990, Return of Organization Exempt From Income Tax

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GSVA

Form

990,

Return of Organization Exempt From Income Tax

Under section 501 (c), 527, or 4947( a)(1) of the Internal Revenue Code ( except private foundations)

Department of the Treasury

Internal Revenue Service

A For the 2013 calendar ear , or tax y ear be g innin g 07 / 01 / 13 and endin

C Name of organization

B Check if applicable

Address change

06 / 30 / 14

GRANVILLE STUDIO OF VISUAL ARTS

Name change

Doing Business As

^ Do not enter Social Security numbers on this form as it may be made public.

^ Information about Form 990 and its instructions is at www . irs. g ov/ form990.

Number and street (or P 0 box if mail is not delivered to street address ) Room/ suite

Initial return

Terminated

537 JONES ROAD

City or town, state or province, country, and ZIP or foreign postal code

2013

on to P ut IiQ

D Employer identification number

E

68-0668426

Telephone number

740-587-2371

Amended return

GRANV I LLE

F Name and address of principal officer

OH 4 3 0 2 3

❑ Application pending

ANNIE V CACCIATO

3691 GALE ROAD

GR.ANV I LLE

X 501 ( c )( 3 ) 501 c ( insert no

OH 4 3 0 2 3

4947 ( a )( 1 ) or Tax-exem p t status

J Website ^ N / A

K Form of organization

Van F

I5 1 Corporation

Summa

Trust

Association

Other ^

1 Briefly describe the organization ' s mission or most significant activities

See Schedule 0

U

-

M

F

527

G Gross recei pts $

H(a) Is this a group return for subordinates'?

❑ Yes No

H(b) Are all subordinates included'?

If "No,' attach a list (see instructions)

Yes

❑ No

H(c) Group exem p tion number ^

L Year of formation 2 0 0 8 M State of legal domicile OH

0

O d

2 Check this box ^ ❑ 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 1 a)

4 Number of independent voting members of the governing body (Part VI, line 1b)

5 Total number of individuals employed in calendar year 2013 (Part V, line 2a)

6 Total number of volunteers (estimate if necessary)

7a Total unrelated business revenue from Part VIII , column ( C), line 12 b Net unrelated business taxable income from Form 990-T, line 34

W

8 Contributions and grants (Part VIII, line 1 h)

9 Program service revenue (Part VIII, line 2g ) yin 10 Investment income (Part VIII, column ( A), lines 3 , 4, and 7d)

3

4

5

6

7a

7b

Prior Year

170,170

7 9 , 6 87

11 Other revenue (Part VIII, column ( A), lines 5 , 6d, 8c , 9c, 10c and 11 e )

2 3 , 5 8 2

2 7 3 , 4 3 9 12 Total revenue - add lines 8 throu g h 11 ( must a ual' Part ll, colurrin?^A , line 12 )

13 Grants and similar amounts paid ( Part IX = c6lumn('A)-; hnes-1 3 \0\

Z 14 Benefits paid to or for members ( Part IX, column(A)'-line 4) (1^N ^c.

15 Salaries , other compensation , employe a benefits( Dart I C umn. (•A), lines 5-10)

16a Professional fundraising fees (Part IX , column (Aj-line 1 e) b Total fundraising expenses (Part IX , column (D),,Ilne25 ) , ^

3 , 014

94 , 142

3 3 6 , 317

17 Other expenses (Part IX , column ( A), lines 11 a 1^Ld 1-24e)

18 Total expenses Add lines 13 - 17 (must equal Part'lX , column (A), line 25)

19 Revenue less ex p enses Subtract line 18 from line 12

20 Total assets ( Part X , line 16) y a21 Total liabilities ( Part X , line 26)

Z1-0

22 Net assets or fund balances Su tract line 21 from line

4 3 0 , 4 5 9

-157,020

Be g innin g of Current Year

181,467

3 , 3 0 2

178,165 1

6

6

4

0

278,411

0

0

Current Year

162,810

114 , 57 3

0

1 , 0 2 8

278,411

0

0

75,703

0

216,338

292,041

- 13, 630

End of Year

169,449

4, 914

164, 535

Under penalties of perj ury, I declare have exa^ined Isrn, cludi accompanying schedules and statements , and to the best of my knowledge and belief, it is

At true, correct, and complete Declar I gfi of prepare? of r th offiOr) all information of which preparer has any knowledge

Sign

Here

I

Signatur

^

J^NNIE V CAC ATOM

/

Type or print name and title

Print/Type preparers name Preparer' s signature

Paid

Preparer

Use Only

Raymond L.

Barber, CPA

Firm's name

^

Raymond L.

Bt

McLeish, Bowman, Barbe:

Firm's address

^

1000 N.

21st St.

Newark, OH 4 3 0 5 5

May the IRS discuss this return with the preparer shown above' (see instructio

For Paperwork Reduction Act Notice , see the separate instructions

DAA

Form99D(2013) GRANVILLE STUDIO OF VISUAL ARTS

Part HI Statement of Program Service Accomplishments

68-0668426

Check if Schedule 0 contains a response or note to any line in this Part III

1 Briefly describe the organization ' s mission

See Schedule 0

GSVA

Paget n

2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ?

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?

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

Yes 1X No

Yes XX No

4a (Code ) (Expenses $ 15 0 , 7 3 6 including grants of $ ) (Revenue $

Local Studio: Each Journey series is a theme-based approach to building creative capacities and knowledge about and through the arts in a studio environment.

The Journey program incorporates art history and art production in numerous mediums, while meeting national, state and collegeready standards.

An innovative care component to all GSVA Journey series is the curatorial practice piece in which students develop critical thinking and aesthetic discernment skills.

All Journey series culminate with the Journey Exhibition.

Each young artist collaborates with other artists in designing, installing, curating and hosting their exhibition of artwork for the community at large.

Journey classes are offered for all ages, from PreK teens (Credit Flex option for high school credit), and

4b (Code ) (Expenses $ 9 9 , 6 3 9 including grants of $ ) (Revenue $

GSVA's Blended-Learning Educational Partnerships: Our blended-learning partnership program extends to school and after-school leadership in numerous educational settings in Ohio and several other mid-western states.

Many educators understand the value of building creative capacities, critical thinking and self-esteem through art education, but have very limited or no staff or curriculum resources available to them.

We partner with educators to bring them high quality creative education curriculum and instruction to their students through technology using online access, quality video-based curriculum and instruction, art supply kits for every student and a strong curatorial component where students exhibit their work online and through a group exhibition in their community.

Our program,

4c (Code ) (Expenses $

5 , 110 including grants of $ ) (Revenue $

Community: GSVA participates in partnerships that benefit the Granville and central Ohio community at large throughout the year.

We intentionally reach out and partner with community partners working with at-risk youth and youth experiencing trauma in their lives.

We also participate and collaborate to many community beautification projects such as our outdoor mural series.

