STRATEGY STUDIO / PUBLIC DATA EXPLORER

HAROLD HAL KELLEY RESPITE FOUNDATION INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
HAROLD HAL KELLEY RESPITE FOUNDATION INC (EIN 26-4398254)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-05-11
IRS object ID
201841319349302909
Schema version
2017v2.3
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)
Return2018-05-11T12:02:51-05:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351785900PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MORTENSEN CPA GROUPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12056 S STATE ROAD 2AddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP463859061ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN264398254EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HAROLD HAL KELLEY RESPITEBusinessNameLine1Txt
Business Name Line2FOUNDATION INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlHAROBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11408 CHICAGO STAddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP46383ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLITA PETERSPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Signature2018-05-07SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHARON A MORTENSENPreparerPersonNm
PTINP00107578PTIN
Phone2194651100PhoneNum
Preparation2018-05-07PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1RESPITE HOUSEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerLITA PETERSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11408 CHICAGO STAddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP46383ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$146,835GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressRESPITEHOUSE.ORG/VALPO-HALFWAY-HOUSEWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionWE ARE A HALF-WAY HOUSE FOR MEN IN PORTER COUNTY WHO ARE SEEKING RECOVERY FROM THE DISEASE OF ADDICTION AND REQUIRE ASSISTANCE IN THEIR HOUSING, CARE, AND RECOVERY PROCESS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee11TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$28,986PYContributionsGrantsAmt
CY Contributions Grants$20,000CYContributionsGrantsAmt
PY Program Service Revenue$86,270PYProgramServiceRevenueAmt
CY Program Service Revenue$126,835CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$1,290PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$116,546PYTotalRevenueAmt
CY Total Revenue$146,835CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$28,365PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$30,842CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$78,951PYOtherExpensesAmt
CY Other Expenses$119,687CYOtherExpensesAmt
PY Total Expenses$107,316PYTotalExpensesAmt
CY Total Expenses$150,529CYTotalExpensesAmt
PY Revenues Less Expenses$9,230PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,694CYRevenuesLessExpensesAmt
Total Assets BOY$455,239TotalAssetsBOYAmt
Total Assets EOY$445,209TotalAssetsEOYAmt
Total Liabilities BOY$42,851TotalLiabilitiesBOYAmt
Total Liabilities EOY$36,515TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$412,388NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$408,694NetAssetsOrFundBalancesEOYAmt
MissionWE ARE A HALF-WAY HOUSE FOR MEN IN PORTER COUNTY WHO ARE SEEKING RECOVERY FROM THE DISEASE OF ADDICTION AND REQUIRE ASSISTANCE IN THEIR HOUSING, CARE, AND RECOVERY PROCESS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$150,529ExpenseAmt
DescASSIST CLIENTS IN THEIR RECOVERY PROCESS (PHYSICALLY, EMOTIONALLY, AND SPRITITUALLY) WITH THE HOPE THAT THEY WILL BECOME RESPONSIBLE AND PRODUCTIVE MEMBERS OF THE COMMUNITY.Desc
Total Program Service Expenses$150,529TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
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 ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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 Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee11EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
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 BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLITA PETERSPersonNm
Phone2195481300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11408 CHICAGO STREETAddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP46383ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
LITA PETERS
EXECUTIVE DI40.00Yes (X)$15,600$0$0
MARK BARNETT
VICE CHAIR PYes (X)$0$0$0
MITCH PETERS
BOARD CHAIRYes (X)$0$0$0
EMILY BACK
TREASURERYes (X)$0$0$0
SCOTT HAMILTON
GRANT WRITERYes (X)$0$0$0
JOHN GUYDON
BOARD MEMBERYes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$15,600TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$20,000AllOtherContributionsAmt
Total Contributions$20,000TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE REVENUEDesc
Total Revenue Column$126,835TotalRevenueColumnAmt
Related Or Exempt Func Income$126,835RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$126,835TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$146,835TotalRevenueColumnAmt
Related Or Exempt Func Income$126,835RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$28,650TotalAmt
Program Services$28,650ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,192TotalAmt
Program Services$2,192ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$200TotalAmt
Program Services$200ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$715TotalAmt
Program Services$715ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,427TotalAmt
Program Services$4,427ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,020TotalAmt
Program Services$1,020ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,728TotalAmt
Program Services$5,728ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$34,291TotalAmt
Program Services$34,291ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$673TotalAmt
Program Services$673ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,740TotalAmt
Program Services$4,740ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$14,396TotalAmt
Program Services$14,396ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,454TotalAmt
Program Services$6,454ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
FOOD$24,771$24,771
REPAIRS & MAINTENANCE$12,041$12,041
PROGRAM SUPPLIES$9,304$9,304
PEST CONTROL$650$650

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$277TotalAmt
Program Services$277ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$150,529TotalAmt
Program Services$150,529ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$20,400BOYAmt
EOY$23,066EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$538,276LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$116,948LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$434,024BOYAmt
EOY$421,328EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$815BOYAmt
EOY$815EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$455,239BOYAmt
EOY$445,209EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,851BOYAmt
EOY$36,515EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$42,851BOYAmt
EOY$36,515EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$412,388BOYAmt
EOY$408,694EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$412,388BOYAmt
EOY$408,694EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$455,239BOYAmt
EOY$445,209EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$3,694ReconcilationRevenueExpnssAmt
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 Minus4 Years$15,951CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,516CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$29,877CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,986CurrentTaxYearMinus1YearAmt
Current Tax Year$20,000CurrentTaxYearAmt
Total$101,330TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,951CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,516CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$29,877CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,986CurrentTaxYearMinus1YearAmt
Current Tax Year$20,000CurrentTaxYearAmt
Total$101,330TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$101,330PublicSupportTotal170Amt
Total Support$101,330TotalSupportAmt
Gross Receipts Rltd Activities$126,835GrossReceiptsRltdActivitiesAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,100OtherCostOrOtherBasisAmt
Book Value$29,100BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$509,176OtherCostOrOtherBasisAmt
Depreciation$116,948DepreciationAmt
Book Value$392,228BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$421,328TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
UNEARNED INCOME$26,567
PAYROLL LIABILITIES$9,948
FieldValueIRS element (for citing)
Total Liability$36,515TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE EXECUTIVE DIRECTOR WILL REVIEW THE RETURN WITH THE BOARD BEFORE IT IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION DOES REGULARLY AND CONSISTENTLY MONITOR AND ENFORCE COMPLINACE WITH THE CONFLICT OF INTEREST POLICY.
FORM 990, PAGE 6, PART VI, LINE 15ATHE EXECUTIVE DIRECTOR SALARY IS SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15BALL OF THE EMPLOYEES SALARY ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.