2015-02-13T15:20:35-06:00 2014-03-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2013-04-01 352187477 INDIANA MASONIC HOME INC INDI 3177366141 690 STATE STREET FRANKLIN IN 46131 ROBERT DEVRIES CFO 3177366141 2015-02-13 1 SCOTT A SCHUSTER P00019243 3175802000 2015-02-13 2013 2016-03-07 17:11:31Z ROBERT DEVRIES 690 STATE STREET FRANKLIN IN 46131 44582687 0 X WWW.INDIANAMASONS.ORG/IMH X 2003 IN TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 19 17 348 70 0 0 4962539 17046628 15299964 13469078 590835 1362257 33170 236552 20886508 32114515 0 0 0 0 10724016 21357072 0 0 0 8607281 8869749 19331297 30226821 1555211 1887694 121647620 122674927 12827232 8107732 108820388 114567195 TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 0 0 15518743 13469078 PROVIDE CARE FOR THE AGED 15518743 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 65 0 1 348 1 0 0 0 0 0 0 0 0 0 0 X 19 17 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X ROBERT DEVRIES 3177366141 690 STATE STREET FRANKLIN IN 46131 MARK A GENUNG GRAND MASTER 1.00 X X 0 0 0 DAN BARENIE DEPUTY GRAND MASTER 1.00 X X 0 0 0 GEORGE A INGLES JR BOARD MEMBER 1.00 X 0 0 0 RICHARD J ELMAN BOARD SECRETARY 1.00 X X 0 87790 0 KENNETH E WILLIS JR BOARD MEMBER 1.00 X 0 0 0 GREGORY WALBRIDGE BOARD MEMBER 1.00 X 0 0 0 MICHAEL D BRUMBACK BOARD MEMBER 1.00 X 0 0 0 ROBERT R STEVENS VICE PRESIDENT 1.00 X X 0 0 0 LORETTA RIEHL BOARD MEMBER 1.00 X 0 0 0 RODNEY A MANN BOARD MEMBER 1.00 X 0 0 0 LINVILLE D CONER BOARD MEMBER 1.00 X 0 0 0 STEPHEN P KROMAN BOARD MEMBER 1.00 X 0 0 0 GARY W LEWIS BOARD MEMBER 1.00 X 0 0 0 ROBERT D HEUCHAN BOARD MEMBER 1.00 X 0 0 0 JEFF ZARING BOARD MEMBER 1.00 X 0 103275 0 JEFF SAUNDERS BOARD MEMBER 1.00 X 0 0 0 SCOTT GENUNG BOARD MEMBER 1.00 X 0 0 0 ROGER VANGORDEN BOARD MEMBER 1.00 X 0 0 0 JAMES BARKDULL BOARD MEMBER 1.00 X 0 0 0 DAWN WENDEL EXECUTIVE DIRECTOR 40.00 X 64015 0 0 JOHN ELEY ADMINISTRATOR 40.00 X 19885 0 0 LYNN AUFFART THRU 21814 CFO 40.00 X 88367 0 0 172267 191065 0 0 0 0 0 MORRISON MANAGEMENT PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 2759987 THERACARE INC 9957 ALLISONVILLE ROAD FISHERS IN 46038 PHYSICAL THERAPY 732729 LIFECARE SERVICES 400 LOCUST ST 820 DES MOINES IA 50309 MANAGEMENT SERVICE 437002 SRS INC PO BOX 421087 INDIANAPOLIS IN 46242 ROOFING 191150 SOCIUS 1 LLC 5457 PERIMETER DRIVE 200 DUBLIN OH 43017 SOFTWARE 122267 5 907281 21650 15665192 452505 17046628 RESIDENCE SERVICES 623000 13469078 13469078 13469078 288536 288536 26951 0 26951 26951 26951 13509669 12435948 1073721 1073721 1073721 6721 21650 32224 -25503 -25503 OTHER INCOME 623990 235104 235104 235104 32114515 13469078 0 1598809 172267 172267 7344723 6687758 656965 11747940 45686 11702254 1498496 1399028 99468 593646 530265 63381 129098 129098 67468 67468 64302 64302 120173 120173 207696 42778 164918 150644 150644 842848 32230 810618 160312 3593 156719 18618 3083 15535 349094 349094 OUTSIDE SERVICES 2804765 2797953 6812 MEDICAL FEES, DRUGS, SU 1395737 1395737 UTILITIES 1133152 1067807 65345 REPAIRS AND MAINTENANCE 816210 816210 609632 545971 63661 30226821 15518743 14708078 0 2075466 1548612 1246667 11902910 930902 1481156 31274 31274 138067 170454 7500650 6275750 4425226 1028714 105299368 100236057 121647620 122674927 1464427 1752983 5666168 5758118 5696637 596631 12827232 8107732 X 3509203 2416435 103385002 110094607 1926183 2056153 108820388 