Lastly, all GSVA exhibitions are free and open to the public at the exhibition openings and during normal business hours.

4d Other program services (Describe in Schedule 0 )

(Expenses $ 0 including grants of $

4e Total program service expenses ^

255,485

DM

) (Revenue $

Form

990 (2013)

Form990'(2013) GRANVILLE STUDIO OF VISUAL ARTS

Part IV Checklist of Re quired Schedules

68-0668426

I Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," cornnlote Schedule A r -•-

2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)?

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

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

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 III

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 1

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

8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III

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

10 Did the organization, directly or through a related organization, hold assets in temporarily restricted

11 endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V

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 D, Part VI 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 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 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 e Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part 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

12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete

Schedule D, Parts XI and XII 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 XI and XII is optional

13 Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E

14a Did the organization maintain an office, employees, or agents outside of the United States?

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 I and IV

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 II and IV

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 III and IV

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 11e? If "Yes," complete Schedule G, Part I (see instructions)

18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on

Part VIII, lines 1c and 8a' If "Yes," complete Schedule G, Part II

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 III

20a Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H b If "Yes" to line 20a , did the org anization attach a co py of its audited financial statements to this return?

OAA

9

10

6

7

8

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Page3

Yes No

3

4

1

2

X

X

X

X

5 X

X

X

X

X

X

11a X

11b

11c

X

X

11d

11e

X

X

11f X

12a X

12b

13

14a

X

X

X

14b

15

16

'

X

X

X

17

18

X

X

19

20a

20b

X

X

Form 990 (2013)

Form990'(2013) GRANVILLE STUDIO OF VISUAL ARTS

Part IV Checklist of Required Schedules (continued)

68-0668426

21

22

23

24a

26

27

28

29

30

31

32

33

34

36

37

38 d

25a a b c b

35a b b c

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part

IY cohumn (A), line 1 7 If

"Yes," complete Schedule 1 Parts 1 and II

Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If "Yes," complete Schedule I, Parts I and III

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

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

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?

Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?

Did the organization act as an "on behalf of issuer for bonds outstanding at any time during the year?

Section 501 ( c)(3) and 501(c)(4) organizations . Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?

If "Yes," complete Schedule L, Part I

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 so, complete Schedule L, Part II

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 III

Was the organization a party to a business transaction with one of the following parties (see Schedule L,

Part IV instructions for applicable filing thresholds, conditions, and exceptions)

A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV

A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete

Schedule L, Part IV

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

Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M

Did the organization receive contributions of art, historical treasures, or other similar assets , or qualified conservation contributions? If "Yes," complete Schedule M

Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,

Part I

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II

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

Was the organization related to any tax-exempt or taxable entity? If "Yes," cI omplete Schedule R, Parts II, III, or IV, and Part V, line 1

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

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

Section 501 ( c)(3) organizations . Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R,

Part VI

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

DAA

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Page4

21

Yes No

X

22 X

23 X

X 24a

24b

24c

24d

25a

25b

26

27 X

28a

32

33

30

31

28b

28c

29

34

35a

35b

36 X

37 X

38 X

Form 990 (2013)

X

X

X

X

X

X

X

X

X

X

X

X

X

Form990 ( 2013 ) GRANVILLE STUDIO OF VISUAL ARTS

Part V

68-0668426

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule 0 contains a res p onse or note to an y line in this Part V is Enter the number repo a in Box 3 of Form 1096

Ent er -0- if not ap p licable b Enter the number of Forms W - 2G included in line 1 a Enter - 0- if not applicable c 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

I la I 1.1.

1 b 0

2a 4 b If at least one is reported on line 2a , did the organization file all required federal employment tax returns?

Note . If the sum of lines 1 a 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 ^

See instructions for filing requirements for Form TD F 90-22 1 , Report of Foreign Bank and Financial Accounts

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?

c If "Yes " to line 5a or 5b , did the organization file Form 8886-T7

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 payor?

b If "Yes ," did the organization notify the donor of the value of the goods or services provided?

c 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?

g If the organization received a contribution of qualified intellectual property , did the organization file Form 8899 as required?

In If the organization received a contribution of cars , boats , airplanes , or other vehicles , did the organization file a Form 1098-C7

8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations . Did the supporting organization , or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?

9 Sponsoring organizations maintaining donor advised funds.

a Did the organization make any taxable distributions under section 49667 b Did the 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 Vill , line 12

11 b Gross receipts , included on Form 990 , Part Vill, line 12, for public use of club facilities

Section 501(c )( 12) organizations. Enter a Gross income from members or shareholders b Gross income from other sources ( Do not net amounts due or paid to other sources against amounts due or received from them )

10a

10b

11a

11b

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 c Enter the amount of reserves on hand

14a Did the organization receive any payments for indoor tanning services during the tax year's b If "Yes , " has it filed a Form 720 to re p ort these p a y ments? If "No," p rovide an ex p lanation in Schedule 0

13b

13c

DAA

12a

13a

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Page 5

Yes No

14a

14b

X

Form 99 0 (2013)

1c

2b

3a

3b

4a

6a

6b

5a

5b

5c

7a

7b

7c

7e

7f

7

7h

8

9a

9b

X

X

X

X

X

X

X

GSVA

Form 990*(2013) GRANVILLE STUDIO OF VISUAL ARTS 68-0668426 Page 6

Part VI Governance, Management , and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 1 Ob 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

S_ w

^l:11U11 N .

Governin g

Bod y d and

M r^ n

Yes No

1a 6

1a 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 1 a, above, who are independent

2

3

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer , , or key employee?

Did the organization delegate control over management duties customarily performed by or under the direct

, or trustees, or key employees to a management company or other person?

lb 6

2

5

6

3

4

X

X

X

X

X

-

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

6 Did the organization have members or stockholders?

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?

8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following a The governing body?

b Each committee with authority to act on behalf of the governing body?

7a

7b

8a X

8b X

X

X

9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the org anization's mailin g address? If "Yes , " p rovide the names and addresses in Schedule 0

9

Section B . Policies (This Section B requests informat ion about policies not required by the Internal Revenue Code )

X

13

14

15

11a b

12a b c

10a b a b

16a b

Did the organization have local chapters, branches, or affiliates?

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?

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

Describe in Schedule 0 the process, if any, used by the organization to review this Form 990

Did the organization have a written conflict of interest policy? If "No," go to line 13

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule 0 how this was done

Did the organization have a written whistleblower policy?

Did the organization have a written document retention and destruction policy?

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization's CEO, Executive Director, or top management official

Other officers or key employees of the organization

If "Yes" to line 15a or 15b, describe the process in Schedule 0 (see instructions)

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?

