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02-21-2017 Business Meeting PKT��i/fir .� /t7f BOARD OF SUPERVISORS BUSINESS MEETING FEBRUARY 21, 2017 1767 Pi PITTSYLVANIA COUNTY BOARD OF SUPERVISORS BUSINESS MEETING TUESDAY, FEBRUARY 21, 2017 General District Courtroom Edwin R. Shields Courthouse Addition 11 Banks Street, Chatham, VA AGENDA 1. Call to Order — 7:00 p.m. 2. Roll Call Barber Hagerman Blackstock Davis Scearce Barksdale Warren 3. Moment of Silence 4. Pledge of Allegiance 5. Items to be added to the Agenda APPROVAL OF AGENDA Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second. Barber Hagerman Blackstock Davis Scearce Barksdale Warren HEARING OF CITIZENS CONSENT AGENDA 6. (a) Proclamation — National Agriculture Day — March 21, 2017 Pages io-7i Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second. Barber Hagerman Blackstock Davis Scearce Barksdale Warren PUBLIC HEARINGS Rezoning Cases: Case 1: Zada Singleton — Staunton River Election District R-17-004 R-1, Residential Suburban Subdivision District to A-1, Agricultural District Open: Close: Speakers: Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Roll Call Vote Comments: Y N A Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Roll Call Vote YorN) Case 2: Hollywood Baptist Church — Callands/Gretna Election District R-17-005 R-1, Residential Suburban Subdivision District to A-1, Agricultural District Open: Close: Sneakers: Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Roll Call Vote Comments: Y N A Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Roll Call Vote YorN) Case 3: Jason Karl Keesee- Callands-Gretna & Banister Election District R-17-006 R-1, Residential Suburban Subdivision District to A-1, Agricultural Open: Close: Speakers: Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Roll Call Vote Comments: Y N A Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Roll Call Vote Yorrv) Public Hearin,: 7. Public Hearing to receive citizen input on the proposed amendment to Chapter 6-6.3, Property Exempt by Classification or Designation, of the Pittsylvania County Code. The proposed amendment would establish a tax exempt status for real property owned by Patrick Henry Community College. Pages 13-106 Open: Close: Speakers: _ Motion: Second. Roll Call Vote Y Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Roll Call Vote Y or N) Barber Hagerman Blackstock Davis Scearce Barksdale Warren Barber Hagerman Blackstock Davis Scearce Barksdale Warren N A Comments: 8. Expenditure Refunds — January for 2017 —At the Board's meeting on February 6, 2017, a motion was made by Mr. Barber, seconded by Mr. Barksdale, which required a 10 -Day Layover that has now been met. Roll Call Vote required. Pages 108-111 Roll Call Vote Comments: Y N A Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Roll Call Vote YorN) NEW BUSINESS 9. Financial Matters (a) Recommendations from Finance Committee — The Finance Committee met at 4:OOpm on Tuesday, February 21, 2017 and any recommendations from that meeting will be submitted to the full Board of Supervisors Pages 113-114 (i) Submission of County Administrator's Recommended Budget Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second. Barber Hagerman Blackstock Davis Scearce Barksdale Warren (b) Tobacco Commission Grant Appropriation — SoVA Vineyard Development and Expansion to Support Virginia's Wine Industry- Roll Call Vote required. Pages 115-129 Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second. Barber Hagerman Blackstock Davis Scearce Barksdale Warren Roll Call Vote Comments: Y N A Barber Hagerman Blackstock Scearce Davis Barksdale Warren (Rall Call Vote Y or N) 10. Request for Public Hearing — Southside Soccer Club Lease Request Pages 130-134 Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second: Barber Hagerman Blackstock Davis Scearce Barksdale Warren BOARD ANNOUNCEMENTS REPORTS FROM COUNTY ADMINISTRATOR ADJOURNMENT Motion: Barber Hagerman Blackstock Davis Scearce Barksdale Warren Second. Barber Hagerman Blackstock Davis Scearce Barksdale Warren Time: TO BE ADDED P7 HEARING OF CITIZENS P8 CONSENT AGENDA P9 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA TITLE: AGENDA DATE: Proclamation — National Agriculture Day 02-21-2017 "Food for Life " March 21, 2017 ACTION: SUBJECT/PROPOSAL/REOUEST Proclamation of Support STAFF CONTACT(S): Mr. Smitherman CONSENT AGENDA: ACTION: Yes ATTACHMENTS: Proclamation ITEM NUMBER: 6(a) INFORMATION: INFORMATION: BACKGROUND: The Board of Supervisors has passed various proclamations in the past supporting Agriculture Day and its associated events throughout Pittsylvania County. DISCUSSION: Attached hereto, is a proclamation declaring March 21, 2017, as National Agriculture Day throughout Pittsylvania County. RECOMMENDATION: Staff recommends the Board of Supervisors approve the proclamation declaring March 21 , 2017 as Agriculture Day throughout Pittsylvania County and direct the County Administrator to forward a copy of the proclamation to all local media sources. P10 Vitt0lbania Couutp �Soarb of .iuperbtoors Vrodamatlon NATIONAL AGRICULTURE DAY March 21, 2017 "FOOD FOR LIFE" WHEREAS, agriculture development in Pittsylvania County is one of the major economic resources of the County and ranks in the top 10 of Agribusiness Counties in the Commonwealth; and WHEREAS, the Virginia Department of Agriculture and Consumer Services suggests this a perfect opportunity to give credit to the farmers of our state and county; and WHEREAS, National Agriculture Day is an important celebration in Virginia because agriculture is the Commonwealth's largest industry that contributes $55 billion to the state's economy each year, and over $62 million in agriculture receipts based on crops and livestock in Pittsylvania County; and WHEREAS, agriculture in the Commonwealth is a diversified industry with products encompassing livestock, field crops, fruits, vegetables, poultry, dairy, aquaculture, vineyards, and more; and the mild climate and rich soil of Virginia provide an environment in which crops are harvested nearly year -around; and WHEREAS, in the 1960s one farmer supplied food for 25.8 persons in the U.S. and abroad. Today, one farmer supplies food for 155 people in the U.S. and abroad; and WHEREAS, every Virginian should understand how food, fiber and renewable resource products are produced and should value the essential role of agriculture in maintaining a strong economy, and appreciate the role Virginia agriculture plays in providing safe, abundant, and affordable products; and WHEREAS, because only two percent of the population is engaged in production of agriculture, basic knowledge about and experience with the industry is on the decline, and National Agriculture Day helps young people to understand and consider career opportunities in the agriculture, food and fiber industries; then BE IT HEREBY PROCLAIMED by the Pittsylvania County Board of Supervisors that March 21, 2017 be proclaimed "National Agriculture Day" in Pittsylvania County and all citizens of Pittsylvania County are encouraged to thank a farmer for the products they provide which enrich our daily lives and urges parents, grandparents, and educators to inform young children on the importance of local agriculture and to consider career opportunities in the agriculture, food and fiber industries. Given under my hand this 21s` day of February, 2017. Robert W. "Bob" Warren, Chair Pittsylvania County Board of Supervisors David M. Smitherman, County Administrator Pittsylvania County Board of Supervisors PH PUBLIC HEARING P12 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA TITLE: AGENDA DATE: Request for Public Hearing to Amend Pittsylvania 02-21-2016 County Code (PCC) Section 6-6.3; Property Exempt by Classification or Designation: Properties owned by ACTION: Patrick Henry Community College Yes SUBJECT/PROPOSAL/REQUEST: Public Hearing STAFF CONTACT(S): Mr. Smitherman CONSENT AGENDA: ACTION: ITEM NUMBER: 7 INFORMATION: INFORMATION: ATTACHMENTS: 1) Letter from the Honorable Shirley Hammock, Commissioner of the Revenue 2) Application from Patrick Henry Community College REVIEWED BY: BACKGROUND: The Patrick Henry Community College is a 501(c)(3) non-profit organization holding the following properties within Pittsylvania County: GPIN 2420-52-1667;2420-53-0687;2420-64-1663;2420-4-2210; and 2420-41-1685, and has submitted applications for tax exempt status for these properties. DISCUSSION: Staff has duly advertised a public hearing notice for citizen input on proposed amendments to Pittsylvania County Code § 6-6.3, Property Exempt by Classification or Designation, as required before the Board of Supervisors could approve granting such types of tax exemptions. The attached letter from the Honorable Shirley Y. Hammock, Commissioner ofthe Revenue, gives a breakdown of the assessed value and exempt levy for each property. The total assessed value is $375,500 and the total exempt levy at $0.59 per $100 is $2,215.45. RECOMMENDATION• Staff recommends the Board of Supervisors hold the Public Hearing for the purpose of citizen input on amending PCC § 6-6.3 to include Parcels GPIN 2420-52-1667; 2420-53-0687; 2420-64-1663; 2420-4-2210; and 2420-41- 1685 owned by Patrick Henry Community College as tax exempt by classification/designation. Should the Board approve Patrick Henry Community College's application for the aforementioned properties to be classified as tax exempt, a Roll Call Vote is required. P13 PUBLIC HEARING NOTICE The Board of Supervisors of Pittsylvania County will hold a public hearing on Tuesday, February 21, 2017, at 7:00 p. m. in the General District Courtroom located on the second floor of the Edwin R. Shields Courthouse Addition at 11 Bank Street, Chatham, Virginia 24531, to receive citizen input on the proposed amendment to Chapter 6-6.3, Property Exempt by Classification or Designation, of the Pittsylvania County Code. The proposed amendment would establish a tax exempt status for real property owned by Patrick Henry Community College. A full text concerning this public hearing is available in the office of the County Administrator, 1 Center Street, Chatham, Virginia, Monday through Friday from 8:OOam to S:OOpm for public viewing and on the County's website at www.nittsvlvaniacountwa gov . P14 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA TITLE: AGENDA DATE: Request for Public Hearing to Amend Pittsylvania 01-19-2016 County Code (PCC) Section 6-6.3; Property Exempt by Classification or Designation. Properties owned by ACTION: Patrick Henry Community College Yes SUBJECT/PROPOSAL/REQUEST: Request for Public Hearing STAFF CONTACT(S): Mr. Smitherman CONSENT AGENDA: ACTION: ITEM NUMBER: 11 INFORMATION: INFORMATION: ATTACHMENTS: 1) Letter from the Honorable Shirley Hammock, Commissioner of the Revenue REVIEWED BY: C_ 7 BACKGROUND: The Patrick Henry Community College is a 501(c)(3) non-profit organization holding the following properties within Pittsylvania County: GPIN 2420-52-1667;2420-53-0687;2420-64-1663;2420-4-2210; and 2420-41-1685. DISCUSSION: Patrick Henry Community College (PHCC) has submitted applications to the Office of the Commissioner of the Revenue requesting tax exemption on these properties. Pittsylvania County Code § 6-6.3 requires a public hearing for citizen input on proposed amendments to that section before the Board of Supervisors could approve granting such types of tax exemptions. Commissioner Hammock's letter of February 1, 2017 is attached. Should the Board of Supervisors approve holding a public hearing on amending PCC § 6-6.3, a public hearing would be held at the Board's next meeting. RECOMMENDATION: Staff recommends the Board of Supervisors approve the request for a Public Hearing to be held at their next meeting for the purpose of citizen input on amending PCC § 6-6.3 to include Parcels GPIN 2420-52-1667; 2420- 53-0687; 2420-64-1663; 2420-4-2210; and 2420-41-1685 owned by Patrick Henry Community College as tax exempt by classification/designation. P15 Shirlev Yeaus Hammock Commissioner December 7, 2016 OFFICE OF COMMISSIONER OF THE REVENUE PITTSYLVAN IA COUNTY P O. ROX 272 CHATHA.ht, VIRGINIA24531 (434)432-7940 (434)656-6211 FNX(434)43 -7957 shiriey.hannnock(o pitt_oe.Or�g Mr. David Smitherman Pittsylvania County Administrator PO Box 426 Chatham, VA 24531 RE: APPLICATIONS FOR TAX EXEMPT DESIGNATION BY BOARD OF SUPERVISORS Dear Mr. Smitherman: Enclosed, please find applications submitted by PHCC Real Estate Foundation (Patrick Henry Community College Real Estate Foundation) requesting tax exemption by designation for nine parcels recently purchased. Pursuant to Virginia Code 58.1-3651, lam forwarding their application for review and submission to the Board of Supervisors for their approval or denial. The following parcels have been submitted by application: GPIN Assessed Value Exempt Levy @.59 2420-43-2534 22,000 129.80 2420-43-3426 22,000 129.80 2420-43-4307 15,000 88.50 2420-52-1667 15,000 88.50 2420-53-0687 2,000 11.80 2420-64-1653 162,500 958.75 2420-64-2210 99,000 584.10 2420-41-1685 16,000 94,40 2420-43-0721 22,000 129.80 Totals 375,500 2,215.45 Should you need any further information, please let me know. Thank you for your prompt attention in this matter. Regards, C>4 u ' Yo-r�tZLnt�vwd�C.lL/ Shirley Y. Hammock Enclosures P16 Bminaes Eraq Decals Alen to corporations regarding unsolicited mailings from VIRGINIA COUNCIL FOR CORPORATIONS Is available from the Bulletin Archive link of the Clerk's Office website. SCC spike will be unable to accept transactions requiring payment beginning Thursday, November 3, at 11:43 P.M. through Friday morning, November 4, 2016, at 3:00 a.m., due to payment vendor site maintenance. SCC _eFils>ntiF tvSearch> Entry Details t SCC I Contact SCC I Privacy Policy a KEVIN W HOLT GENTRY LOCKE ET AL 10 FRANKLIN RD SE PO BOX 40013 ROANOKE VA 24022 ROANOKE CITY 217 Status: Active Effective Date: 1/5/2000 lupe//s oafilesce.vininia.gov/Buuoess/0512418(11/3201511'.4850 AMI P17 SCC eFHe SCC eFile Business Entity Details e� FAST. Si'ApIESECURE PHCC REAL ESTATE FOUNDATION, INC. Scc enle Nome Page General Select an Olerk Name action Distinguishability easiness Enbty searrn SCC ID: 05124185 019 eenlflrate vemiration FAQs it Luoustered agant change Entity Type: Corporation File a ran 'st r d off cc address chance Contact us Jurisdiction of Formation: VA Re=gn as ie iistered aoent Give Us Feedbe<e Date of Formation/Registration: 12/7/1998 File an anneal reoort My Favorites Status: Active Pad annual r fee t film( Order a cer['Fcate of goon stand no of G Principal Office submit a PDF for ororess nc (what can I guh�tvt View transaction tory ons ih Manage oe email notifications 645 PATRIOT AVENUE MARTINSVILLE VA24112 Registered Agent/Registered Office KEVIN W HOLT GENTRY LOCKE ET AL 10 FRANKLIN RD SE PO BOX 40013 ROANOKE VA 24022 ROANOKE CITY 217 Status: Active Effective Date: 1/5/2000 lupe//s oafilesce.vininia.gov/Buuoess/0512418(11/3201511'.4850 AMI P17 ARTICLES OF INCORPORATION OF PHCC REAL ESTATE FOUNDATION, INC. I hereby form a nonstock corporation without members under the provisions of Chapter 10 of Title 13.1 of the Code of Virginia (1950), as amended, and to that end set forth the following: FIRST: The name of the Corporation is PHCC REAL ESTATE FOUNDATION, INC. SECOND: The Corporation shall not have members. THIRD: The Corporation is organized exclusively for the charitable and educational purposes set forth in the Articles of Incorporation of the Patrick Henry Community College Foundation (a Virginia nonstock corporation determined by the Internal Revenue Service to be an organization of the type described in sections 509(a)(1) and 170(b)(1)(A)(vi) of the Internal Revenue Code of 1986, as amended, and determined to be exempt from taxation under section 501(c)(3) of the Internal Revenue Code of 1986, as amended) and to support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, and otherwise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry i Community College Foundation. FOURTH: The Corporation shall have and exercise all powers and authorities now or hereafter conferred upon nonstock corporations under the laws of the Commonwealth of Virginia; 11626\1\526109.1 P18 provided, however, that no part of the net earnings of the Corporation shall inure to the benefit of or be distributable to any incorporator, trustee, director, or officer of the Corporation or any private individual, except that the Corporation shall be authorized and empowered to pay reasonable compensation to any of the foregoing persons for goods sold or services rendered and to make payments and distributions to, for the benefit of, or in furtherance of the purposes of the Patrick Henry Community College Foundation. No substantial part of the activities of the Corporation shall be the carrying on of propaganda, or otherwise attempting to influence legislation, and the Corporation shall not participate in, or intervene in (including the publishing or distribution of statements) any political campaign on behalf of or in opposition to any candidate for public office. Notwithstanding any other provision of these articles, the Corporation shall not carry on any activities which are not in support of or do not benefit the Patrick Henry Community College Foundation. FIFTH: The initial Board of Directors shall comprise three (3) persons appointed by the Board of Directors of the Patrick Henry Community College Foundation. Thereafter, the number of Directors shall be fixed by the Bylaws of the Corporation. Directors shall serve one year terms, and shall be appointed each year by the Board of Directors of the Patrick Henry Community College Foundation, before the term of office of the incumbent Board of Directors of the Corporation expires. No Director may be removed from office except for cause, and then only upon the affirmative vote of two-thirds (213) of the Directors. For purposes of this Article, "cause" shall mean misfeasance, malfeasance, or gross incompetence of the Director in question. SIXTH: In the event of dissolution of the Corporation, and after all liabilities of the Corporation have been paid, satisfied, and discharged or adequate provisions made therefor, all 11626111526109.1 2 P19 remaining assets of the Corporation shall be distributed to the Patrick Henry Community College Foundation, or if the Patrick Henry Community College Foundation, is not then in existence, to such other organization or organizations that are organized or operated for similar purposes pursuant to section 501(c)(3) of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax law, as the Board of Directors shall determine. SEVENTH: The post office address of the initial registered office of the Corporation shall be at the law offices of Gentry Locke Rakes & Moore, 800 Crestar Plaza, Post Office Box 40013, in the City of Roanoke, Virginia 24022-0013, and its initial Registered Agent at such address is Henry L. Adkins, Jr., who is a resident of Virginia and a member of the Virginia State Bar. EIGHTH: Any person who is a party or is threatened to be made a party to any threatened, pending, or completed action, suit, or proceeding, whether civil, criminal, administrative, or investigative, by reason of the fact that he is or was a director or executive officer of the Corporation, or is or was so serving with respect to another corporation, partnership, joint venture, trust, or other enterprise at the request of the Corporation, shall be indemnified by the Corporation against liability, costs, and expenses (including, but not limited to, reasonable attorneys' fees) to the full extent permitted by applicable law. The Corporation may, but shall not be required to, indemnify any and all other officers, employees, or agents of the Corporation to the same extent as directors and executive officers. NINTH: Except in the case of willful misconduct or a knowing violation of criminal law or of any federal or state securities law, no officer or director of the Corporation shall be liable 11626"1526109.1 3 P20 for damages in any amount whatsoever in any proceeding brought by or in the right of the Corporation. 11626111526109.1 P21 Date: December 2, 1998 Return of Organization Exempt From Income Tax Form 990 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundai Department of the Treasury ► Do not enter social security numbers on this form as it may be made public. Internal ne°erise ss,°"e Information about Form 990 and its instructions is at Iinvil, s. ov/form990. .af A For the 2015 calendar year, or tax year beginning JUL 1, 201:) and ending JUN 3 0 , 2 016 B applicable k e if: boo C Name of organization D Employer identification number D�n� reae PHCC Real Estate Foundation, Inc. for the benefit of Nan, a � 9e E3Z" 54-1921978 Doing business as n� Number and street (or P.O. box if mail is delivered Number of voting members of the governing body (Part A, line 1 a) Fine �rat"m not to street address J 645 NO E Telephone number e Patriot Ave .,. 276-656-0250 e" e Amended City or town, state or province, country, and ZIP or foreign postal code G cross recrapts $ 75,006. Martinsville, VA 24112 Martinsville, VA 24112 H(a)Is this agroup return O�crn, F Name and address of principal officer:Pam Allen tion peo.... for subordinates? Yes ®No 6 645 Patriot Ave, Martinsville, VA 24112 H(b)ao en subordinates mauaedv�Yes =No If "No," attach a list. (see instructions) .1-1 ,.__..__.____.,_. _ Tazexem t status: 501(c)(3) 601(c) ( ) (insert no.) 4947(a)(1) or 527 Jwebsite:►http.://www.ph.vccs.eau ar 1 Briefly describe the organization's mission or most significant activities. To deal with real property and Sign icer the proceeds thereof, and leases of property for the benefit of Pam Allen, Treasurer 2 Check this box ► if the organization discontinued its operations or disposed of more than 25% of its net assets. 03 Number of voting members of the governing body (Part A, line 1 a) a e chect L J PTIN 3 4 ,a 4 Number of independent voting members of the governing body (Part VI, line 1 b) .,. Use 0111Y Firm's address I, 1079 Spruce Street, Suite B 4 Martinsville, VA 24112 5 Total number of individuals employed in calendar year 2015 Part V, line 2a ...... s 0 .5 6 Total number of volunteers (estimate B necessary) _,.,.,, 6 0 a7 a Total unrelated business revenue from Part VIII column (C) line 12 .. . _ . 7a 0 . b Net unrelated business taxable income from Form 990-T, line 34 . _..._...__..._.............. ................ ...._ . ...................... .......... 7b 0. is 8 Contributions and grants (Part VIII, line 1h) Prior Year Current Year4 35,000. Q , 9 Program service revenue (Part VIII, line 2g) 0 0 ¢ 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ....... –2,375. 6. 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 1Oc, and 1le) �.,..... 4,500 . 67,731. 12 Total revenue - add lines 8 through 11 must equal Part Vlll column (A), line 12 ......... 