114567195 121647620 122674927 X 1887694 -435464 4294577 X X 0 1 X 1 0 X 5716039 7247941 8634423 4962539 17046628 43607570 15695657 16623131 15260272 15299964 13469078 76348102 21411696 23871072 23894695 20262503 30515706 119955672 3737428 5648388 6518562 3511780 15665192 35081350 0 3737428 5648388 6518562 3511780 15665192 35081350 84874322 396968 377966 383384 363667 315487 1837472 396968 377966 383384 363667 315487 1837472 22872 4253 21749 235104 283978 21808664 24271910 24282332 20647919 31066297 122077122 0.69530 0.67890 0.01510 0.01960 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2010 AMOUNT: $ 22,872. 2011 AMOUNT: $ 4,253. 2012 AMOUNT: $ 21,749. 2013 AMOUNT: $ 235,104. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 INTEREST IN NET ASSETS OF FOUNDATION 98155272 BENEFICIAL INTEREST IN TRUSTS 2080785 100236057 REFUNDABLE ADVANCE FEES 482100 RESIDENT DEPOSIT 114531 596631 X 20026590 32254 32254 19994336 120173 12000006 12120179 32114515 30138872 32224 32224 30106648 120173 120173 30226821 PART X, LINE 2: THE HOME IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF INDIANA TAX LAWS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, THE HOME HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED MARCH 31, 2014 AND 2013. THE HOME FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. IT IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 32,224. NET ASSETS RELEASED FROM RESTRICTIONS 30. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN TEMPORARILY RESTRICTED NET ASSETS-CONTRIBUTIONS 12,000,006. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 32,224. GOLF OUTING 28371 21650 6721 32224 28371 21650 6721 32224 32224 -25503 FORM 990, PART VI, SECTION A, LINE 3 THE HOME PREVIOUSLY ENTERED INTO A CONTRACT WITH A THIRD PARTY TO MANAGE, OPERATE AND MAINTAIN THE HOME. EFFECTIVE JULY 1, 2013, THE MANAGEMENT AGREEMENT WAS TERMINATED AND THE HOME IS NO LONGER UTILIZING A MANAGEMENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT WILL REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C REVIEW NOTATIONS ON CONFLICT OF INTEREST POLICY AND DISCUSS AND RESOLVE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. ANNUAL STATE DISCLOSURE STATEMENT THAT IS AVAILABLE TO ALL POTENTIAL NEW RESIDENTS. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -3,665,192. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION -1,522,252. MINIMUM PENSION LIABILITY ADJUSTMENT 10,385,680. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -1,027,792. CHANGE IN BENEFICIAL INTREST IN TRUST 124,133. FORM 990, PART XII, LINE 2C THE PROCESS HAD NOT CHANGED. FORM 990, PART VI, SECTION B, LINE 14 RECORD RETENTION AND DESTRUCTION POLICY MEDICAL RECORDS OF THE ORGANIZATION ARE GOVERNED BY A RETENTION AND STORAGE POLICY, AS WELL AS A CLOSED CHART POLICY. INDIANA MASONIC HOME FOUNDATION INC 525 N ILLINOIS ST INDIANAPOLIS IN 46204 351091997 PROVIDE SUPPORT TO THE INDIANA MASONIC HOME IN 501(C)(3) LINE 11A, I 0 IMH REALTY INC 690 STATE STREET FRANKLIN IN 46131 364513246 PROVIDE PROPERTY TO ENSURE THE RESIDENTIAL AND MEDIAL CARE FOR THE ELDERLY IN 501(C)(2) 0 GRAND LODGE 525 N ILLINOIS ST INDIANAPOLIS IN 46204 350300010 FRATERNAL ORGANIZATION IN 501(C)(10) 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 IMH REALTY I 1027792 FAIR MARKET VALUE INDIANA MASONIC HOME FOUNDATION C 15665192 FAIR MARKET VALUE