Self Inc in Waterbury, Connecticut (CT)

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Self Inc
Employer Identification Number (EIN)061240040
Name of OrganizationSelf Inc
Address19 4th St, Waterbury, CT 06708-4209
ActivitiesMental health care
SubsectionCharitable Organization
Ruling Date11/1992
DeductibilityContributions are deductible
FoundationOrganization which receives a substantial part of its support from a governmental unit or the general public
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period06/2014
Assets$100,000 to $499,999
Income$1,000,000 to $4,999,999
Filing Requirement990 (all other) or 990EZ return
Asset Amount$191,623
Amount of Income$1,514,502
Form 990 Revenue Amount$1,514,502


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Financial snapshot ($)

Revenue for 2014

Assets at the end of 2014

Functional expenses for 2014

Support schedule

Checklist
201220132014
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?NoNoYes
Is the organization required to complete Schedule B, Schedule of Contributors?YesYesNo
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?NoNoNo
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?NoNoNo
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?NoNoNo
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?NoNoNo
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?NoNoNo
Did the organization maintain collections of works of art, historical treasures, or other similar assets?NoNoNo
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?NoNoNo
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?NoNoNo
Did the organization report an amount for land, buildings, and equipment?YesYesYes
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?NoNoNo
Did the organization report an amount for investments-program related that is 5% or more of its total assets?NoNoNo
Did the organization report an amount for other assets that is 5% or more of its total assets?YesNoYes
Did the organization report an amount for other liabilities?YesYesYes
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)?NoNoYes
Did the organization obtain separate, independent audited financial statements for the tax year?YesNoYes
Was the organization included in consolidated, independent audited financial statements for the tax year?NoNoNo
Is the organization a school described in section 170(b)(1)(A)(ii)?NoNoNo
Did the organization maintain an office, employees, or agents outside of the United States?NoNoNo
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?NoNoNo
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?NoNoNo
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?NoNoNo
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?NoNoNo
Did the organization report more than $15,000 total of fundraising event gross income and contributions?NoNoNo
Did the organization report more than $15,000 of gross income from gaming activities?NoNoNo
Did the organization operate one or more hospital facilities?NoNoNo
Did the organization attach a copy of its audited financial statements?NoNoNo
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?NoNoNo
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?NoNoNo
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?NoNoNo
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?NoNoNo
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?NoNoNo
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?NoNoNo
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?NoNoNo
Did the organization engage in an excess benefit transaction with a disqualified person during the year?NoNoNo
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?NoNoNo
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?NoNoNo
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?NoNoNo
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?NoNoNo
A family member of a current or former officer, director, trustee, or key employee?YesNoNo
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?NoNoNo
Did the organization receive more than $25,000 in non-cash contributions?NoNoNo
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?NoNoNo
Did the organization liquidate, terminate, or dissolve and cease operations?NoNoNo
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?NoNoNo
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?NoNoNo
Was the organization related to any tax-exempt or taxable entity?NoNoNo
Did the organization have a controlled entity within the meaning of section 512(b)(13)?NoNoNo
Did the organization make any transfers to an exempt non-charitable related organization?NoNoNo
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?NoNoNo
Statements Regarding Other IRS Filings and Tax Compliance
2011201220132014
The number reported in Box 3 of Form 1096577
The number of Forms W-2G000
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?NoNoYes
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 return434141
Did the organization file all required federal employment tax returns?YesYesYes
Did the organization have unrelated business gross income of $1,000 or more during the year?NoNoNoNo
Has it filed a Form 990-T for this year?NoNoNo
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)?NoNoNo
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?NoNoNo
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?NoNoNo
Did the organization file Form 8886-T?NoNoNo
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?NoNoNo
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?NoNoNo
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?NoNoNo
Did the organization notify the donor of the value of the goods or services provided?NoNoNo
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?NoNoNo
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?NoNoNo
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?NoNoNo
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?NoNoNo
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?NoNoNo
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?NoNoNo
Did the sponsoring organization make any taxable distributions under section 4966?NoNoNo
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?NoNoNo