437 , 125 . 67,737. 13 Grants and similar amounts paid (Part IX, column (A), lines 1.3) 14,132 , 0 14 Benefits paid to or for members (Part IX, column (A), line 4) 0 , 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) 0 . Q , � 16a Professional fundraising fees (Pan . IX, column (A), line t Is) ...................................... ,,. Q , 0 w b Total fundraising expenses (Part IX, column (D), line 25) ► 0 , 17 Other expenses (Part IX, column (A), lines 11a -1I d, 11f -24e) ., 12,378 , 81,228 . 18 Total expenses. Add lines 1317 (must equal Part IX, column (A), line 25) ...,_ �_._. .. 26,510 81.29. $ , 19 Revenue less expenses. Subtract line 18 from line 12 ............. .... 410 , 615 . —13,49 1 . �� ,w 20 Total assets (Part X, line 16) Beginning of Current Year End of Year 1,047,392. 1,031,599. ?a d 21 Total liabilities (Part X, line 26) 0 PnrF 22 11 Net assets or fund balances. Subtract line 21 from line 20......_....._......._._......_....... C:...ekeif__ or....r. 1,043,752, _ 1,030,261. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and comolete. Declarafinn of nreoarnr mthnr than "a,-1 ,....��,,,. _ _._____...._._._... ...... .....P waiG,.„—,,awvcr i.ke, msnucuons ......... ......... .......... ..._ ... Yes No 532001 12-13-15 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2015) See Schedule 0 for Organization Mission Statement Continuation P22 ' Ignature o o ..,,urn Pi PPai ci IIda any nnowlecge. Sign icer ate Here Pam Allen, Treasurer ' ype or pnnt name an tRe PrintlType preparer's name Preparer's signature a e chect L J PTIN Paid TalTies K. Sells, CPA If 6 00006337 Preparer Firm'sname iibells, Hogg & Associates, SiI ,eee CPAs, PC Firm'sEIN 54-1681507 Use 0111Y Firm's address I, 1079 Spruce Street, Suite B Martinsville, VA 24112 Phone no.2 7 6 - 6 3 8 - 3 9 0 4 Mona thn IRA A;—.—•u� _ _._____...._._._... ...... .....P waiG,.„—,,awvcr i.ke, msnucuons ......... ......... .......... ..._ ... Yes No 532001 12-13-15 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2015) See Schedule 0 for Organization Mission Statement Continuation P22 Form990 2015 PHCC Real Estate Foundation, Inc. 54-1921978 Pa e2 Part 1 1 tatement of Program Service Accomp ishments Check if Schedule O contains a response or note to any line in this Part III 1 Briefly describe the organization's mission: To deal with real property and the proceeds thereof, and leases of property for t e benefit of Patrick Henry Community College Foundation. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990 -FS? =Yes M No If "Yes," describe these new services on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? .................. =Yes ®No fir "Yes," describe these changes on Schedule O. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program servicera 0p 1 d. e 4a (code; ) (Expanses $ 81 , 2 0 3 . intluding wants d $ ) (Revenue $ ) The Foundation receives, purchases, owns, eve ops, operates leases, sells, and otherwise des s wit res property an t e proceeds t ereof for the benefit of Patric Henry Community College Foundation, operating as a Section 09 (A)(j) supporting organization. 4b (Code' ) (Expenses $ _ rdudm0 grants of $ ) (Revenue $ 4c (cods: )(Expenses$ irdudingwantad$ ) (R.,e .$ 4d other program services (Describe in Schedule O.) $32002 12-19-15 P23 Form 990 (2015) Formsso 2015 PHCC Real Estate Foundation, Inc. 54-1921978 Page art Checklist of Required Schedules 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? Yes No If"Yes," complete Schedule A.............................................................................................................................. I.............. 2 Is the organization required to complete Schedule 8, Schedule of Contributors? .... ......... 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for 1 X 2 X public office? If 'Yes," complete Schedule C, Part l............................................................................................................ 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect 3 X during the tax year? If "Yes, " complete Schedule C, Part lI................................................................................................... 5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or 4 X similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part Ill ...................... 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to 5 X provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes, " complete Schedule D, Part / 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, 6 X the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part It ............ ..... 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? if "Yes," complete 7 X ScheduleO, Part lll............................................................................................................................................................ 9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for 8 X amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? /f "Yes,' complete Schedule D, Part /V 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or qua6endowmants? If "Yes,"complete Schedule D, Part V 11 If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If 'Yes,' complete Schedule D, PartVl...................................................................... ........................................................................................................ b Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total 11a X assets reported in Part X, line 16? If "Yes, " complete Schedule D, Part Vll .................................................. c Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total 11b X assets reported in Part X, line l6?If"Yes,'complete Schedule D, Part Vlll.................................................................. .. ....... 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 11c X 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 11d X 11e X the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes,' complete Schedule D, PartX ............ 12a Did the organization obtain separate, independent audited financial statements for the tax year? /f "Yes,' complete 11f X ScheduleD, Parts X/ and Xll............................................................................................................................................. b Was the organization included in consolidated, independent audited financial statements for the tax year? 12a X If "Yes, " and if the organization answered "No" to line 12a, then completing Schedule D, Parts X/ and A is optional ,. 13 Is the organization a school described in section 170(b)(1)(A)()? 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, 12b X 14a X 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 / and /V......................................................................................................... 15 Did the organization report on Part IX, column (P), line 3, more than $5,000 of grants or other assistance to or for any 14b X foreign organization? /f "Yes," complete Schedule F, Parts I/ and /V .................................................................................... 16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to 15 X or for foreign individuals? /f'Yes,' complete Schedule F, Parts /I/and IV .............................................................................. 17 Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, 16 X column (A), lines 6 and 11 a? If "Yes," complete Schedule G, Part l....................................................................................... 18 Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part Vlll, lines 17 X 1 c and 8a? /f "Yes,' complete Schedule G, Part // 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 II/ .......................................................... ......... ...................................................................... 19 X Form 990 (2015) 532OD3 12-16-15 P24 Form sso z015 PHCC Real Estate Foundation, Inc. 54-1921978 Page art Checklist of Required Schedules (continued) Yes No 20a Did the organization operate one or more hospital facilities? If "Yes, " complete Schedule H 20a X b If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? .............................. 20b 21 Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 19 If 'Yes,' complete Schedule /, Parts / and I/ .......................................... 21 X 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? /f "Yes,' complete Schedule I, Parts I and 111 22 X 23 Did the organization answer "Yes' to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? /f "Yes,' complete Schedule........................................................................................................................................................................ 23 X 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 20029 If "Yes, " answer lines 24b through 24d and complete ScheduleK If 'No', go to line 25a.................................................................................................................................... 24a X b Did the organization invest any proceeds of taxexempt bonds beyond a temporary period exception? ...................... ........... 24b c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease anytax-exempt bonds?...................................................................................................................................................... 24c d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?................................. 24d 25a Section 601(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part 1 .._.. _. _.,., 25a X b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ? If'Yes,"complete Schedule L. Part l.................................. ................................................................................... ....................................... 25b X 26 Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part 11 27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35°% controlled entity or family member of any of these persons? If 'Yes," complete Schedule L, Part l//.......................................................................................... 27 X 28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ................................. 28a X Is A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part /V 28b X c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? 1f "Yes," complete Schedule L, Part /V28c ............................................................... X 29 Did the organization receive more than $25,000 in non-cash contributions? N "Yes, " complete Schedule M ........................... 29 X 30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes,' complete Schedule M..................................................................................................................... 31 Did the organization liquidate, terminate, or dissolve and cease operations? 30 X If "Yes," complete Schedule N, Part l 31 X 32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?/f "Yes,' complete ScheduleN, Part It ............................................................................................................................................................ 32 X 33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.77013?If"Yes," complete Schedule R, Part/........................................................................ 33 X 34 Was the organization related to any taxexempt or taxable entity? if "Yes,' complete Schedule R, Part I/, /1/, or /V, and PartV, line 1..................................................................................................................................................................... 35a Did the organization have a controlled entity within the meaning of section 512(b)(13)?.................................................. 34 X 35a X b If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ............... 35b 36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If 'Yes,' complete Schedule R, Part V, line 2........................................................................................................................ 36 X 37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If 'Yes,' complete Schedule R, Part V/ 37 X 38 Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? 532004 12-16.15 P25 Form 990 (2015) Form 990 2015 PNCC Real Estate Foundation, Inc. 54-1921978 Pa e5 art Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule O contains a response or note to any line in this Part V EJ la Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ................................. 1a 1 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?................................................................................................................................. 1c X 20 Enter the number of employees reported on Form W3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return .............................. 2a 0 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? .............................. 2b Note. If the sum of lines 1 a and 2a is greater than 250, you may be required to a -file (see instructions) ................................. 3a Did the organization have unrelated business gross income of $1,000 or more during the year? ......................................... 3a X b If "Yes," has it filed a Form 990-T for this year? If "No, " to line 3b, provide an explanation in Schedule O .............................. 3b 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: l► 4a X See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR). 5a Was the organization a party to a prohibited tax shelter transaction at anytime during the tax year! .. ......................... I........ 5a X 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 51b, did the organization file Form 8886-T9 ....................................................... 5c 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? _................ 60 X b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? .................................................. ................................................................................................. 6b 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? 78 X 7b 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 tofile Form 8282?............................................................................................................................................................ 7c X d If 'Yes," indicate the number of Forms 8282 filed during the year ....... ............ .................. ........... 7tl e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? 7e X f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ................. .......... 7f X g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?... 7 7h It If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-0? 8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ....................................................... 8 9 Sponsoring organizations maintaining donor advised funds. a Did the sponsoring organization make any taxable distributions under section 4966? ....................................................... b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? ..... .................... 10 Section 501(c)(7) organizations. Enter: a Initiation fees and capital contributions included on Part VIII, line 12 .......................................... b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities ................. tOb 11 Section 501(c)(12) organizations. Enter: a Gross income from members or shareholders...................................................... 11a b Gross income from other sources (Do not net amounts due or pard to other sources against amounts due or received from them.).......................................................................................... 11b 12a Section 4947(6)(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 .................. 112b 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 O. b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ..... 13b ............................................................. c Enter the amount of reserves on hand ..........................13c................................................................ 14a Did the organization receive any payments for indoor tanning services during the tax year? ................................................ 532005 12-15-15 P26 Form 990 (2015) Form 990 2015 PNCC Real Estate Foundation, Inc. 54-1921978 p,0,6 81't Govemance, Management, and Disclosure For each "Yes"response to lines 2 through 7b below, and fora "No' response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions. 1a Enter the number of voting members of the governing body at the end of the tax year....... .........„ l a 4 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 1a, above, who are independent ,,,,,,,,,,,,,,,, ib 4 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee?........................................................................................................................ 2 X 3 Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? .......................................... 3 X 4 Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .............. 4 X 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?...........................................................................7a ......................... X b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body?........................................................................................................................... 7bX a Did the organization contemporaneously document the meetings held or written actions undertaken during the year bythe following: aThe governing body?......................................................................................................................................................... as X b Each committee with authority to act on behalf of the governing body? ..................sb ............................................................ X 9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization's mailing address? If "Yes," provide the names and addresses in Schedule O ......................... ........ 9 X 10a Did the organization have local chapters, branches, or affiliates? ..............:................................................. .... 10a X b If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....................................... 10b 11a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? 11a X b Describe in Schedule O the process, if any, used by the organization to review this Form 990. 12a Did the organization have a written conflict of interest policy? If "No," go to line 1312a X ............................................................ b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? 12b .................. c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done 13 Did the organization have a written whistleblower policy?................................................................................................... 13 X 14 Did the organization have a written document retention and destruction policy?................................................................. 14 X 15 Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? a The organization's CEO, Executive Director, or top management official_.................._.__,„,,,,.,__.__.__._,_...,.,...,, 15a X b Other officers or key employees of the organization ............. _.. ........... ..... ... 15b X If "Yes” to line 15a or 15b, describe the process in Schedule O (see instructions). 16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?......................................................................................................................... ................. 16a X b If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to be filed ► None 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. E] Own website = Mother's website ® Upon request 0 Other (explain in Schedule O) 19 Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. 20 State the name, address, and telephone number of the person who possesses the organization's books and records: No. the Foundation - 276-656-0250 532056 12-16-15 P27 PHCC Real Estate Foundation, Inc. 54-1921978 Employees, and Independent Contractors Check if Schedule O contains a response or note to any line in this Part VII L] Section A. Officers Directors Trustees Key Employees and Highest Compensated Employees 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year. • List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid. • List all of the organization's current key employees, if any. See instructions for definition of "key employee." • List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received report- able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations. • List all of the organization's former officers; key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. • List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. ® Check this box if neither the oroanizatinn nor any relatad nrnani,cbo,, cam„ ..e.,. ..w:,.e, a;.,....,,... (A) Name and Title IB) Average hours per week (list any hours for related organizations below line) (c) Position n (do at shark more than one bo., unless person is both an officer and a director/trustee) (D) Reportable compensation from the organization (W-2/1099-MISC) (E) Reportable compensation from related organizations (W-2/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations - - _ - - -E a. (1) Ron Raley President 0,50 X Q Q Q (2) David Purvis Vice President 0,50 X I 1 Q Q Q (3) Pam Allen Treasurer 1.00 X Q Q Q (4) Gary Collins secretary Q,SQ Ix Q Q Q 532007 12-16-15 P2S Form 990 (2015) Form 96O15) PHCC Real Estate Foundation, Inc. 54-1921978 Page 8 art90 I Section A. Officers, Directors, Tru east Key Em to ees, and Highest Compensated Em to ees (continued) (A) Name and title (B) Average hours per week (list any hours for related organizations below line) (C) Position bo.,nuni °s 'checkot an one son ismore hboth an office, and a dtr«baltrustaol (D) Reportable compensation from the organization (W-2/1099-MISC) (E) Reportable compensation from related organizations (W-2/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations _ a = = _ r E _ o va E 2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization IN, 0 lb Sub -total ............ ........ _..... ..__. ► c Total from continuation sheets to Part VII, Section A _ _. .. .. lie d Total add lines 1b and 1c ............ ....._ .. ...... (• 0. 0. 0. . 0 . 0. 0 . 0 . 0 . 2 Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable 3 Did the organization list any former officer, director, or trustee, key employee, or highest compensated employee on line 1 a? If "Yes," complete Schedule J for such individual 3 X 4 For any individual listed on line la, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual 4 X 5 Did any person listed on line to receive or accrue compensation from any unrelated organization or individual for services rendered to the organization?If"Yes,"complete Schedule J forsuch person_._.._ ....................._...._. 5 X 1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar vear endinq with or within the organization's tax vear. (A) Name and business address NONE (B) Description of services (C) Compensation 2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization IN, 0 532008 12-16-15 P29 Form 990 (2015) MWForm ss0 zo15 PHCC Real Estate Foundation, Inc. 54-1921978 Page 9 1 I Statement of Revenue Check if Schedule 0 contains a resoonse or note to an, line in this Part leu 532009 12-16-15 P30 Form 990 (2015) _. _._ _._............__._ Total revenue ......................................... Related or Unrelated .......... Revenu excluded from tax under exempt function business revenue revenue512-514sections cc 1 a Federated campaigns ....._____,._.... 1a '30b Membership dues ........................ 1b c Fundraising events 1c ra �n .........,. d Related organizations ......- 1d a Government grants (contributions) 1e «y f All other contributions, gifts, grants, and similar amounts not included above„ if bMM t 9 Noncash contributions Included In Imes to -H: $ C U m h Total. Add lines to -1f .................._............_._.........__. Business Code 2 a }gym b' b E v c d `off e o Q. If All other program service revenue ............... Total. Add lines 2a -2f ... 3 Investment income (including dividends, interest, and other similar amounts)_ ... ..... .__................ ._.__..... ► 6. 6. 4 Income from investment of tax-exempt bond proceeds ► 5 Royalties .......... ......... .......................... ..._.............. .._. ► I Real 00 Personal 5, 0 0 0. 6 a Gross rents .. . ..................... b Less: rental expenses....___ 7,269. c Rental income or (loss) ..._ 6 7 , 7 31 . d Net rental income or (loss) .................... ............... ► 67,731. 67,731. 7 a Gross amount from sales of Securities 00 Other assets other than inventory b Less: cost or other basis and sales expenses „_._... c Gain or (loss) dNet gain or (loss) ...... ......... ..........._..._....................... ► 8 a Gross income from fundraising events (not including $ of contributions reported on line 1c). See y Part IV, line 18 .......... ..................... a t b Less: direct expenses ......... C Net income or (loss) from fundraising events ............. ► 9 a Gross income from gaming activities. See Part IV, line 19 .._.........._ _........... a b Less: direct expenses .......................... b c Net income or (loss) from gaming activities .................. ► 10 a Gross sales of inventory, less returns and allowances b Less: cost of goods sold_..........,__..__„ b c Net income or loss from sales of invento .................. Miscellaneous Revenue Business Cod 11 a b c d All other revenue ....................................... e Total. Add lines 11 a -11d .._„_ ........................._...,..,__ ► 12 Total revenue. See instructions. _............_.._„_,,,_...,..__._, 67,737. 67,737. 0. 0. 532009 12-16-15 P30 Form 990 (2015) ion, Inc. 54-1921978 Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Check if acneauie G contains a res unse Do not Include amounts reported on lines 6b, 7b, 86, 96, and f06 of Part W11.ex v, nine w an nne m Total expenses uns rm, ,A....................... Program service enses ......................................... Management and eneral expenses �-.. Dl Fun raising expenses 1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ., 2 Grants and other assistance to domestic individuals. See Part IV, line 22 ..................... 3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 .... 4 Benefits paid to or for members ..................... 5 Compensation of current officers, directors, trustees, and key employees ........................ 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 ............................ .. a 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 ................................................ bLegal............................................................ c Accounting ................................................... dLobbying...................................................... e Professional fundraising services. See Part IV, line 17 f Investment management fees ,,,,,,,,,,,,,,,,,,,,,,,, 9 Other. (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Sch 0.) 12 Advertising and promotion ........................... 13 Office expenses ............................................. 14 Information technology .............................. .. 15 Royalties...................................................... 16 occupancy ................................................... 17 Travel......................................................... 18 Payments of travel or entertainment expenses for any federal, state, 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) amount, list line 24e expenses on Schedule 0.) ... a 25- 25. 59,375. 59,375. , 8 28 • 21,828. b c d e All other expenses 25 Total functional expenses. Add lines 1 through 24e 1 , 2 2 8 . 8-1,203. 25. 0 . 26 Joint costs. Complete this line only if the organization reported in column (B) pint costs from a combined educational campaign and fundraising solicitation. Check Sere l0l o iffoub ing SOP 98-2 ASC 958-720 532010 12-16-15 P31 Form 990 (2015) PNCC Real Estate Foundation, Inc. 54-1921978 Check If Schedule O contains a rpsnnntp nr nntu to an., Imm in ♦1.:.- D., v _.. ...._ ... ............. ....................................................................................... (A) Beginning of year Ear1 Cash-nominterest-bearing_..................._... Savings and temporary cash investments3 Pledges and grants receivable, net Accounts receivable, net ................_..._...... 5 Loans and other receivables from current and former officers, directors, 21,858. 1 'i 342.2 jof 34 60,779. 4 927. trustees, key employees, and highest compensated employees. Complete Part11 of Schedule _.._.__..._._................................._............_............._. 6 Loans and other receivables from other disqualified persons (as defined under 5 section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing v employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instr). Complete Part II of Sch L 7 Notes and loans receivable, net 8 Inventories for sale or use8 ........ _.......... _.............._........_._......... _.......... 9 Prepaid expenses and deferred charges ........... 102 Land, buildings, and equipment: cost or other 6 basis. Complete Part VI of Schedule D ...,. _.. I 10a 976,043. b Less: accumulated depreciation .._, 10b 33,71 11 Investments - publicly traded securities ................................................ 12 Investments - other securities. See Part IV, line 11 13 Investments - program -related. See Part IV, line 1113 ................... .. 14 Intangible assets...................................................................... ......... ........... 15 Other assets. See Part IV, line 11 ................ ,__......, „_.,..,., 16 Total assets. Add lines l through 15 mustequal line 34 ...__........_......_..... 964,158. 1oc 942,330. 11 12 597. 15 1,047,392. 16 1,031,599. A J 17 Accounts payable and accrued expenses ............. _...... ... 18 Grants payable ... ,.... .... 19 Deferred revenue ..............._.,....._.., ..... ._ ................................................... 20 Tax-exempt bond liabilities......_......_.........__......._._..._.............._......... ... 21 Escrow or custodial account liability. Complete Part IV of Schedule D .,,., .. 22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and 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 3,640. 17 1 , 3 3 8 . 18 19 20 21 22 24 parties, and other liabilities not included on lines 17-24). Complete Part X of ScheduleD...... ._..._..... ..._........ ......... ...._......... .._......... ... ...... _.... _......._ 26 Total liabilities. Add lines l7through 25 ..... ........ ._.......... ............__........_.. 25 3,640. 26 1,338. y m27 2 M LL Organizations that follow SFAS 117 (ASC 958), check here ► and complete lines 27 through 29, and lines 33 and 34. Unrestricted net assets .._ ...,.__.1 ..... ., _......._ _.,._.,, 28 Temporarily restricted net assets564, .................................................................. 29 Permanently restricted net assets ..... ........_._......__................... _.._......... Organizations that do not follow SFAS 117 (ASC 958), check here ► 479,217. 27 476,191. 5 3 5. 28 554,070. 29 o d Z and 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....... ........ ....... 31 32 1,043,752. 33 1,030,261. 1 , 047,392. 34 1, 0 31, 5 9 9 . 532011 12-16-15 P32 Form 990 (2015) Form 990 2015 PHCC Real Estate Foundation, Inc. 54-1921978 Pa e12 Part XI Reconciliation of Net Assets 1 Total revenue (must equal Part VIII, column (A), line 12)1 .............................................................................. 67,737. 2 Total expenses (must equal Part IX, column (A), line 25) 2 81,228. 3 Revenue less expenses. Subtract line 2from line l.................................................................................... 3 —13,491. 4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) _. ... ............. 4 1 , 043,752. 5 Net unrealized gains (losses) on investments 6 Donated services and use of facilities6 ............... ........ ..__................ ........ ........ _._................... 7 Investment expenses _ ... ............_ _ ................... ................._......._..... ................................................... _ 7 8 Prior period adjustments................................................... ................................. .......... ....__.._...___...... 8 9 Other changes in net assets or fund balances(explain in Schedule 0) ,,,,,,,.,_._ .............. .................._ 9 0. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, fine 33, column (B)) .... _...-- to 1.030.261. Fl[�FY�L•]{FY-I.1lR•3{:�{•Y-T•i•I IL.T lliiilGi�ill � 1 Accounting method used to prepare the Form 990: E:1 Cash ® Accrual EJ Other If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O. 2a Were the organization's financial statements compiled or reviewed by an independent accountant? .................................... 2a X If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: 0 Separate basis 0 Consolidated basis 0 Both consolidated and separate basis b Were the organization's financial statements audited by an independent accountant?......2b X ................................................... If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: = Separate basis ® 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? ............................................. 2c X If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. 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 Actand OMB Circular A-133?............................................................................................................................................. 3a X b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit 532012 12-16-15 P33 Form SCHEDULE A IOMB No. 1545-0047 (Form 990 or 990 -EZ) Public Charity Status and Public Support 2015 Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. Department of the Treasury 110,Attach to Form 990 or Form 990 -EZ. Open to Public Internal Revenue Service 00, IMwmation about Schedule A (Form 990 w g90 -EZ) and its Instructions is atwww.Ira.90001Im980. Inspection rncC Real Estate Foundation, Inc. 1 54-1921978 JPartl I Reason for Public Charity Status (Ail 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 A church, convention of churches, or association of churches described in section 170(b)(1)(A)(1). 2 A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990 -EZ).) 3 A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(ili). 4 0 A medical research organization operated in conjunction with a hospital described in section 170(b)(1NA)(ili). 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 0 A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v). 7 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)(1xAxvi). (Complete Part II.) a A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.) 9 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 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(x)(2). (Complete Part III.) 10 An organization organized and operated exclusively to test for public safety. See section 509(a)(4). 11 ® 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 Mma)(3). Check the box in lines 11a through 11 d that describes the type of supporting organization and complete lines 11 e, 11f, and 11 g. a El Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B. b ® Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C. c E::] Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E. d Type III non -functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V. e Check this box if the organization received a written determination from the IRS that it is a Type 1, Type II, Type III functionally integrated, or Type III non -functionally integrated supporting organization. f Enter the number of supported organizations .................................................. g Provide the followino information about the su000rted omani7afinnlsl (1) Name of supported organization g (ii) EIN (iii) Type of organization described on lines 1x9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) Amount othherer support (see ee instructions) Yes No Patric Henry Community College 54-1185803 5 X 0. 0. Total 0.1 0. LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 99D -EZ. 532021 09-23-15 P34 Schedule A (Form 990 or 990 -EZ) 2015 ScheduleA Form990 or 990- 2015 PHCC Real Estate Foundation, Inc. 54-1921978 pa e2 art upport c e u e or Organizations Described in Sections Iv an vl (Complete only if you checked the box on line 5, 7, or 8 of Part I or'd the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) Section A. Public Support Calendar year (or fiscal year beginning in) Is. a 2011 b 2012 c 2013 d 2014 a 2015 Total 16a33 1/3% support test - 2015. If the organization did not check the box online 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization► .......................................................................................... 0 b 33 1/3% support test - 2014. 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 1 Gifts, grants, contributions, and membership fees received. (Do not ► 0 17a 10% -facts-and-circumstances test - 2016. 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 VI how the organization meets the "facts -and -circumstances" test. The organization qualifies as a publicly supported organization ........................................ include any "unusual grants.") b 10% -facts-and-circumstances test - 2014. 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-andcircumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-andcircumstances" test. The organization qualifies as a publicly supported organization ........................ ► 2 Tax revenues levied for the organ. is, EJ ization's benefit and either paid to or expended on its behalf ............ 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. subved line 5 from line 4. aecuon B. t otai Support Calendar year (or fiscal year beginning in) No, a 2011 b 2012 a 2013 2014 a 2015 Total 7 Amounts from line 4 ..................... 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources 9 Net income from unrelated business activities, whether or not the business is regularly carried on 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) 11 Total support. Add lines 7 through 10 12 Gross receipts from related activities, etc. (see instructions) .................................. 1p 13 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) 14 Public support percentage for 2015 (line 6, column (f) divided byline 11, column (f)) .................................... 14 °% 15 Public support percentage from 2014 Schedule A, Part II, line 14 ........................... 16a33 1/3% support test - 2015. If the organization did not check the box online 13, and line 14 is 33 1/3% or more, check this box and stop here. The organization qualifies as a publicly supported organization► .......................................................................................... 0 b 33 1/3% support test - 2014. 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 ............................. ► 0 17a 10% -facts-and-circumstances test - 2016. 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 VI how the organization meets the "facts -and -circumstances" test. The organization qualifies as a publicly supported organization ........................................ ► 0 b 10% -facts-and-circumstances test - 2014. 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-andcircumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-andcircumstances" 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 ......__. is, EJ 532022 09-23-15 P35 Schedule A (Form 990 or 990-F2) 2015 orm 990 990 2015 PHCC Real Estate Foundation, Inc. 54-1921978 Pa e3Supportc e1 e or urganizations Uesciribed In Section a (Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part 11. If the organization fails to qualify under the tests listed below, please complete Part II.) Section A. Public Support Calendar year (or fiscal year beginning in)► a 2011 b 2012 a 2013 d 2014 a 2015 Total 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") 2 Gross receipts from admissions, merchandise sold or services per- formed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities that are not an unrelated trade or bus- iness under section 513 4 Tax revenues levied for the organ- ization'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 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 ..................... 8 Public sUbli Section B. Total Support Calendar year (or fiscal year beginning in) 10- a 2011 b 2012 c 2013 d 2014 a 2015 Total 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 ............ c Add lines 10a and 10b .................. 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 VI.) 13 Total support. (Add lines 9, 101 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, 15 Public support percentage for 2015 (line 8, column (f) divided byline 13, column (f)) .............._.___.,..,____,_,. of Investment Income 17 Investment income percentage for 2015 (line 10c, column (f) divided byline 13, column (f)) ............. .__ ._.17 % 18 Investment income percentage from 2014 Schedule A, Part III, line 17 .......... _. ............... ... _ _........ I... _ _ _. 18 % 19a33 1/3% supporttests -2015. 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 _ _, _, _...._ 11.0 ................. . b 33 1/3% support tests - 2014. 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 oroanization did not check a box on line 14, 19a, or 191b, check this box and see instructions ........................ ► 0 532023 09-23-15 Schedule A (Form 990 or 990 -EZ) 2015 P36 SWForm 990or990-F2 2015 PHCC Real Estate Foundation, Inc. 54-1921978 Pa e4 Supporting Organizations (Complete only if you checked a box in line 11 on Part 1. If you checked 11 a of Part I, complete Sections A and B. If you checked 11 b of Part I, complete Sections A and C. If you checked 11c of Part I, complete No I Are all of the organization's supported organizations listed by name in the organization's governing documents? If "No' describe in Part VI how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain. 1 X 2 Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2). 2 X 3a Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? if "Yes,' answer (b) and (c) below. 3a X b Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination. 3b c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use. 3c 4a Was any supported organization not organized in the United States ("foreign supported organization")? If "Yes," and if you checked 11 a or 11b in Part I, answer (b) and (c) below. 4a X b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If "Yes,' describe in Part W how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations. 4b c Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If "Yes, " explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes. 4c Se Did the organization add, substitute, or remove any supported organizations during the tax year? It "Yes," answer (b) and (c) below (if applicable). Also, provide detail in Part Vl, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; O the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document). 5a X b Type I or Type it only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document? 5b Sc c Substitutions only. Was the substitution the result of an event beyond the organization's control? 6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than () its supported organizations, (i) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (ii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? If "Yes," provide detail in Part W. 6 X 7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35"A controlled entity with regard to a substantial contributor? If 'Yes," complete Part I of Schedule L (Form 990 or 990 -EZ). 7 X 8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If "Yes,' complete Part I of Schedule L (Form 990 or 990-E4. 8 X 9a Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If "Yes, " provide detail in Part VI. 9a X b Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If'Yes," provide detail in Part Vi. 9b X 9c X c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If "Yes," provide detail in Part Vl. 10a Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type 11 supporting organizations, and all Type III non -functionally integrated supporting organizations)? If "Yes," answer 10b below. 10a X b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to 532024 0e-23-15 P37 Schedule A (Form 990 or 990 -EZ) 2015 54-1921978 11 Has the organization accepted a gift or contribution from any of the following persons? a A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization? 11a X b A family member of a person described in (a) above? 