FRIENDS OF HOSPICE WAYNE COUNTY OHIO: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: FRIENDS OF HOSPICE WAYNE COUNTY OHIO (EIN 20-1370925)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201333199349301538
Schema version: 2012v2.3
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
Form 990
Schedule A
Schedule D
Schedule I
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T08:08:21-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LONG COOK & SAMSA INC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	505 N MARKET ST	AddressLine1
City	WOOSTER	City
State	OH	State
ZIP Code	44691	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	201370925	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	FRIENDS OF HOSPICE	BusinessNameLine1
Business Name Line2	WAYNE COUNTY OHIO	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	FRIE	NameControl
Phone	3302622012	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	223 W LIBERTY STREET	AddressLine1
City	WOOSTER	City
State	OH	State
ZIP Code	44691	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARLENE BARKHEIMER	Name
Title	TREASURER	Title
Phone	3302622012	Phone
Date Signed	2013-11-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JENNIFER M HALVORSEN	Name
Phone	3302627111	Phone
Date Prepared	2013-11-14	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MARLENE BARKHEIMER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	11 SOUTH MAIN STREET	AddressLine1
City	WEST SALEM	City
State	OH	State
ZIP Code	44287	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	301324	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.FRIENDTIQUE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2004	YearFormation
State Legal Domicile	OH	StateLegalDomicile
Activity Or Mission Description	FRIENDS OF HOSPICE, WAYNE COUNTY OHIO OPENED ITS DOORS ON SEPTEMBER 20, 2004. IT IS A SELF-SUSTAINING STORE SELLING FURNITURE, HOUSEHOLD ITEMS AND CLOTHING WHERE THE PROFITS ARE GIVEN TO HOSPICE & PALLIATIVE CARE OF GREATER WAYNE COUNTY OHIO TO PROVIDE AN ON-GOING SOURCE OF REVENUE FOR PATIENT CARE. MOST OF THE INVENTORY AT THE STORE IS DONATED BY THE PUBLIC. THE ORGANIZATION CLEANS AND REPAIRS DONATIONS AND HOLDS THEM FOR SALE. THE ORGANIZATION HAS A LARGE VOLUNTEER STAFF, AND IS ABLE TO OPERATE WITH TWO FULL-TIME EMPLOYEES AND TWO PART-TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF SIX NON-COMPENSATED MEMBERS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	4	TotalNbrEmployees
Total Nbr Volunteers	41	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	770	ContributionsGrantsPriorYear
Contributions Grants Current Year	1020	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	298950	ProgramServiceRevenuePriorYear
Program Service Revenue CY	295029	ProgramServiceRevenueCY
Investment Income Prior Year	98	InvestmentIncomePriorYear
Investment Income Current Year	25	InvestmentIncomeCurrentYear
Other Revenue Prior Year	5706	OtherRevenuePriorYear
Other Revenue Current Year	2415	OtherRevenueCurrentYear
Total Revenue Prior Year	305524	TotalRevenuePriorYear
Total Revenue Current Year	298489	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	71000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	65000	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	81511	SalariesEtcPriorYear
Salaries Etc Current Year	89214	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	79322	OtherExpensePriorYear
Other Expenses Current Year	79167	OtherExpensesCurrentYear
Total Expenses Prior Year	231833	TotalExpensesPriorYear
Total Expenses Current Year	233381	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	73691	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	65108	RevenuesLessExpensesCY
Total Assets BOY	645621	TotalAssetsBOY
Total Assets EOY	633877	TotalAssetsEOY
Total Liabilities BOY	172149	TotalLiabilitiesBOY
Total Liabilities EOY	95297	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	473472	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	538580	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	FRIENDS OF HOSPICE, WAYNE COUNTY OHIO OPENED ITS DOORS ON SEPTEMBER 20, 2004. IT IS A SELF-SUSTAINING STORE SELLING FURNITURE, HOUSEHOLD ITEMS AND CLOTHING WHERE THE PROFITS ARE GIVEN TO HOSPICE & PALLIATIVE CARE OF GREATER WAYNE COUNTY OHIO TO PROVIDE AN ON-GOING SOURCE OF REVENUE FOR PATIENT CARE. MOST OF THE INVENTORY AT THE STORE IS DONATED BY THE PUBLIC. THE ORGANIZATION CLEANS AND REPAIRS DONATIONS AND HOLDS THEM FOR SALE. THE ORGANIZATION HAS A LARGE VOLUNTEER STAFF, AND IS ABLE TO OPERATE WITH TWO FULL-TIME EMPLOYEES AND TWO PART-TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF SIX NON-COMPENSATED MEMBERS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	221567	Expense
Grants	65000	Grants
Revenue	295029	Revenue
Description	FURNITURE, HOUSEHOLD ITEMS AND CLOTHING ARE DONATED BY THE PUBLIC SORTED AND PROCESSED AND ARE THEN SOLD BACK TO THE PUBLIC. PROFITS OF WHICH ARE GIVEN TO HOSPICE & PALLIATIVE CARE OF GREATER WAYNE COUNTY OHIO TO PROVIDE ON-GOING CARE TO THEIR PATIENTS. DURING 2012 PROFITS OF 65,000 WERE GIVEN.	Description
Total Program Service Expense	221567	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	4	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	OH	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MARLENE BARKHEIMER	NamePerson
Telephone Number	4198531100	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	11 SOUTH MAIN STREET	AddressLine1
City	WEST SALEM	City
State	OH	State
ZIP Code	44287	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
DAWN SCHIRM
EXECUTIVE DI	40.00	X	44202	0	0
MARTHA LEARY
BOARD MEMBER	1.00	X	0	0	0
MICKEY WORKMAN
BOARD MEMBER	1.00	X	0	0	0
PAM TAYLOR
PRESIDENT	1.00		0	0	0	X
SARAH LITTLE
SECRETARY	1.00		0	0	0	X
MARLENE BARKHEIMER
TREASURER	1.00		0	0	0	X
FRED CANNON
VICE PRES.	1.00		0	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	44202	TotalReportableCompFromOrg
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
All Other Contributions	1020	AllOtherContributions
Total Contributions	1020	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	DONATED GOODS/RETAIL	Description
Business Code	448000	BusinessCode
Total Revenue Column	295029	TotalRevenueColumn
Related Or Exempt Function Income	295029	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	295029	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	25	TotalRevenueColumn
Exclusion	$25	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	5250	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	2835	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	2415	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	2415	TotalRevenueColumn
Exclusion	$2,415	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	298489	TotalRevenueColumn
Related Or Exempt Function Income	295029	RelatedOrExemptFunctionIncome
Exclusion	$2,440	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	65000	Total
Program Services	65000	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	44202	Total
Program Services	44202	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	38100	Total
Program Services	38100	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	6912	Total
Program Services	6912	ProgramServices

