2021-06-02T15:37:32-05:00 2020-12-31 BKD LLP 201 N Illinois Street Indianapolis IN 46204 990 2020-01-01 351694366 Van Ausdall & Farrar Inc Employee Benefit Trust % TIM MULLEN VAN 3179747219 6430 E 75TH STREET INDIANAPOLIS IN 46250 TIM MULLEN CFO 3179747219 2021-06-02 true TIM MULLEN 999009999 STEVEN J KRITZMIRE P00275426 3173834000 2 2020 2022-09-23 18:48:47Z VAN AUSDALL FARRAR INC 6430 E 75TH ST INDIANAPOLIS IN 46250 774447 false X N/A X 1987 IN TO PROVIDE MEDICAL EXPENSE BENEFITS TO PARTICIPATING EMPLOYEES AND OTHER QUALIFIED PARTICIPANTS OF THE VAN AUSDALL & FARRAR, INC. EMPLOYEE BENEFIT TRUST (WELFARE BENEFIT PLAN). 2 0 0 2 0 0 0 950550 774447 0 0 0 0 950550 774447 0 0 947062 755450 0 0 0 0 0 11268 14501 958330 769951 -7780 4496 2076 6572 0 0 2076 6572 TO PROVIDE MEDICAL EXPENSE BENEFITS TO PARTICIPATING EMPLOYEES AND OTHER QUALIFIED PARTICIPANTS OF THE VAN AUSDALL & FARRAR, INC. EMPLOYEE BENEFIT TRUST (WELFARE BENEFIT PLAN). false false 767338 TO PROVIDE MEDICAL EXPENSE BENEFITS TO PARTICIPATING EMPLOYEES AND OTHER QUALIFIED PARTICIPANTS OF THE VAN AUSDALL & FARRAR, INC. EMPLOYEE BENEFIT TRUST (WELFARE BENEFIT PLAN). false false false false false false false false false false false false false false false true false false false false false false false false false false false false false false false false true true false false false false false false true false false true 0 0 0 false false false false false false false false X 2 0 true false false false false false false true false false false true false false false false IN X X TIM MULLEN 3179747219 6430 E 75TH ST INDIANAPOLIS IN 46250 TIM MULLEN TRUSTEE 1.0 40.0 X 0 0 0 ERIC VON GRIMMENSTEIN TRUSTEE 1.0 40.0 X 0 0 0 0 0 0 0 false false false 0 0 EMPLOYER CONTRIB 900099 412612 412612 EMPLOYEE CONTRIB 900099 354726 354726 REINSURANCE REIMBURSEMENTS 900099 7109 7109 774447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774447 774447 0 0 0 755450 0 0 0 0 0 0 0 0 0 0 0 0 14501 0 0 0 0 0 0 0 0 0 0 0 0 769951 2076 6572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2076 6572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 2076 6572 2076 6572 2076 6572 4496 X false true false false 774447 774447 774447 769951 769951 769951 ERIC VON GRIMMENSTEIN SEE PART V SEE PART V VAN AUSDALL FARRAR INC SEE PART V 412612 SEE PART V VAF FINANCIAL INC SEE PART V SEE PART V COLUMN (B) ERIC VON GRIMMENSTEIN ERIC VON GRIMMENSTEIN OWNS 88.36% (100% THROUGH FAMILY ATTRIBUTION) OF VAN AUSDALL & FARRAR, INC. (A FOR PROFIT C CORPORATION) AND 81.82% OF VA&F FINANCIAL, INC. (A FOR PROFIT C CORPORATION) COLUMN (B) VAN AUSDALL & FARRAR, VA&F FINANCIAL VAN AUSDALL & FARRAR, INC. AND VA&F FINANCIAL, INC. ARE ENTITIES MORE THAN 35% OWNED DIRECTLY BY ONE OR MORE CURRENT TRUSTEES. COLUMN (D) ERIC VON GRIMMENSTEIN ERIC VON GRIMMENSTEIN (A TRUSTEE OF THIS ORGANIZATION) DID NOT HAVE ANY BUSINESS TRANSACTIONS WITH THE ORGANIZATION. COLUMN (D) VAN AUSDALL & FARRAR, INC. VAN AUSDALL & FARRAR, INC. CONTRIUBUTES AMOUNTS TO THE TRUST THAT ARE NECESSARY TO FUND CLAIMS AND EXPENSES OF THE VAN AUSDALL & FARRAR, INC. EMPLOYEE BENEFIT TRUST THAT IT SPONSORS. PART VI, SECTION A, LINE 2 THE TRUSTEES OF THIS TRUST (THAT ARE MEMBERS OF THE GOVERNING BODY) ARE ALSO OFFICERS OF A RELATED ORGANIZATION REPORTED ON SCHEDULE R. AS A RESULT, ALL TRUSTEES HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 WAS REVIEWED BY THE GOVERNING BODY PRIOR TO FINALIZATION. AFTER THE FORM IS REVIEWED AND ITS ACCURACY CONFIRMED BY INDIVIDUALS WITH DIRECT KNOWLEDGE OF THE OPERATIONS OF THE ORGANIZATION, THE FORM 990 IS FINALIZED AND PROVIDED TO A MEMBER OF THE GOVERNING BODY FOR SIGNATURE AND FILING. PART VI, SECTION C, LINES 18 & 19 AS UNDER REGULATIONS SECTIONS 301.6104(D)-1 THROUGH 3, THE ORGANIZATION WILL MAKE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST THE GOVERNING DOCUMENTS AND EACH ANNUAL INFORMATION RETURN (FORM 990) AND RELATED SCHEDULES AND ATTACHMENTS (INCLUDING THE AUDITED FINANCIAL STATEMENTS). IN ADDITION, THIS RETURN IS AUTOMATICALLY POSTED ON GUIDESTAR.ORG. PART VII THE TRUSTEES LISTED IN PART VII ON LINE 1(A) COLUMN A LINES 1-2 ARE EMPLOYEES OF THE RELATED ORGANIZATION (AS DISCLOSED ON SCHEDULE R) THAT SPONSORS THIS 501(C)(9) VEBA. HOWEVER, BECAUSE THE RELATED ORGANIZATION IS A FOR-PROFIT ORGANIZATION THAT IS NOT OWNED OR CONTROLLED DIRECTLY OR INDIRECTLY BY THIS VEBA REPORTING ORGANIZATION AND DOES NOT PROVIDE MANAGEMENT SERVICES FOR A FEE TO THIS REPORTING ORGANIZATION, COMPENSATION FROM THE RELATED ORGANIZATION (VEBA SPONSOR) IS NOT DISCLOSED AS EACH OF THE TRUSTEES LISTED ON THESE LINES ARE VOLUNTEERS WHO SERVE THE REPORTING ORGANIZATION WITHOUT COMPENSATION FROM THE REPORTING ORGANZATION. VAN AUSDALL & FARRAR INC 6430 E 75TH STREET INDIANAPOLIS IN 46250 351067666 RETAIL SALES IN NA C false false false false false false false false false false false false false true false false false false VAN AUSDALL & FARRAR INC EE SH SEE BELOW PART V, LINE 1o AS THE SPONSOR OF THE ASSOCIATED WELFARE PLAN, VAN AUSDALL & FARRAR, INC. EMPOLYEES MAY PROVIDE IMMATERIAL SERVICES TO THE PLAN AND THIS TRUST FROM TIME TO TIME FOR WHICH THE RELATED PARTY RECEIVES NO COMPENSATION.