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'

Section C. Disclosure

17 List the states with which a copy of this Form 990 is required to be filed ^

OH

10a

10b

Ila

12a X

12b X

12c X

13

14

15a

15b

16a I

X

X

X

X

X

X

I X

18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501 (c)(3)s only) available for public inspection Indicate how you made these available Check all that apply

1-1 Own website n Another's website

19 Upon request 11

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, physical address, and telephone number of the person who possesses the books and records of the organization ^ ANNIE V CACCIATO 537 JONES RD

GRANVILLE OH 43023 740-587-2371

Form 990 (2013)

DAA

GSVA

Form 990' ( 2013) GRANVILLE STUDIO OF VISUAL ARTS

Part V11

68-0668426 Page 7

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 th is Part VII

Section A.

Officers , Directors , Trustees , Key Employees and Highest Compensated Employees

1a Complete this table for all persons required to be listed Report compensation for the calendar year ending with or within the organization ' s tax year

• 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 reportable compensation ( Box 5 of Form W-2 and / or Box 7 of Form 1099-MISC) of more than $ 100,000 from the organization and any related organizations

• 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

X Check this box if neither the organization nor any related organizations compensated any current officer, director, or trustee

(A)

Name and Title

(B)

Average hours per week

(list any hours for related organizations below dotted line)

(C)

Position

(do not check more than one box , unless person is both an officer and a directorltrustee) o a

,g _ "I

° m o d l 2

Cs

CD

8

2 m

3

0 m a

(D)

Reportable compensation from the organiza t ion

(W-211099-MISC)

(E)

Reportable compensation from related organizations

( )

(F)

Estimated amount of other compensation f rom th e organization and related organizations

(1)ANNIE V CACCIAT

CO-PRESIDENT & TREA.

(2)KERRY DIXON

0.00

0.00

X X 0 0 0

CO-PRESIDENT & SEC.

(3) ROBERT ABBOTT

0.00

0.00

X X 0 0 0

DIRECTOR

(4)SETH CHIN-PARKER

0.00

0.00

X 0 0 0

DIRECTOR

(5)PAUL HAMILTON

0.00

0.00

X 0 0 0

DIRECTOR

(6)LESLEE K HERRO

0.00

0.00

X 0 0 0

DIRECTOR

(7)WILLIAM T MCCO

DIRECTOR

(8) RYAN MILLS

0.00

0.00

ELL

0.00

0.00

X

X

0

0

0

0

0

0

DIRECTOR

(9) ELI SA WOLFE

0.00

0.00

X 0 0 0

DIRECTOR

(10)

0.00

0.00

X 0 0 0

(11)

AAA Form 9 90 (2013)

(13)

(14)

(15)

Form 990(2013) .GRANVILLE

STUDIO OF VISUAL ARTS

Part Vtj

68-0668426

Section A. Officers, Directors , Trustees, Key Employees , and Highest Compensated Employees (continued)

(A)

Name and title

(B)

Average hours per week

(list any nours for related organizations below dotted line)

(C)

Position

(do not check more than one box, unless person is both an officer and a director/trustee)

Q _ s

`.

c o m l 2 °-

0

2

-

;K

DO is o)j v o

T

R is 0

N y

N

(D)

Reportable compensation from the

(W-2/1099-MISC)

(E)

Reportable compensation from related organizations

(iAr-2il099 nnI5 •

(12)

(F)

Estimated amount of other compensation from fhe organization and related organizations

GSVA

Pag_e8

(1g)

(17)

(1$)

(19)

1 b Sub-total c Total from continuation sheets to Part VII, Section A

^

^ d Total add lines 1b and 1c ^

2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organization ^ 0

1

3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual

4 For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,0007 If "Yes," complete Schedule J for such individual

5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person

B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization Report compensation for the calendar year ending with or within the organization's tax year

A

Name and business address

(B)

Descri p tion of services

3

4

5

C

Com p ensation

X

X

X

2 Total number of independent contractors (including but not limited to those listed above) who received more than $100 , 000 of com p ensation from the org anization

DAA

0

Form 990 (2013)

GSVA

Page 9

Form 990'(2013) GRANVILLE STUDIO OF VISUAL ARTS 68-0668426

Part VIII Statement of Revenue

Check If Schedule 0 contains a response or note to any line in this Part VIII

(A)

Total revenue

(B)

Related or

AYamnt function revenue

1a Federated campaigns 1a cc o b Membership dues 1 b

1c c Fundraising events

`m d Related organizations 1d ui E e Government grants (contributions) co f All other contributions, gifts, grants, and similar amounts not included above y g Noncash contributions included in lines 1a-1f r_-0 rcc In Total. Add lines 1a-1f

V

1 e if

$

E o

162,810

^

Busn Code

2a LICENSE FEES b

C d

JOURNEY

MEDIA STUDIO CLASS

WORKSHOPS e f All other program service revenue

Total. Add lines 2a-2f

3 Investment income (including dividends, interest,

^ and other similar amounts) ^

4 Income from investment of tax-exempt bond proceeds ^

5 Royalties ^

(i) Real (u) Personal r

0

6a Gross rents b Less rental exps

C Rental inc or (loss) d Net rental inco me or ( loss )

7a Gross amount from

(i) Securities sales of assets other than inventory b Less cost or other basis & sales exps c Gain or (loss) d Net gain or (lo ss)

8a Gross income from fundralsing events of contributions reported on line 1c)

See Part IV, line 18 a b Less direct expenses b c Net income or (loss) from fundraisin events

9a Gross income from gaming activities

See Part IV, line 19 a b Less direct expenses b c Net income or (loss) from gaming activities

10a Gross sales of inventory, less b

(not including $ returns and allowances

Less cost of goods sold a b c Net income or ( loss ) from sales of invento ry

Miscellaneous Revenue

(ii) Other

^

^

^

^

11111.

Busn Code

11a RENTAL b MISC REVENUE

C d All other revenue e Total. Add lines 11a-11d

12 Total revenue. See instructions

^

^

162 , 810

52,477

28,273

24,696

9, 12 7

114 , 573

920

108

1, 028

278,411

52,477

28,273

24,696

9, 12 7

920

108

115,601 1

DAA

(C)

Unrelated h, y„ess revenue

0

(D)

Revenue excluded from tax under sections

512-514

0

Form 990 (2013)

Form990'(2013) GRANVILLE STUDIO OF VISUAL ARTS

Part IX Statement of Functional Expenses

68-0668426

Section 501(c)(3) and 501(c)(4) organizations must complete all columns All other organizations must complete column (A)

(hank if Schedule 0 contains a resoonse or note to any line in this Part IX

Do not include arriouritS reported on lines 6b,

(c)

Management ano general expenses

7b, 8b , 9b, and 10b of Part VIII .

