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CLARK-LINDSEY VILLAGE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CLARK-LINDSEY VILLAGE INC (EIN 37-1017284)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-06-21
IRS object ID
201341729349300324
Schema version
2012v2.1
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)
Timestamp2013-06-21T13:43:25-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

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 Line1600 WASHINGTON AVENUE SUITE 1800AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN371017284EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLARK-LINDSEY VILLAGE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLARNameControl
Phone2173442144Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 WEST WINDSOR ROADAddressLine1
CityURBANACity
StateILState
ZIP Code61802ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS B BERNSName
TitleCHAIRMANTitle
Phone2173442144Phone
Date Signed2013-06-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFF PARKERName
PTINP00970069PTIN
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS B BERNSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1101 WEST WINDSOR ROADAddressLine1
CityURBANACity
StateILState
ZIP Code61802ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18352534GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CLARK-LINDSEY.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees290TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year51720ContributionsGrantsPriorYear
Contributions Grants Current Year42312ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13530880ProgramServiceRevenuePriorYear
Program Service Revenue CY14121884ProgramServiceRevenueCY
Investment Income Prior Year338007InvestmentIncomePriorYear
Investment Income Current Year329134InvestmentIncomeCurrentYear
Other Revenue Prior Year222242OtherRevenuePriorYear
Other Revenue Current Year240414OtherRevenueCurrentYear
Total Revenue Prior Year14142849TotalRevenuePriorYear
Total Revenue Current Year14733744TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6715873SalariesEtcPriorYear
Salaries Etc Current Year6835697SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6678161OtherExpensePriorYear
Other Expenses Current Year6764720OtherExpensesCurrentYear
Total Expenses Prior Year13394034TotalExpensesPriorYear
Total Expenses Current Year13600417TotalExpensesCurrentYear
Revenues Less Expenses Prior Year748815RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1133327RevenuesLessExpensesCY
Total Assets BOY26823054TotalAssetsBOY
Total Assets EOY28524107TotalAssetsEOY
Total Liabilities BOY13990553TotalLiabilitiesBOY
Total Liabilities EOY14189473TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12832501NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY14334634NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12115349Expense
Revenue14121884Revenue
DescriptionCLARK-LINDSEY VILLAGE'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE HOUSING, SERVICES, AND HEALTHCARE TO THE ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. IN 2012, CLARK- LINDSEY VILLAGE PROVIDED HOUSING AND SERVICES TO 454 ELDERLY PEOPLE, RESULTING IN 83,225 DAYS OF CARE. IN ADDITION, CLARK-LINDSEY PROVIDED 162,198 HOURS OF NURSING CARE, 41,971 SESSIONS OF THERAPY, AND MORE THAN 400 SENIOR PROGRAMS DESIGNED TO PROMOTE CONTINUED LEARNING AND SUCCESSFUL AGING.Description
Total Program Service Expense12115349TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
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 Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109648NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees290NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEBRA REARDANZ CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2173442144TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 WEST WINDSOR ROADAddressLine1
CityURBANACity
StateILState
ZIP Code61802ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS B BERNS
CHAIRMAN2.00XX59200
GLEN C PAINE
VICE-CHAIRMAN2.00XX68300
CATHERINE A MURPHY
TREASURER2.00XX000
CHRISTOPHER MOYER
BOARD MEMBER2.00X000
CAMILLE S HARMON
BOARD MEMBER2.00X000
MICHAEL B PROVENZANO
BOARD MEMBER2.00X000
MICHAEL W LYON
SECRETARY2.00XX000
ROLAND WHITE
BOARD MEMBER2.00X000
DAVID W HOOD
BOARD MEMBER2.00X45900
ELIZABETH H TYLER
BOARD MEMBER2.00X000
KATHLEEN HOLDEN
BOARD MEMBER2.00X000
JAMES D GREEN
BOARD MEMBER2.00X000
DEBRA S REARDANZ
PRESIDENT / CEO40.00X192483031054
TIMOTHY P MAST
CFO40.00X96655018874
FieldValueIRS element (for citing)
Total Reportable Comp From Org290872TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation49928TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHABCARE GROUP INC
7733 FORSYTH BLVD SUITE 2300ST LOUISMO63105THERAPY SERVICES801128
DUCE CONSTRUCTION CO
47 WILBUR AVECHAMPAIGNIL61822CONSTRUCTION SERVICES187335
MTK TECHNOLOGIES INC
701 DEVONSHIRE DRIVECHAMPAIGNIL61820TECHNOLOGY CONSULTING AND HARDWARE146221
PERKINS EASTMAN ARCHITECTS
115 FIFTH AVENUENEW YORKNY10003ARCHITECT SERVICES102161
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions42312AllOtherContributions
Total Contributions42312TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT SERVICES6230001266632912666329
AMORTIZATION OF DEFERRED REVENUE62300013139921313992
MISCELLANEOUS PROGRAM REVENUE900099141563141563
FieldValueIRS element (for citing)
Total Program Service Revenue14121884TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column224200TotalRevenueColumn
Exclusion$224,200ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3646899Securities
Other76825Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3543562Securities
Other75228Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities103337Securities
Other1597Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column104934TotalRevenueColumn
Exclusion$104,934ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MEAL REVENUE900099147406$147,406