11b X c A 35% controlled entitv of a Demon described in (a) or (b) above?lf "Yes' to a, b, or c, provide detail in Part Vl. I. X 1 Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization's directors or trustees at alt times during the tax yeah If "No," describe in Part VI how the supported organization(s) effectively operated, supervised,or controlled the organization's activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year. 2 Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If "Yes," explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, I Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organzation(s)? If 'No,' describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed 1 Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (i) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? 2 Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) cr (i) serving on the governing body of a supported organization? If "No, " explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s). 3 By reason of the relationship described in (2), did the organization's supported organizations have a significant voice in the organization's investment policies and in directing the use of the organization's income or assets at all times during the tax year? If "Yes, " describe in Part W the role the organization's supported oroanizations played in this recard. 1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the yea(see Instructions). a 0 The organization satisfied the Activities Test. Complete line 2 below. b The organization is the parent of each of its supported organizations. Complete line 9 below. c The organization supported a governmental entity. Describe in Part V1 how you supported a government entity (see ins 2 Activities Test. Answer (a) and (b) below. a Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes, " then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more of the organization's supported organization(s) would have been engaged in? If Yes,' explain in Part VI the reasons for the organization's position that its supported organizations) would have engaged in these activities but for the organization's involvement. 3 Parent of Supported Organizations. Answer (a) and (b) below. a Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part Vl. b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each 592025 09-23-15 P39 KI in m Schedule A (Form 990 or 990 -EZ) 2015 Estate 54-1921978 1 — U Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See Instructions. All VY161 1 C,u,v„-,u„V.,u„a„ ,,,.c ,n.c�au ....n• v. .....�................ Section A - Adjusted Net Income .......... .-..-. .....__ .. _. (A) Prior Year (e) Current Year (optional) 1 Net short-term capital gain 1 2 Recoveries ofprior-year distributions 2 3 Other gross income see instructions 3 4 Add lines 1 through 3 4 5 Depreciation and depletion 5 6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income see instructions 6 7 Other expenses see instructions 7 8 Adjusted Net Income subtract lines 5 6 and 7 from line 4 8 Section B - Minimum Asset Amount (A) Prior Year (B) Current Year (optional) 1 Aggregate fair market value of all nonexempt -use assets (see a Average moncrn value or secunues b Average monthly cash balances 1b c Fair market value of other non -exempt -use assets 1c d Total add lines 1a, 1b, and 1 c)1d e Discount claimed for blockage or other 4 Cash deemed held for exempt use. Enter 1.1/2% of line 3 (for greater amount, Section C - Distributable Amount I I Current Year 1 Adjusted net income for prior year (from Section A line 8 Column A) 1 2 Enter 85% of line 1 2 4 Enter greater of line 2 or line 3 a 5 Income tax imposed in prior year 5 6 Distributable Amount Subtract line 5 from line 4, unless subject to 7 U Check here if the current year is the organization's first as a non -functionally -integrated Type III supporting organization (see instructions) Schedule A (Form 990 or 990 -EZ) 2015 532026 08-23-15 P39 ate Foundation. Inc aecrmn u - ulsumunons _ I Current Year 2 Amounts paid to perform activity that directly furthers exempt purposes of supported of 7 Total annual distributions. Add lines 1 through 6. 8 Distributions to attentive supported organizations to which the organization is responsive line 6 M Oil(iii) Excess Distributions Underdistributions Distributable Section E -Distribution Allocations (see instructions) Pre -2015 Amount for 2015 1 Distributable amount for 2015 from Section C, line 6 2 Underdistributions, if any, for years prior to 2015 Excess distributions a b C d From 2013 e From 2014 f Total of lines 3a thro 9 Applied to underdisti In Applied to 2015 distl i Can-vover from 2010 4 Distributions for 2015 from Section D, underdistributions c Remainder. Subtract lines 4a and 4b from 4. 5 Remaining underdistributions for years prior to 2015, ff any. Subtract lines 3g and 4a from line 2 (if amount 6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see 7 Excess distributions carryover to 2016. Add lines 3j 532027 09-23-15 P40 Schedule A (Form 990 or 990 -EZ) 2015 Real Estate Foundation, Inc. 54-1921 un -1 I bupplemental InTormation. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11 a, 11 b, and 11 c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.) 532028 09-23-15 P41 Schedule A (Form 990 or 990 -EZ) 2015 SCHEDULE D Supplemental Financial Statements I► Complete H the answered "Yes" on Form 990, OMB No. 1565-0047 2015 (Form 990) organization Part IV, line 6, 7, 8, 9, 10, 11a, ttb, Ito, 11d, tie, 11f, 12a, or 12b. 1► Attach to Form 990. Open to Public Department of the Treasury into nai Revenue s. ic. Information about Schedule D Form 990 and Its instructions is at www.1m. ov/form990. Inspection Name of the organization Employer identification number PHCC Real Estate Foundation, Inc. 54-1921978 [E2rtlJ Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.Complete if the organization answered "Yes" on Form 990, Part IV, line 6. (a) Donor advised funds (b) Funds and other accounts 1 Total number at end of year ............................................. 2 Aggregate value of contributions to (during year) .........._ 3 Aggregate value of grants from (during year) ................. 4 Aggregate value at end of year ,.,,.. I ............ -............ 5 Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control?...................................................... Yes El No 6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring imermissible dvate benefit?.................................................................................................................................... Yes No Part II Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7. 1 Purposes) of conservation easements held by the organization (check all that apply). Preservation of land for public use (e.g., recreation or education) E] Preservation of a historically important land area 0 Protection of natural habitat 0 Preservation of a certified historic structure 0 Preservation of open space 2 Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a day of the tax year. a Total number of conservation easements............................................................................................... b Total acreage restricted by conservation easements .............. ................................ c Number of conservation easements on a certified historic structure included in (a) of Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register................................................................................................................. 3 Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year 1110� 4 Number of states where property subject to conservation easement is located 0. 5 Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements R holds?.. ......................................................................... Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year 1111. 6 7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year 00$ 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) andsection 170(h)(4)(B)(n)?.._............................................. .............. ............................. ..................................... ....... = Yes No 9 In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for conservationeasements. Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete if the organization answered "Yes' on Form 990, Part IV, line 8. to 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 hems: (i) Revenue included on Form 990, Part VIII, line 1.................................................................................... 111� $ (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 Revenue included on Form 990, Part VIII, line 1.......................................................................................... $ b Assets included in Form 990 Part X......................................................................................................... ► $ LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule D (Form 990) 2015 532051 11-02-15 P42 PHCC 54- 3 Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply): a = Public exhibition d Loan or exchange programs b Scholarly research e Other c Preservation for future generations 4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. 5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as art of the o anization's collection? .................................... Yes No Part IV I Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. is Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X7 ......... .. ..................................................... ................................................................................... ED Yes No b If "Yes," explain the arrangement in Part XIII and complete the following table: c Beginning balance dAdditions during the year ... ... ......... .._....... .... ................. ......_..._..._....... ............. .............. ................. 1d e Distributions during the year ....... ...... ............................. .._..........._._..._..........._..,......................_...... 1e fEnding balance....................................................................................................................................... 1f 2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? .... ........... LJ Yes O No b If "Yes " ex Iain the arran ement in Part XIII. Check here if the explanation has been provided on Part XIII ....................................... ParF Fndewmant Funds. Oomnlete if the orcanization answered "Yes" on Form 990, Part IV, line 10. _ a Current year b Prior ar c Two years back d Three years back a Four years back 1a Beginning of year balance ..................... b Contributions .......................................... c Net investment earnings, gains, and losses d Grantsor scholarships ........................... e Other expenditures for facilities and programs ....................................... If Administrative expenses ........................ g End of year balance .............................. 2 Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as: a Board designated or quasi -endowment jo- % b Permanent endowment 0, % c Temporarily restricted endowment 0- % The percentages on lines 2a, 2b, and 2c should equal 100%. 3a Are there endowment funds not in the possession of the organization that are held and administered for the organization by. Yes No (i) unrelated organizations................................................................................................................................................ 3a i (H) related organizations3a ................................................................................................................................................... ii b If "Yes" on fine 3a(ii), are the related organizations listed as required on Schedule R?., ............................................. ........ 3b 4 Describe in Part XIII the intended uses of the organization's endowment funds. Part M Land, Buildings, and Equipment. Complete if the organization answered "Yes" on Form 990, Part IV, line 11 a. See Form 990, Part X, line 10. Description of property (a) Cost or other (b) Cost or other (c) Accumulated (d) Book value basis (investment) basis (other) depreciation 1aLand............................................................ bBuildings...................................................... c Leasehold improvements dEquipment ................................................... 532052 09-21-15 P43 . I JYG, II.. Schedule D (Form 990) 2015 ScheduleD Form990 2015 PHi Real Estate Foundation, Inc. 54-1921978 Pa e3 Part Vfl Investments - Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12. (a) Description of security or category (including name or security) (b) Book value (c) Method of valuation: Cost or end -of -year market value (1) Financial derivatives (2) Closely -held equity interests (3) Other line 2. Liability for uncertain tax positions. In Part All, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 7401 Check here if the text of the footnote has been provided in Part XIII Schedule D (Form 990) 2015 532053 09-21-15 P44 Inc. 54-1921978 Pal rt Xi I Heconclflatlon of Revenue per Audited Flnanclal btatements wltn Kevenue per Keturn. Complete if the organization answered "Yes" on Form 990, Part IV, line 12a. 1 Total revenue, gains. and other support per audited financial statements 1 , 1 11 1 1 ,_____,_ ___,_ 1 2 Amounts included on line 1 but not on Form 990, Part VIII, line 12. a Net unrealized gains (losses) on investments ...,._.,,..,..,.. 2a b Donated services and use of facilities .................................................................. 2b c Recoveries of prior year grants ,,,,,, ......._.. 2c d Other (Describe in Part XIII) _.. __. 2d e Add lines 2a through 2tl 2e 3 Subtract line 2e from line 1 3 4 Amounts included on Form 990, Part VIII, line 12, but not on line 1: a Investment expenses not included on Form 990, Part VIII, line 7b ....................... 4a b Other (Describe in Part XIII.) .. ... ..__. ..... 4b c Add lines 4a and 4b 4c ral rtAll Reconcivatlon of txpenses per Auanea rinanclal btatements wlm txpenses per Return. Complete if the organization answered "Yes" on Form 990. Part IV, line 12a. 1 Total expenses and losses per audited financial statements.,,_ I I I I __ 1 , 1 11 1 1 ,_____,_ ___,_ 1 2 Amounts included on line 1 but not on Form 990, Part IX, line 25: a Donated services and use of facilities 2a b Prior year adjustments._................._.......__..................................................... 2b c Other lasses ..._ ................................................. _..__ ....................................... 2c d Other (Describe in Part XIII.) ....__. _. _...... ..__.......__ 2d e Add lines 2a through 2d ... _, _,. 2e 3 Subtract line 2e from line 1 3 4 Amounts included on Form 990, Part IX, line 25, but not on line 1 a Investment expenses not included on Form 990, Part VIII, line 7b 4a b Other (Describe in Part XIII.) _., .,__.. ..,,.,. 4b c Add lines 4a and 4b4c Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1 a and 4; Part IV, lines lb and 21c; 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. a9-2r-rs P45 Schedule D (Form 990) 2015 SCHEDULE O (Form 990 or 990 -EZ) Department of the Treasury Internal Revenue Ser" Name of the organization Supplemental Information to Form 990 or 990 -EZ Complete to provide information for responses to specific questions on 2015 Form 990 or 990 -EZ or to provide any additional information. Do. Attach to Form 990 or 990 -EZ. Open to Public Employer identification number ion. Inc. 1 54-1921978 Form 990, Part I, Line 1, Description of Organization Mission: Patrick Henry Community College Foundation. Form 990, Part VI, Section B, line 11: A copy of Form 990, either paper or a PDF file, was provided to each voting member of the foundation's board of directors for review before filing. Form 990, Part VI, Section C, Line 19: The Foundation makes it governing documents, conflict of interest policy, and financial statements available to the public upon request, either for viewing in the Foundation's office or providing copies to the requester. LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990 -EZ. Schedule O (Form 990 or 990 -EZ) (2015) 532211 09-02-15 P46 SCHEDULER Related Organizations and Unrelated Partnerships (Form M) Is Complete if the organization answered "Yee" on Form M, Part IV, line 33, 34, 35b, 30, or 37. 2015 Is to Form M. .seri en a,hl Name of the organization part I Identification of Disregarded Entities Complete if the organization anawered'Yes' on Form 990, Pert IV, line 33. number Is) Name, address, and EIN (if applicable) of disregarded entity (b) Primary activity lo) Legal domicile (and. or foreign country) (d) Total income lel Endaf-year assets (O Direct controlling entity Yes No Patrick Henry community college Foundation - 54-1105803, 645 Patriot Ave, Martinsville, supporting community VA 24112 ollege 4ginia 01(c)(3) Arm 11b, II /A x part 11 Identification of RelNed Tae -Exempt Organizations Complete if the organization answered'Yes' on Form g9Q Part IV, line 34 because it had one or more related tanazempt organizabons during the tax year. W Ib) Name, address, and EIN primary activity of related organization In) Legal domicile (slate or foreign country) (d) Exempt Code section la) Public chesty stat.. (if section 501(c)(3)) (1) Direct controlling entity s.osoel�faaNui media .may' Yes No Patrick Henry community college Foundation - 54-1105803, 645 Patriot Ave, Martinsville, supporting community VA 24112 ollege 4ginia 01(c)(3) Arm 11b, II /A x For palosrwurk Reduction Act Notice, see the Inati.ob... for Form M. 691161 oe..1l LRA P47 Schedule R (Form 990)2015 Soh d I R(F 990)2015 PRCC Real Estate Foundation Inc. - 54-1921978 P.ge2 Part III Identification of Related 0r9anizationa Texebla as a PartnerahiP Complete if the organization enawrad "Yes' on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year. (a) Name, add,.., and EIN of related argenaetion Ibl Pmnery activity (c) aom ie pates —n" (d) Direct comrdlirg entity (el Predominant income I.Odbd translated, exclluded translated, under sections 512-514) (fl Share of total income 19) Share m endaf-year assets (h) p=osoodonm apse (1) Code V-UBI amount in box 20 of Schedule K-1 (Form 1085) 8) m^ni T��se�s (k) Percema9e ownership Year No No Part IV Identification of Relatetl Organization. Taxable as a Corporation or Trust Complete if the organization answered'Yes" on Form 990, Port IV, lire 34 because it had one or more rected izmione treated as a comomtion or trust durimc the tax Year. (a) add,.., and EIN of related oMarnzatim (b) Primary activity Prima (o)(d) Laamma. gs g a av) Direct controlling amity (a) Type of amity (C corp, S corp, artrust) (fl Share of total income (9) Share of end-of.yeer ..sets (h) Porcenta9e ownership allNemo, 3) 512eN1 rr v Vas No 5]2182 09AL15 P48 Schedule R (Form 990) 2015 Schedule R (Form 99M 2015 PNCC Real Estate Foundation, Inc. 54-1921978 Pecs 3 Pat Transactions With Ralersil Organizations Complete if the organization answered 'Yes'on FornigN, Part IV, line 34, 35b, or 38. Nota. Complete line I if any entity is listed in Parts 11, 111, or IV of this schedule. I During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Paris 1110. s Receipt of (i),nt ... t, (ii) arn.b., (ifi),.yalfiss, or(iv) rent from a controlled! entity ........... .......... . ............ . ..... ... ...... ..... ......... ...... .. . ........ b Gift, grant, or capital contribution to related organization(s) . ..... .. . ... .. ..... .... . ......... .. . . . ..... . ..... .... ... .... . c Gift, grant, orcapdal contribution from related organization(.) .............. . .. . ....... .. .. ... .... . ... .... ....... .. .. ..... . ... .. ..... it 1-oam, or scan guarantees to or for related organization(s) ...... ... . ..... . ..... . .... .. .. ... ..... ... . * Loans or loan guarantees by related oManization(a) . _ .. ..... ... .. . . .. ... ....... .. .. I Dividends from related m9anization(s) .. .... . . ........ ... ... ......... .. .. . ........... . ... .... ... . ... ... .. .. .. ... ... g Sala of assets to related organization(a) ........ ..... ...... h purchase of assets from related organization(s) ........ ............... . . ...... ... . ... .......... .... I Exchange of assets with related organization(s) .. ... .. .... .. . . ..... ...... ....... ...... . j Lease offacriffies, equipment, a other inuretato related organization(.) .... ............ . . ....... .... ... ... . .. .... . k 1-aaaeoffsoildes, equipment, oroftneraessurfrom related organization(s) ................ ......... . .... ... .. ...... I Performance of six -vices or membership or fundraising solicitations for related organization(s) ...... . rn Performance of services w membership or fundlizinlin, solicitations by misted organizaton(s) .. .. ... * Sharing of facilities, equipment, mailing lies, or other assea with related oram.etW(.) ... . ... . . .... .. ......... .... ...... * Sharing of paid employees with related organization(s) .. ........... . . . ................ .. ...... ... .. . .. . ....... .. ... . ... p Reimbursement paid to rained organization(s) for expenses _ , ... . . .... .... q Reniburashent paid by related organization(s)for expenses ... ..... ..... .. r OthertrwaferofcwhapropedytoreleedoManizWion(s) . . ......... . a Other transfer of cash or property from related orgamizabon(s) X X 2 If the answer to any of the above is 'Yes, 'seethe instructions for information on who N Name f,.Ie.d organization must complete this (b) Transaction type line including covered (a) Amount involved Glabonships and transaction mmanolos. (d) Method of determining amount involved (1) (2) (3) (4) (5) (at S Ixl cii-ixi-11 P49 Sch.d.I.Pfform W0)2015 PHCC Real Estate Foundation, Inc. 54-1921978 pa..a Part VI Unrelated Organization. Taxable as a Partnership Complete N the organization entreated 'Yes' on Form 99Q Part IV, line 37. Provide the following Information for each entity taxed ea a partnership thr h which the organization conducted more than five percent of ds activities (measured by total assets or gross revenue) that was not a related omanization. See instructions r.oarclaoe..I.e n for certain investment partnerships. (a) Name, address, and EIN of entity (b) Primary adivtty lel Legal domicile (state or foreign countM (10 Predominant income (related, unrelated, eX'tuded frenno, under sections 512.5 14)) ace mer vial) >> as IN. If) Share of total income (9) Share of endaf-year assets (h) @;moor life- w Ba (1) Code V-UBI amouminb,,2o of SchedulsO (Form 1065) 0) oea 'rI (k) Percentage ownership u No vae4 ae-re-ss P50 Sohedule Ft (Farm M) 2015 :ate Foundation, Inc. 54-1921978 Provide additional information for responses to questions on Schedule R (see instructions). 