STRATEGY STUDIO / PUBLIC DATA EXPLORER

HAROLD HAL KELLEY RESPITE FOUNDATION INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
HAROLD HAL KELLEY RESPITE FOUNDATION INC (EIN 26-4398254)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-05-29
IRS object ID
201541499349300224
Schema version
2014v5.0
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)
Return2015-05-29T10:53:39-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

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 Begin2014-01-01TaxPeriodBeginDt

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 STREETAddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP46383ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLITA PETERSPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Signature2015-05-20SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHARON A MORTENSENPreparerPersonNm
PTINP00107578PTIN
Phone2194651100PhoneNum
Preparation2015-05-20PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLITA PETERSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11408 CHICAGO STREETAddressLine1Txt
CityVALPARAISOCityNm
State AbbreviationINStateAbbreviationCd
ZIP46383ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$83,778GrossReceiptsAmt
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 Employee8TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$15,951PYContributionsGrantsAmt
CY Contributions Grants$6,516CYContributionsGrantsAmt
PY Program Service Revenue$55,771PYProgramServiceRevenueAmt
CY Program Service Revenue$77,262CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$71,722PYTotalRevenueAmt
CY Total Revenue$83,778CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$28,664PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,264CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$67,057PYOtherExpensesAmt
CY Other Expenses$80,147CYOtherExpensesAmt
PY Total Expenses$95,721PYTotalExpensesAmt
CY Total Expenses$100,411CYTotalExpensesAmt
PY Revenues Less Expenses-$23,999PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$16,633CYRevenuesLessExpensesAmt
Total Assets BOY$463,045TotalAssetsBOYAmt
Total Assets EOY$452,345TotalAssetsEOYAmt
Total Liabilities BOY$44,252TotalLiabilitiesBOYAmt
Total Liabilities EOY$50,185TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$418,793NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$402,160NetAssetsOrFundBalancesEOYAmt
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$100,411ExpenseAmt
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$100,411TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee8EmployeeCnt
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)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerInd
SCOTT KAZYNSK
BOARD MEMBERYes (X)$0$0$0
JOHN GUYDAN
BOARD MEMBERYes (X)$0$0$0
LITA PETERS
EXECUTIVE DI$13,600$0$020.00Yes (X)
MITCHELL PETERS
CHAIRMAN$0$0$0Yes (X)
MARC BARNETT
VICE CHAIR$0$0$0Yes (X)
EMILY KIRK
SECRETARY/TR$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$13,600TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$6,516AllOtherContributionsAmt
Total Contributions$6,516TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE REVENUEDesc
Total Revenue Column$77,262TotalRevenueColumnAmt
Related Or Exempt Func Income$77,262RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$77,262TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$83,778TotalRevenueColumnAmt
Related Or Exempt Func Income$77,262RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$18,700TotalAmt
Program Services$18,700ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,564TotalAmt
Program Services$1,564ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,916TotalAmt
Program Services$5,916ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,068TotalAmt
Program Services$6,068ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$14,288TotalAmt
Program Services$14,288ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$505TotalAmt
Program Services$505ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$15,163TotalAmt
Program Services$15,163ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,356TotalAmt
Program Services$5,356ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
FOOD$21,321$21,321
PENALTIES BACK TAXES$7,352$7,352
BUILDING MAINTENANCE$2,600$2,600
PROGRAM SUPPLIES$800$800

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$778TotalAmt
Program Services$778ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$100,411TotalAmt
Program Services$100,411ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$560BOYAmt
EOY$2,372EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$522,881LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$73,723LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$461,670BOYAmt
EOY$449,158EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$463,045BOYAmt
EOY$452,345EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,252BOYAmt
EOY$50,185EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,252BOYAmt
EOY$50,185EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$418,793BOYAmt
EOY$402,160EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$418,793BOYAmt
EOY$402,160EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$463,045BOYAmt
EOY$452,345EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$16,633ReconcilationRevenueExpnssAmt
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$37,052CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,448CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$33,720CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,951CurrentTaxYearMinus1YearAmt
Current Tax Year$6,516CurrentTaxYearAmt
Total$125,687TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37,052CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,448CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$33,720CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,951CurrentTaxYearMinus1YearAmt
Current Tax Year$6,516CurrentTaxYearAmt
Total$125,687TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$125,687PublicSupportTotal170Amt
Total Support$125,687TotalSupportAmt
Gross Receipts Rltd Activities$77,262GrossReceiptsRltdActivitiesAmt
Public Support CY1701.00000PublicSupportCY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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$493,781OtherCostOrOtherBasisAmt
Depreciation$73,723DepreciationAmt
Book Value$420,058BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$449,158TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
UNEARNED INCOME$26,567
PAYROLL LIABILITIES$23,618
FieldValueIRS element (for citing)
Total Liability$50,185TotalLiabilityAmt

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.