STRATEGY STUDIO / PUBLIC DATA EXPLORER

ABHE & SVOBODA INC HEALTH AND WELFARE TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ABHE & SVOBODA INC HEALTH AND WELFARE TRUST (EIN 20-0005676)
Tax period
2011-05-01 to 2012-04-30
Filed
2013-01-28
IRS object ID
201310289349300531
Schema version
2011v1.2
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)
Timestamp2013-01-28T11:26:18-06:00Timestamp
Tax Period End Date2012-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN200005676EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ABHE & SVOBODA INC HEALTH AND WELFARE TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlABHENameControl
Phone9524476025Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line117066 REVERE WAYAddressLine1
CityPRIOR LAKECity
StateMNState
ZIP Code55372ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROXANE SVOBODAName
TitleTRUSTEETitle
Phone9524476025Phone
Date Signed2013-01-25DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSTACY MEYERName
PTINP00970265PTIN
Phone6123764500Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROXANE SVOBODANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line117066 REVERE WAYAddressLine1
CityPRIOR LAKECity
StateMNState
ZIP Code55372ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1682677GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation2003YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionFUNDS GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., & THEIR DEPENDENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers2TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1717853ProgramServiceRevenuePriorYear
Program Service Revenue CY1682677ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1717853TotalRevenuePriorYear
Total Revenue Current Year1682677TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year1268346BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY1506252BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year176573OtherExpensePriorYear
Other Expenses Current Year218401OtherExpensesCurrentYear
Total Expenses Prior Year1444919TotalExpensesPriorYear
Total Expenses Current Year1724653TotalExpensesCurrentYear
Revenues Less Expenses Prior Year272934RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-41976RevenuesLessExpensesCY
Total Assets BOY717972TotalAssetsBOY
Total Assets EOY615795TotalAssetsEOY
Total Liabilities BOY60201TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY657771NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY615795NetAssetsOrFundBalancesEOY
Mission DescriptionABHE & SVOBODA, INC. HEALTH AND WELFARE TRUST PROVIDES FUNDING FOR GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., AND THEIR DEPENDENTSMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionFUNDING FOR GROUP INSURANCE COVERAGE FOR EMPLOYEES OF ABHE & SVOBODA, INC., AND THEIR DEPENDENTSDescription
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ABHE & SVOBODA INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9524476025TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117066 REVERE WAYAddressLine1
CityPRIOR LAKECity
StateMNState
ZIP Code55372ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (2 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
ROXANNE SVOBODA
TRUSTEE1.00X000
GAIL SVOBODA
TRUSTEE1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SHEFFIELD OLSON & MCQUEEN INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12145 FORD PARKWAY SUITE 300AddressLine1
CityST PAULCity
StateMNState
ZIP Code55116ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesTHIRD PARTY ADMINISTRATORDescriptionOfServices
Compensation174922Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
EMPLOYER CONTRIBUTIONS90000113550491355049
EMPLOYEE CONTRIBUTIONS900001327628327628
FieldValueIRS element (for citing)
Total Program Service Revenue1682677TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1682677TotalRevenueColumn
Related Or Exempt Function Income1682677RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total1506252Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total176124Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3422Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total38855Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1724653Total

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY711113BOY
EOY606843EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6859BOY
EOY8952EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY717972BOY
EOY615795EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY60201BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY60201BOY
EOY0EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY657771BOY
EOY615795EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY657771BOY
EOY615795EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY717972BOY
EOY615795EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-41976ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue1682677TotalRevenue
Total Expenses1724653TotalExpenses
Excess Or Deficit For Year-41976ExcessOrDeficitForYear
Excess Or Deficit Per FS-41976ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1682677TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal1682677RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901682677TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1724653TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal1724653ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901724653TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE TRUST ESTABLISHED UNDER THE PLAN TO HOLD THE PLAN'S ASSETS QUALIFIES UNDER SECTION 501(C)(9) OF THE INTERNAL REVENUE CODE (IRC). THE TRUST HAS RECEIVED A FAVORABLE TAX DETERMINATION LETTER DATED DECEMBER 16, 2010 FROM THE INTERNAL REVENUE SERVICE. THE PLAN SPONSOR BELIEVES THAT THE TRUST, AS AMENDED, CURRENTLY QUALIFIES AND OPERATES AS A TAXABLE TRUST IN ACCORDANCE WITH APPLICABLE PROVISIONS OF THE IRC. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE PLAN MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PLAN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE PLAN ADMINISTRATOR HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PLAN, AND HAS CONCLUDED THAT AS OF APRIL 30, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PLAN ADMINISTRATOR BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 2GAIL SVOBODA AND ROXANE SVOBODA HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT IS FILED AND IT IS REVIEWED IN CONJUNCTION WITH THE REVIEW OF THE RELATED PLAN'S ANNUAL AUDIT.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE TRUST IS IN THE PROCESS OF DRAFTING A CONFLICT OF INTEREST POLICY.
FORM 990, PART VII, LINE 1A:COMPENSATION FROM A RELATED ORGANIZATION FOR THE TRUSTEES LISTED IS EXCLUDED AS ALLOWED UNDER THE VOLUNTEER EXCEPTION IN THE FORM 990 INSTRUCTIONS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ABHE & SVOBODABusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117066 REVERE WAY PO BOX 251AddressLine1
CityPRIOR LAKECity
StateMNState
ZIP Code55372ZIPCode
FieldValueIRS element (for citing)
EIN411224817EIN
Primary ActivityRENOVATION AND REPAIR OF STRUCTURAL COMPONENTS.PrimaryActivity
Legal Domicile StateMNLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg