2020-06-26T12:39:47-05:00 2019-12-31 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2019-01-01 204841856 MOSAIC ILLINOIS HOUSING OF ROCKFORD I MOSA 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 KRISTIN ROSSOW PRESIDENT 4028963884 2020-06-23 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2020-06-23 14:41:01 CD P 269B3A6CFEBE93A73A929783B6584231D56B63A4 5D066E2939FE45487034BD10C4A0DC94BE27FEF9 2019 2020-09-23 17:36:50Z KRISTIN ROSSOW 4980 SOUTH 118TH STREET OMAHA NE 68137 56936 0 X WWW.MOSAICINFO.ORG X 2008 NE THE ORGANIZATION PROVIDES LOW INCOME AFFORDABLE HOUSING UNDER IHDA GUIDELINES. 4 4 0 5 0 0 0 0 74576 56159 951 777 9050 0 84577 56936 0 0 0 0 0 0 0 0 0 165943 157087 165943 157087 -81366 -100151 1096583 987617 630309 621494 466274 366123 THE ORGANIZATION PROVIDES LOW INCOME AFFORDABLE HOUSING UNDER ILLINOIS HOUSING DEVELOPMENT AUTHORITY GUIDELINES. 0 0 144886 56159 THE ORGANIZATION PROVIDES LOW INCOME AFFORDABLE HOUSING UNDER ILLINOIS HOUSING DEVELOPMENT AUTHORITY GUIDELINES. 144886 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X KRISTIN ROSSOW 4028963884 4980 S 118 STREET OMAHA NE 68137 DEANNA WAGNER CHAIRPERSON 0.10 2.30 X X 0 0 0 JOAN NIEDFELDT VICE CHAIRPERSON THRU 4/19 0.10 2.30 X X 0 0 0 BARBARA PETSKA VICE CHAIRPERSON 0.10 2.30 X X 0 0 0 CYNTHIA WEBER DIRECTOR 0.10 2.30 X 0 0 0 JENNIFER DOAN DIRECTOR 0.10 2.30 X 0 0 0 KRISTIN ROSSOW PRESIDENT 0.50 39.50 X 0 166547 26239 GREG PASKACH SECRETARY/TREASURER 0.50 39.50 X 0 91869 17154 0 258416 43393 0 0 1 0 0 RENTAL INCOME 531110 56159 56159 56159 777 777 56936 56159 0 777 3317 3317 196 196 6130 6130 1187 1187 597 597 41449 41449 774 774 99783 99783 3654 3654 157087 144886 12201 0 14975 7016 2550 2589 448 158 1868318 934288 1029351 934030 49259 43824 1096583 987617 18211 9789 612098 607098 0 4607 630309 621494 X 346274 366123 120000 0 466274 366123 1096583 987617 -100151 0 X X 0 1 X 1 1 1 X 87187 90000 82650 74576 56159 390572 87187 90000 82650 74576 56159 390572 0 0 0 390572 16 114 386 951 777 2244 16 114 386 951 777 2244 750 1200 21596 9050 32596 87953 91314 104632 84577 56936 425412 0.91810 0.92230 0.00530 0.00320 X 40176 40176 1828142 934288 893854 934030 DUE TO AFFILIATES 4607 4607 X 56936 0 56936 0 56936 157087 0 157087 0 157087 PART X, LINE 2: THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD ASC 740, INCOME TAXES. THE CORPORATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2019 AND 2018, THE CORPORATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 0 0 0 0 0 0 0 0 0 KRISTIN ROSSOW PRESIDENT 0 159907 0 6000 0 640 0 4601 0 21638 0 192786 0 0 PART I, LINE 3 MOSAIC, A RELATED ENTITY, COMPENSATES THE PRESIDENT OF MOSAIC ILLINOIS HOUSING OF ROCKFORD I. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS FOR MOSAIC, A RELATED ENTITY, APPOINTS BOARD MEMBERS FOR THIS ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B EACH DECEMBER, THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND VICE PRESIDENT OF COMPLIANCE IDENTIFY THE DISQUALIFIED PERSONS BASED ON INFORMATION FILED IN EACH KEY EMPLOYEE'S ANNUAL CONFLICT OF INTEREST FORM. THE VP OF HR SOLUTIONS AND VP OF ACCOUNTING REVIEW THE SALARY AND BENEFIT INFORMATION REQUIRED FOR ALL DIRECTORS, OFFICERS, KEY EMPLOYEES AND DISQUALIFIED PERSONS AND PREPARE A SCHEDULE FOR REVIEW BY THE SVP OF HUMAN RESOURCES AND SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER. A REVIEW OF ALL INTERNATIONAL, LOBBYING AND UNRELATED BUSINESS ACTIVITIES IS COMPLETED BY THE CHIEF FINANCIAL OFFICER AND VP OF ACCOUNTING WITH RELEVANT STAFF. FORM 990 IS PREPARED BY THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM. THE CHIEF FINANCIAL OFFICER, THE ORGANIZATION'S OUTSIDE ACCOUNTING FIRM, AND THE CHIEF EXECUTIVE OFFICER REVIEW THE RETURN. THE FINANCE AND AUDIT COMMITTEE AND THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE RETURN PRIOR TO FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS EACH BOARD DIRECTOR COMPLETES A CONFLICT OF INTEREST FORM AND SUBMITS IT TO THE CHAIRPERSON OF THE BOARD INTEGRITY COMMITTEE. ANY FINANCIAL CONFLICTS OF INTEREST ARE REPORTED TO THE CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ON AN ANNUAL BASIS ALL STAFF COMPLETE A CONFLICT OF INTEREST FORM IN CONJUNCTION WITH THEIR ANNUAL EVALUATION. ALL CONFLICTS OF INTEREST ARE REVIEWED BY THE HUMAN RESOURCES. ANY CONFLICTS OF INTEREST OF THE CHIEF EXECUTIVE OFFICER ARE REPORTED TO THE BOARD OF DIRECTORS. CONFLICTS OF INTEREST OF SENIOR STAFF ARE REVIEWED BY THE SENIOR VICE PRESIDENT FOR HUMAN RESOURCES AND VICE PRESIDENT OF COMPLIANCE AND REPORTED TO THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER FOR REPORTING ON THE FORM 990. ANY NEW CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR ARE REQUIRED TO BE REPORTED AT THAT TIME. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC, UPON REQUEST, ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS. FORM 990, PART XII, LINE 2C: THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC 4980 S 118 STREET OMAHA NE 68137 113669999 CARE & ADVOCACY FOR THE INTELLECTUALLY DISABLED NE 501(C)(3) LINE 10 N/A 0 MOSAIC FOUNDATION 4980 S 118 STREET OMAHA NE 68137 363837360 FUNDRAISING & INVESTMENT ASSET MGMT NE 501(C)(3) LINE 12A, I MOSAIC 1 THE OAKS OF DUNN COUNTY 4980 S 118 STREET OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 STREET OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 STREET OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 STREET OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 STREET OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 STREET OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 STREET OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 STREET OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 STREET OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 STREET OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 STREET OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV - ROCKFORD 4980 S 118 STREET OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XV - COUNCIL BLUFFS 4980 S 118 STREET OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI - FARMINGTON 4980 S 118 STREET OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVII - BEATRICE 4980 S 118 STREET OMAHA NE 68137 261710013 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII - OSCEOLA-WAUKON 4980 S 118 STREET OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX - WINFIELD 4980 S 118 STREET OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XX - GARDEN CITY 4980 S 118 STREET OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXII - LOGAN 4980 S 118 STREET OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII - AUSTIN 4980 S 118 STREET OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING I 4980 S 118 STREET OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING II 4980 S 118 STREET OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB I 4980 S 118 STREET OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 STREET OMAHA NE 68137 363831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC HOUSING CORPORATION XXI - MEMPHIS 4980 S 118 STREET OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC SENIOR SERVICES INC 4980 S 118 STREET OMAHA NE 68137 831746407 SENIOR LIVING SERVICES AZ 501(C)(3) LINE 12A, I MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICAL INC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 MEDICAL EQUIPMENT/SUPPLIES SALES NE N/A C 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 1 CHARITABLE REMAINDER TRUSTS (5) INVESTMENT MANAGEMENT NE N/A T 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0