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	2904	Total
Management And General	2904	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	3240	Total
Program Services	3240	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	4286	Total
Program Services	4286	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	29623	Total
Program Services	29623	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	8137	Total
Management And General	8137	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	13646	Total
Program Services	13646	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	4120	Total
Program Services	3362	ProgramServices
Management And General	758	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
AUCTION PURCHASES-RESALE	7789	7789
DISCOUNTS	3915	3915
AUTO	1492	1492
BANK CHARGES	15		15

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	233381	Total
Program Services	221567	ProgramServices
Management And General	11814	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	34795	BOY
EOY	27535	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	67480	BOY
EOY	57552	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2474	BOY
EOY	2474	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1486	BOY
EOY	1486	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	602542	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	57712	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	539386	BOY
EOY	544830	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	645621	BOY
EOY	633877	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	36	BOY
EOY	36	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	172113	BOY
EOY	95261	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	172149	BOY
EOY	95297	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

Field	Value	IRS element (for citing)
BOY	473472	BOY
EOY	538580	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	473472	BOY
EOY	538580	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	645621	BOY
EOY	633877	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	65108	ReconcilationRevenueExpenses
Method Of Accounting Cash	X	MethodOfAccountingCash
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	149441	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	19815	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	16465	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	770	CurrentTaxYearMinus1Year
Current Tax Year	1020	CurrentTaxYear
Total	187511	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	246905	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	251127	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	254961	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	298950	CurrentTaxYearMinus1Year
Current Tax Year	295029	CurrentTaxYear
Total	1346972	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	396346	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	270942	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	271426	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	299720	CurrentTaxYearMinus1Year
Current Tax Year	296049	CurrentTaxYear
Total	1534483	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	136000	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8100	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5043	CurrentTaxYearMinus2Years
Total	149143	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	136000	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	8100	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5043	CurrentTaxYearMinus2Years
Total	149143	Total

