach to Form 990.
Department of the Treasury
Open to Public
Internal Revenue Service
II. Go to www.irs.gov/Form990 for instructions and the latest information.
Inspection
Name of the organization
Planned Parenthood New Hampshire
Employer identification number
Action Fund, Inc.
46-5554692
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
(b)
(c)
(d)
(e)
(f)
Name, address, and EIN (if applicable)
Primary activity
Legal domicile (state or
Total income
End-of-year assets
Direct controlling
of disregarded entity
foreign country)
entity
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related tax-exempt
Part 11
organizations during the tax year.
(a)
(b)
(c)
(d)
(e)
(0
(9
Section 5
2
(bX13)
Name, address, and EIN
Primary activity
Legal domicile (state or
Exempt Code
Public charity
Direct controlling
controlled
of related organization
foreign country)
section
status (if section
entity
ent ty?
501
(c)(3))
Yes
No
Planned Parenthood Vermont Action Fund, Inc. Social welfare regarding
Planned
-
03-0326364
,
784 Hercules Drive
, Suite
110,
reproductive healthcare
Parenthood of
Colchester
, VT
05446
and education.
Vermont
501
(c)
(4)
Northern New
Planned Parenthood of Northern New England, Social welfare regarding
Inc.
-
03-0222941
,
784 Hercules Drive, Suite
reproductive healthcare
110, Colchester, VT
05446
and education.
Vermont
51
01(c)(3)
Line
7
N/A
Planned Parenthood New Hampshire Action Fund Social welfare regarding
Planned
PAC
-
84-1703533
784 Hercules Drive, Suite
reproductive healthcare
Parenthood of
110, Colchester, VT
05446
and education.
New Hampshire
527
Northern New
Planned Parenthood Maine Action Fund
, Inc.
- Social welfare regarding
Planned
46-5689688
,
784 Hercules Drive, Suite
110,
reproductive healthcare
Parenthood of
Colchester, VT
05446
and education.
Maine
501
(c)(4)
Northern New
X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Schedule R (Form 990) 2017
See Part VII for Continuations
732161
09-11-17
LHA
28
Planned Parenthood New Hampshire
Schedule R (Form 990)
Action Fund, Inc.
46-5554692
Part II Continuation of Identification of Related Tax-Exempt Organizations
(a)
(b)
(c)
(d)
(e)
(f)
(0)
Section 512(:113)
Name, address, and EIN
Primary activity
Legal domicile (state or
Exempt Code
Public charity
Direct controlling
controlled
of related organization
foreign country)
section
status (if section
entity
organization?
501
(c)(3))
Yes
No
Planned Parenthood Maine Action Fund PAC
-
Social welfare regarding
Planned
84-1703535
784 Hercules Drive
, Suite
110,
reproductive healthcare
Parenthood of
Colchester
VT
05446
and education,
aine
527
Northern New
X
Planned Parenthood Vermont Action Fund
Social welfare regarding
Planned
Independent Expenditure PAC
-
81-3700
,
784
reproductive healthcare
Parenthood of
Hercules Drive, Suite
110, Colchester
, VT
and education,
Jermont
527
Northern New
Planned Parenthood New Hampshire Votes
-
Social welfare regarding
Planned
81-3990297
784 Hercules Drive
, Suite
110,
reproductive healthcare
Parenthood of
Colchester
, VT
05446
and education,
Hew Hampshire
527
Northern New
732222
04-01-17
29
Planned Parenthood New Hampshire
Schedule R (Form 990) 2017
Action Fund, Inc.
46-5554692
Page 2
Part
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related
organizations treated as a partnership during the tax year.
(a)
(b)
(c)
(d)
(e)
(f)
(9)
(h)
(i)
(i)
(k)
Name, address, and EIN
Primary activity
domicile
Direct controlling
Predominant income
Share of total
Share of
Disproportionate
Code V-UBI
General or
Percentage
of related organization
(state or
entity
(related, unrelated,
income
end-of-year
amount in box
managing
ownership
foreign
excluded from tax under
assets
allocations?
