2019-10-15T09:05:10-05:00 2018-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH STREET SUITE 500 SIOUX FALLS SD 57104 990 2018-01-01 201115155 WINFIELD GOOD SAMARITAN HOUSING INC WINF 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 THOMAS A SYVERSON PRESIDENT 6053623100 2019-10-08 1 LAURIE HANSON P00851848 6053391999 2019-10-08 216.147.181.46 2019-10-08 16:16:16 CD P C5ADF3E96DC5FD5E5884512D59AB882B10EDFEC1 2498296C43E1E89153AA0CA2385E379BE62769D4 2018 2019-02-21 02:37:17Z WHEAT RIDGE HEIGHTS THOMAS A SYVERSON 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 139480 0 X WWW.GOOD-SAM.COM X 2004 SD TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 7 7 1 8 0 0 0 0 141040 139425 52 55 0 0 141092 139480 0 0 0 0 41557 42885 0 0 0 148915 159614 190472 202499 -49380 -63019 1365294 1297770 32154 27649 1333140 1270121 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 0 0 130986 139425 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 6,858 RESIDENT DAYS IN 2018. 130986 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 0 0 0 1 3 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 1 0 0 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X ERIC VANDEN HULL 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 DAVID J HORAZDOVSKY CHAIRPERSON OF THE BOARD 0.10 57.00 X X 0 772988 22451 GWEN WAGSTROM HALAAS VICE CHAIRPERSON 0.10 3.90 X X 0 0 0 H THEODORE GRINDAL VICE CHAIRPERSON UNTIL 06/18 0.10 3.90 X X 0 0 0 JOHN R RACEK DIRECTOR 0.10 3.90 X 0 0 0 NORVAL DEAN BUCKNEBERG DIRECTOR 0.10 3.90 X 0 0 0 LEE O LAAVEG DIRECTOR 0.10 3.90 X 0 0 0 CINDY GOERTZ DIRECTOR 0.10 0.00 X 0 0 0 HAROLD GROSS JR DIRECTOR 0.10 0.00 X 0 0 0 TOMISHA JO JORDAN DIRECTOR 0.10 0.00 X 0 0 0 THOMAS A SYVERSON PRESIDENT 0.10 55.60 X 0 340464 27731 TERRY PARKER VICE PRESIDENT BEG 10/18 1.60 53.40 X 0 110514 26788 G GRANT TRIBBLE TREASURER 0.10 57.00 X 0 365523 23381 THOMAS J KAPUSTA SECRETARY 0.10 57.00 X 0 340616 11645 MISTY HAM-QUICK ASSISTANT SECRETARY 0.10 44.90 X 0 50809 17748 0 1980914 129744 0 0 1 0 0 RENTAL CHARGES 624100 137834 137834 ANCILLARY CHARGES 624100 1591 1591 139425 55 55 139480 139425 0 55 33332 12269 21063 1041 393 648 6225 6225 2287 869 1418 9083 9083 1165 1165 10110 10110 19164 19164 3012 3012 8276 8276 30719 30719 1777 1777 67572 67572 7717 7717 1019 1019 202499 130986 71513 0 16976 9345 574 645 2153 1747 2028008 803763 1284275 1224245 61316 61788 1365294 1297770 17130 14519 1282 0 13742 13130 32154 27649 X -645760 -708779 1978900 1978900 1333140 1270121 1365294 1297770 -63019 0 X 0 1 X 1 1 1 X 2097 2097 125776 143570 138913 141040 139425 688724 127873 143570 138913 141040 139425 690821 0 24459 36333 35141 37111 28010 161054 24459 36333 35141 37111 28010 161054 529767 35 38 66 52 55 246 35 38 66 52 55 246 127908 143608 138979 141092 139480 691067 0.76660 0.77060 0.00040 0.00040 X 91203 91203 1792461 720534 1071927 52596 37026 15570 91748 46203 45545 1224245 RELATED PARTY PAYABLE 6977 TENANT SECURITY DEPOSIT 6153 13130 X 139480 0 139480 0 139480 202499 0 202499 0 202499 PART X, LINE 2: THE PROJECT IS ORGANIZED AS A SOUTH DAKOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATION. THE PROJECT IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE PROJECT IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE PROJECT HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017 AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE PROJECT BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE PROJECT WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF INCURRED. 