2018-10-15T12:42:24-05:00 2017-12-31 450250958 EIDE BAILLY LLP 200 EAST 10TH STREET SUITE 500 SIOUX FALLS SD 57104 990 2017-01-01 201115155 WINFIELD GOOD SAMARITAN HOUSING INC WINF 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 G GRANT TRIBBLE TREASURER 6053623100 2018-10-10 1 LAURIE HANSON P00851848 6053391999 2018-10-09 8.39.233.43 2018-10-10 14:13:35 CD P 27B5425C9C23CB5B55D8DA2EDCCE42DD005DD81A 401A7809F2AA56B1FE621E55666FA95C3E42E950 2017 2018-06-14 16:35:46Z WHEAT RIDGE HEIGHTS G GRANT TRIBBLE 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 141092 0 X WWW.GOOD-SAM.COM X 2004 SD TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 8 8 4 10 0 0 0 0 138913 141040 -119 52 0 0 138794 141092 0 0 0 0 41056 41557 0 0 0 149738 148915 190794 190472 -52000 -49380 1411477 1365294 28957 32154 1382520 1333140 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 0 0 172931 141040 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 7,035 RESIDENT DAYS IN 2017. 172931 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 1 0 1 4 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 X G GRANT TRIBBLE 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 DAVID J HORAZDOVSKY CHAIRPERSON OF THE BOARD 0.10 55.90 X X 0 779485 21494 H THEODORE GRINDAL VICE CHAIRPERSON 0.10 4.60 X X 0 0 0 JOHN R RACEK VICE CHAIRPERSON 0.10 3.90 X X 0 0 0 GWEN WAGSTROM HALAAS VICE CHAIRPERSON BEG 6/17 0.10 3.90 X X 0 0 0 DENNIS STENE DIRECTOR UNTIL 6/17 0.10 3.90 X 0 0 0 CONNIE MARCH-CURTIS DIRECTOR UNTIL 6/17 0.10 3.90 X 0 0 0 NORVAL DEAN BUCKNEBERG DIRECTOR BEG 6/17 0.10 3.90 X 0 0 0 LEE O LAAVEG DIRECTOR BEG 6/17 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 RAYE NAE NYLANDER PRESIDENT UNTIL 7/17 1.60 53.40 X 0 127547 9740 THOMAS A SYVERSON VP 1/17-10/17; PRESIDENT 10/17 0.10 55.00 X 0 338875 32218 G GRANT TRIBBLE TREASURER 0.10 55.00 X 0 343572 28768 THOMAS J KAPUSTA SECRETARY 0.10 55.00 X 0 331655 21468 MISTY HAM-QUICK ASSISTANT SECRETARY 0.10 44.90 X 0 47455 16138 0 1968589 129826 0 0 1 0 0 RENTAL CHARGES 624100 138716 138716 ANCILLARY CHARGES 624100 2324 2324 141040 52 52 141092 141040 0 52 32619 32619 1053 1053 5553 5553 2332 2332 9402 9402 308 308 7831 7831 12259 12259 3679 3679 8035 8035 30109 30109 1966 1966 7 7 66510 66510 7619 7619 1190 1190 190472 172931 17541 0 12261 16976 234 574 2060 2153 2020466 736191 1343056 1284275 53866 61316 1411477 1365294 15275 17130 131 1282 13551 13742 28957 32154 X -596380 -645760 1978900 1978900 1382520 1333140 1411477 1365294 -49380 0 X 0 1 X 1 1 1 X 2097 2097 120043 125776 143570 138913 141040 669342 120043 127873 143570 138913 141040 671439 0 20774 24459 36333 35141 37111 153818 20774 24459 36333 35141 37111 153818 517621 77 35 38 66 52 268 77 35 38 66 52 268 120120 127908 143608 138979 141092 671707 0.77060 0.79510 0.00040 0.00060 X 91203 91203 1791088 660957 1130131 50995 33285 17710 87180 41949 45231 1284275 RELATED PARTY PAYABLE 6977 TENANT SECURITY DEPOSIT 6765 13742 X 141092 0 141092 0 141092 190472 0 190472 0 190472 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, 2017 AND 2016 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 681167 0 0 0 98318 0 0 0 21951 0 801436 0 0 THOMAS A SYVERSON VP 1/17-10/17; PRESIDENT 10/17 0 290573 0 0 0 48302 0 0 0 32675 0 371550 0 0 G GRANT TRIBBLE TREASURER 0 310373 0 0 0 33198 0 0 0 29225 0 372796 0 0 THOMAS J KAPUSTA SECRETARY 0 250310 0 0 0 81345 0 0 0 21925 0 353580 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 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 REQUIRE THE APPROVAL OF THE BOARD OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. 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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