HAIR SALON SERVICES90009966275$66,275
MISCELLANEOUS REVENUE90009926733$26,733
FieldValueIRS element (for citing)
Total Other Revenue240414TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14733744TotalRevenueColumn
Related Or Exempt Function Income14121884RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$569,548ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total339066Total
Management And General339066ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5470396Total
Program Services4970757ProgramServices
Management And General499639ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total155044Total
Program Services137465ProgramServices
Management And General17579ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total394866Total
Program Services360586ProgramServices
Management And General34280ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total476325Total
Program Services422873ProgramServices
Management And General53452ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total63057Total
Management And General63057ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total87134Total
Management And General87134ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total39265Total
Management And General39265ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total15050Total
Management And General15050ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total59811Total
Management And General59811ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12871Total
Program Services12871ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total219790Total
Program Services189027ProgramServices
Management And General30763ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total505885Total
Program Services500408ProgramServices
Management And General5477ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total45916Total
Program Services8835ProgramServices
Management And General37081ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total16873Total
Program Services8866ProgramServices
Management And General8007ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total161912Total
Program Services161912ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1496570Total
Program Services1480366ProgramServices
Management And General16204ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total249435Total
Program Services246734ProgramServices
Management And General2701ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
THERAPY, NURSING SUPPLI13454981345498
DIETARY856219856219
MAINTENANCE AND GROUNDS4916354863125323
REAL ESTATE TAXES4090384046094429

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total688761Total
Program Services522011ProgramServices
Management And General166750ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13600417Total
Program Services12115349ProgramServices
Management And General1485068ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY500BOY
EOY500EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1202368BOY
EOY1177502EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY994627BOY
EOY913247EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY29336BOY
EOY25798EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY93555BOY
EOY132969EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis31857960LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec18350066LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY13938849BOY
EOY13507894EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY10563819BOY
EOY12766197EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY26823054BOY
EOY28524107EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1419104BOY
EOY1512475EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY8244128BOY
EOY8512209EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4071843BOY
EOY3904221EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY173000BOY
EOY173000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY82478BOY
EOY87568EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13990553BOY
EOY14189473EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12477885BOY
EOY13965456EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY335530BOY
EOY350092EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY19086BOY
EOY19086EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12832501BOY
EOY14334634EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26823054BOY
EOY28524107EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1133327ReconcilationRevenueExpenses
Reconciliation Unrealized Invest368799ReconciliationUnrealizedInvest
Reconcilation Other Changes7ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years354943CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years95282CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21069CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year51720CurrentTaxYearMinus1Year
Current Tax Year42312CurrentTaxYear
Total565326Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11626029CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11951946CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12860979CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13530880CurrentTaxYearMinus1Year
Current Tax Year14121884CurrentTaxYear
Total64091718Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years195321CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year222242CurrentTaxYearMinus1Year
Current Tax Year240414CurrentTaxYear
Total657977Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11980972CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12047228CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13077369CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13804842CurrentTaxYearMinus1Year
Current Tax Year14404610CurrentTaxYear