0 0 0 0 0 0 0 0 0 DAVID J HORAZDOVSKY CHAIRPERSON OF THE BOARD 0 620178 0 0 0 152810 0 0 0 22622 0 795610 0 0 THOMAS A SYVERSON PRESIDENT 0 280311 0 0 0 60153 0 0 0 27903 0 368367 0 0 G GRANT TRIBBLE TREASURER 0 318296 0 0 0 47227 0 0 0 23553 0 389076 0 0 THOMAS J KAPUSTA SECRETARY 0 252178 0 0 0 88438 0 0 0 11817 0 352433 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE MANAGEMENT DUTIES OF THE PROJECT HAVE BEEN DELEGATED TO THE PROJECT'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (TELGSS). TELGSS IS PAID A MANAGEMENT FEE EQUAL TO A PERCENTAGE OF REVENUE OTHER THAN INVESTMENT AND GIFT INCOME. THE FEE HAS BEEN APPROVED BY THE US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 4 THE ARTICLES OF INCORPORATION WERE AMENDED TO: 1. REVISE THE PROCESS TO AMEND THE BYLAWS TO INCLUDE THAT ANY AMENDMENT MUST BE APPROVED, IN WRITING, BY THE PRESIDENT OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, THE SPONSOR ORGANIZATION, PRIOR TO BEING AMENDED BY THE BOARD OF DIRECTORS. 2. REVISE THE PROCESS TO AMEND THE ARTICLES OF INCORPORATION TO REQUIRE A MAJORITY VOTE OF THE DIRECTORS OF THE CORPORATION AND SUBJECT THE AMENDMENT TO PRIOR WRITTEN APPROVAL OF THE PRESIDENT OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, AS THE SPONSOR ORGANIZATION. THE BYLAWS WERE AMENDED TO: 3. REVISE THE NUMBER OF BOARD OF DIRECTORS TO NO LESS THAN 3 AND NO MORE THAN 15 AND REMOVED THE DIRECTORS OF THE CORPORATION LISTING. PREVIOUSLY, THE NUMBER OF DIRECTORS WAS TO BE NO LESS THAN 9 AND NO MORE THAN 15. 4. REVISE THE PROCESS TO AMEND THE BYLAWS TO INCLUDE THAT ANY AMENDMENT MUST BE APPROVED, IN WRITING, BY THE PRESIDENT OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, THE SPONSOR ORGANIZATION, PRIOR TO BEING AMENDED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS ARE APPOINTED BY THE DIRECTORS OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION A, LINE 7B ARTICLES OF INCORPORATION AND BY-LAW CHANGES MUST BE APPROVED, IN WRITING, BY THE PRESIDENT OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, THE SPONSOR ORGANIZATION, PRIOR TO BEING AMENDED BY THE FILING ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B ACCOUNTANTS WITH THE MANAGING AGENT, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, REVIEW THE 990 IN DETAIL PRIOR TO IT BEING FILED. ANY QUESTIONS ARE RESOLVED WITH THE TREASURER AND/OR THE PRESIDENT OF THE CORPORATION PRIOR TO THE 990 BEING FILED. A COPY OF THE 990 IS PROVIDED TO THE CORPORATION'S OFFICERS PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE. THE ORGANIZATION ASKS THAT ALL OFFICERS AND DIRECTORS COMPLY WITH THE IRS CONFLICT OF INTEREST AND DISCLOSURE CERTIFICATION. THE ORGANIZATION REQUIRES ALL OFFICERS AND DIRECTORS TO PROVIDE A SIGNED COPY TO THE CORPORATION'S MAIN OFFICE ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT EMPLOY A CEO, AN EXECUTIVE DIRECTOR, A TOP MANAGEMENT OFFICIAL, OR ANY KEY EMPLOYEES. THE MANAGEMENT FUNCTIONS OF THE ORGANIZATION HAVE BEEN OUTSOURCED TO THE ORGANIZATION'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION C, LINE 19 THE PROJECT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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