(A)

Total expenses

(B)

Program service expenses

1 Grants and other assistance to governments and organizations in the U S See Part IV, line 21

2 Grants and other assistance to individuals in the U S See Part IV, line 22

3 Grants and other assistance to governments, organizations , and individuals outside the

U S See Part IV , lines 15 and 16

4 Benefits paid to or for members

5 Compensation of current officers, directors, trustees , and key employees

6 Compensation not included above, to disqualified persons ( as defined under section 4958 ( f)(1)) and persons described in section 4958 ( c)(3)(B)

7 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 b Legal c Accounting d Lobbying e Professional fundraising services See Part IV, line 17 f Investment management fees

68,999

6,704

46,229

4,492

22,080

2,145 g Other ( If line 11g amount exceeds 10 % of line 25 , column

(A) amount , list line 11g expenses on Schedule 0)

12 Advertising and promotion

13 Office expenses

14 Information technology

15 Royalties

16 Occupancy

17 Travel

18 Payments of travel or entertainment expenses

, or local public officials

19 Conferences , conventions , and meetings

20 Interest

21 Payments to affiliates

22 Depreciation , depletion , and amortization

23 Insurance

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

(A) amount , list line 24e expenses on Schedule 0

ART MATERIALS b MISC EXP c REFUND d FEES & LICENSES

97 , 246

6, 046

7,717

28,787

18,599

5,246

1, 013

10,302

3,702

96 , 274

5, 9 8 6

5,865

25, 045

16,739

3,463

800

9, 580

3,332

31,844

4,070

1,608

125

33

255,485

1,466

3,742

1,860

944

213

722

370

33 , 542 e All other expenses

25 Total functional ex p enses . Add lines 1 throu g h tae

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 ^ F] if following SOP 98-2 ( ASC 958-720 )

DAA

31,844

4,070

1,608

125

33

292,041

GSVA

Page 10

(D)

Fu iuraisiri9 expenses

IRI

690

67

972

60

386

839

3,014

Form 990 (2013)

Form990(2013)

Part X

GR.ANVILLE

STUDIO OF VISUAL ARTS

Balance Sheet r'h ,-t, if Crhnl1ni ( l rnntninc 9 rce nnnee or nnto to nnv hna in this Part X

68-0668426 a

1 Cash-non-interest bearing

2 Savings and temporary cash investments

3

Pledges and grants receivable , net

4 Accounts receivable , net

5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees

Complete Part II of Schedule L

6 Loans and other receivables from other disqualified persons (as defined under section

4958(0(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L

7 Notes and loans receivable , net

8 Inventories for sale or use

9 Prepaid expenses and deferred charges

10a Land, buildings, and equipment cost or other basis Complete Part VI of Schedule D b Less accumulated depreciation

11 Investments-publicly traded securities

12 Investments-other securities See Part IV , line 11

13 Investments-program-related See Part IV , line 11

14 Intangible assets

15 Other assets See Part IV , line 11

16 Total assets. Add lines 1 throu g h 15 ( must e q ual line 34 )

17 Accounts payable and accrued expenses

10a

10b

2 0 5 , 4 9 0

59,855

18 Grants payable

19 Deferred revenue

20 Tax-exempt bond liabilities

21 Escrow or custodial account liability Complete Part IV of Schedule D u) 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and

M disqualified persons Complete Part II of Schedule L

23 Secured mortgages and notes payable to unrelated third parties

24 Unsecured notes and loans payable to unrelated third parties

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

26 Total liabilities. Add lines 17 throu g h 25

Organizations that follow SFAS 117 (ASC 958), check here ^ and av'i complete lines 27 through 29, and lines 33 and 34.

27 Unrestricted net assets

C1

'03 28 Temporarily restricted net assets

29 Permanently restricted net assets

ILL o

Organizations that do not follow SFAS 117 (ASC 958), check here ^

N

Q

Z complete lines 30 through 34.

30 Capital stock or trust principal , or current funds

31 Paid-in or capital surplus , or land, building, or equipment fund

32 Retained earnings , endowment , accumulated income, or other funds

33 Total net assets or fund balances

34 Total liabilities and net assets/fund balances

_ and

(A)

Beginning of year

25,465 1

2

3

4

5

155,937 1 oc

11

12

13

14

65 15

181,467 16

3 , 3 0 2 17

18

19

20

21

30

31

32

178,165

181

33

,467 34

6

7

8

9

22

23

24

25

3 , 3 0 2 26

178,165 27

28

29

GSVA

Page 11 n

(B)

End of year

20,024

3,725

145,635

65

169,449

4 , 914

4 , 914

164,535

164,535

169,449

Form 99 0 (2013)

DAA

Form990(2013) GRANVILLE STUDIO OF VISUAL ARTS

Part X1 Reconciliation of Net Assets

68-0668426

Check If Schedule 0 contains a res p onse or note to an y line in this Part XI

1 Total revenue (must equal Part VIII, column (A), line 12)

2 Total expenses (must equal Part IX, column (A), lino 25)

3 Revenue less expenses Subtract line 2 from line 1

4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))

5 Net unrealized gains (losses) on investments

6 Donated services and use of facilities

7 Investment expenses

8 Prior period adjustments

9 Other changes in net assets or fund balances (explain in Schedule 0)

10 Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line

33, column ( B ))

Part XII Financial Statements and Reporting

Check If Schedule 0 contains a res p onse or note to an y line in this Part XII

1 Accounting method used to prepare the Form 990 ❑ Cash

IX

Accrual ❑ 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?

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

11

Both consolidated and separate basis b Were the organization's financial statements audited by an independent accountant?

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

❑ Consolidated basis ❑ 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?

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 Act and OMB Circular A-1337 b If "Yes," did the organization undergo the required audit or audits' If the organization did not undergo the required audit or audits. explain why in Schedule 0 and describe any steps taken to underqo such audits

5

6

7

8

9

3

4

2

1

10

GSVA

Page 12

278,411

292,041

- 13 , 6 3 0

178,165

164 , 53 5

Yes No

2a X

2b X

2c

3a

3b

Form 990 (2013)

DAA

(B)

(C)

(D)

(E)

SCHEDULE A

(Form 990 or 990-EZ)

Public Charity Status and Public Support

Complete if the organization is a section 501 (c)(3) organization or a section

OMB No 1545-0047

2013

4947( a)(1) nonexempt charitable trust.

Department of the Treasury

R-er,ue Ser.,ea ahntit

^ Attach to Form 990 or Form 990-EZ .