Total65315021Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50965315021PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years236724CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years129044CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years206025CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year271682CurrentTaxYearMinus1Year
Current Tax Year224200CurrentTaxYear
Total1067675Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years236724CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years129044CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years206025CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year271682CurrentTaxYearMinus1Year
Current Tax Year224200CurrentTaxYear
Total1067675Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12217696CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12176272CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13283394CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14076524CurrentTaxYearMinus1Year
Current Tax Year14628810CurrentTaxYear
Total66382696Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98390PublicSupportPercentage509
Prior Year Support Percentage0.98190PriorYearSupportPercentage
Investment Income Percentage0.01610InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01810PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1895464BeginningOfYearBalance
Contributions15000Contributions
Investment Earnings Or Losses184989InvestmentEarningsOrLosses
Other Expenditures20816OtherExpenditures
Administrative Expenses13711AdministrativeExpenses
End Of Year Balance2060926EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1975526BeginningOfYearBalance
Contributions10000Contributions
Investment Earnings Or Losses-36476InvestmentEarningsOrLosses
Other Expenditures41076OtherExpenditures
Administrative Expenses12510AdministrativeExpenses
End Of Year Balance1895464EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1912590BeginningOfYearBalance
Contributions10100Contributions
Investment Earnings Or Losses143851InvestmentEarningsOrLosses
Other Expenditures77947OtherExpenditures
Administrative Expenses13068AdministrativeExpenses
End Of Year Balance1975526EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1651044BeginningOfYearBalance
Contributions10000Contributions
Investment Earnings Or Losses281355InvestmentEarningsOrLosses
Other Expenditures15567OtherExpenditures
Administrative Expenses14242AdministrativeExpenses
End Of Year Balance1912590EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.89830BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00930PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.09240TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis225000OtherCostOrOtherBasis
Book Value225000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis24243250OtherCostOrOtherBasis
Depreciation12936350Depreciation
Book Value11306900BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7124702OtherCostOrOtherBasis
Depreciation5413716Depreciation
Book Value1710986BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis265008OtherCostOrOtherBasis
Book Value265008BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13507894TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
FUNDS HELD FOR OTHERS$21,862
DEFERRED COMPENSATION$65,706
FieldValueIRS element (for citing)
Total Of Amounts87568TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt15037896TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments368799NetUnrealizedGainsInvestments
Other Revenues7OtherRevenues
Revenue Not Rptd F990368806RevenueNotRptdF990
Revenue Subtotal14669090RevenueSubtotal
Other Revenues Not Included64654OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt64654RevenueNotRptdOnFinStmt
Total Revenue Per Form99014733744TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13535763TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal13535763ExpensesSubtotal
Other Expenses Not Included64654OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt64654ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013600417TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ARMSEY BEAUTIFICATION FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR CLARK-LINDSEY RESIDENT GROUNDS AND GARDENS. THE THOMPSON LIBRARY FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE WEBBER EDUCATIONAL FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF CONTINUING EDUCATION FOR HEALTH CENTER STAFF. THE STEWART LIBRARY FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE KAULFERS FUND IS A BOARD DESIGNATED, QUASI ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR QUALITY OF LIFE IMPROVEMENTS INDCLUDING PROGRAMS AND FACILITIES ESPECIALLY DEVELOPED FOR SENIOR CITIZENS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE VILLAGE QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE VILLAGE IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE VILLAGE IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE VILLAGE QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. THE VILLAGE'S 2011, 2010 AND 2009 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:ROUNDING 7.
PART XI, LINE 4B - OTHER ADJUSTMENTS:GAIN ON DISPOSAL OF ASSET 1,597. MANAGEMENT FEES INCLUDED IN REVENUE 63,057.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GAIN ON DISPOSAL OF ASSETS 1,597. MANAGEMENT FEES NET AGAINST REVENUE 63,057.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonDEBRA S REARDANZNamePerson
TitlePRESIDENT / CEOTitle
Base Compensation Filing Org183183BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org9300BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org12276DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org18778NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org223537TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE ORGANIZATION PROVIDED REIMBURSEMENT FOR COMPANION TRAVEL TO ITS BOARD MEMBERS. THE SPECIFIC INDIVIDUALS AND AMOUNTS ARE INCLUDED ON FEDERAL FORM 990, PART VII, SECTION A.