Field	Value	IRS element (for citing)
Public Support Total509	1385340	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2891	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	13161	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	12843	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	12698	CurrentTaxYearMinus1Year
Current Tax Year	5275	CurrentTaxYear
Total	46868	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	2891	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	13161	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	12843	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	12698	CurrentTaxYearMinus1Year
Current Tax Year	5275	CurrentTaxYear
Total	46868	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	399237	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	284103	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	284269	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	312418	CurrentTaxYearMinus1Year
Current Tax Year	301324	CurrentTaxYear
Total	1581351	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.87600	PublicSupportPercentage509
Prior Year Support Percentage	0.85110	PriorYearSupportPercentage
Investment Income Percentage	0.03000	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.03000	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	84980	OtherCostOrOtherBasis
Book Value	84980	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	496369	OtherCostOrOtherBasis
Depreciation	56709	Depreciation
Book Value	439660	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	320	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	20873	OtherCostOrOtherBasis
Depreciation	1003	Depreciation
Book Value	20190	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	544830	TotalOfBookValueLandBuildings

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
HOSPICE & PALLIATIVE CARE OF GREATE
2525 BACK ORRVILLE RD	WOOSTER	OH	44691	341352875	3	55000	PATIENT CARE
WAYNE COUNTY COMMUNITY FOUNDATION
517 N MARKET STREET	WOOSTER	OH	44691	341281026	3	10000	BUILDING-GARDEN CTR

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Noncash Contribs Rptd F990	295029	NoncashContribsRptdF990
Method Of Determining Revenues	RESALE VALUE	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	false	ReviewProcessUnusualNCGifts
Third Parties Used	false	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

Field	Value	IRS element (for citing)
Identifier	SUPPLEMENTAL INFORMATION	Identifier
Return Reference	SCHEDULE M, PAGE 2, PART II	ReturnReference
Explanation	THE ORGANIZATION DID NOT RECORD REVENUE RELATED TO ANY CLOTHING, HOUSEHOLD AND OTHER GOODS DONATED IN PART VIII, STATEMENT OF REVENUE, LINE 1G. THIS REVENUE WAS RECORDED IN PART VIII, LINE 2A. DONATED ITEMS HELD FOR RESALE ARE RECORDED AS PROGRAM SERVICE REVENUE AS THIS IS THE ORGANIZATIONS EXEMPT PURPOSE.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 - ORGANIZATION'S MISSION	FRIENDS OF HOSPICE, WAYNE COUNTY OHIO OPENED ITS DOORS ON SEPTEMBER 20, 2004. IT IS A SELF-SUSTAINING STORE SELLING FURNITURE, HOUSEHOLD ITEMS AND CLOTHING WHERE THE PROFITS ARE GIVEN TO HOSPICE & PALLIATIVE CARE OF GREATER WAYNE COUNTY OHIO TO PROVIDE AN ON-GOING SOURCE OF REVENUE FOR PATIENT CARE. MOST OF THE INVENTORY AT THE STORE IS DONATED BY THE PUBLIC. THE ORGANIZATION CLEANS AND REPAIRS DONATIONS AND HOLDS THEM FOR SALE. THE ORGANIZATION HAS A LARGE VOLUNTEER STAFF, AND IS ABLE TO OPERATE WITH TWO FULL-TIME EMPLOYEES AND TWO PART-TIME EMPLOYEE. THE BOARD OF DIRECTORS IS COMPRISED OF SIX NON-COMPENSATED MEMBERS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 WAS PROVIDED TO THE BOARD AND OFFICERS TO REVIEW. ANY QUESTIONS OR COMMENTS ARE DISCUSSED AND NECESSARY CHANGES ARE MADE.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	THE BOARD REVIEWS THE SALARIES AND COMPARES THEM TO SIMILAR NON-PROFITS WITH COMPARABLE INCOME TYPES AND SALES FIGURES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.