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GRACE BRETHREN VILLAGE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GRACE BRETHREN VILLAGE INC (EIN 23-7085581)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201343169349304314
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)
Timestamp2013-11-12T13:22:12-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN310210560EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BATTELLE & BATTELLE LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12000 WEST DOROTHY LANEAddressLine1
CityDAYTONCity
StateOHState
ZIP Code45439ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237085581EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRACE BRETHREN VILLAGEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGRACNameControl
Phone9378364011Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11010 TAYWOOD ROADAddressLine1
CityENGLEWOODCity
StateOHState
ZIP Code45322ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL MONTGOMERYName
TitleEXECUTIVE DIRECTORTitle
Phone9378364011Phone
Date Signed2013-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKAREN O CRIMName
PTINP00368385PTIN
Phone9372980201Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHAEL MONTGOMERYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11010 TAYWOOD ROADAddressLine1
CityENGLEWOODCity
StateOHState
ZIP Code45322ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4062273GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GBVILLAGE.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1969YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE A CONTINUUM OF CARE FOR OLDER ADULTS IN A SAFE, NURTURING CHRISTIAN ENVIRONMENT INCLUDING SKILLED AND INTERMEDIATE HEALTHCARE AS WELL AS ASSISTED LIVING AND INDEPENDENT LIVINGActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees96TotalNbrEmployees
Total Nbr Volunteers99TotalNbrVolunteers
Total Gross UBI2644TotalGrossUBI
Net Unrelated Business Txbl Income1644NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4841ContributionsGrantsPriorYear
Contributions Grants Current Year22379ContributionsGrantsCurrentYear
Program Service Revenue Prior Year3921935ProgramServiceRevenuePriorYear
Program Service Revenue CY4016995ProgramServiceRevenueCY
Investment Income Prior Year26264InvestmentIncomePriorYear
Investment Income Current Year19882InvestmentIncomeCurrentYear
Other Revenue Prior Year1711OtherRevenuePriorYear
Other Revenue Current Year2644OtherRevenueCurrentYear
Total Revenue Prior Year3954751TotalRevenuePriorYear
Total Revenue Current Year4061900TotalRevenueCurrentYear
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 Year2492549SalariesEtcPriorYear
Salaries Etc Current Year2179054SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1897079OtherExpensePriorYear
Other Expenses Current Year1626315OtherExpensesCurrentYear
Total Expenses Prior Year4389628TotalExpensesPriorYear
Total Expenses Current Year3805369TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-434877RevenuesLessExpensesPriorYear
Revenues Less Expenses CY256531RevenuesLessExpensesCY
Total Assets BOY6581870TotalAssetsBOY
Total Assets EOY6614396TotalAssetsEOY
Total Liabilities BOY5210750TotalLiabilitiesBOY
Total Liabilities EOY4963585TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1371120NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1650811NetAssetsOrFundBalancesEOY
Mission DescriptionTO FOSTER, MAINTAIN, AND OPERATE A CHRISTIAN RETIREMENT COMMUNITY AND TO PROVIDE SERVICES WHICH ENHANCE PHYSICAL, MENTAL, AND SPIRITUAL WELL-BEING ENABLING PERSONS TO LIVE SECURELY WITH DIGNITY, CONTINUING TO LOVE, LEARN, AND ACHIEVE PERSONAL FULFILLMENT.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3318049Expense
Revenue4016995Revenue
DescriptionGRACE BRETHREN VILLAGE (GBV) IS A FAITH-BASED NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY. GBV HAS BEEN SERVING AREA SENIORS WITH HOUSING AND SERVICES FOR INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING SINCE 1971. OUR GOAL IS MUCH GREATER THAN TO PROVIDE JUST HOUSING AND SERVICES TO OUR RESIDENTS. OUR GOAL IS TO EXEMPLIFY THE VALUES OF THE CHRISTIAN TRADITION WHILE FULFILLING RESIDENTS' PHYSICAL, INTELLECTUAL, SOCIAL, EMOTIONAL AND SPIRITUAL NEEDS. THE CAMPUS CONSISTS OF A 50-BED NURSING HOME, OF WHICH FOUR UNITS ARE ASSISTED-LIVING APARTMENTS, IN ADDITION TO 77 INDEPENDENT-LIVING UNITS. DURING 2006, THE ORGANIZATION BECAME DUALLY CERTIFIED FOR MEDICAID AND MEDICARE FOR 45 NURSING HOME BEDS.Description
Total Program Service Expense3318049TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
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 Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees96NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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 Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
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 Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
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 Line1MICHAEL MONTGOMERYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9378364011TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11010 TAYWOOD ROADAddressLine1
CityENGLEWOODCity
StateOHState
ZIP Code45322ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
STEVE HAGEN
CHAIRMAN1.00XX000
BRUCE MCKENZIE
VICE CHAIRMAN1.00XX000
RONALD WYSS
SECRETARY1.00XX000
BAMBI PEIRSON-CLINE
TREASURER1.00XX000
ROBERT FOOTE
MEMBER1.00X000
CAROLYN GUITTAR
MEMBER1.00X000
TIM MIHOJEVICH
MEMBER1.00X000
GREG RYERSON
MEMBER1.00X000
JOSEPH PATTERSON
MEMBER1.00X000
MICHAEL MONTGOMERY
EXECUTIVE DIRECTOR40.00X89999028
PAMELA JONES
DIRECTOR OF NURSING40.00X8394009552
FieldValueIRS element (for citing)
Total Reportable Comp From Org173939TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation9580TotalOtherCompensation
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 Line1CONCEPT REHABBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17150 GRANITE CIRCLEAddressLine1
CityTOLEDOCity
StateOHState
ZIP Code43617ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesTHERAPY SERVICESDescriptionOfServices
Compensation136659Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions22379AllOtherContributions
Total Contributions22379TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column4016995TotalRevenueColumn
Related Or Exempt Function Income4016995RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue4016995TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19882TotalRevenueColumn
Exclusion$19,882ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3017Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real373Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2644Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2644TotalRevenueColumn
Unrelated Business Revenue2644UnrelatedBusinessRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4061900TotalRevenueColumn
Related Or Exempt Function Income4016995RelatedOrExemptFunctionIncome
Unrelated Business Revenue2644UnrelatedBusinessRevenue
Exclusion$19,882ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total183519Total
Program Services183519ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1476369Total
Program Services1363720ProgramServices
Management And General112649ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total217678Total
Program Services214558ProgramServices
Management And General3120ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total301488Total
Program Services249112ProgramServices
Management And General52376ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1043Total
Management And General1043ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total32403Total
Management And General32403ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6544Total
Management And General6544ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total11508Total
Program Services9954ProgramServices
Management And General1554ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total232414Total
Program Services205689ProgramServices
Management And General26725ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total211451Total
Program Services211451ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total580Total
Management And General580ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total70168Total
Management And General70168ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total311883Total
Program Services302763ProgramServices
Management And General9120ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total80947Total
Management And General80947ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACT SERVICES28992426332826596
FRANCHISE & INCOME TAX212875212875
REPAIRS & MAINTENANCE9996099960
MISCELLANEOUS6260762607