PART I, LINE 4BTHE CEO HAS A BALANCE IN A 457 PLAN, BUT THERE WERE NO PAYMENTS TO THE PLAN IN 2012.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF URBANA CHAMPAIGN COUNTY ILLINOISBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN376000524IssuerEIN
CUSIP NumberNONEAVAILCUSIPNumber
Date Issued2004-05-20DateIssued
Issue Price5000000IssuePrice
Description Of PurposeIMPROVEMENTS TO HEALTHCARE FACILITYDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired1095779AmountRetired
Total Proceeds5000000TotalProceeds
Issuance Costs From Proceeds100000IssuanceCostsFromProceeds
Capital Expenditures4900000CapitalExpenditures
Year Of Subst Completion2005YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due1NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART IV, LINE 2CIdentifier
ExplanationTHE ARBITRAGE REBATE COMPUTATION WAS PERFORMED FOR THE PERIOD MAY 20, 2004, THE DELIVERY DATE OF THE BONDS, TO MAY 20, 2009, THE COMPUTATION DATE. PER THE COMPUTATION, NO REBATE PAYMENT WAS REQUIRED.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
DEBRA REARDANZ
PRESIDENT/CEO16940DUES PAID TO LIFE SERVICES NETWORK (LSN), ON WHICH, MS. REARDANZ IS A BOARD MEMBER.0
CIVIL ENGINEERING FEES PAID TO BERN
BOARD CHAIRMAN35726CIVIL ENGINEERING FEES PAID TO BERNS, CLANCY & ASSOCIATES (BCA), OF WHICH MR. BERNS IS AN OFFICER AND STOCKHOLDER WITH BCA.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE BOARD DIRECTS THAT AT LEAST ONE BOARD MEMBER, WHO SERVES ON THE FINANCE COMMITTEE, CONDUCT THE ANNUAL REVIEW OF THE FORM 990 AND PRESENT IT TO THE FULL BOARD PRIOR TO BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD DIRECTS THAT OFFICERS, DIRECTOR, AND KEY EMPLOYEES ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR PREPARING QUARTERLY REPORTS TO THE BOARD FINANCE COMMITTEE THAT DISCLOSES ACTUAL, POTENTIAL OR PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT THAT A CONFLICT EXISTS, THE PERSON IS REQUIRED TO RECUSE HIMSELF OR HERSELF FROM PARTICIPATING IN THE DECISION.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD DIRECTS THAT THE PERSONNEL & POLICY COMMITTEE (P&PC) CONDUCT THE PRESIDENT'S ANNUAL PERFORMANCE REVIEW AND DEVELOP SALARY AND COMPENSATION RECOMMENDATIONS FOR FULL BOARD APPROVAL. A COMPARATIVE ANALYSIS OF THE PRESIDENT'S ANNUAL COMPENSATION IS REVIEWED BY THE P&PC USING SOURCES SUCH AS INDEPENDENT SALARY SURVEYS, REVIEW OF FORM 990S AND OTHER INFORMATION AS IT IS AVAILABLE. TO ENSURE THE INDEPENDENCE AND OBJECTIVITY OF THE COMPARATIVE REVIEW, THE DATA AND ANALYSIS IS PREPARED BY SOMEONE OTHER THAN THE PRESIDENT. IN REGARDS TO OTHER OFFICERS AND KEY EMPLOYEES, THE PRESIDENT PERFORMS A SIMILAR PROCESS USING INDEPENDENT SALARY SURVEY DATA TO DETERMINE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19CLARK-LINDSEY VILLAGE, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION.
FORM 990, PART XI, LINE 9:ROUNDING 7.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE PROCESS FOR REVIEW AND OVERSIGHT OF THE AUDIT PROCESS IS CONSISTENT WITH PRIOR YEARS.