A (Form 990 or 990-EZ) and its instructio ns is at www.irs

Open to Public,

Part I

Employer identification number

Name of the organization

GRANVILLE STUDIO OF VISUAL ARTS 68-0668426

Reason for Public Charity Status (All organizations must complete this part) See instructions

The organization is not a private foundation because it is (For lines 1 through 11, check only one box )

1 H A church , convention of churches , or association of churches described in section 170 ( b)(1)(A)(i).

2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E )

3 F] A hospital or a cooperative hospital service organization described in section 170 ( b)(1)(A)(iii).

4

1-1 A medical research organization operated in conj unction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state

5 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b )( 1)(A)(iv). (Complete Part II )

6

7

8

9

A federal , state, or local government or governmental unit described in section 170 ( b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b )( 1)(A)(vi). (Complete Part II )

F]

170(b)(1)(A)(vi ). (Complete Part II )

1-1 A community trust described in section

An organization that normally receives ( 1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions-subject to certain exceptions , and (2 ) no more than 33 1/3% of its

10

11 f e support from gross investment income and unrelated business taxable income ( less section 511 tax ) from businesses acquired by the organization after June 30, 1975 See section 509(a)(2). (Complete Part III )

An organization organized and operated exclusively to test for public safety See section 509 ( a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a )( 1) or section 509(a)(2) See section

509(a )( 3). Check the box that describes the type of supporting organization and complete lines 11 a through 11 h a

F1 Type I b Type II c

1-1 Type III-Functionally integrated d [] Type III -Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)

If the organization received a written determination from the IRS that it is a Type I, Type 11, or Type III supporting organization, check this box g h

Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons

(i) A person who directly or indirectly controls , either alone or together with persons described in (it) and

(iii) below , the governing body of the supported organization?

(ii) A family member of a person described in (I) above?

(iii) A 35% controlled entity of a person described in (i) or (u ) above?

Provide the followina information about the suooorted oraanlzatfon(s)

(i) Name of supported organization

(n) EIN (ui) Type of organization

(described on lines 1-9 above or IRC section

(soe instructions ))

(iv) Is the organization in cot (I) listed in your governing document's

(v) Did you notify the organization in col (I) of your support?

Yes No Yes No

(vi) Is the organization in cot

(1) organized in the

US?

Yes No

11

11 ^t

Yes No

(vu) Amount of monetary support

(A)

GSVA

Total

For Paperwork Reduction Act Notice, see the Instructions for

Form 990 or 990-EZ.

DAA

Schedule A (Form 990 or 990-EZ) 2013

GSVA

Schedule A (Form 990 or 990-EZ) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part 11

68-0668426

Support Schedule for Organizations Described in Sections 170(b )( 1)(A)(iv) and 170 (b)(1)(A)(vi)

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under

Part III If the organization fails to qualify under the tests listed below, please complete Part III )

A Pnhlir Siinnnrt

(e) 2013

Page 2

(f) Total

Calendar year (or fiscal year beginning in) ^ (a) 2009 (b) 2010 (c) 2011 (d) 2012

1 Gifts, grants, contributions, and membership fees received (Do not include any "unusual grants ")

2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf

176,387 243,803 326,443

170,170 162,810 1, 079, 613

3 The value of services or facilities furnished by a governmental unit to the organization without charge

4 Total. Add lines 1 through 3

5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)

6 Public support. Subtract line 5 from line 4

Section B . Total Su pp ort

Calendar year ( or fiscal year beginning in ) ^

7

8

Amounts from line 4

Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources

176,387

(a) 2009

176,387

243,803

(b) 2010

243,803

326,443

(c) 2011

326,443

170,170

(d) 2012

170,170

(e) 2013 (f) Total

162,810 _1,079,61

9 Net income from unrelated business activities, whether or not the business is regularly carried on

10

11

Other income Do not include gain or loss from the sale of capital assets

(Explain in Part IV )

Total support. Add lines 7 through 10

12

13

Gross receipts from related activities, etc (see instructions)

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here

Section C. Computation of Public Support Percentage

14 Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))

15 Public support percentage from 2012 Schedule A, Part II, line 14

16a 33 1/3% support test-2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization b 33 1/3% support test-2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization

17a 10%-facts-and-circumstances test-2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is

10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in

Part IV how the organization meets the "facts-and-circumstances" test The organization qualifies as a publicly supported organization b 10%-facts-and-circumstances test-2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line

15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.

Explain in Part IV how the organization meets the "facts-and-circumstances" test The organization qualifies as a publicly supported organization

18 Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions

162,810

12

14

15

1,079,613

1,079,613

,079,613

115, 601

^

100.00%

100.00%

^

^ ❑

^ ❑

^ ❑

^

Schedule A (Form 990 or 990-EZ) 2013

DAA

GSVA

Schedule A (Form 990 or 990-EZ) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part III Support Schedule for Organizations Described in Section 509(a)(2)

68-0668426

(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II.

If the organization fails to qualify under the tests listed below, please complete Part II )

Section A. Public Sup p ort

Calendar year (or fiscal year beginning in) ^ (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013

Page 3

(f) Total

1 Gifts, grants, contributions, and membership fees received (Do not include any "unusual g rants ")

2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the

3 Gross receipts from activities that are not an unrelated trade or business under section 513

4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf

5 The value of services or facilities furnished by a governmental unit to the organization without charge

6 Total. Add lines 1 through 5

7a Amounts included on lines 1, 2, and 3 received from disqualified persons

8 b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1 % of the amount on line 13 for the year c Add lines 7a and 7b

Public support (Subtract line 7c from line 6 )

Section B. Total Sun ort

Calendar year ( or fiscal year beginning in) ^

9 Amounts from line 6

10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources b Unrelated business taxable income (less section 511 taxes ) from businesses acquired after June 30, 1975

(a) 2009 (b) 2010 ( c) 2011 (d ) 2012 (e) 2013 (f) Total c Add lines 1 Oa and 1Ob

11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on

12 Other income Do not include gain or loss from the sale of capital assets

(Explain in Part IV )

13 Total support. (Add lines 9, 1Oc, 11, and 12 )

14 First five years . If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization, check this box and stop here

Section C. Computation of Public Support Percentage

^ ❑

15 Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))

16 Public support percentage from 2012 Schedule A , Part III line 15

Section D. Com p utation of Investment Income Percenta g e

15

16

%

%

17 Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))

18 Investment income percentage from 2012 Schedule A, Part III, line 17

19a 33 1/3% support tests-2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line

17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization

17

18

^

%

%

❑ b 33 1/3% support tests-2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization

^ ❑

20 Private foundation. If the organization did not check a box on line 14, 19a, o r 1 9 b, check this box and see instructions ^

Schedule A (Form 990 or 990 -EZ) 2013

DAA

GSVA

Schedule A (Form 990 or 990-EZ) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part IV

68-0668426

Supplemental Information . Provide the explanations required by Part II, line 10, Part II, line 17a or 17b, and

Part III, line 12 Also complete this part for any additional information (See Instructions)

Page 4

DAA

Schedule A (Form 990 or 990 -EZ) 2013

Supplemental Financial Statements

^ Complete if the organization answered "Yes," to Form 990,

Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.

^ Attach to Form 990.

Information about Schedule D (Form 990) and its instructions is at www.irs.

OMB No 1545-0047

2013

Open to Public

I Employer identification number

GSVA

SCHECIULE D

(Form 990)

Department of the Treasury

Internal Revenue Service

Name of the organizauun

GRANVILLE STUDIO OF VISUAL ARTS

Part I

168-0668426

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.