532165 09-08-15 P51 Schedule R (Form 990) 2015 r�.. PITTSYLVANIA COUNTY, VIRGINIAyt_ ' SHIRLEY Y. HAMMOCK, COMMISSIONER of THE REVENUE l PO Box 272 Chatham, VA 24531 ' Y Phone: 434432-7940 Fax: 434-432-7957 ys+ Email: shirlev.hammock(EDoittoov.ora ^"n Website: www.oittsvlvaniacountv.00v REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION APPLICATION INFORMATION Please read the information below, prior to completing the application. Return your completed application and any supporting documentation to the Commissioner of the Revenue Office. The Commissioner of the Revenue will submit the application and a report on the revenue impact to the locality and its taxpayers of exempting the property to the Board of Supervisors. After review by the County Administrator, the application request will be placed on the agenda for the Board of Supervisors to consider no sooner than five days after a notice of public hearing shall be published in the newspaper. Note, the applicant will be responsible for the cost of the advertisement per §58.1-3651. IMPORTANT INFORMATION FOR APPLICANT 1. The Code of Virginia sets out that exemption is the exception and that exemptions are to be strictly construed. If there is any doubt, the doubt must be resolved against the party claiming the exemption. The applicant has the burden of proving that the property meets the qualifications for the exemption. 2. The Commissioner of the Revenue requests the application data in accordance with Article X, Section 6 of the Constitution of Virginia and Chapter 36 of the Code of Virginia 58.1 Title Taxation. 3. Submitting this application for Real Property/Personal Property Tax Exemption does not release the owner from the responsibility of timely payment of taxes prior to official approval. 4. The applicant must submit a separate application for each parcel that is to be considered for real estate tax exemption. 5. The applicant is responsible for reporting the detailed uses of the property in accordance with the Code of Virginia as well as the amount of land that is attributable to each specified use. 6. The Assessor and/or Commissioner of the Revenue may conduct field inspections as a part of the application process. 7. If the Pittsylvania Board of Supervisors approves the request for tax exempt status, the exemption will become valid on the date as noted in the approved ordinance and contingent on the continued use of the property in accordance with the purpose for which the exemption is granted. The County will notify organization of the outcome of the public hearing and the vote. If you have any questions regarding the procedure outlined above, please contact the Commissioner of the Revenue at(434)432-7940. P52 peri r,it y PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE PO Box 272 Chatham, VA 24531 Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website: www.i)ittsylvaniacountvva.gov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE) APPLICANT:214U, &"e, QUPdATtW REALESTATE: REQUESTED PARCEL ID(S) c�4a0- L13- Q534 PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE da. 000 ASSESSED VALUE LEVY LEVY TOTAL LOSS OF REVENUE IF EXEMPT: Iaq, 2 I Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P53 a n PHCC REAL ESTATE FOUNDATION INC Acct 232675 Dst: 04 AC:Tx 0.0000 Map k: 2420-43-2534 Card 1 of 1 Date 11/29/16 C15: 2 AD 0 Desc BLAIRMONT ACRES SUBD 151C0010J00100 645 PATRIOT AVE Sk/Pg: LR16/05830 Zen: R-1 LOT 10 SEC J Printed:12/07/16 Mb/Lt: Nhd: 100 08 Lc Util: Updated:KS MARTINSVILLE, VA 24112 Cons : 0 Rd : 01 PAVED Tope Aft: DRURY LANE Appr: SS Date:02/12/13 Info: E Time: 11:40 BnBmUse MhCdDes Rem Ayb CndUnits Rate Pc Fo RsnEo RSnIcValue SOLmSeg Type Ac Frnt Dpth SE TFctrLtUp Adj%Value Remarks Mkt Val L 22,DO0 1FV1000 SITE VALUE 0 22,000LOT WOODED Mkt Val B 0 Mkt Val T 22,000 Def Val 0 Net Val 22,000 Old Mkt L 22,000 Old Mkt B 0 Old Def 0 Old Net 22,000 P54 Pittsylvania County Shirley Y.Hammock, Commissioner of the Revenue c a PO Box 272 Chatham, Va 24531 •:'• V�• y Phone: 434-432-7940 Fax: 434-432-7957 is +TM Email: shirlev.hammock(a�p tteov.ore A Website: www.oittsylvan'acountyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-43-2534 (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation MAILING ADDRESS: FEDERAL ID#: 54-1921978 PROPERTY ADDRESS: Blal LEGAL DESCRIPTION OF PROPERTY: ACREAGE: Martinsville, VA 24112 CITY, (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION:. 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES .� NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community Foundation, including receiving, purchasing, owning; developing, operating, leasing, selling, an dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECiPIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND {AND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P55 BEGINNING DATE June 2016 Continued Applicant: PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES NO IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES No IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP: ARE DEDUCTIBLE BY THE DONOR? YES No (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS. THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPT{ON IS SOUGHT? YES. NO 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OFA REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NO.� 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I J I 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME A PART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THEPERIODFROM July 1, 2014 TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. (C) ATTACH A LIST REFLECTING THE NAMES OFALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or officers. P56 Contihued ' Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Notapplicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (E) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: 3 P57 DATE: Dec. 1, 2016 Pittsylvania 2420-43-2534.pdf Page 8 of 12 TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 DNTA 3 PERSON: Gregory J. Hodges .TALI PHONE NUMBER:, -X76.636:028 I, Gregory J. Hodges - - , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR 11 NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE./OFFICER TITLE' Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND ETRN 7 B£F ME THIS DAY OF L NOTARY PUBLIC: Cy My COMMISSION EXPIRES: ZOlB ••.•�MpRri �A °•.,° ��' NOTARY'•�!� . W ; PUBLIC 7335308 ' ' MY COMMISSION % �O ': EXPIRES https://cfl.dropboxstatic.com/static/javascript/pdf-js/Ddf-j s-9e9df56/web/viewer-vflPDUR... 12/1/2016 P58 RGl , PITTSYLVANIA COUNTY, VIRGINIA �� . SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE Y I ` PO Box 272 Chatham, VA 24531 , y y /' Phone: 434-432-7940 Fax: 434-432-7957 �iY.1e Email: shirley.hammock@pittgov.org y @pittgov.org Website: www Dittsylvaniacountvva gov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED By COMMISSIONER OF THE REVENUE OFFICE) ' P. MAREMPMROMW REAL ESTATE: REQUESTED PARCEL ID(S) ASSESSED VALUE M PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE Date of public hearing: Effective Date of exemption: LEVY • .1 LEVY TOTAL LOSS OF REVENUE IF EXEMPT: I Aq _ R Q Approved or Disapproved: ignature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P59 PHCC REAL ESTATE FOUNDATION INC 645 PATRIOT AVE MARTINSVILLE, VA 24112 DRURY LANE Appr: SS Date:08/01/13 Into: E Time: 4:12 Bn BmUse MhCdDes SnIaReg Type Ac 1 FV1000 SITE VALUE Acct 232875 Dst: 04 AC:Tx Date 11/29/16 Cls: 2 Ap Bk/Pg: LR16/05830 Zen: R-1 Mb/Lt: Nhd: 100 0% Cons : 0 Rd : 01 PAVED 0.0000 Map H: 2420-43-3426 0 Desc RLAIRMONT ACRES SURD LOT 9 SEC J to Util: Top. Rem Fret Dpth Sf TFctrLtUp P60 Ayb CndUnits Rate Adj%Value Remarks 0 22,000 LOT. Card 1 of 1 151C0010J00090 Printed:12/07/16 Updated:BR Att: PdFo RsnEo RsnlcValue Mkt Val L 22,000 Mkt Val B 0 Mkt Val T 22,000 Def Val 0 Net Val 22,000 Old Mkt L 22,000 Old Mkt e 0 Old Def 0 Old Net 22,000 Pittsylvania County . Shirley Y. Hammock, Commissioner of the Revenue ' • +±� ? PO Bax 272 Chatham, Va 24531 ••• v •• • Phone: 434-432-7940 Fax: 434-432-7957 ''� Email: shirlev.hammock@pittgov.ol Website: www.pittsvlvaniacouniyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ✓❑ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-43-3426 (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation ACREAGE: MAILING ADDRESS: 645 Patriot Ave. Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ll 54-1921978 PROPERTY ADDRESS: Blairmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: Lot 9, Section J (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION, NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES —LJ— NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, an o—d t envise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION 100% DESCRIPTION OF USE Held for sale P61 BEGINNING DATE June 2016 Continued Applicant: PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES NO_z_ IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO. IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES �I�NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 - (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THEABCBOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES NO 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NO 7_ 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I J I 11. REQUIRED DOCUMENTATION (A) .ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME A PARTOF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014 TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. _ (C) ATTACH A LIST REFLECTING THE NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or officers. P62 Continued ° Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3661. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE. IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 1, Gregory J Hodges AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: 3 DATE: Dec. 1, 2016 P63 Pittsylvania 2420-43-3426.pdf Page 8 of 12 TITLE: Executive Director DATE SumTTEO: Dec. 1, 2016 £ONTACT PERSON; Gregory J. Hodges T6LpH0N1 fiftar tBER:, 276.656.:028 I, Gregory J.Hodges - , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION 18 TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SW nnTO, BEFORE ME THI DAY OF NOTARI' PUBLIC: .C�1, My COMMISSION EXPIRES: D ••.•`•`MARTIN pG`•,�. s <u; PUBLIC " j `REG # 7335308 ; MY COMMISSION.; � p EXPIRES = t � ••, 313112018 � �\ •' om https://cfl.dropboxstatic.comlstatic/javascript/pdf-js/Ddf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P64 PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y.HAMMOCK, COMMISSIONER OF THE REVENUE �\ PO Box 272 Chatham, VA 24531 J� Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website: www.Dittsvlvaniacountvva.gov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE( REAL ESTATE: REQUESTED PARCELID(S) ASSESSED VALUE PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE '3qn' LEVY LEVY TOTAL LOSS OF REVENUE IF EXEMPT: '0' 5a Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P65 1 lubylvwna �-ounry rict, Page I of 1 PROP REAL ESTATE FOUNDATION INC Acct : 232875 Dst: 04 AC:T. 0.0000 Map R: 2420-43-4307 Date : 11/29/16 Cls: 2 Ap 0 DescS SUED Card 1 of 1 BLAI RMONT ACRE 645 PATRIOT AVE Rk/Pq: LR16/05830 Zon: R-1 151C0010J00080 Mb/Lt: Nhd: 100 08 LOT 8 SEC .J Printed:12/0]/16 MARTINSVILLE, VA 29112 Cons 0 Rtl OS PAVED Le Util: Uptlatetl:BH Att: DRURY LANE Apps: SS Date:02/12/13 Info: E Time: 11:45 BnBmUSa MhCdDes Rem AyD CndUnits Rate PdFo RsnEo RsnICValue SnLNSeg Type Ac Fant Dpth Sf TFctrLtU 1FV1000 SITE VALUE P AdjBValve Remarks Mkt Val L 15,000 0 15,000BELON GRADE) Mkt Val B. 0 Mkt Val T 15,000 Def Val 0 Net Val 15,000 Old Mkt L 15,000 Old Mkt B 0 Old Def 0 Old Net 15,000 file:///C:/Program%20Files%20(x86)/Keystone%2066 nt/temp.htm 12/7/2016 u Pittsylvania County - ' Shirley Y. Hammock, Commissioner of the Revenue •. i '� PO Box 272 Chatham, Va 24531 Phone: 434-432-7940 Fax: 434-432-7957 rrar Email: shirr hammockr�o'ttso o z r Website: www.oittsylvan'acountyva.gov 4a APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-434307 (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation ACREAGE: MAILING ADDRESS: 645 Patriot Ave. Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ID#: 54-1921978 PROPERTY ADDRESS: Blalrmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY. Lot H. Section J PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL ASA COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED W THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: RVI 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? Tn sunnnrt and enaaae in activities that support the purposes of the Patrick Henry Community receiving, purchasing, of the Patrick 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE IFTHERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P67 BEGINNING DATE June 2016 Continued " Applicant: PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES NO IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO IF YES, PLEASE GIVE DETAIL: 7. DOES. YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES_____ NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-9921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES NO ^ —� 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NOFv/1_ 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE. FOR PUBLIC OFFICE? YES NO 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME A PART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014 TG June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELRTED DOCUMENTS. Attached. (C) ATTACH A LIST' REFLECTING THE NAMESOF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or officers. P68 Continued Applicant: PNCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-$551. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED), APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: P69 Pittsylvania 2420-43-4307.pdf Page 8 of 12 TITLE:: Executive Director DATE SUBMITTED: Dec. 1, 2016 .GONTAO'PERSOW Gregory.J.Hodges TELBPHDNENUMBER: 276.656.028 1, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED ANDSWORN TO BEFORE ME NOTARY PUBLIC: tebllA q MY COMMISSION EXPIRES: 3 l ��' NOTARY '• �!� cv;' PUBLIC ftEG# 7335308 MY COMMISSION n EXPIRES � %% 313112018 '00u14a0'` OF i DATE: Dec. 1, 2016 https://cfl.dropboxstatic.com/static/javascript/pdf-js/ndf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P70 PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE PO Box 272 Chatham, VA 24531 Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website www.i)ittsylvaniacountvva.gov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE) • ■ • • �n -I da REALESTATE: REQUESTED PARCEL ID(S) PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE ASSESSED VALUE LEVY LEVY TOTAL LOSS OF REVENUE IF EXEMPT: H. 5 Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County Official:, If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P71 PNCC REAL ESTATE FOUNDATION INC 695 PATRIOT AVE MARTINSVILLE, VA 24112 FINCH ENCUMBERED By NEIGHBOR'S WELL Appr: SS Date:02/12/13 Info: E Time: BnBmUse MhCdDes SnLmSeg Type Ac 1FV1000 SITE VALUE Acct 232875 Dst: 09 AC:T, Date 11/29/16 Cls: 2 AD Bk/Pg: LR16/05830 Zon: R-1 Mb/Lt: Nhd: 100 0% Cons : 0 Rd : 01 PAVED Rem Frnt Dpth Sf TFctzLtUp P72 0.0000 Map A: 2920-52-1667 0 Desc BLAIRMONT ACRES SUBD LOT 9A SEC H Lc Util: PUBLIC Topo Ayb CndUnits Rate Adj%Value Remarks 0 15,000LOT Card 1 of 1 151COO1OH0004A Pcinted:12/07/16 Updated:BR Art: PdFo RsnEo RsnIcValue Mkt Val L 15,000 Mkt Val B 0 Mkt Val T 15,000 Def Val 0 Net Val 15,000 Old Mkt L 15,000 Old Mkt B 0 Old Def 0 Old Net 15,000 y Pittsylvanla County t Shirley Y. Hammock, Commissioner of the Revenue 's t,. . •• PO Box 272 Chatham, Va 24531 • o Phone: 434-432-7940 Fax: 434-432-7957 a. + � •. Email: shirlev hammockPp ttgo o g ° Website: www.oittsylvaniacountyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-52-1667 ACREAGE: (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC. Real Estate Foundation MAILING ADDRESS: 645 Patriot Ave. Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ID*: 54-1921978 PROPERTY ADDRESS: Blairmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: Lot 4A, Section H (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: ryll 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES --Z— NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, an of erwlse dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION 100% DESCRIPTION OF USE Held for sale P73 BEGINNING DATE June 2016 Contihued PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES No IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO 1F YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES-�^— NO - (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES. No -0- 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NO _� 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I d I 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME APART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM JUIy1,2014 TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached.. (C) ATTACH A LIST REFLECTING THE. NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or Officers. P74 Contihued ' Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: P75 DATE. Dec. 1, 2016 Pittsylvania 2420-52-1667.pdf Page 8 of 12 TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 ,I✓ONTACT PERSON; Gregory J Hodges TEEFPHON1 Nl' BER= 276.656.028 I, Gregory J Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER. TITLE: Executive Director SUBSCRIBED AND NOTARY PUBLIC: MX COMMISSION E DATE: Dec. 1, 2016 e°eeeeeeeoe® °•�� lET/r ........... . D�:m• Zm:,a� https://cfl.dropboxstatic.com/static/javascript/pdf--j s//n7df-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 PITTSYLVANIA COUNTY, VIRGINIA(DI SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE PO Box 272 Chatham, VA 24531Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website: www.oittsvlvaniacountyva gov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE LTO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE) REAL ESTATE: REQUESTED PARCEL ID(S) ASSESSED VALUE LEVY a (�-S3- A(A97 x000 11.90 PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE LEVY TOTAL LOSS OF REVENUE IF EXEMPT: ) _ 90 Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P77 PHCC REAL ESTATE FOUNDATION INC Acct 232875 Dat: 04 AC:Tx 0.0000 Map N: 2420-53-0687 Card 1 of 1 Date 11/29/16 Cls: 2 Ap 0 Desc DIALRMONT ACRES SUED 15100010DO0090 645 PATRIOT AVE Bk/Pg: LR16/05830 Zon: R-1 LOT 9 SEC D Printed:12/07/16 Mb/Lt: Nhd: 100 08 Lc Util: Updated:MLF MARTINSVILLE, VA 24112 Cons : 0 Rd : 01 PAVED Topo Att: 1:111!\Y3'u61�YliUl Appr: SS Date:08/01/13 Info: E Time: 12:30 BnRnvse MhCdDes Rem Ayb CndUnits Rate PdFo RanEo RsnlcValue SnLmSeg Type Ac Frnt Dpth Sf TFctrLtUp Adj%Value Remarks Mkt Val L 2,000 1FV1000 SITE VALUE 0 2,000LOT, BELOW GRADE, DRAINMkt Val B 0 AGE Mkt Val T 2,000 Def Val 0 Net Val 2,000 Old Mkt L 2,000 Old Mkt B 0 Old Def 0 Old Net 2,000 P78 Flttsylvanla County 7 Shirley Y. Hammock, Commissioner of the Revenue tk `� PO Box 272 Chatham, Va 24531 O ti Phone: 434-432-7940 Fax: 434-432-7957 0 rrar •: Email: shirlev ham ock(aot Website: www Pittsylvaniacountyva,go, APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATEW] PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-53-0687 (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation ACREAGE: MAILING ADDRESS: 645 Patriot Ave. Martinsville VA 24112 (STREET) CITY, STATE, ZIP FEDERALID#: 54-1921978 PROPERTY ADDRESS: Blairmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: (C (REAL ESTATE) - PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION:, 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, and otherwise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FORWHATPURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDEUSEOF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P79 BEGINNING DATE June 2016 Contihued PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES No_� IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO _7 IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES �I�NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 199$ (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES —N O — R-7 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NO.-_ 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST REGENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD; WHICH STATEMENT WILL BECOME A PART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014 TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. (C) ATTACH A LIST REFLECTING THE NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees 01 Officers. P80 Contihued Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED. UNDER VA. CODE §68.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276-656.02$1 I,._ Gregory J. Hodges . , AN APPOINTED OR ELECTED TRUSTEEIOFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: 3 P81 DATE: Dec. 1, 2016 Pittsylvania 2420-53-0687.pdf Page 8 of 12 TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 ON7AG7 PERSDN: Gregory J. Hodges ITELFpHONE NumsER;,276.656.028 I, GregoryJ. Hodges - , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND SIGNATURE OF TRUSTEEIOFFICER: TITLE, Executive Director SUBSCRIBED ANDRN TO BEFORE ME • NOTARY PUBLIC: TLA MIY. COMMISSION EXPIRES: ••�(oeeH r��II �ARrny ,••01 ��: •'niorARr'•�'ll REG # 7335308 cy MY COMMISSION � ' • � , EXPIRES t 'S�q�'•. 3/31/2018 �_� LTH OF�a`.••• OF DATE. Dec. 1, 2016 https:Hcfl.dropboxstatic.com/static/javascript/pdf-js/ndf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P82 PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE I J PO Box 272 Chatham, VA 24531 ' Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website: www Dittsvlvaniacountvva oov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED By COMMISSIONER OF THE REVENUE OFFICE) APP ICANT: IMMUREi REALESTATE: REQUESTED PARCEL ID(S) PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE ASSESSED VALUE LEVY 100 LEVY TOTAL LOSS OF REVENUE IF EXEMPT: g58, "ice Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P83 Tittsylvania County PRC rage i or i PHCC REAL ESTATE FOUNDATION INC Acct 232875 Det: 04 AQTx 7.1100 Map 4: 2420-64-1663 Card 1 of 1 Mkt Date 11/29/16 Cle: 2 Ap 7.11 Deee BLAIRMONT ACRES SUED 7.11 AC 151COOIGA0011O 645 PATRIOT AVE Bk/Pq: LR16/O583O Zen: 5-2 DB877-495 M22-40 Priated:12/07/16 Val 0 Mb/Lt: Nhd: 100 08 Lc Util: PUBLIC Updated:SH MARTINSVILLE, VA 24112 Cons : 0 Rd : 01 PAVED Topa SLOPES DOWN Att 29 Aper: BY Date:08/07/13 Info: E Time: 3:47 BnSmUse MhCdDes Be. Ayb CndUnits Rate PdFo RsnEo RsnICValne SaLmsae Type Ac Fret Dpth If TFctrLt Up Adj Waldo Remarks Mkt Val L 162,500 lA 9210 COMIERC/IND 85.73 10000 0 57,300 Mkt Val B 0 2S 9220 COM4ERC/IND B1.38 400.00 150.00 60113.00 1.75 0 1O5,2OOB/G POOR TOPO Mkt Val T 162,500 Def Val 0 Net Val 162,500 Old Mkt L 162,500 Old Mkt B 0 Old Def 0 Old Net 162,500 file:///C:/Program"/`20Files%20(x86)/Keystone%2P8'Iient/temp.htm 12/7/2016 ;'. Plttsywanla county a ' Shirley Y. Hammock, Commissioner of the Revenue '- tf'�. d • ' PO Box 272 Chatham, Va 24531 •. ;.a.