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X Short Form OMB No 1545-1150 Fwm 990-EZ, Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 41115- 0 0 form as it may ► Do not enter social seaaity numbers on this be made public. Information about Form 990-EZ and its instructions is at www.bs.gov/lonn9®0. ► ia A For the 2015 calendar year, or tax year beginning October 1 , 2015, and ending September 30 .20 16 g check it appp e C Name of organization D Employer Identification number 0 Address diang• Optimist tntemationa135 Dakotas Manitoba Minnesota District 41-6053928 q Name change Number and street (or P.O. box, if mail is not delivered to street address) Room/surte E Telephone number inmainiturn q F ^ 475 Marley Avenue 204 453-7524 wm q Gly w town, state w province, country, and ZIP w foreign postal code F Group Exemption Amended Appsaeanperilina lonnima. L QY8 Number ► 1334 q Other (specify) G Accounting Method: 0 Cash Accrual ► H Check ► 0 if the organization is not Website: ► www.optitnist-dmm.org required to attach Schedule B J Tax-en pt slates (check only one) - q 501 (c)(3 ) q 501 c 4 t insert no.) q 4947(a)(1 ) or [1527 (Form 990, 990-E. or 990-PF). K Form of organization: q Corporation q Trust 2 Association q Other L Add lines 5b, 6c, and 7b to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets (Part 11, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . IIN- $ 60,449 Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part 1) [;heck if the organization used Schedule 0 to respond to any auestion in this Part I . M, 1 Contributions, gifts, grants, and similar amounts received . 1 1 ,485 2 Program service revenue including government fees and contracts . 2 27 3 Membership dues and assessments . 3 28,718 CM I 4 Investment income . 4 39 5a Gross amount from sale of assets other than inventory . 5a 0 b Less: cost or other basis and sales expenses . 5b 0 c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . 5c 0 UriI 6 Gaming and fundraising events a Gross income from gaming (attach Schedule G if greater than =•k„, 0 A 3 $15,000) . 8a a C b Gross income from fundraising events (not including $ o of contributions ;A from fundraising events reported on line 1 ) (attach Schedule G if the sum of such gross income and contributions exceeds $15,000) . 6b 0 •, rNa c Less: direct expenses from gaming and fundraising events . Sc 0 d Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c) . 6d 0 7a Gross sales of inventory, less returns and allowances . 7a 2,517 b Less : cost of goods sold . 7b 2508 ,'; °^ c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . 7c 9 8 Other revenue (describe in Schedule 0) . 8 642 9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . ► 9 57,941 10 Grants and similar amounts paid gist in Schedule 0) . RECEIVE D . 10 0 11 Benefits paid to or for members . [^ 11 0 •+ 12 Salaries, other compensation , and employee benefits 12 0 13 Professional fees and other payments to independent contra MAY. 1 x"997 13 0 a 14 Occupancy, rent, utilities, and maintenance . 14 0 15 Printing, publications , postage, and shipping . 15 131 16 Other expenses (describe in Schedule 0) . Lp U T 16 55 942 17 Total expenses. Add lines 10 throug h 16 . I. 17 56,073 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . .^ . 18 1 19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with Q end-of-year figure reported on prior year's return) . 19 18,333 m 20 Other changes in net assets or fund balances (explain in Schedule 0) . 20 0 Z 21 Net assets or fund balances at end of year. Combine lines 18 through 20 . ► 21 20,201 For Paperwork Reduction Act Notice, see the separate instructions. Cat No. 106421 Form 9W-EZ (2015) 3 Form 990-EZ (2015) Page 2 Balance Sheets (see the instructions for Part II) Chock if the organization used Schedule 0 to resound to any question in this Part 11 _ f'I (A) Beginning of year (B) End of year 22 Cash, savings, and investments . 18,333 22 20,201 23 Land and buildings . 0 23 0 24 Other assets (describe in Schedule 0) . o 24 0 25 Total assets . 1 333 25 20,201 26 Total liabilities (describe in Schedule 0) . 0 26 0 27 Net assets or fund balances ine 27 of column B must agree with line 21 ) 18 333 27 20 201 jMM Statement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule 0 to respond to any question in this Part III . q Eq)enses What is the organization's primary exempt purpose? Promote Optimist vision of bringing out the best in kids. (mquued for sea,on 501(oX3) and 501(c)(4) Describe the organization's program service accomplishments for each of its three largest program services, organmijons; opts for as measured by expenses. In a clear and concise manner, describe the services provided, the number of 0010m) persons benefited, and other relevant information for each program title. 28 Premote_optmst- -------vision of bringing out the best in kdis through leadership developmer confer and --- - conventions. DMM oversees over 2,000 volunteers-throughout-theDistrict who serve tthousands ofyouth________ by impfemerningprograms and suppext foc,outfi in local corrununities_ If this amount includes rants, check here q (Grants $ foreign ► 26a 64,641 29 Hosted-Youth Oratorical Contes,_Com nunication Contest the Deaf and Hard of Hearing,_and-Essay Contest to a0aw youth oppofhuiinr to compete at the national level for scholarships - -- - --------------------------------------------------------------------------------------------------------------------------------------------- 10. Grants $ If this amount includes foreign grants, check here . E] 29a 1 ,432 30 -------------------------------------------------------------------------------------------------------------------------------------------- ------------- --- --- --------------------------------------------------------------------- -------- ---- - ---- - --- -- ---- --------------------------- ----------------------------------------------------- - - - - - -- - -- ----------------------------- q Grants $ If this amount includes foreign grants, check here ► 303 31 Other program services (describe in Schedule 0) . q Grants $ If this amount includes foreign rants, check here ► 31a 32 Total program service expenses (add lines 28a through 31 a) . ► 32 56,073 '/ List of unicers, Directors, l rustees, ana Key irmptoyees (list each one even it not compensated - see the instnjr:tiong for Part I) Check if the oroariization used Scheduie 0 to respond to any question in this Part IV f-l (c) Reportable (d) Health (b) Average benefits, - compensation contnbubons to employee (e) Estimated amount (a) flame and Mle hours per k of (Forms devoted to position not pae)) dbenerd plans, and other compensation eferred compensabon Kenneth Schulz- Go_v_ernor________________________________________ 15 0 0 0 Jo-Anne Pelzer. District Secretarylrreasurer ---------------- 10 0 0 0 Don Stover, Immediate Past Govemor ___________-- 1 0 0 0 Wes Shewchuk, Past Governor ------------------------------------------- 1 0 0 0 Terry-Gormat Governor_Elect------- -__---------------- 3 0 0 0 -------------------------------------------------------------------------- ----------------------------------------------------------------------- ------------------------------------------------------------------------- ------------------------------------------------------------------ -------------------------------------------------------------------------- ------------------------------------------------------------------------ Form 9W-EZ (2015) Forth 990-EZ (2015) Page 3 Other Information (Note the Schedule A and personal benefit contract statement requirements in the instructions for Part Check if the organization used Schedule 0 to respond to any question in this Part V q Yes No 33 Did the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule 0 . 33 34 Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization's name. Otherwise, explain the change on Schedule 0 (see instructions) . $4 35a Did the organization have unrelated business gross income of $1,000 or more during the year from business activities (such as those reported on lines 2, 6a, and 7a, among others)? . b If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule 0 c Was the organization a section 501(cx4), 501(cx5), or 501 (cX6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements during the year? If "Yes," complete Schedule C, Part III . 36 Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If "Yes," complete applicable parts of Schedule N . 37a Enter amount of political expenditures, direct or indirect, as described in the instructions ► 137a b Did the organization file Form 1120-POL for this year? . 38a Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of
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