Complete if the organization answered "Yes" to Form 990, Part IV, line 6

(a) Donor advised funds (b) Funds and other accounts

1 Total number at end of year

2 Aggregate contributions to (during year)

3 Aggregate 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 controls

6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used a Total number of conservation easements 2a b Total acreage restricted by conservation easements c Number of conservation easements on a certified historic structure included in (a) d Number of conservation easements included in ( c) acquired after 8 / 17/06, and not on a historic structure listed in the National Register

2b

2c

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 ^

5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds?

6 Staff and volunteer hours devoted to monitoring , inspecting , and enforcing conservation easements during the year

10.

7 Amount of expenses incurred in monitoring , inspecting , and enforcing conservation easements during the year

❑ Yes ❑ No only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit?

Part II Conservation Easements.

Complete if the organization answered "Yes" to Form 990, Part IV, line 7

❑ Yes ❑ No

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)

Protection of natural habitat

❑ Preservation of an historically important land area

❑ 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 Held at the End of the Tax Year

Yes ❑ No

8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)

(i) and section 170(h)(4)(B)(li)'

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

Part Ili Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.

Complete if the organization answered "Yes" to Form 990, Part IV, line 8

❑ Yes ❑ No la 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) Revenues Included in Form 990, Part VIII, line 1 ^ $

(ii) Assets included in Form 990, Part X

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 Revenues Included in Form 990, Part VIII, line 1 b Assets Included in Form 990 , Part X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

DAA

^ $

^ $

Schedule D (Form 990) 2013

GSVA

ScheduleD(Form990)2013 GR.ANVILLE

STUDIO OF VISUAL ARTS

Part III

68-0668426

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Page2

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 fl Public exhtb tton b Scholarly research c Preservation for future generations d e

Loan or Pxchanoe programs

Other

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?

Part IV Escrow and Custodial Arrangements.

❑ Yes ❑ No

Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or reported an amount on Form

990, Part X, line 21

1a Is the organization an agent , trustee , custodian or other intermediary for contributions or other assets not included on Form 990, Part X" b If "Yes," explain the arrangement in Part XIII and complete the following table

❑ Yes ❑ No

Amount c Beginning balance d Additions during the year e Distributions during the year f Ending balance

2a Did the organization include an amount on Form 990, Part X, line 21" b If "Yes," explain the arrangement in Part XIII Check here if the explanation has b een provided in Part XIII

Part V Endowment Funds.

Com p lete if the org anization answered "Yes" to Form 990 Part IV. line 10

(a) Current year (b) Prior year (c) Two years back (d) Three years back

Yes I I No

(c) Four years back la 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 1 g, column ( a)) held as a Board designated or quasi-endowment ^ % b Permanent endowment ^ c Temporarily restricted endowment ^

%

%

The percentages in 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 " to 3a(II), are the related organizations listed as required on Schedule R7 p3a

4 Describe in Part Xiii the intended uses of the organization ' s endowment funds

Part VI Land , Buildings , and Equipment.

Comnlete if the nraanizatlnn answered "Yes" to Form 990. Part IV . line 11a See Form 990. Part X. line 10

Yes No

Description of property (a) Cost or other basis

(investment)

(b) Cost or other basis

(other)

(c) Accumulated depreciation

(d) Book value

1a Land b Buildings c Leasehold improvements d Equipment e Other

158,808

38,357

8, 325

Total. Add lines 1 a through 1 e (Column (d) must equal Form 990, Part X, column (B), line 10(c))

33,874

21,325

4,656

^

124,934

17,032

3,669

145,635

Schedule D (Form 990) 2013

DAA

GSVA

Schedule D (Form 990) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part VI!

68-0668426

Investments - Other Securities.

Com p lete if the org anization answered "Yes" to Form 990, Part IV, line 11 b See Form 990, Part X, line 12

( c) Method of valuation

(a) Description of security or category (b) Book value

Cost or end-of-year market value

(includinq name of security)

(1) Financial derivatives

(2) Closely- held equity interests

(3) Other

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

Total . ( Column ( b ) must e q ual Form 990 , Part X , col ( 13 ) line 12 ^

Part VIII Investments -Program Related.

r`nmr i s if thin nrmmni7mfinn sncwsrar1 "Yac" to Fnrm qqD Part IV Imp 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

Page 3

(5)

(6)

(7 )

(8 )

(1)

(2)

(3)

(4)

( 9)

Total . ( Column ( b) must equal Form 990 , Part X , col (B) line 13) ^

Part IX Other Assets.

r'nn,nlctc if thin nrnnni7attnn nncwfv srari "Y-z" to Fnrm qqC) Part IV lint 11d See Form 990. Part X. line 15

( b) Book value

(a) Description

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

Total. (Column (b) must equal Form 990, Part X, col (B) line 15 )

Part X Other Liabilities.

^

Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f See Form 990, Part X, line 25

(b) Book value

1.

(a) Description of liability I

Federal income taxes

Total . (Column ( b) must equal Form 990 , Part X , col (B ) line 25) ^

1 I

2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization ' s financial statements that reports the

Check here if the text of the footnote has been provided in Part XIII organization ' s liability for uncertain tax positions under FIN 48 (ASC 740)

DAA

I

Schedule D (Form 990) 2013

Schedule D (Form 990) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part XI

68-0668426

Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.

Com p lete if the or anlzation answered "Yes" to Form 990, Part IV, line 12a

1 Total revenue, gains, and other support per audited financial statements 1

2 Arnounts included on line 1 but not on Form 990, Part VIII line 12 a Net unrealized gains on investments b Donated services and use of facilities

2a

2b c Recoveries of prior year grants d Other (Describe in Part Xlll) e Add lines 2a through 2d

3 Subtract line 2e from line 1

2c

2d

2e

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 b Prior year adjustments

4a a b Other (Describe in Part XIII)

Donated services and use of facilities

4b c Add lines 4a and 4b

5 Total revenue Add lines 3 and 4c. (This must equal Form 990, Part I, line 12)

2

5 c

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.

Com p lete if the org anization answered "Yes" to Form 990, Part IV, line 12a

1 Total expenses and losses per audited financial statements

Amounts included on line 1 but not on Form 990, Part IX, line 25

2a

2b c Otherlosses 2c d Other (Describe in Part XIII) e Add lines 2a through 2d

3 Subtract line 2e from line 1

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

2d

4a

2e

3 b Other (Describe in Part XIII) 4b c Add lines 4a and 4b

5 Total expenses Add lines 3 and 4c. (This must equal Form 990, Part I, line 18) 5 c

Part XItt Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9 , Part III, lines la and 4 , Part IV , lines lb 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

GSVA

Page 4

DAA Schedule D (Form 990) 2013

Schedule' D (Form 990) 2013 GRANVILLE STUDIO OF VISUAL ARTS

Part XIII Supplemental Information (continued)

68-0668426

GSVA

Page 5

DAA

Schedule D (Form 990) 2013

GSVA

SCHEDULE O 1

(Form 990 or 990-EZ) I

Department of the Treasury

Internal Revenue Service

Name of the organization

Supplemental Information to 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.