20 of Schedule
partner?
country)
sections 512-514)
Yes No
K-1
(Form 1065)
YesNo
Part IV Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related
organizations treated as a corporation or trust during the tax year.
(a)
(b)
(c)
(d)
(e)
(f)
(9)
(h)
(i)
Section
Name, address, and EIN
Primary activity
Legal domicile
Direct controlling
Type of entity
Share of total
Share of
Percentage
512
(b)(13)
of related organization
(state or
entity
(C corp, S corp,
income
end-of-year
ownership
controlled
foreigncountry)
or trust)
assets
entity?
Yes No
732162
09-11-17
Schedule R (Form 990) 2017
Planned Parenthood New Hampshire
ScheduleR Form 990 2017
Action Fund, Inc.
46-5554692
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note: Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes No
1
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity
is
X
b
Gift, grant, or capital contribution to related organization(s)
lb
X
c
Gift, grant, or capital contribution from related organization(s)
lc
X
d
Loans or loan guarantees to or for related organization(s)
id
X
e
Loans or loan guarantees by related organization(s)
le
X
f
Dividends from related organization(s)
if
g
Sale of assets to related organization(s)
lg
h
Purchase of assets from related organization(s)
1h
i
Exchange of assets with related organization(s)
ii
j
Lease of facilities, equipment, or other assets to related organization(s)
lj
k
Lease of facilities, equipment, or other assets from related organization(s)
1k
I
Performance of services or membership or fundraising solicitations for related organization(s)
11
X
m Performance of services or membership or fundraising solicitations by related organization(s)
lm X
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
in
X
o
Sharing of paid employees with related organization(s)
lo
X
p
Reimbursement paid to related organization(s) for expenses
1p
X
q
Reimbursement paid by related organization(s) for expenses
lq
X
r
Other transfer of cash or property to related organization(s)
1r
X
s
Other transfer of cash or property from related organization(s)
is
X
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
(b)
(c)
(d)
Name of related organization
Transaction
Amount involved
Method of determining amount involved
type (a-s)
Planned Parenthood of Northern New England,
mine.
C
422,193.FMV
Planned Parenthood of Northern New England,
mine.
N
86,376.FMV
(3)
(4)
(5)
6
732163
09-11-17
31
Schedule R (Form 990) 2017
Planned Parenthood New Hampshire
Schedule R (Form 990) 2017
Action Fund, Inc.
46-5554692
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)
that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(I)
(j)
(k)
Name, address, and EIN
Primary activity
Legal domicile
Predominant income
partners
Are
all
sec.
Share of
Share of
Dispropor-
Code V-UBI
General or
Percentage
of entity
(state or foreign
e jiruellaetAounnirIlxatuedn,der
5001r(csy)
total
end-of-year
tionate
amount in box 20
managingpartner?
ownership
allocations?
of Schedule K-1
country)
income
assets
sections 512-514)
YesNo
YesNa
(Form 1065)
YesNo
Schedule R (Form 990) 2017
732164
32
Planned Parenthood New Hampshire
Schedule R (Form 990) 2017
Action Fund, Inc.
46-5554692 Pages
artVrri Supplemental Information.
Provide additional information for responses to questions on Schedule R. See instructions.
Part II, Identification of Related Tax-Exempt Organizations:
Name of Related Organization:
Planned Parenthood Vermont Action Fund, Inc.
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
Name of Related Organization:
Planned Parenthood New Hampshire Action Fund PAC
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
Name of Related Organization:
Planned Parenthood Maine Action Fund, Inc.
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
Name of Related Organization:
Planned Parenthood Maine Action Fund PAC
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
Name, Address, and EIN of Related Organization:
Planned Parenthood Vermont Action Fund Independent
Expenditure PAC
EIN:
81-3700425
784 Hercules Drive, Suite
110
Colchester, VT
05446
732165
06-11-17
Schedule R (Form 990) 2017
33
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Planned Parenthood New Hampshire
Schedule R Form 990) 2017
Action Fund, Inc.
