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HAVEN EILEEN KILEY FOUNDATION INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
HAVEN EILEEN KILEY FOUNDATION INC (EIN 81-0698389)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202013219349316466
Schema version
2019v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-11-16T15:15:19-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN453643178PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1iQ Tax Services LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12155 JERICHO TURNPIKEAddressLine1Txt
CityCOMMACKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11725ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN810698389EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HAVEN EILEEN KILEY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JANICE KILEYInCareOfNm
Business Name ControlHAVEBusinessNameControlTxt
Phone7042192449PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117915 GOLDEN MEADOW CTAddressLine1Txt
CityDAVIDSONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28036ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJANICE KILEYPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7042192449PhoneNum
Signature2020-11-16SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL HALLPreparerPersonNm
PTINP00941894PTIN
Phone6314621040PhoneNum
Preparation2020-11-16PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address68.196.196.237IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id12312220203211250408FederalOriginalSubmissionId
Federal Original Submission Id2020-11-16FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id69FBCDF003503DE8F2AEC9E462DED51F7EB16328AtSubmissionCreationDeviceId
At Submission Filing Device Id62BD91E822412F626A071E43F9D1984F2133E01BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJANICE KILEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line117915 GOLDEN MEADOW CTAddressLine1Txt
CityDAVIDSONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28036ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$107,442GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://havensfoundation.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateNCLegalDomicileStateCd
Activity Or MissionHelp families cope with trauma of childhood illnessinjury Lend financial support to institutions that care for these childrenActivityOrMissionDesc
Voting Members Governing Body2VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$39,241PYContributionsGrantsAmt
CY Contributions Grants$72,910CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$6,618PYOtherRevenueAmt
CY Other Revenue$16,738CYOtherRevenueAmt
PY Total Revenue$45,859PYTotalRevenueAmt
CY Total Revenue$89,648CYTotalRevenueAmt
PY Grants And Similar Paid$20,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$51,215CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,651PYOtherExpensesAmt
CY Other Expenses$3,334CYOtherExpensesAmt
PY Total Expenses$25,651PYTotalExpensesAmt
CY Total Expenses$54,549CYTotalExpensesAmt
PY Revenues Less Expenses$20,208PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$35,099CYRevenuesLessExpensesAmt
Total Assets BOY$94,984TotalAssetsBOYAmt
Total Assets EOY$130,083TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$94,984NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$130,083NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHelp families cope with trauma associated with childhood illness or injury. Lend financial support to individuals/institutions dedicated to caring for these children in their time of need.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$25,000ExpenseAmt
Grant$25,000GrantAmt
Desc$25,000 Cash Donation to Hemby Childrens HospitalDesc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$20,000ExpenseAmt
Grant$20,000GrantAmt
Desc$20,000 Cash Donation to Childrens Hope AllianceDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$5,000ExpenseAmt
Grant$5,000GrantAmt
Desc$5,000 Cash Donation to The Spokes GroupDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,215ExpenseAmt
Grant$1,215GrantAmt
Desc$1,215 Cash Donation to EquuvationDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,215TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$1,215TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$51,215TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members2GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyfalseMinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJANICE KILEYPersonNm
Phone7042192449PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117915 GOLDEN MEADOW CTAddressLine1Txt
CityDAVIDSONCityNm
State AbbreviationNCStateAbbreviationCd
ZIP28036ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
BRIAN KILEY
DIRECTOR10.00Yes (X)$0$0$0
JANICE KILEY
PRESIDENT10.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$72,910AllOtherContributionsAmt
Noncash Contributions$2,000NoncashContributionsAmt
Total Contributions$72,910TotalContributionsAmt
Fundraising Gross Income$34,532FundraisingGrossIncomeAmt
Fundraising Direct Expenses$17,794FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,738TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$89,648TotalRevenueColumnAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$51,215TotalAmt
Program Services$51,215ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,000TotalAmt
Management And General$2,000ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$488TotalAmt
Management And General$488ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescBANK FEESDesc
Total$846TotalAmt
Management And General$846ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$54,549TotalAmt
Program Services$51,215ProgramServicesAmt
Management And General$3,334ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$94,984BOYAmt
EOY$130,083EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$94,984BOYAmt
EOY$130,083EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$94,984BOYAmt
EOY$130,083EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$94,984BOYAmt
EOY$130,083EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$94,984BOYAmt
EOY$130,083EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$35,099ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$39,719CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$49,519CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$39,241CurrentTaxYearMinus1YearAmt
Current Tax Year$72,910CurrentTaxYearAmt
Total$201,389TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$39,719CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$49,519CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$39,241CurrentTaxYearMinus1YearAmt
Current Tax Year$72,910CurrentTaxYearAmt
Total$201,389TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$201,389PublicSupportTotal170Amt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$22,637CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,556CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,618CurrentTaxYearMinus1YearAmt
Current Tax Year$16,738CurrentTaxYearAmt
Total$59,549TotalAmt
FieldValueIRS element (for citing)
Total Support$260,938TotalSupportAmt
First5 Years170Yes (X)First5Years170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePart II Line 10/Part III Line 12FormAndLineReferenceDesc
ExplanationIncome from Golf Event Form 990, Part 1, Line 11ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNEvent1Nm
Gross Receipts Event1$34,532GrossReceiptsEvent1Amt
Gross Revenue Event1$34,532GrossRevenueEvent1Amt
Other Direct Expenses Event1$17,794OtherDirectExpensesEvent1Amt
Gross Receipts Total$34,532GrossReceiptsTotalAmt
Gross Revenue Total Events$34,532GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$17,794OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$17,794DirectExpenseSummaryEventsAmt
Net Income Summary$16,738NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
HEMBY CHILDRENS HOSPITAL
2515 200 HAWTHORNE LNCHARLOTTENC28204581413074$25,000$0CASH DONATION
CHILDRENS HOPE ALLIANCE
PO BOX 1BARIUM SPRINGSNC28010560529993$20,000$0CASH DONATION
THE SPOKES GROUP
125 DEVENPORT DRMATTHEWSNC28104450562248$5,000$0CASH DONATION
EQUUVATION INC
196 OLD STAGECOACH LANESTATESVILLENC28625471761541$1,215$0CASH DONATION
FieldValueIRS element (for citing)
Total501c3 Org0Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI Line 11bNO REVIEW WAS OR WILL BE CONDUCTED
Part VI Line 19NO DOCUMENTS AVAILABLE TO PUBLIC
Part III Line 4dExpenses: $1215.00 including grants of: $1215.00 Revenue: $0.00
Part III Line 4d$1,215 Cash Donation to Equuvation