�' r, Phone: 434-432-7940 Fax: 434-432-7957 rrar Email: shirley.hammockPp ttgov org R Website: www.pittsylvaniacountyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-64-1656 (03 ACREAGE: (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation MAILING ADDRESS: 645 Patriot Ave. Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ID#. 54-1921978 PROPERTY ADDRESS: Blairmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: 7.11 Acres, Highway 29 (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? � YES �_ NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, an of erwise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF. USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P85 BEGINNING DATE June 2016 Continued PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES No IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE By THE DONOR? YES._ NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING; 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 & HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES No 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES No 7 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I J I 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE. APPLICABLE, IRS FORMS 900; 990, 990EZ; 99OT; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME APART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014 TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. _ (C) ATTACH A LIST REFLECTING THE. NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or officers. P86 Continued Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE. IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT, SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC. MY COMMISSION EXPIRES: 3 P87 Pittsylvania 2420-64-1653.pdf Page 8 of 12 TITLE: Executive Director .DATE SUBMITTED: Dec. 1, 2016 CONTACT RE RSON: Gregory J. Hodges TELEPHONE NiJMBER:, 276.656.028 I, _ GregoryJ. Hodges - - - , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND SIGNATURE OF TRUSTEE/OFFICER TITLE' Executive Director DATE: Dec. -• 1, 2001166 SUBSCRIBED AND S /N {T.�O..{B�EFFORE ME THIS DAY OF 4,il(�j�VLY. e , 91 NOTARY PUBLIC: �.L�1.1`I LA MY COMMISSION EXPIRES: D 3 IS a NOTARYG<< v , PUBLIC REG # 7335308 n MY COMMISSION EXPIRES Q . X313112018 �ZyALTH ` 0400060100 bttps://cfl.dropboxstatiacom/static/javascript/pdf-js/Ddf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P88 j• a PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE 1' PO Box 272 Chatham, VA 24531 /- Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.org Website: www.oittsvlvaniacountvva.00v REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE) APPLICANT: PRCC teal E�4e. i:niuudA-Tld/J REAL ESTATE: REQUESTED PARCELID(S) ASSESSED VALUE C=INao- 64-zallo W660 PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE LEVY LEVY TOTAL LOSS OF REVENUE IF EXEMPT: S.14.16 Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P89 Fittsylvama County YKC Page 1 of 1 PHCC REAL ESTATE FOUNDATION INC Acct 232075 Dat: 04 AC:TX 1.9800 Map k: 2420-64-2210 Card 1 of 1 Frnt Date 11/29/16 Cls: 4 Ap 1.98 Desc HNY 29 1.98 AC 151COOlOA00120 645 PATRIOT AVE Bk/Pg: LR16/05830 Zon: B-2 DB877-495 MB22-40 Printed:12/07/16 Mb/Lt: Nhd: 100 08 Lc Util: PUBLIC Updated:BH MARTINSVILLE, VA 24112 Cons : 0 Rd : 01 PAVED Tops Art: BLAIRMONT DR Appr: IT Date:08/07/13 Info: E Time: 3:47 SnBmUse MhCdDes Be. Ayb CndUnits Rate PdFo RenEO RsnICValue SnLNSeg Type At Frnt Dpth Sf TFctrLtUp Adj%Value Remarks Mkt Val L 99,000 IA 9220 COMMERC/IND B1. 98 175.00 150.00 50000 0 99,000 Mkt Val B 0 Mkt Val T 99,000 Def Val 0 Net Val 99,000 Old Mkt L 99,000 Old Mkt B 0 Old Def 0 Old Net 99,000 file:///C:/Program%20Files%20(x86)/Keystone%2Nlient/temp.htm 12/7/2016 ratsylvanla county Shirley Y. Hammock, Commissioner of the Revenue ° d PO Box 272 Chatham, Va 24531 D:. < Phone: 434-432-7940 Fax: 434-432-7957 rm Email: shirlev ha mock(cDpittgo o g Website: www. oittsvlvaniacountyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-64-2210 (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation ACREAGE: MAILING ADDRESS: 645 Patriot Ave., Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERALID#: 54-1921978 PROPERTY ADDRESS: Blalrmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: 1.98 Acres, Highway 29 (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES FZI—LZ— NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 1 FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, an of erwise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4: FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE. IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS, ACREAGE/PORTION 100% DESCRIPTION OF USE Held for sale P91 BEGINNING DATE June 2016 Continued ' Applicant: PHCC Real Estate Foundation 5, DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES No IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES No IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.H. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES __z__ NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING; 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES. NO 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES NO_.. 571_ 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANYPOLITICALCAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I d I 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 99OT, REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME A PART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014- TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. (C) ATTACH A LIST REFLECTING THE NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or officers. P92 Continued Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: P93 Pittsylvania 2420-64-2210.pdf Page 8 of 12 TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 'IpONTA�;T t-RsON. Gregory J. Hodges TEi £PHDNBlVUMBER 276.656.A28 I, Gregory J. Hodges- AN APPOINTEE OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TMUf AND SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director SUBSCRIBED AND 5 RN TO BEF.ORq ME THIS NOTARY PUBLIC: MY COMMISSION EXPIRES: D ,.•`��pRTIN pU•., -� '' • -REG # 7335308 •i _ MY COMMISSION n EXPIRES .� 2 DATE: Dec. 1, 2016 https:Hcfl.dropboxstatic.comlstatic/javascript/pdf-js/Ddf-js-9e9df56/web/viewer-vflPDUR... 12/1/2016 P94 PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y HAMMOCK, COMMISSIONER OF THE REVENUE �. S PO Box 272 Chatham, VA 24531 Phone: 434-432-7940 Fax: 434-432-7957''.: Email: shirley.hammock@pittgov.org Website www Dittsvlvaniacountyva aov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE )TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE) i t•r-WO&TWro t1tr1rdyL REAL ESTATE: REQUESTED PARCEL ID(S) a�12t1-Ll t- tl„A5 PERSONAL PROPERTY: DESCRIPTION OF PROPERTY Date of public hearing: ASSESSED VALUE ASSESSED VALUE LEVY g4.4a LEVY TOTAL LOSS OF REVENUE IF EXEMPT: g4.ga Approved or Disapproved: Effective Date of exemption: Signature of County Official: If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P95 ,Pittsylvania County PRC PHCC REAL ESTATE FOUNDATION INC Acct 232875 Dst: 04 AC:Tx 0.0000 Map 4: 2420-41-1685 Date 11/29/16 Cls: 2 Ap 0 Dead BLAIRMONT ACRES SUED 645 PATRIOT AVE Bk/Pg: LR16/05830 Pon: R-1 LOT 18 SEC H Mb/Lt: Nhd: 100 08 In Util: MARTINSVILLE, VA 24112 Cons : 0 Rd : 01 PAVED Top. LYNROCK CT Appr: SS Date:02/12/13 Info: E Time: 11:29 BnBmUse MhCdDes SnLmseg Type AC 1FV1000 SITE VALUE Page 1 of 1 Card 1 of 1 151C0010HOO180 erintsd:12/07/16 Updated:MLF Aft: Rem Ayb CodUnits Rate PdFo RsnEo RarICValue Fret Dpth Sf TFctrLCUp Adj%Value Remarks Mkt Val L 16,000 0 16,000 LOT, LOW. Mkt Val B 0 Mkt Val T 16,000 Def Val 0 Net Val 16,000 Old Mkt L 16,000 Old Mkt 8 0 Old Def 0 Old Net 16,000 file:///C:/Program%20Files%20(x86)/Keystone%2C"ient/temp.htm 12/7/2016 Pittsylvania County o a . _ Shirley Y. Hammock, Commissioner of the Revenue v , < PO Box 272 Chatham, Va 24531 a rma Phone: 434-432-7940 Fax: 434-432-7957 Email: shirley.hammock@pittgov.or¢ 4Website: www.pittsylvania ountyva.gov APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ✓❑ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-41-1685 ACREAGE: (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation MAILING ADDRESS: 645 Patriot Ave. Martinsville, VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ID#: 54-1921978 PROPERTY ADDRESS: Blalrmont S/D (REAL ESTATE) LEGAL. DESCRIPTION OF PROPERTY: Lot 18, Section H (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES—z— NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, and otherwise dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLEIF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P97 BEGINNING DATE June 2016 Continued PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES NO,�_ IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO IF YES, PLEASE GIVE DETAIL: 7. DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTIOFF--N UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR �� GROUP ARE DEDUCTIBLE BY THE DONOR? YES No - (A) IF -YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 (B) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES �TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES NO -1_ 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANY POLITICAL CAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES - NO 11. REQUIRED DOCUMENTATION ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 990T; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME APART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July.1; 2014- TO June 30, 2015 (B) ATTACH A COPY OF THE ORGANI7ATION'S CONSTITUTION,: BY-LAWS, ARTICLES OF INCQfRPORATION, AND/OR OTHER RELATED DOCUMENTS, Attached. - (C) ATTACH A LIST REFLECTING THE NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees or Officers. P98 Continued ' Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §55.1-3651. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED WITHDRAWN. (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFIQER FOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC. MY COMMISSION EXPIRES: P99 f:ttsylvania 2420-41-1685.pdf Page 8 of 12 TITLE: Executive Director DATE SuBMITTED: Dec. 1, 2016 CDNTPG? PERSON: Gregory J. Hodges TeUFpHOItENum IBER: 276.656.028 1 Gregory J. Hodges e5 - - , AN APPOWEtD OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER TITLE: Executive Director SUBSCRIBED AND SWORN TOBEFORE NOTARY $UBLIC: J/ MY COMMISSION EXPIRES: •.�ORTI I .•P Np. �•��\NOTARY PUBLIC * �; REG rt 7335308 ;9' CCS MY COMMISSION' O • EXPIRES .3131/201B..., . TH • 'A,,•••• Y OF DATE: Dec. 1, 2016 https://efl.dropboxstatic.comlstatic/javascript1pdf-jslndf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P100 ' ! PITTSYLVANIA COUNTY, VIRGINIA SHIRLEY Y. HAMMOCK, COMMISSIONER OF THE REVENUE PO Box 272 Chatham, VA 24531 Phone: 434-432-7940 Fax: 434-432-7957 \\\ Email: shidey.hammock@pittgov.org Website: www.oittsvlvaniacountvva.aov REAL ESTATE/PERSONAL PROPERTY TAX EXEMPTION WORKSHEET FOR EXEMPT REVENUE (TO BE COMPLETED BY COMMISSIONER OF THE REVENUE OFFICE( .•• . �•I_ .l- d W I REAL ESTATE: REQUESTED PARCEL ID(S) PERSONAL PROPERTY: DESCRIPTION OF PROPERTY ASSESSED VALUE ASSESSED VALUE LEVY LEVY TOTAL LOSS OF REVENUE IF EXEMPT: I aq. 96 Date of public hearing: Approved or Disapproved: Effective Date of exemption: Signature of County If approved, exemption granted only for above listed items. Any changes to property must be reported to the County for an addendum to the adopted ordinance. (Please submit copy to Commissioner of the Revenue after public hearing and Board of Supervisor action taken) P101 PHCC REAL ESTATE FOUNDATION INC 645 PATRIOT AVE MARTINSVILLE, VA 24112 DRURY LANE Appr: SS Date:02/12/13 Info: E Time: 11:35 BnBmUse MhCdDes SnLmSeg Type Ac 1 F71000 SITE VALUE Acct 232875 Dst: 04 AC:Tx Date 11/29/16 Cls: 2 AP Bk/Pg: LR16/05830 Zon: R-1 Mb/Lt: Nhd: 100 08 Cons : 0 Rd : 01 PAVED 0.0000 Map k: 2420-43-0721 0 Desc BLAIRMONT ACRES SOLD LOT 12 SEC J to Util: Topo Rem Frnt Dpth Sf TFctrLtUp P102 Ayb CndUnits Rate Adj4Value Remarks 0 22,000LOT WOODED Card 1 of 1 151CO010JO0120 Printed:12/07/16 Updated:HS Att: PdFo RsnEo RsnIcValue Mkt Val L 22,000 Mkt Val B 0 Mkt Val T 22,000 Def Val 0 Net Val 22,000 Old Mkt L 22,000 Old Mkt B 0 Old Def 0 Old Net 22,000 r. Pittsylvania County c Shirley Y. Hammock, Commissioner of the Revenue a PO Box 272 Chatham, Va 24531 U� < Phone: 434-432-7940 Fax: 434-432-7957 IrN Email: sh TleV hammockRp ttgoV n g R Website: www.oittsvlvaniacountyva.gov 4D APPLICATION FOR REAL ESTATE -PERSONAL PROPERTY EXEMPTION BY QUALIFYING CLASSIFICATION OR DESIGNATION (FOR ANY ANSWERS THAT REQUIRE MORE SPACE, PLEASE INCLUDE ATTACHMENTS) APPLICATION FOR: REAL ESTATE ❑✓ PERSONAL PROPERTY ❑ BOTH ❑ TAX PARCEL ID# 2420-43-0721 ACREAGE: (IF REAL ESTATE) APPLICANT ORGANIZATION: PHCC Real Estate Foundation MAILING ADDRESS: 645 Patriot Ave. Martinsville VA 24112 (STREET) CITY, STATE, ZIP FEDERAL ID#. 54-1921978 PROPERTY ADDRESS: Blalrmont S/D (REAL ESTATE) LEGAL DESCRIPTION OF PROPERTY: Lot 12, Section .I (REAL ESTATE) PERSONAL PROPERTY: ATTACH A SCHEDULE SHOWING ALL PERSONAL PROPERTY FOR WHICH EXEMPTION IS REQUESTED. SCHEDULE MUST INCLUDE VEHICLE IDENTIFICATION NUMBERS AS WELL AS A COMPLETE DESCRIPTION. NOTE: IF EXEMPTION APPROVED AND ADDITIONAL PROPERTY OBTAINED, A NEW LIST MUST BE FILED WITH THE COUNTY ADMINISTRATION REQUESTING THE ADDITIONAL PROPERTY BE INCLUDED IN THE EXEMPTION ORDINANCE. PLEASE ANSWER THE FOLLOWING QUESTIONS REGARDING THE ORGANIZATION: 1. INDICATE THE TYPE OF EXEMPTION DESIRED: CLASSIFICATION: DESIGNATION: 2. IS THE PROPERTY OWNERSHIP CHARTERED OR INCORPORATED UNDER THE LAWS OF THE COMMONWEALTH OF VIRGINIA? YES_ NO (IF YES, ATTACH A COPY OF THE CHARTER) Attached 3. FOR WHAT PURPOSE IS THE OWNERSHIP CHARTERED, INCORPORATED OR OTHERWISE IN EXISTANCE? To support and engage in activities that support the purposes of the Patrick Henry Community College Foundation, including receiving, purchasing, owning, developing, operating, leasing, selling, an of eiwlse dealing with real property and the proceeds thereof for the benefit of the Patrick Henry Community College Foundation. 4. FOR WHAT PURPOSE IS THE PROPERTY BEING USED? PLEASE BE SPECIFIC AND INCLUDE USE OF ACREAGE, IF APPLICABLE - IF THERE ARE SEVERAL TYPES OF USE, INDICATE SUCH USAGES BY ACRES OF THE BUILDING, FLOOR LOCATIONS AND LAND ALLOCATIONS. ACREAGE/PORTION DESCRIPTION OF USE 100% Held for sale P103 BEGINNING DATE June 2016 Contihued PHCC Real Estate Foundation 5. DOES ANY OTHER INDIVIDUAL, ORGANIZATION, ASSOCIATION OR CORPORATION OCCUPY OR USE ANY PART OF THE PREMISES? YES NO_z_ IF YES, PLEASE GIVE DETAIL: (HOW OFTEN, WHAT PART OF THE BUILDING OR PROPERTY, NAME OF ORGANIZATION) 6. IS ANY INCOME, BE IT EARNEST MONEY OR IN KIND SERVICES, RECEIVED FROM THE USE OF ANY PORTION OF THE PROPERTY BY OTHER INDIVIDUALS OR GROUPS, WHETHER CONSIDERED AS RENT OR REIMBURSEMENT FOR NECESSARY EXPENSED FOR SERVICES INCURRED? YES NO . 7 IF YES, PLEASE GIVE DETAIL: DOES YOUR OWNERSHIP GROUP HAVE AN EXEMPTION UNDER U.S. INTERNAL REVENUE CODE SO THAT GIFTS TO YOUR GROUP ARE DEDUCTIBLE BY THE DONOR? YES_ NO (A) IF YES, GIVE DATE OF INTERNAL REVENUE RULING: 1998 (8) GIVE INTERNAL REVENUE IDENTIFICATION NUMBER: 54-1921978 8. HAS THE ABC BOARD ISSUED A CURRENT ANNUAL ALCOHOL BEVERAGE LICENSE FOR SERVING ALCOHOL BEVERAGES TO THE ORGANIZATION FOR USE ON THE PROPERTY FOR WHICH TAX EXEMPTION IS SOUGHT? YES No 9. DOES ANY DIRECTOR, OFFICER, OR EMPLOYEE OF THE ORGANIZATION RECEIVE COMPENSATION IN EXCESS OF A REASONABLE ALLOWANCE FOR SALARIES OR OTHER COMPENSATION FOR PERSONAL SERVICES WHICH SUCH DIRECTOR, OFFICER, OR EMPLOYEE ACTUALLY RENDERS? YES No 7 10. DOES THE ACTIVITIES OF THE ORGANIZATION INVOLVE CARRYING ON PROPAGANDA, OR OTHERWISE ATTEMPTING TO - INFLUENCE LEGISLATION AND DOES THE ORGANIZATION PARTICIPATE IN OR INTERVENE IN ANYPOLITICALCAMPAIGN ON BEHALF OF ANY CANDIDATE FOR PUBLIC OFFICE? YES NO I J I 11. REQUIRED DOCUMENTATION (A) ATTACH TO THIS APPLICATION YOUR MOST RECENT FINANCIAL STATEMENT, INCLUDING, WHERE APPLICABLE, IRS FORMS 900; 990; 990EZ; 990T; REFLECTING INCOME AND EXPENDITURES FOR THE MOST CURRENT TWELVE (12) MONTH REPORTING PERIOD, WHICH STATEMENT WILL BECOME A PART OF THIS APPLICATION. THE ATTACHED FINANCIAL STATEMENT IS FOR THE PERIOD FROM July 1, 2014 TQ June 30, 2015 (B) ATTACH A COPY OF THE ORGANIZATION'S CONSTITUTION, BY-LAWS, ARTICLES OF INCORPORATION, AND/OR OTHER RELATED DOCUMENTS. Attached. (C) ATTACH A LIST REFLECTING THE: NAMES OF ALL TRUSTEES OR CORPORATE/ORGANIZATION OFFICERS, THE DATE APPOINTED OR ELECTED, AND THE COURT IN WHICH THEY QUALIFIED OR IDENTIFY THE INSTRUMENT IN WHICH THEY WERE OFFICIALLY APPOINTED. There are no trustees OI Officers. P104 Contthued ' Applicant: PHCC Real Estate Foundation (D) IF INVESTMENTS, SUCH AS STOCKS OR BONDS, ARE REFLECTED ON THE FINANCIAL STATEMENT, ATTACH A LIST OF ALL SUCH INVESTMENTS, INCLUDING NAME OF STOCK, DATE RECEIVED AND VALUE. Not applicable (E) IF APPLYING FOR EXEMPTION BY DESIGNATION, YOU WILL BE RESPONSIBLE FOR THE APPLICABLE COST FOR THE PUBLICATION NOTICE AS REQUIRED UNDER VA. CODE §58.1-3651.. YOU SHALL RECEIVE AN INVOICE FOLLOWING THE ADVERTISEMENT FOR EXEMPTION AND PAYMENT SHALL BE MADE TO PITTSYLVANIA COUNTY PRIOR TO BOARD CONSIDERATION. NOTE: IF PAYMENT NOT RECEIVED PRIOR TO PUBLIC HEARING APPLICATION WILL CONSIDERED l I.t�2 (F) ANY OTHER CRITERIA, FACTS AND CIRCUMSTANCES THAT THE GOVERNING BODY DEEMS PERTINENT TO THE ADOPTION OF SUCH ORDINANCE. (APPLICANT WILL BE NOTIFIED IF NEEDED). APPLICATION COMPLETED BY: Gregory J. Hodges TITLE: Executive Director DATE SUBMITTED: Dec. 1, 2016 CONTACT PERSON: Gregory J. Hodges TELEPHONE NUMBER: 276.656.0281 I, Gregory J. Hodges , AN APPOINTED OR ELECTED TRUSTEE/OFFICERFOR THE ABOVE NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE BEEN EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CORRECT. SIGNATURE OF TRUSTEE/OFFICER TITLE: Executive Director DATE: Dec. 1, 2016 SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF NOTARY PUBLIC: MY COMMISSION EXPIRES: 3 P105 Pittsylvania 2420-43-0721.pdf Page 8 of 12 TITLE Executive Director DATE SUBMITTED: Dec. 1, 2016 EONTApt pj*SaN: Gregory.J. Hodges TALE'PH6NE wUMBEFL 276.656 028 I, Gregory J. Hodges- AN APPOINTED OR ELECTED TRUSTEE/OFFICER FOR TI NAMED ORGANIZATION, CERTIFY UNDER PENALTY OF LAW THAT THIS APPLICATION AND ALL ATTACHMENTS HERETO HAVE EXAMINED BY ME AND ALL INFORMATION IS TRUE AND CQRRECT. SIGNATURE OF TRUSTEE/OFFICER: TITLE` Executive Director SUBSCRIBED AND SWQRN NOTARY PUBLIC: ?7 MY COMMISSION EXPIRES: MARTIAI v REG # 7335308 MY COMMISSION �0%. EXPIRES ;� , 3/31/2018 �R- 41 ( DATE: Dec. 1, 2016 v OF https://cfl.dropboxstatic.comlstatic/javascriptlpdf-js/ndf-js-9e9df56/web/viewer-vflPDUR... 12/l/2016 P106 UNFINISHED BUSINESS P107 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA DATE: AGENDA TITLE: 1 2-21-17 Expenditure Refunds for January 2017 -Motion made ACTION: by Mr. Barber and seconded by Mr. Barksdale and has Yes now met the 10 -day layover regirement. Requires a Roll Call Vote. SUBJECT/PROPOSAL/REOUEST: Budget Amendment for expenditure refunds STAFF CONTACT(S): BACKGROUND: CONSENT AGENDA: ACTION: ATTACHMENTS: Expenditures Refunds Memo REVIEWED BY: ITEM NUMBER: 8 INFORMATION: INFORMATION: DISCUSSION: Attached is a list of expenditure refunds for the month of January 2017 for review. As discussed earlier with the Board, the simple routine of putting every refund back in the budget is extremely time consuming and leaves room for errors. To stay in balance with the Treasurer, we need to reappropriate refunds into the budget so the budget would increase with every expenditure refund. RECOMMENDATION: Staff recommends the reappropriation of $19,244.06 as follows: $117.39 to Fleet -Travel (100-4-012520- 6008), $100.00 to Clerk of Court -Copier Lease, $1.18 to Comm Atty.-Office Supplies (100-4-022100-6001), $150.00 to Sheriff -Undercover Account (100-4-031200-6024), $2,037.31 to Sheriff -Capital Outlay -Vehicles (100-4-031200-8105), $35.75 to Extradition (100-4-033100-5550), $62.00 to Jail -Food Supplies (100-4- 033100-6002), 100-4- 033100-6002), $100.00 to Animal Control -Donations (100-4-035100-5883), $42.73 to B&G-Bldg Maint Supplies (100-4-043100-6007), $1,593.58 to Library -Office Supplies (100-4-073100-6001), $425.99 to Library -Furniture & Fixtures (100-4-073100-6003), $1.33 to Library -Bldg Maint Supplies (100-4-073100- 6007), $540.00 to Library -Books & Subscriptions (100-4-073100-6012), $14,036.80 to WIA-Rent (251-4- 353853-6014). MOTION MADE BY MR. BARBER AND SECONDED BY MR.BARKSDALE AND HAS NOW MET THE 10 -DAY LAYOVER REQIREMENT. REQUIRES A ROLL CALL VOTE. P108 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA TITLE: Expenditure Refunds for January 2017 -Requires a motion, .second and a 10 -day layover SUBJECT/PROPOSAL/REOUEST Budget Amendment for expenditure refunds STAFF CONTACT(S): BACKGROUND: AGENDA DATE: 2-06-17 ACTION: Yes CONSENT AGENDA: ACTION: ATTACHMENTS: Expenditures Refunds Memo REVIEWED BY: ITEM NUMBER: 10(b) INFORMATION: INFORMATION: DISCUSSION: Attached is a list of expenditure refunds for the month of January 2017 for review. As discussed earlier with the Board, the simple routine of putting every refund back in the budget is extremely time consuming and leaves room for errors. To stay in balance with the Treasurer, we need to reappropriate refunds into the budget so the budget would increase with every expenditure refund. RECOMMENDATION: Staff recommends the reappropriation of $19,244.06 as follows: $117.39 to Fleet -Travel (100-4-012520- 6008), $100.00 to Clerk of Court -Copier Lease, $1.18 to Comm Atty.