46-5554692 Pages
1 Part VII 1 Supplemental Information.
Provide additional information for responses to questions on Schedule R. See instructions.
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
Name of Related Organization:
Planned Parenthood New Hampshire Votes
Direct Controlling Entity: Planned Parenthood of Northern New England,
Inc.
732165
09-11-17
Schedule R (Form 990) 2017
34
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2017.03050 Planned Parenthood New Hamp
07605_01
Form
8868
Application for Automatic Extension of Time To File a
(Rev. January 2017)
Exempt Organization Return
OMB No. 1545-1709
Department of the Treasury
File a separate application for each return.
Internal Revenue Service
Information about Form 8868 and its instructions is at www.irs.gov/form8868 .
Electronic filing (e-file). You can electronically file Form 8868 to request a 6-month automatic extension of time to file any of the
forms listed below with the exception of Form 8870, Information Return for Transfers Associated With Certain Personal Benefit
Contracts, for which an extension request must be sent to the IRS in paper format (see instructions). For more details on the electronic
filing of this form, visit www.irs.gov/efile, click on Charities & Non-Profits, and click on e-file for Charities and Non-Profits.
Automatic 6-Month Extension of Time. Only submit original (no copies needed).
All corporations required to file an income tax return other than Form 990-T (including 1120-C filers), partnerships, REMICs, and trusts
must use Form 7004 to request an extension of time to file income tax returns.
Enter filer's identifying number
Type or
Name of exempt organization or other filer, see instructions.
Employer identification number (EIN) or
print
Planned Parenthood New Hampshire
Action Fund, Inc.
46-5554692
File by the
due date for
Number, street, and room or suite no. If a P.O. box, see instructions.
Social security number (SSN)
filing your
784 Hercules Drive, Suite
110
return. See
instructions.
City, town or post office, state, and ZIP code. For a foreign address, see instructions.
Colchester, VT
05446
Enter the Return Code for the return that this application is for (file a separate application for each return)
Application
Return
Application
Return
Is For
Code
Is For
Code
Form 990 or Form 990-EZ
01
Form 990-T (corporation)
07
Form 990-BL
02
Form 1041-A
08
Form 4720 (individual)
03
Form 4720 (other than individual)
09
Form 990-PF
04
Form 5227
10
Form 990-T (sec. 401(a) or 408(a) trust)
05
Form 6069
11
Form 990-T (trust other than above)
06
Form 8870
12
Heather Bushey
CPA
• Thebooksareinthecareofill■
784 Hercules Drive, Suite
110
- Colchester, VT
05446
Telephone No.0-
8 0 2 - 4 4 8 - 9 7 2 8
Fax No. II.
* If the organization does not have an office or place of business in the United States, check this box
0*-
• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN)
. If this is for the whole group, check this
box 110. i
. If it is for part of the group, check this box
Ti and attach a list with the names and EINs of all members the extension is for.
1
I request an automatic 6-month extension of time until
November
15,
2018
, to file the exempt organization return
for the organization named above. The extension is for the organization's return for:
111*-1 X I calendar year 2 017 or
tax year beginning
, and ending
2
If the tax year entered in line 1 is for less than 12 months, check reason:
LI Initial return
LI Final return
C] Change in accounting period
3a If this application is for Forms 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any
nonrefundable credits. See instructions.
$
0.
b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and
estimated tax payments made. Include any prior year overpayment allowed as a credit.
3b
0.
c Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,
by using EFTPS (Electronic Federal Tax Payment System). See instructions.
3c
$
0.
Caution: If you are going to make an electronic funds withdrawal (direct debit) with this Form 8868, see Form 8453-EO and Form 8879-EO for payment
instructions.
LHA
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Form 8868 (Rev. 1-2017)
723841
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35
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2017.03050 Planned Parenthood New Hamp
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