OMB No 1545-0047

2013

^ Aiaac h to Form.

or 990-EZ.

^ Information about Schedule 0 (Form 990 or 990 - EZ) and its instructions is at www . irs.gov /form990.

Open to Public inspection

Employer identification number

GRANVILLE STUDIO OF VISUAL ARTS 68-0668426

Form 990 Organization' s Mission

Organization 's Mission:

Our mission is to provide extraordinary creative thinking education and to foster creative courage in all people.

We believe that every human being is a uniquely creative individual.

And each individual through sustained, careful guidance in a supportive, creative environment is capable of becoming an innovative thinker and doer.

We believe that creative courage is the indispensible foundation of all innovations.

At GSVA we welcome, embrace and nurture every person's creative self-esteem, vision, thinking and skills.

Above all, we are committed to helping people of all ages and backgrounds lead artful, creative, and fulfilling lives.

Our programs build creative self-esteem, problem-solving skills, self-discipline and cultural awareness.

We serve students of all ages, from preschoolers to senior citizens, and reach out to students of all socio-economic backgrounds.

GSVA's curricula combine studio art activities, art history and art theory instruction.

We encourage teamwork and communication skills by teaching students how to design group exhibitions of their own work.

Four things make us unique.

1.

We develop proprietary curriculum for progressive learning.

2.

Our staff expertise is a blend of trained, professional artists, arts curriculum designers and art educators.

3.

We partner with educational institutions, artists and community non-profits committed to quality education.

4.

We are focused on bringing quality arts and design thinking education to students in different settings, to create breakthrough creative education experiences that will become life skills.

Schedule 0 (Form 990 or 990-EZ) (2013)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

DM

GSVA

Schedule 0 (Form 990 or 990-EZ) (2013

Name of the organization

GRANVILLE STUDIO OF VISUAL ARTS

Employer identification number

68-0668426

Page 2

What this means is that our students gain experiences that change how they perceive themselves, how they engage their peers and how they interact with the world around them.

Students learn to believe in themselves, develop the "creative courage" to dream and become empowered and inspired to be productive doers in their own lives and community.

Form 990, Part III, Line 4a First Accomplishment adults.

All exhibition openings are 2 hours, are free and open to the public at large.

Attendance at an exhibition opening and life of the exhibition at GSVA's home gallery ranges from 400-800 people.

Attendance at our off-site gallery at THe Ohio State University Newark CampusCOTC,

Christine Warner Student Center & Library ranges from 3,000-8,000 people.

Form 990, Part III, Line 4b Second Accomplishment

(named "Orange Couch") has been described as "the second or third teacher in the room" bringing the studio thinking environment, the engaging artist-teacher and quality curriculum to the "non-studio" classroom space.

GSVAs' Orange Couch program is one of the leading blended-learning curriculum partners for visual arts education in the U.S.

Form 990, Part VI, Line llb Organization ' s Process to Review Form 990

FORM 990 REVIEW AT MONTHLY BOARD MEETING.

Form 990, Part VI, Line 12c Enforcement of Conflicts Policy

REVIEWED AT MONTHLY BOARD MEETINGS.

Form 990, Part VI, Line 19 Governing Documents Disclosure Explanation

Schedule 0 ( Form 990 or 990-EZ ) ( 2013)

DAA

Schedule 0 (Form 990 or 990-EZ) (2013)

Name of the organization

GRANVILLE STUDIO OF VISUAL ARTS

SCUM rnN

L V I. Vl•^l^IYl Y

TS

AVAIBLE UPON

Form 990, Part IX, Line llg Other Fees for Services

Description

Mgt & General Program Service

PROFESSIONAL FEES

$ 96,274 $ 0

$ 0 $ 0

$ 0 $ 0

Employer identification number

68-0668426

$

$

$

Fundraising

972

0

0

GSVA e 2

$

$

$

56,801

37,547

954

$

$

$

0

0

0

$

$

$

972

0

0

Schedule 0 ( Form 990 or 990-EZ ) ( 2013)

DAA

Depreciation and Amortization

Form

4562

(Including Information on Listed Property)

Department of the Treasury

Internal Revenue Service (9 9)

^ See se p arate instructions .

^ Attach to y our tax return .

rvamets/ snuwi, ui ieturn

GRANVILL E STUDIO OF VI SUAL ARTS I 6

Business or activity to which this form relates

Indirect Depreciation

Part I Election To Expense Certain Property Under Section 179

Note: If you have an y listed p ro p erty, com p lete Part V before y ou com p lete Part I

1 Maximum amount (see instructions)

2 Total cost of section 179 property placed in service (see instructions)

3 Threshold cost of section 179 property before reduction in limitation (see instructions)

4 Reduction in limitation Subtract line 3 from line 2 If zero or less, enter -0-

5

6

Dollar limitation for tax year Subtract line 4 from line 1 If zero or less, enter -0- If married filin g se p aratel y , see instructions

(a) Description of property (b) Cost (business use only) (c) Elected cost

3

4

1

2

5

GSVA

OMB No 1545-0172

2013

Attachment

Se q uence No 1 79

500,000

2,000,000

7

8

Listed property Enter the amount from line 29

Total elected cost of section 179 property Add amounts in column (c), lines 6 and 7

9 Tentative deduction Enter the smaller of line 5 or line 8

10 Carryover of disallowed deduction from line 13 of your 2012 Form 4562

7

11 Business income limitation Enter the smaller of business income (not less than zero) or line 5 (see instructions)

12 Section 179 expense deduction Add lines 9 and 10, but do not enter more than line 11

13 Car ry over of disallowed deduction to 2014 Add lines 9 and 10, less line 12

Note : Do not use Part II or Part III below for listed property Instead , use Part V

^

I

13

Part II S p ecial De p reciation Allowance and Other De p reciation ( Do not include listed p ro p ert y

14 Special depreciation allowance for qualified property (other than listed property) placed in service during the tax year (see instructions) 14

15 Property subject to section 168(f)(1) election 15

16 16 Other de p reciation ( includin g ACRS )

Part III MACRS Depreciation ( Do not include listed property ) (See instructions )

Sectio n A

8

9

10

11

12 instructions

10,302

17

18

MACRS deductions for assets placed in service in tax years beginning before 2013 17

If you are electing to group any assets placed in service during the tax year into one or more general asset accounts, check here ^ I I

Section B -Assets Placed in Service During 2013 Tax Year Using the General Depreciation System