Initiation fees and capital contributions$0$0$0$0
Gross receipts for public use of club facilities $0$0$0$0
Gross income from members or shareholders$0$0$0$0
Gross income from other sources$0$0$0$0
Is the organization filing Form 990 in lieu of Form 1041?NoNoNo
The amount of tax-exempt interest received or accrued during the year$0$0$0
Is the organization licensed to issue qualified health plans in more than one state?NoNoNo
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans$0$0$0
The amount of reserves on hand$0$0$0
Did the organization receive any payments for indoor tanning services during the tax year?NoNoNo
Has it filed a Form 720 to report these payments?NoNoNo
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
201220132014
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization$71,895$71,384$92,925
Total reportable compensation from related organizations$0$0$0
Total estimated amount of other compensation from the organization and related organizations$14,522$17,441$0
Total number of individuals who received more than $100,000 of reportable compensation from the organization000
Total number of independent contractors who received more than $100,000 of compensation from the organization000
Statement of Revenue
2011201220132014
Total revenue$1,419,359$1,503,725$1,533,023$1,514,502
Contributions, Gifts, Grants and Other Similar Amounts$1,351,846$1,432,941$1,454,632$1,447,306
Program Service Revenue$64,830$67,053$66,295$67,194
900099$67,053$66,295$67,194
All other program service revenue$0$0$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$24$21$33$2
Income from investment of tax-exempt bond proceeds$0$0$0$0
Royalties$0$0$0$0
Net rental income$0$0$0$0
Net gain/loss from sales of assets other than inventory$0$0$0$0
Net income/loss from fundraising events$0$0$0$0
Net income/loss from gaming activities$0$0$0$0
Net income/loss from sales of inventory$0$0$0$0
Miscellaneous Revenue$2,659$3,710$12,063$0
Statement of Functional Expenses
2011201220132014
Total functional expenses$1,401,456$1,482,706$1,533,369$1,572,661
Grants and other assistance to domestic organizations and domestic governments$0$0$0
Grants and other assistance to domestic individuals$0$0$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals$0$0$0
Benefits paid to or for members$0$0$0
Compensation of current officers, directors, trustees, and key employees$0$85,242$92,812$0
Compensation not included above, to disqualified persons$0$0$0
Other salaries and wages$895,219$858,574$889,314$918,253
Pension plan accruals and contributions$12,731$0$0
Other employee benefits$150,346$177,210$235,830
Payroll taxes$86,238$87,143$98,396$70,322
Fees for services (non-employees)
Management$0$0$0
Legal$0$0$0
Accounting$0$0$0
Lobbying$0$0$0
Professional fundraising services$0$0$0$0
Investment management fees$0$0$0
Other$9,500$8,300$75,278
Advertising and promotion$0$0$0
Office expenses$0$0$0
Information technology$0$0$0
Royalties$0$0$0
Occupancy$76,926$79,045$10,667
Travel$0$0$33,195
Payments of travel or entertainment expenses for any federal, state, or local public officials$0$0$0
Conferences, conventions, and meetings$0$0$6,403
Interest$5,913$4,166$7,836
Payments to affiliates$0$0$0
Depreciation, depletion, and amortization$10,557$10,268$10,207
Insurance$25,352$24,827$29,236
Other expenses$26,960$30,436$46,584
Other expenses$38,475$32,203$32,347
Other expenses$46,800$41,605$21,245
Other expenses$47,818$43,632$75,258
Balance Sheet
2011201220132014
Total assets$292,629$345,336$440,983$191,623
Cash - non-interest-bearing$98,248$225,095$3,691
Savings and temporary cash investments$31,359$7,442$0
Pledges and grants receivable, net$0$0$0
Accounts receivable, net$3,206$378$0
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees$0$0$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations$0$0$0
Notes and loans receivable, net$0$0$0
Inventories for sale or use$0$404$0
Prepaid expenses and deferred charges$100$4,310$3,712
Land, buildings, and equipment: cost or other basis$187,044$180,176$173,308
Investments - publicly traded securities$0$0$0
Investments - other securities$0$0$0
Investments - program-related$0$0$0
Intangible assets$6,930$3,530$191
Other assets$18,449$19,648$10,721
Total liabilities$233,252$264,940$360,933$169,732
Accounts payable and accrued expenses$76,036$163,379$150,995
Grants payable$0$0$0
Deferred revenue$14,526$0$0
Tax-exempt bond liabilities$0$0$0$0
Escrow or custodial account liability$0$0$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons$0$0$0
Secured mortgages and notes payable to unrelated third parties$89,224$64,559$38,309$7,973
Unsecured notes and loans payable to unrelated third parties$0$0$0$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)$109,819$159,245$10,764
Total net assets or fund balances$59,377$80,396$80,050$21,891
Unrestricted net assets$80,396$80,050$21,891
Temporarily restricted net assets$0$0$0
Permanently restricted net assets$0$0$0
Capital stock or trust principal, or current funds$0$0$0
Paid-in or capital surplus, or land, building, or equipment fund$0$0$0
Retained earnings, endowment, accumulated income, or other funds$0$0$0$0
Reason for Public Charity Status (for 2014)
The organization is not a private foundation because it is: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)
Number of organizations supported0
Sum of amounts of support$0
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (for 2010 - 2014)
2010 - 2014 Total
Public Support$7,029,981
Subtotal Support$7,029,981
Gifts, grants, contributions, and membership fees received$7,029,981
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf$0
The value of services or facilities furnished by a governmental unit to the organization without charge$0
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) that exceeds 2% of the total support$0
Total Support$7,116,057
Public Support$7,029,981
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources$91
Net income from unrelated business activities, whether or not the business is regularly carried on$3,018
Other income. Do not include gain or loss from the sale of capital assets$82,967
Gross receipts from related activities, etc.$0
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