-Office Supplies (100-4-022100-6001), 5150.00 to Sheriff -Undercover Account (100-4-031200-6024), $2,037.31 to Sheriff -Capital Outlay -Vehicles (100-4-031200-8105), $35.75 to Extradition (100-4-033100-5550), $62.00 to Jail -Food Supplies (100-4- 033100-6002), 100-4- 033100-6002), $100.00 to Animal Control -Donations (100-4-035100-5883), $42.73 to B&G-Bldg Maint Supplies (100-4-043100-6007), $1,593.58 to Library -Office Supplies (100-4-073100-6001), $425.99 to Library -Furniture & Fixtures (100-4-073100-6003), $1.33 to Library -Bldg Maint Supplies (100-4-073100- 6007), $540.00 to Library -Books & Subscriptions (100-4-073100-6012), $14,036.80 to WIA-Rent (251-4- 353853-6014). REQUIRES A MOTION, SECOND AND A 10 -DAY LAYOVER. P109 Finance Department P.O. Sox 426 Chatham, Virginia 24531 PITTSYLVANIA COUNTY VIRGINU MEMO TO: David M. Smitherman County Administrator FROM: Kim Van Der Hyde Finance Director SUBJECT: January Expenditure Refunds DATE: January 31, 2017 Phone (434) 432.7740 Fax (434) 432-7746 Gretna/Hurt(434)656-6211 The list below shows all expenditure refunds that were sent to the Finance Department during the month of January. I am recommending that all of the following expenditure refunds be reappropriated by the Board of Supervisors: 100-4-012520-6008 Fleet -Travel 117.39 Out of State Gas Reimbursement 100-4-021600-60051 Clerk of Court -Copier Lease 100.00 Reimbursement 100-4-022100-6001 Comm. Atty-Office Supplies 1.18 Tax Reimbursement 100-4-031200-6024 Sheriff -Undercover Account 150.00 Restitution 100-4-031200-8105 Sheriff -Capital Outlay -Vehicles 2,037.31 Insurance Claim 100-4-033100-5550 Extradition 35.75 Extradition 100-4-033100-6002 Jail -Food Supplies 62.00 Reimbursement 100-4-035100-5883 Animal Control -Donations 100.00 Donation 100-4-043100-6007 B&G-Bldg Maint Supplies 42.73 Restitution Pilo 100-4-073100-6001 Library -Office Supplies 1,593.58 Donations 100-4-073100-6003 Library -Furniture & Fixtures 425.99 Donations 100-4-073100-6007 Library -Bldg Maint Supplies 1.33 Donations 100-4-073100-6012 Library -Books & Subscriptions 540.00 Donations 251-4-353853-6014 WIA-Other Operating 14,036.80 Rent Payments (251-3-000000-150201) TOTAL JANUARY EXPENDITURE REFUNDS Pill $19,244.06 NEW BUSINESS P112 PITTSYLVANIA COUNTY EXECUTIVE SUMMARY AGENDA TITLE: AGENDA DATE: Recommendations from Finance Committee 1 02-21-2017 ACTION: SUBJECTIPROPOSAL/REOUEST: Yes Recommendations from Finance Committee CONSENT AGENDA: ACTION: STAFF CONTACT(S): INFORMATION: Mr. Smitherman; Ms. Van Der Hyde ATTACHMENTS: Yes REVIEWED BY: BACKGROUND: ITEM NUMBER: 9 (a) INFORMATION: DISCUSSION: The Finance Committee of the Pittsylvania County Board of Supervisors will meet at 4:00 pm on Tuesday, February 21, 2017. (See attached agenda). Any recommendations from that committee will be presented to the full Board of Supervisors. RECOMMENDATION: Staff submits this to the Board of Supervisors for their consideration. Pll3 FINANCE COMMITTEE Pittsylvania County Board of Supervisors Tuesday, February 21, 2017 4:00 PM Main Conference Room County Administration Building 1 Center Street Chatham, Virginia AGENDA 1. Call to Order 4:00 pm 2. Roll Call 3. Approval of Agenda 4. New Business (a) Submission of County Administrator's Recommended Budget (f) Questions/Open Discussion 5. Adjournment P114 AGENDA TITLE: PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA DATE: 2-21-17 Tobacco Commission Grant Appropriation-SoVA Vineyard Development and Expansion to Support ACTION: Virginia's Wine Industry—Requires a Roll Call Vote Yes SUBJECT/PROPOSAL/REOUEST: CONSENT AGENDA: ACTION: Appropriation of Tobacco Funds for the SoVa Vineyard Development and Expansion to Support Virginia's Wine Industry Project -(Grant #3102) ATTACHMENTS: Yes STAFF CONTACT(S): ITEM NUMBER: 9(b) INFORMATION: INFORMATION: BACKGROUND: Pittsylvania County was awarded a tobacco grant in the amount of $811,526 for the SoVA Vineyard Development and Expansion to Support Virginia's Wine Industry project. This grant does involve multi - jurisdictional partners, however; Pittsylvania County will serve as the fiscal agent and must be appropriated in the County's budget. This grant does not require a local match from the County. This grant was approved by the Tobacco Commission on January 12, 2016. A copy of the grant award is attached. DISCUSSION: The Board of Supervisors needs to appropriate a total of $811,526 to the SoVA Vineyard Development and Expansion to Support Virginia's Wine Industry Project in the Industrial Development Fund (Fund 325) RECOMMENDATION: Staff recommends that the Board amend the Economic Development budget and appropriate $811,526 of Tobacco Funds to the SoVA Vineyard Development and Expansion to Support Virginia's Wine Industry Project. REQUIRES A ROLL CALL VOTE. P115 a TICRC Grant Application Budget Worksheet 1. Financial Information: Sources of Funds a. Requested TICRC Funds: Enter a Description and Budget Line Item Amounts in the blue highlighted boxes below. Pleose include specrrw, derailed hedgernac saw as on oddider d atlachmerrr in your application. b. Other Funding: Enter Source Information, Status, Description and Budget Line Item Amounts in the blue highlighted boxes below. Select funding type and status from the dropdown menus in the blue highlighted boxes where indicated. Please lndade specffi ,,[cad7cd hadganarradua os an oddtriorra/ attachment in your application. Matching Funds Detail Requested TICRC Fund Details State Funds will be used to support educational, cos[ -share, and research aspects of the proposed grant applicattion. I. Description (Enter a brief description of how 2. Ageocy/Locality Name (Enter the vane the the TICRC fonds will be used) bureau, for Advanced Learning and Research 3. States (Select the status fthe matching foods 2. Budget Line Item Personal I Contractual I Supplies & Continuous Property & Foods will be mdaed to offset salary and fringe for staff assigned to the research aspects of tlda gran[ app&anon. Plant & Transfer the matching funds will be used) Services Services Materials Charges Improvements Improvements Pa emus 3. Budget line Item Amount (Enter the amount Transfer Semces Services Materials charges B Improvements Pr offends allocated to each budget line) $65,979.00 $10,327.00 $13,220.00 $6,000.00 5716,000.00 4, Total Amount (Self Touching) $811,526.00 b. Other Funding: Enter Source Information, Status, Description and Budget Line Item Amounts in the blue highlighted boxes below. Select funding type and status from the dropdown menus in the blue highlighted boxes where indicated. Please lndade specffi ,,[cad7cd hadganarradua os an oddtriorra/ attachment in your application. Matching Funds Detail L Funding Type (Select the type ofmatching State funds from the dropdown list) 2. Ageocy/Locality Name (Enter the vane the somce of the watching funds) bureau, for Advanced Learning and Research 3. States (Select the status fthe matching foods from the dropdown tis[) Money in Hand Foods will be mdaed to offset salary and fringe for staff assigned to the research aspects of tlda gran[ app&anon. 4. Description (Enterabrie[deacriptiov ofhow the matching funds will be used) 5. Budget Line Item Description Personal Contractual Supphes & Continuous Property & Equipment Plant & Transfer Semces Services Materials charges B Improvements Pr Improvement Payments 6. Budges Line Item Amount (Enter the an000t offends allocated to each budget line) $85,872.00 T Total !'m mat (SelfTotaftg) S85,87200 Matching Funds Detail 1. Funding Type (Select the type of matching Private funds from the dtopdown list) 2.Agency/Locality Name (Enter the more the somce of the matching foods) Cost -share applicants 3. Status (Select the states ofthe matching foods from the dropdown lisp Application Intended TRRC cost -share will be limited to 53,000.00/9ne and less than 33%of capiml costs. However, total Match contributions from producers over a 4. Description (Enter a brief description of how 5 year period for esNblishing the vineyard is estimated to be closer to $7 6 m0lion. due matching fords will be used) 5. Budget Line Item Description Personal Con[mcteal Supplies & Continuous Property & Equipment Plant &— Transfer S ervices Services Materials Charges Improvements Improvements Payments 6. Budget Line Item Amount (Enter the amour[ of funds allocated to each budget line) $1,453,697.00 7. Total Amount (Self Totalling) $1,453,697.00 Matching Funds Detail 1, Funding Type (Select the type of matching fonds from the dropdown fist) 2. Agency/Locality Name (Enter the were, the source of the matehivg funds) 3. Status (Select the states ofthe matclting foods from the drelid.. list) 4. Description(Enwrabriefdescriphonofhow the matching funds will be used) 5. Budge Line Itum Description Personal Contractual Supplies & Continuous Property & Equipment Plant & Transfer Services Services Materials Charges Improvements improvemrnts Payments 6. Budget Line Item Amount (Enter the amount off ands allocated to each budget line 7. Total Amount (Self Tomlling) 50.00 P116 Matching Funds Detail 1. Funding Type (Select the type of matching funds from the dropdown list) 2. Ageucy/locality Name (Enter the name the source of the snatching fords) 3. Status (Select the status of the matching funds from the drop low" list) 4. Description (Enter a bnefdescription of how the matching funds will be used) 5. Budget Line Item Description Personal Contractual Supplies ffi Continuous Property ffi EgmPme"t Plant & Tremsfm Services Services Materials Char es Improvement Improvements Payments 6. Budget Line Item Amoant (Enter the amount of funds allocated to each budget line) 7. Total Amoant (Self Totalling) SO,Oo Matching Funds Detail 1. Funding Type (Select the type of matching fords from the drop tow" fist) 2. Agency/Locality Name (Enter the name the source of the matching funds) 3. Status (Select the status of the matching funds from the cimpdown list) 4. Description (Enter a brief description ofhow, the matching funds will he used) 5. Budget Line Item Description Personal Comment.) Supplies & Continuous Property & Equipment Plant & Transfer Services Services Materials Changes Improvements Improvements Payments 6. Budget Line Item Amount (Enter the amount of funds allmakd to each budget fine) 7. Total Amount (Self Totalling) SOA Matching Funds Detail 1. Funding Type (Select the type of matching fords from the dropdown fist) 2. Agemy/Lecality, Name (Enter the name die source ofthe matching funds) 3. Status (Select the status ofthe matching fonds from the drop low" list) 4. Description (Enter a brief description of how the matching fonds will be used) 5. Budget Line Item Description Persons] Contractual Supplies & Contmuous Property & Equipment Plat & Transfer Seances Services Materials Charges Improvements Improvements Payments 6. Budget Line Item Amoant (Enter the amount of funds allocated to each budget line) 7. Total Amount (Self Totalling) $0.00 Matching Funds Devil L Funding Type (Select the type of matching (ands from the dropdown fist) 2. Agency/l-ocality Name (Enter the name the murce ofthe matching funds) 3. Status (Select the sfmus of d c matching funds from the dropdown list) 4. Description (Enter a brief description of how the matching funds will be used) 5. Budget Line Item Description Persaml Co"rcamuil Supplies & Continuous Property & EquipmentPlant '& Transfer Services Services Matenals Charges Improvements Improvements Payments 6. Budget Line Item Amount (Enter the rumors of fands allocated to each budget line) 7. Total Amount (Self Totalfing) WWI 1`117 2. Financial Information: Budgeted Expenditures Ya do nen need loafer ay fnformodon in this seerbn. The table below is selfcalculering based on dw infection v entered to acefion 1(Financed bt£mmals.. Sources o£Funds). Please fill in the bluehighlighted fields in section Ito populate the table below The amowts from the "TICRC Fonds" column and the "Tool Matching Foods Colman" should correspond an the amomds enured in the giant application. Proposed Project intact TICRC Funds Slate Local Federal Private In -Kind Total Matching Grand Total Funds Personal Se"ices $65,97900 $85,872.00 $85,872.00 %1511851.00 (Salaries, Wages, Benefits, eu.) Contractual Services (A&E, Legal, Printing, Media, TmveL Training, $10,327.00 $10,327.00 etc.) Supplies & Materials (Engineering Supplies, Building & Mechanical $13,22000 $13,220.00 Repair, Supplies, Educational Supplies, etc.) Continuous Charges (Insurance, Lease Payments, Utilities, etc.) Property & Improvements (Land Acquisition, Site Development, etc) Equipment (Computers, Phones, Fundtuse, Fixtures, $6,00000 $6,000.00 Manufacturing Equipment, etc.) Plant & Improvements (Building Acquisition, Construction/Renovation, etc.) Transfer Payments $716,00000 $1,453,697.00 51,453,697.00 $2,169,697.00 (Scholaoshq s, Ivcatives, etc) Total Costa: %811,526.00 %85,872.00 SIA53,697.00 MS39,569.00 $2,351,095.00 P118 nCRC OFFICE USE ONLY Grant # 3102 GRANT AGREEMENT This Grant Agreement (this "Agreement") made and entered into the 12tb day of January, 2016 (the "Award Date"), by and between the Tobacco Region Revitalization Commission, a body corporate and political subdivision of the Commonwealth of Virginia (the "Commission"), and Pittsylvarda County. (the "Grantee"). WITNESSETH: WHEREAS, the Virginia General Assembly created the Commission to, among other things, stimulate the economic growth and development of tobacco -dependent communities in the Southside and Southwest regions (the "Region") of the Commonwealth of Virginia (the "Commonwealth'), and WHEREAS, the Grantee has submitted an application, which by this reference is incorporated herein and made a part of this Agreement (the "Application"), to the Commission for funding to acquire, construct, improve, equip, famish and/or otherwise undertake the project entitled SoVA Vineyard Development and Expansion to Support Virginia's Wine Industry described on Exhibit A attached hereto (the "Project"), and WHEREAS, the Commission, in reliance upon the information set forth in the Application, has determined that the Project benefits the Region and is consistent with and in furtherance of the Commission's public purposes and approved a grant to the Grantee in the amount of $811,526.00 (the "Grant") to fund the Project, the approval and funding of such Grant the Commission has determined constitutes a valid public purpose for the expenditure of public funds and is the animating purpose for the Grant, and WHEREAS, the Commission and the Grantee desire to set forth their understanding and agreement as to the use of the Grant and the obligations of the Grantee regarding the use of the Grant, NOW, THEREFORE, in consideration of the foregoing, the mutual benefits, promises and undertakings of the parties to this Agreement, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto hereby represent, warrant, covenant and agree as follows: 1. Project and Budget. The Grantee agrees to use the Grant to provide funds for that portion of the Project not being paid from other sources as set forth in the budget for the Project attached hereto as Exhibit B (the "Project Budget"). No portion of the Grant shall be used for any purpose whatsoever other than the Project without the prior written approval of the Executive Director of the Commission (the 'Txecutive Director"). No material changes shall be made in the scope of the Project or to the Project Budget without the prior written approval of the Executive Director. Any document signed by the Executive Director accepting a change in the scope of the Project or to the Project Budget shall set forth with specificity the accepted change. If the maximum 1/14/16 1- rev. 4/1/13 P119 authorized amount of the Grant exceeds the amount necessary to complete the Project, the excess shall not be disbursed to the Grantee but shall remain with the Commission or, if previously disbursed, be returned to the Commission within thirty (30) days of the earlier of the completion of the Project or the expiration of this Agreement The Grantee agrees to cause the Project to be acquired, constructed, improved, equipped, furnished and/or otherwise undertaken as described in Exhibit A and will cause the Project to be completed on or before the expiration of this Agreement. The Grant funds and funds available from the other sources specified in the Project Budget will be sufficient to cause the Project to be completed. The Grantee agrees to comply with any applicable governmental requirements pertaining to the Project and the use and application of Grant funds provided hereunder, including but not limited to, applicable requirements of the Virginia Public Procurement Act (Virginia Code Section 2.2-4300 et seq., as amended) but only as and to the extent required by any such governmental requirements, and the Commission shall not in any way be responsible for determining the extent, to which any such governmental requirements apply to this Grantee. 2. Payment of Grant Funds. Subject to the terms of this Agreement, including but not limited to, satisfaction by the Grantee, in the sole discretion of the Commission, of the conditions set forth on Exhibit C attached hereto, the Grant shall be disbursed on a reimbursement basis upon submission of a signed payment request on the Commission's then -current form (`Payment Request Form") with adequate supporting documentation. The Grantee agrees to comply with the Commission's General Funding Policies, Grant Disbursement Guidelines and Guidelines for Advance of Funds as adopted by the Commission as in effect from time to time and applied in the sole discretion of the Commission. Expenses incurred prior to the Award Date are not eligible for reimbursement. Prior to any disbursement, the Commission shall have on record documentation from the Grantee designating the officers, employees or agents authorized to make a reimbursement request (such documentation may be in the form of a resolution or minutes of the Grantee appointing such designee). Reimbursement requests shall be submitted not more frequently than quarterly, unless the Commission otherwise agrees. Appropriate supporting documentation shall be attached to all Payment Request Forms and may include, but is not limited to, invoices from goods purchased and services performed, receipts, vouchers, reporting forms or other evidence of the actual payment of costs related to the Project and consistent with the Project Budget. The Grantee shall also provide appropriate supporting documentation of the expenditure and application of any required matching funds for the Project as set forth on Exhibit C attached hereto. The Commission may in its sole discretion refuse to make a disbursement if the Grantee's documentation is not adequate or if such disbursement does not appear to be within the Project Budget or otherwise contrary to or in violation of the provisions hereof. The Commission in its sole discretion may refuse to disburse any funds to the Grantee if the Grantee has previously received a grant award and a final grant report for the previous grant award has not been received by the Commission. The Grantee may request in writing an advance of up to twenty-five percent (25%) of the Grant if the Grantee lacks sufficient working capital to fund the Project. Approval of such request shall be in the sole discretion of the Commission and shall be available no earlier than ninety days (90) prior to the start of the Project. If an advance is disbursed, the Grantee may request additional 1/14/16 - 2 - rev. 4/1/13 P120 disbursements only upon submission of signed Payment Request Forms with adequate supporting documentation for actual expenditures incurred for which the previous disbursement was used. 3. Quality of Work. The Commission, and its members, employees and agents, shall have the right to inspect the Project at reasonable times from time to time. Upon a determination that the quality of work done or the progress toward completion of the Project is unsatisfactory, the Commission may take whatever action is necessary to preserve the integrity of the Grant and its original intended purpose, including but not limited to, the actions set forth in Section 9 of this Agreement. The Project may be monitored through on-site visits by representatives of the Commission or in any other manner deemed appropriate by the Executive Director. 4. Parties' Relationship. In connection with the award or the administration of the Grant, the Commission does not and shall not assume any liability for any financial or other obligations of the Grantee made to thud parties, whether or not related to the Project. The Grantee shall provide written notice to all vendors, contractors and any other party retained to work on the Project that neither the Commission nor the Commonwealth shall be liable for the Project or any payment failure or other obligation related thereto. Such written notice shall provide that by accepting work on the Project, all such vendors, contractors and other parties release and relinquish the Commission and the Commonwealth from any claim which might otherwise be asserted, and that each parry accepting such work thereby indemnifies and holds the Commission, and its members, employees and agents, harmless against any and all such obligations; and further, that if any action is brought against the Commission, or its members, employees or agents, the party accepting such work shall be liable for all legal expenses and other costs related to such action. The Grantee is and will be acting as an independent contractor in the performance of the Project, and agrees to be responsible, where found liable and to the extent not covered by insurance or specified by statute, for the payment of any claim for loss, personal injury, death, property damage, or otherwise arising out of any act or omission of its members, employees or agents in connection with the performance of the Project. Nothing contained herein shall be deemed an express or implied waiver of the sovereign immunity of the Commission or the Commonwealth. In the event the Commission is required to take legal action under this Agreement, the Grantee shall be liable for all of the Commission's costs expended for the administration and enforcement of this Agreement, including but not limited to, reasonable attorney's fees and court costs. 5. Recordkeeping. The Grantee shall maintain proper books of record and account with respect to the Grant and the Project in which accurate and timely entries shall be made in accordance with generally accepted accounting principles, consistently applied, during the term of this Agreement. Grant funds received from the Commission shall be held in a separate and segregated account (the "Fund") and the Fund shall reflect all activity of the moneys received from the Commission for the Project, itemized by category of expenses in the same manner as in the Project Budget. The Grantee shall retain all invoices from goods purchased and services performed, receipts, vouchers, reporting forms or other evidence of the actual payment of costs related to the Project. All books of record and account and all records of receipts and expenditures with respect to the Grant and the Project and copies of Payment Request Fomes with supporting documentation and annual and final reports submitted to the Commission shall be retained for at least three (3) years 1/14/16 - 3 - rev. 4/1/13 P121 after the later of the completion of the Project or the expiration of this Agreement. The Commission, and its members, employees and agents, shall have the right at reasonable times from time to time to inspect and make copies of the books and records of the Grantee and the Fund. 6. Annual Reports. The Grantee shall submit to the Commission annual financial and narrative reports reflecting activity in the Fund and progress made toward completion of the Project. Annual financial reports shall be presented on the Commission's grant reporting form then in effect (the "Grant Reporting Form'n. Annual narrative reports shall indicate the progress made toward achieving the goals of the Grant and shall be submitted with the Grant Reporting Form. Annual reports shall be due one year from the Award Date and annually thereafter until the Project is complete. The Commission reserves the right to request additional information to supplement the information provided in the Grant Reporting Form or the annual narrative reports, including but not limited to, the Grantee's audited financial statements. 