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2008Total
Program Services1120ProgramServices
Management And General888ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3805369Total
Program Services3318049ProgramServices
Management And General487320ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY286435BOY
EOY251583EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY211061BOY
EOY440062EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3534BOY
EOY1896EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY31979BOY
EOY9706EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10226617LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4877724LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5526671BOY
EOY5348893EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY504290BOY
EOY544356EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY17900BOY
EOY17900EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6581870BOY
EOY6614396EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY419273BOY
EOY428027EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3370696BOY
EOY3137023EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY4656BOY
EOY2617EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1215079BOY
EOY1195561EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY201046BOY
EOY200357EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5210750BOY
EOY4963585EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1238503BOY
EOY1513743EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY32617BOY
EOY37068EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY100000BOY
EOY100000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1371120BOY
EOY1650811EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6581870BOY
EOY6614396EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses256531ReconcilationRevenueExpenses
Reconciliation Unrealized Invest23160ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
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 Years8370CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years6798CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50391CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4841CurrentTaxYearMinus1Year
Current Tax Year22379CurrentTaxYear
Total92779Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3848339CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4151137CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3734590CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3921935CurrentTaxYearMinus1Year
Current Tax Year4016995CurrentTaxYear
Total19672996Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3856709CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4157935CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3784981CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3926776CurrentTaxYearMinus1Year
Current Tax Year4039374CurrentTaxYear
Total19765775Total

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 Total50919765775PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30489CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17504CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21456CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21777CurrentTaxYearMinus1Year
Current Tax Year19882CurrentTaxYear
Total111108Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years30489CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17504CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years21456CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21777CurrentTaxYearMinus1Year
Current Tax Year19882CurrentTaxYear
Total111108Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1685CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2734CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years832CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year711CurrentTaxYearMinus1Year
Current Tax Year1644CurrentTaxYear
Total7606Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3888883CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4178173CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3807269CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3949264CurrentTaxYearMinus1Year
Current Tax Year4060900CurrentTaxYear
Total19884489Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99400PublicSupportPercentage509
Prior Year Support Percentage0.99230PriorYearSupportPercentage
Investment Income Percentage0.00560InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00730PriorYrInvestIncomePercentage
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

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtc
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis39558OtherCostOrOtherBasis
Book Value39558BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9026379OtherCostOrOtherBasis
Depreciation3998641Depreciation
Book Value5027738BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis749850OtherCostOrOtherBasis
Depreciation554634Depreciation
Book Value195216BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis410830OtherCostOrOtherBasis
Depreciation324449Depreciation
Book Value86381BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5348893TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionMUTUAL FUNDSDescription
Book Value544356BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities544356TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionCOST REPORT SETTLEMENTS PAYABLEDescription
Amount$200,357Amount
FieldValueIRS element (for citing)
Total Of Amounts200357TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt4085060TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments23160NetUnrealizedGainsInvestments
Revenue Not Rptd F99023160RevenueNotRptdF990
Revenue Subtotal4061900RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9904061900TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3805369TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal3805369ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9903805369TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 2B:THE ORGANIZATION HOLDS DEPOSITS FROM RESIDENTS TO BE USED BY THE RESIDENTS FOR INCIDENTAL EXPENSES.
PART X, LINE 2:A PROVISION FOR INCOME TAXES HAS NOT BEEN INCLUDED IN THE FINANCIAL STATEMETNS SINCE THE ORGANIZATION HAS RECEIVED TAX-EXEMPT STATUS FROM THE INTERNAL REVENUE SERVICE UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2009.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION DOES NOT HAVE A SEPARATE COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 WILL BE MADE AVAILABLE TO THE BOARD
FORM 990, PART VI, SECTION B, LINE 12CEACH MEMBER OF THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY
FORM 990, PART VI, SECTION B, LINE 15AREVIEWED BY THE FINANCE COMMITTEE WITH FINAL APPROVAL BY THE BOARD OF TRUSTEES
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART XII, LINE 2C:THE PROCESS BY WHICH THE ORGANIZATION SELECTS AN INDEPENDENT ACCOUNTANT TO CONDUCT ITS AUDIT HAS NOT CHANGED SINCE THE PRIOR YEAR