( a) Classification of property

(b) Month and year placed in service

(c) Basis for depreciation

(business /investment use onl y -see instructions

(d) Recovery period

(o) Convention (f) Method

19a 3 -y ear p ro p ert y

5- y ear p ro p ert y

7- y ear p ro p ert y

10-ear p ro p erty

15 ear p ro p erty

20 ear p ro p ert y ear p ro p ert y h Residential rental property i Nonresidential real property y rs

27 5 y rs

27 5 y rs

39 y rs

MM

MM

MM

MM

S/L

S/L

S/L

S/L

S/L

Section C-Assets Placed in Serv ice During 2013 Tax Year Using the Alternative Depreciation System

(g) Depreciation deduction

0

20a Class life b 12- y ear

12 yrs

S/L

S/L c 40- year

Part fV Summa See instructions

40 y rs MM

21 Listed property Enter amount from line 28

22 Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21 Enter here

S/L

21 and on the appropriate lines of your return Partnerships and S corporations-see instructions

23 For assets shown above and placed in service during the current year, enter the

For Paperwork Reduction Act Notice , see separate instructions .

DAA p ortion of the basis attributable to section 263A costs

22 10 , 3 0 2

F 23

Form 4562 (2013)

There are no amounts for Page 2

GSVA GRANVILLE STUDIO OF VISUAL ARTS

68-0668426

Federal Asset Report

FYE: 6/30/2014 Form 990 , Page 1

Asset Description

Du±o

I n Servic e Cost

Rim Ca;; Raclc

179 Bonus for Depr PerConv Meth

Other Depreciation:

I LEASEHOLD IMPROVEMENTS

2 EQUIPMENT

3 FURNITUREW & FIXTURES

4 FURINTURE & FIXTURES

5 EQUIPMENT

Total Other Depreciation

1/01/10

1/01/10

1/01/10

7/01/11

7/01/11

158,808

27,080

8,125

200

11,277

205,490

158,808 40 MO S/L

27,080 7 MO S/L

8,125 10 MO S/L

200 5 MO S/L

11,277 7 MO S/L

205,490

Prior

29,903

12.624

3,724

80

3,222

49,553

Current

3,971

3,868

812

40

1.611

10,302

205,490 49,553 10,302

Total ACRS and Other Depreciation 205,490

Grand Totals

Less : Dispositions and Transfers

Less : Start - up/Org Expense

Net Grand Totals

205,490

0

0

205,490

205.490

0

0

205,490

49,553

0

0

49,553

10.302

0

0

10,302

GSVA GRANVILLE STUDIO OF VISUAL ARTS

68-0668426

FYE: 6/ 30/2014

Federal Statements

Description

PROFESSIONAL FEES

Form 990, Part IX, Line 11g - Other Fees for Service ( Non-employee)

$

Total

Expenses

97,246 $

Program

Service

96,274 $

Management &

General

0

Total $ 97,246 $ 96,274 $

Description

CATERING & HOSPITALITY

Total

Form 990, Part IX , Line 24e - All Other Expenses

$

$

Total

Expenses

33

33

$

$

Program

Service

33

33

$

Management &

General

$ 0

$

Fund

R aisin

972

$ 972

$

Fund

R aisin g

0 r

GSVA GRANVILLE STUDIO OF VISUAL ARTS

68-0668426

FYE: 6/ 30/2014

Federal Statements

Description

Schedule A, Part II, Line 1(e)

Description

Schedule A, Part II, Line 12

JOURNEY

WORKSHOPS

MEDIA STUDIO CLASS

LICENSE FEES

MISC REVENUE

RENTAL

Total

$

$

Amount

95,094

14,701

43,515

9,500

162,810

$

$

Amount

28,273

9,127

24,696

52,477

108

920

115,601

I

Form

8

868

Application for Extension of Time To File an

Exempt Organization Return rI^^

(Rev January 2014)

Department of the Treasury

Internal Revenue Service

10

^ File a separate application for each return.

' Information about Form 8868 and its instructions is atwww . irs.gov /form8868.

• If you'are filing for an Automatic 3-Month Extension , complete only Part I and check this box

• if you are filing for an Additional ( Not Automatic ) 3-Month Extension , complete only Part II (on page 2 of this form)

Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868

OMS No 1545-1709

Electronic filing (e-file). You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporation required to file Form 990-T), or an additional (not automatic) 3-month extension of time You can electronically file Form

8868 to request an extension of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information

Return for Transfers Associated With Certain Personal Benefit Contracts, which 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 and click on e-file for Charities & Nonprofits

Part I Automatic 3-Month Extension of Time. Only submit original (no copies needed)

A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and complete

Part I only

Type or print

I Name of exempt organization or other filer, see instructions

^ ❑

All other corporations (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 identifvina number . see instructions

Employer identification number (EIN) or

GRANVILLE STUDIO OF VISUAL ARTS

68-0668426

Social security number (SSN)

File by the due date for filing your return See instructions

Number, street , and room or suite no If a P 0 box, see instructions

537 JONES ROAD

City, town or post office , state, and ZIP code For a foreign address , see instructions

GRANVILLE OH 43023

Enter the Return code for the return that this application is for (file a separate application for each return)

Application

Is For

Form 990 or Form 990-EZ

Form 990-BL

Form 4720 ( individual )

Form 990-PF

Form 990-T ( sec 401 a or 408 ( a ) trust )

Form 990-T (trust oth er than above )

ANNIE V CACCIATO

537 JONES RD

° The books are in the care of ^ GRANVILLE

Return

Code

01

02

03

04

05

06

Application

Is For

Form 990-T ( cor p oration )

Form 1041-A

Form 4720 ( other than individual )

Form 5227

Form 6069

Form 8870

OH 43023

Return

Code

07

08

09

10

11

12

Telephone No 01 740-587-2371 FAX No ^

• If the organization does not have an office or place of business in the United States, check this box

• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) for the whole group, check this box ^ ❑ If it is for part of the group, check this box

If this is

^ H and attach a list with the names and EINs of all members the extension is for

I I request an automatic 3-month (6 months for a corporation required to file Form 990-T) extension of time until 0 2 / 15 / 15 , to file the exempt organization return for the organization named above The extension is for the organization's return for

^

❑ calendar year or

^ ❑

2

^ ® tax year beginning 07/01/13 , and ending 06/30/14

If the tax year entered in line 1 is for less than 12 months , check reason ❑ Initial return ❑ Final return

1-1

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 b If this application is for Forms 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated tax p a y ments made Include an y p rior y ear over p a y ment allowed as a credit c Balance due. Subtract line 3b from line 3a Include your payment with this form, if required, by using

3b $

EFTPS Electronic Federal Tax Pa y ment S y stem ) See instructions 3c $

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

For Privacy Act and Paperwork Reduction Act Notice, see instructions.

DAA

0

0

0

Form 8868 (Rev 1-2014)

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