7. Final Report. The Grantee shall provide a final financial and narrative report to the Commission within thirty (30) days of the earlier of the completion of the Project or the expiation of this Agreement. The final report shall contain the type of information contained in the annual reports, including a narrative as to the success of the Project and a description of the long-term achievements and expectations for the Project. The Commission may withhold final disbursement of up to ten percent (10%) of the Grant until receipt of a final report that is in all respects satisfactory to the Commission. After the completion of the Project and expiration of this Agreement, the Commission may in its sole discretion require additional reporting on the long-term achievements and expectations of the Project. 8. Interim Reports. In addition to the annual reports and final report required by Sections 6 and 7 of this Agreement, the Commission may reasonably request that the Grantee submit additional or interim information from time to time to ensure that the provisions of this Agreement are properly carried out, administered and enforced. 9. Misuse of Award; Rights of Commission. If the Commission determines that any part of a Grant has not been used for the Project or for a purpose otherwise approved in writing by the Executive Director, or that the Grantee has failed to comply with any material term or condition of this Agreement, including but not limited to, the Grantee complying with the reporting requirements of this Agreement or making in any material respect a false or misleading statement or other written or oral representation, warranty or statement famished or made to the Commission in this Agreement, the Application or otherwise, the Commission in its sole discretion may withhold any Rather disbursements to the Grantee and, in addition: (a) rescind the Grant by written notice to the Grantee, in which event the Grantee shall be obligated to return to the Commission, within five (5) days following receipt of such notice, an amount, from legally available funds, equal to all Grant payments received pursuant to this Agreement, plus interest from the date of receipt of such noticc at the prime rate set forth in the Wall Street Journal on the date of such notice; (b) require the Grantee to take whatever action at law or in equity the Commission may direct in order to recover any Grant funds not used for the actual payment 1114/16 - 4 - rev. 4/1/13 P122 of costs related to the Project and consistent with the Project Budget, and comply with any procedures that the Commission may direct in order to prevent further improper use of the Grant; (c) take any other action as necessary to preserve the integrity of the Grant and to preserve Grant funds for appropriate uses; (d) determine that the Grantee is ineligible to receive future grant funding through the Commission; (e) withhold any and all disbursements requested by the Grantee from the Commission under any other grant previously approved by the Commission; and/or (f) take such judicial action as is necessary to collect any amounts owed, including legal action for breach of this Agreement, pursuant to this Section or as otherwise provided in this Agreement. The Grantee agrees to pay the Commission's attorneys' fees and actual costs incurred in the collection of funds or for the enforcement of any obligations of the Grantee set forth in this Agreement. The Commission reserves the right to modify or withhold any disbursement of Grant funds if the Commission in its sole discretion determines that it is necessary in order to protect the purposes and objectives of the Commission and the Grant or to comply with any law or regulation applicable to the Commission, the Grant and/or the Grantee. 10. Sale or Encumbrance; Security Interest. Until the Commission has determined that the public purposes of the Grant have been satisfied, none of the assets or property acquired, constructed, improved, equipped, and/or furnished as part of the Project shall be leased, sold, exchanged, disposed of, hypothecated, mortgaged or encumbered without the prior written approval of the Executive Director. In the event that such asset or property is leased, sold, exchanged, disposed of, hypothecated, mortgaged or encumbered without the prior written approval of the Executive Director, the Commission may assert its interest in the asset or property to recover the Commission's share of the value of such asset or property and/or recover from the Grantee, unless otherwise prohibited by law. Grantee hereby pledges, delivers and assigns to the Commission a security interest in, to and on all property purchased with the Grant, which security interest shall be held by the Commission to secure Grantee's full performance under this Agreement. Upon the request of the Commission, Grantee will execute, provide and sign all documents necessary to establish and/or perfect Commission's security interest in such property, including deeds of trust, supplemental deeds of trust, amendments or modifications hereto, financing statements, continuation statements or other instruments and documents which may be reasonably required from time to time. The Commission will release its security interest upon Grantee's full performance under this Agreement, including, without limitation, Grantee's full compliance with all reporting requirements required herein, and once the Commission has determined that the public proposes of the Grant have been satisfied. 1/14/16 - 5 - rev. 4/1/13 P123 11. Press Releases. The Grantee agrees that it shall not issue any press releases or other public statements regarding the Grant without the prior written consent of the Commission. 12. Future Funding. The Grant provided pursuant to this Agreement shall not be deemed to be an actual or implied promise of the Commission to fund the Project except as provided for herein. No representation by the Commission, or its members, employees or agents, shall be binding unless set forth in writing and signed by the Executive Director. In addition to the other remedies provided by law or in this Agreement, if the Grantee fails to comply with the terns of this Agreement, the Grantee shall not be entitled to additional funding for the Project. 13. Entire Agreement. To the extent there are inconsistencies between this Agreement and its supporting documents, including the Application and the exhibits attached hereto, this Agreement shall control. This Agreement expresses the entire understanding and all agreements between the Commission and the Grantee and may not be modified except in a writing signed by the Commission and the Grantee. 14. Governing Law; Jurisdiction; Venue. This Agreement shall be govemed by the applicable laws of the Commonwealth. The venue of any judicial action shall be in the Circuit Court of the City of Richmond, Virginia, and such litigation shall only be brought in such court. 15. Limitation of Commission's Liability. Nothing herein shall be deemed to be a covenant, agreement or obligation of a present or future member of the Commission or of an employee or agent of the Commission. No member, employee or agent of the Commission shall incur any personal liability with respect to any action taken by him or her pursuant to this Agreement. 16. Severability. If any provision of this Agreement shall be held invalid by any court of competent jurisdiction, such holding shall not invalidate any other provision hereof. 17. Public Documents. Unless specifically exempted pursuant to the Virginia Freedom of Information Act (Virginia Code Section 2.2-3700 et seq., as amended), all reports, documents, financial data and other information provided to the Commission shall be public records. 18. Notices. Unless otherwise provided for herein, all notices, approvals, consents, correspondence and other communications pursuant to this Agreement shall be in writing and shall be deemed received upon receipt or refusal after mailing of the same in the United States Mail by certified mail, postage fully pre -paid or by overnight courier (refusal shall mean return of certified mail or overnight courier package not accepted by the addressee) to (a) the Commission at 701 East Franklin Street, Suite 501, Richmond, Virginia 23219, Attention: Executive Director, or (b) the Grantee at the address set forth below. 19. Conditional Funding. In the event that disbursement of Grant funds is contingent upon the happening of an event or events described herein that have not yet occurred as of the Award Date, the Commission may withdraw the Grant if such event or events have not been substantiated with appropriate documentation satisfactory to the Commission within twelve (12) months of the 1/14/16 - 6 - rev. 4/1/13 P124 Award Date. This Agreement is subject to the availability of Commission funds. If such funds become unavailable and the Commission is unable to obtain sufficient funds, this Agreement shall be amended or terminated, as appropriate. 20. Expiration. Thirty-six (36) months after the date on which the Grant is approved, the Grant shall be automatically rescinded with respect to all funds not yet disbursed by the Commission, unless an extension is granted in writing by the Commission. 21. Survival. The rights and remedies available to the Commission shall survive any expiration or termination of this Agreement, including but not limited to, Sections 4, 7, 9, 10 and 21. 22. Counterparts. This Agreement may be executed in counterparts, each of which shall be an original, and all of which together shall constitute but one and the same instrument. fRemainder of this page intentionally left blank] 1/14/16 - 7 - rev. 4/1/13 P125 ` IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date first written above. TOBACCO REGION REVITALIZATION CO SS ON, a body corporate and political subdivision of the mm wealth Vir nia Signature of Executive Director: Printed Name of Executive Director: EvanFFeimn/an — Date: iU{'h Pittsylvania County Signature of Grantee's Chief Executive: Printed Name of Chief Executive: t^,LCLV-e�rW-P Grantee Information: Date: j .ay Federal lD # 1/14/16 - 8 - mv.4/1/13 P126 Exhibit A Project Description The SoVA VDE project is a three year program consisting of four components. Educational aspects will be administered by the vineyard experts within Virginia Cooperative Extension (VCE). Second, a new producer cost -share, to incentivize interested producers/individuals who have never operated or managed a vineyard to establish at least 5 acres of new vines. Third, expanding current vineyards, will be a cost -share program as well. To participate, the vineyard must consist of at least 3 acres currently, with adequate production and would be willing to expand their acreage by at least 2 new acres of vines. The fourth component, on-farm research and development, will be initiated by the Institute for Advanced Learning and Research (ULR). IALR will be evaluating new varietals and genetics to improve disease resistance for increasing vineyard yields and reducing chemical costs for the Southern region. This project will target all Southside counties in the TRRC. 1/14/16 - 9 - rev. 4/1/13 P127 Exhibit B Project Budget The Budget Worksheet is available as a separate attachment. 1/14/16 -to- rev. 4/1/13 P128 Exhibit C Grant Conditions No less than 50% of the total Project Budget shall be funded by non -commission sources and satisfactory evidence thereof submitted to the Commission prior to disbursement of any Commission money. Un -approved applications to other funding sources are not satisfactory evidence. 2. Award of $811,526 approved contingent on program guidelines limiting cost -share at the maximum thresholds identified in the proposal and not to exceed 33% of eligiblc costs for establishment of new acreage. 3. Eligibility for existing vineyards of three (3) or more acres will require a minimum of one (1) new acre of vineyard to qualify for cost -share incentives, rather than the two (2) acre minimum proposed in the grant application. 1/14/16 - I1 - rev. 4/1/13 P129 PITTSYLVANIA COUNTY Board of Supervisors EXECUTIVE SUMMARY AGENDA TITLE: AGENDA DATE: ITEM NUMBER: Southside Soccer Club Lease Request of Blairs 2/21/17 (T) 10 _ School Fields and 3 Outbuildings ACTION: REQUEST: Yes Authorization to Conduct Required Public Hearing ATTACHMENT: STAFF CONTACT: (1) Southside Soccer Club Lease Request Letter Mr. Hunt (Ex. "A") (2) Virginia Code § 15.2-1800 (Ex. `B") As indicated by the letter attached hereto as Exhibit "A," Southside Soccer Club has requested to lease from the Pittsylvania County Board of Supervisors ("BOS") fields and three (3) outbuildings located at the Old Blairs Middle School for youth soccer purposes. Per Virginia Code § 15.2-1800, attached hereto as Exhibit `B," a public hearing is legally required to lease County -owned property. RECOMMENDATION: For the BOS' consideration. Staff recommends authorization to advertise and conduct the legally required public public at the March BOS meeting to potentially lease the above - referenced property to Southside Soccer Club. P130 ChrisAnderson Southside Soccer Club 200 Blairs Middle School Circle Blairs, VA 24527 February 1, 2017 David M Smitherman County Administrator Pittsylvania County 1 Center St Chatham, VA 24531 Mr. Smitherman: I have been designated as a point of contact by the Board of Directors of Southside Soccer Club in reference to an agreement between Pittsylvania County and Southside Soccer Club (SSC). The following information is intended to provide limited background information about SSC and what we do, as well as a recommended working agreement between the two aforementioned entities. • SSC is a registered non-profit organization that was formed in 2003. • SSC has an all -volunteer, 11 member Board of Directors. • SSC has an annual membership that fluctuates between approximately 900 —1000 players, which form 70-80 teams. • SSC has an annual volunteer force of approximately 180 adults, including coaches, concession workers and grounds maintenance volunteers. • SSC employs between 75 —100 referees per year, made up of teenagers and adults. • SSC employs 2 soccer coaches at the Academy level and 1 Director of Technical Training. • SSC receives no outside funding • SSC has approximately $20,000 in grounds maintenance equipment in secure storage at facility. • SSC spends approximately $4500 in lawn/grounds mowing and weed control annually as well as parking lot repair. • SSC spends approximately $800-$1000 per year in fertilizer and seed per year on soccer fields. • SSC currently occupies 2 buildings at facility, the Clubhouse and a secured garage/shop. • The Clubhouse holds one restroom, an office, a secure storage room with video surveillance equipment, a concession stand and a large multi -use area for eating/breaks, training and BOD meetings. This area has been maintained by SSC at no cost to Pittsylvania County. • SSC currently occupies the entire East side, and South Side fields on the Blairs property which is used for 6-8 soccer fields during Spring and Fall seasons. • SSC is a member of Virginia Youth Soccer Association and United States Soccer Association. • SSC participates in Interleague play with the City of Danville, and the Counties of Halifax, Charlotte, Mecklenburg, Appomattox and Rockingham, NC. • SSC is the largest soccer body in southern VA. The following bullet points represent the ways in which SSC offers to serve the citizens of Pittsylvania County. Reference may be made to the additionally attached photo from Google Earth: • Continue to provide superior and exemplary service to the 900-1000 players and their supporting families. • Continue to maintain the grass covered grounds at the Blairs facility within the red lines of the complex on the Google Earth attachment, including but not limited to: fertilizer, lime, seed, aerating, grass mowing and weed control, removal of debris, fallen trees and litter. • General maintenance, such as filling in potholes, of the parking lot area on the Western, Southern and Eastern sides of the building. • General maintenance of clubhouse, Shop #1 and Shop #2 including but not limited to light bulbs, drop ceilings, floor coverings and interior paint. 0 P131 a- Provide and maintain weekly, Porta -Potties, including ADA approved devices. The following bullet points represent the requests of SSC to Pittsylvania County Board of Supervisors in return of the services offered by SSC: • Continued use of clubhouse building, shop #1 and shop #2. Please note; currently SSC only uses shop #1. We are now asking for use of shop #2 in addition to #1. The benefit for SSC in having both shops will be that we can store our soccer goals inside during the offseason, prolonging the life of the steel goals and the nylon nets, as well as protection from theft. • Continued use of all grass covered fields within red outlined area on Google Earth image. • Continued use of all parking areas and common areas outlined on Google Earth image. • Use of electrical service, water service and septic service for clubhouse and both shops. • Repair of, and use of field lights on East side of field. These lights were in working order until PCSA trenched on the property, now only a few lights work. • Repair of broken windows to shop. We do not need glass. If boarding is less expensive that is fine. • Repair of caps on septic system, located on south side of building and maintenance of septic system. This area is identified by yellow circle on Google Earth image. • 10 year lease agreement — While this may seem like a long commitment, we are happy to agree to termination with a 90 day aereement. The reason we want this is because if we are able to secure such an agreement, it makes us eligible for turf management grants as well as administrative grants through US Soccer. As you can tell by the photos, the common areas of the fields are very worn due to the high traffic during the seasons. The 90 days would be sufficient for us to finish a season if we were mid-season and you wished to terminate the agreement. • lease agreement to be at no cost to SSC. In closing, I would like to point out that the buildings we request to occupy are not attached to the main building. They are in much better shape and have been reviewed by the Fire Marshall. On behalf of SSC BOD, thank you very much for entertaining our requests, allowing us to continue to serve our children and community. Sincerely, Chris Anderson 434-441-7194 Papagoat34@gmail.com P132 ,E.4AM x i! '..M - .. 5. •�Sa.il. f-. x p ri 2/16/2017 Code of Virginia Title 15.2. Counties, Cities and Towns Chapter 18. Buildings, Monuments and Lands Generally § 15.2-1800. Purchase, sale, use, etc., of real property. A. A locality may acquire by purchase, gift, devise, bequest, exchange, lease as lessee, or otherwise, title to, or any interests in, any real property, whether improved or unimproved, within its jurisdiction, for any public use. Acquisition of any interest in real property by condemnation is governed by Chapter 19 (§ 15.2-1901 et seq.). The acquisition of a leasehold or other interest in a telecommunications tower, owned by a nongovernmental source, for the operation of a locality's wireless radio communications systems shall be governed by this chapter. B. Subject to any applicable requirements of Article VII, Section 9 of the Constitution, any locality may sell, at public or private sale, exchange, lease as lessor, mortgage, pledge, subordinate interest in or otherwise dispose of its real property, which includes the superjacent airspace (except airspace provided for in § 15.2-2030) which may be subdivided and conveyed separate from the subjacent land surface, provided that no such real property, whether improved or unimproved, shall be disposed of until the governing body has held a public hearing concerning such disposal. However, the holding of a public hearing shall not apply to (i) the leasing of real property to another public body, political subdivision or authority of the Commonwealth or (ii) conveyance of site development easements across public property, including, but not limited to, easements for ingress, egress, utilities, cable, telecommunications, storm water management, and other similar conveyances, that are consistent with the local capital improvement program, involving improvement of property owned by the locality. The provisions of this section shall not apply to the vacation of public interests in real property wider the provisions of Articles 6 (§ 15.2-2240 et seq.) and 7 (§ 15.2-2280 et seq.) of Chapter 22 of this title. C. A city or town may also acquire real property for a public use outside its boundaries; a county may acquire real property for a public use outside its boundaries when expressly authorized by law. D. A locality may constrict, insure, and equip buildings, structures and other improvements on real property owned or leased by it. E. A locality may operate, maintain, and regulate the use of its real property or may contract with other persons to do SO. Notwithstanding any contrary provision of law, general or special, no locality providing access and opportunity to use its real property, whether improved or unimproved, may deny equal access or a fair opportunity to use such real property to, or otherwise discriminate against, the Boy Scouts of America or the Girl Scouts of the USA. Nothing in this paragraph shall be construed to require any locality to sponsor the Boy Scouts of America or the Girl Scouts of the USA, or to exempt any such groups from local policies governing access to and use of a locality's real property. The provisions of this paragraph applicable to a locality shall also apply equally to any local governmental entity, including a department, agency, or authority. F. This section shall not be construed to deprive the resident judge or judges of the right to control the use of the courthouse. G. "Public use" as used in this section shall have the same meaning as in § 1-219.1. Code 1950, § 1.5-692; 1962, c. 623, § 15.1-262; 1968, c. 418; 1974, c. 282; 1977, c. 269; 1979, c. 431; 1980, cc. 212, 559; 1984, c. 241; 1986, cc. 477, 573; 1990, c. 813; 1997, c. 587; 1998,. c. 696; 2005, c. 822; 2006, c. 57; 2007, cc. 882, 901, 926. a P134 REPORTS FROM MEMBERS P135 REPORTS FROM COUNTY ADMINISTRATOR P136 ADJOURNMENT P137