2012-11-15T12:59:36-06:00 2012-06-30 020471217 LEONE MCDONNELL & ROBERTS PA 10 DUPREY ROAD NORTH CONWAY NH 03860 990 2011-07-01 020300994 NORTHERN HUMAN SERVICES INC NORT 6034473347 87 WASHINGTON STREET CONWAY NH 03818 DALE HEON 6034473347 2012-11-15 1 JOHN D CALLAHAN JR P00224470 6033566358 2012-11-15 2011 2016-02-24 21:20:13Z DALE HEON 87 WASHINGTON STREET CONWAY NH 03818 33129394 0 X WWW.NORTHERHS.ORG X 1971 NH ASSIST PEOPLE AFFECTED BY MENTAL ILLNESS, DEVELOPMENTAL DISABILITIES AND RELATED DISORDERS. 11 11 912 10 0 0 1594310 1269317 32729096 31265397 7105 2257 516821 592423 34847332 33129394 0 0 0 0 20293259 19638383 0 0 0 14485413 13427516 34778672 33065899 68660 63495 8772302 8903246 1912308 1957082 6859994 6946164 TO ASSIST PEOPLE AFFECTED BY MENTAL ILLNESS, DEVELOPMENTAL DISABILITES AND RELATED DISORDERS TO LIVE MORE MEANINGFUL LIVES. 0 0 11500547 10843449 PROVIDED VARIOUS SERVICES TO MENTALLY ILL CLIENTS IN ALL OF NORTHERN NEW HAMPSHIRE, INCLUDING PSYCHIATRIC EMERGENCY SERVICES, OUTPATIENT THERAPY, PSYCHIATRIC EMERGENCY CARE, SUBSTANCE ABUSE TREATMENT AND OUTREACH. 19575092 21014371 PROVIDED SERVICES TO DEVELOPMENTALLY DISABLED CLIENTS IN ALL OF NORTHERN NEW HAMPSHIRE, INCLUDING COMPREHENSIVE DAY SERVICES, PERSONAL HYGIENE, COMMUNITY INTEGRATION, RESIDENTIAL SERVICES AND NURSING. 31075639 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 176 0 1 912 1 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 1 0 NH X DALE HEON 6034473801 71 HOBBS STREET 3RD FLOOR CONWAY NH 03818 MARGARET MCCLELLAN 1.00 X X 0 0 0 STEPHEN MICHAUD 1.00 X 0 0 0 JAMES SALMON 1.00 X X 0 0 0 MADELENE COSTELLO 1.00 X 0 0 0 GEORGIA CARON 1.00 X X 0 0 0 MARTI FAULKNER 1.00 X 0 0 0 LISA DANAULT 1.00 X 0 0 0 LOUISE VALLIERE 1.00 X 0 0 0 JENN PINEO 1.00 X 0 0 0 DENNIS MACKAY 40.00 X 145136 0 1348 ERIC JOHNSON 40.00 X 79221 0 3679 DALE HEON 40.00 X 74555 0 1803 PAUL LIDSTROM 35.00 X 182262 0 5389 LESTER NICHOLSON 40.00 X 178955 0 1057 ERINN FELLNER 40.00 X 137763 0 5676 MELLISSA MYERS 40.00 X 126485 0 5676 ERIC VAN LEUVEN 40.00 X 183177 0 4703 1107554 0 29331 7 0 1 0 THERESA MAURA PO BOX 255 TAMWORTH NH 03886 CLIENT CARE 196677 DONNA SAWYER 2665 E CONWAY RD CENTER CONWAY NH 03813 CLIENT CARE 194258 PAUL KONKEL 386 N SKINNYRIDGE RD LITTLETON NH 03561 CLIENT CARE 170308 DAWN PATNEAUDE 2 NORTH COURT STREET WOODSVILLE NH 03785 CLIENT CARE 128776 SHARON DAVIS 24 MOODY POND ROAD CENTER OSSIPEE NH 03814 CLIENT CARE 106274 5 625598 643719 1269317 CLIENT SERVICE FEES 624100 30802459 30802459 CLIENT PRODUCTION INCO 624100 462938 462938 31265397 2257 2257 OTHER REVENUE 624100 592423 592423 592423 33129394 31857820 0 2257 15135708 14009482 1126226 3297610 3109261 188349 1205065 1121524 83541 9089398 8797644 291754 1257199 1174299 82900 1013145 1005112 8033 152190 142953 9237 CONSUMABLE SUPPLIES 541870 511012 30858 CLIENT WAGES 395155 395155 COMMUNICATIONS 379271 324869 54402 EQUIPMENT EXPENSE 293656 217793 75863 305632 266535 39097 33065899 31075639 1990260 0 5883811 5309916 52998 48749 2102106 2887702 255852 199982 3340160 3182603 291608 157557 185927 299340 8772302 8903246 1847862 1922739 14757 16533 49689 17810 1912308 1957082 X 6606658 6691811 919 1936 252417 252417 6859994 6946164 8772302 8903246 X 63495 22675 X X 0 1 1 X 1 1 X 1948998 1706821 1812337 1594310 1296317 8358783 26669453 32039287 32508520 32729096 31265397 155211753 28618451 33746108 34320857 34323406 32561714 163570536 0 0 0 163570536 44115 11899 15559 7105 2257 80935 44115 11899 15559 7105 2257 80935 142520 106216 248736 28805086 33864223 34336416 34330511 32563971 163900207 0.99800 0.99630 0.00050 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2744980 2609734 135246 595180 572869 22311 157557 GIFT ANNUITY PAYABLE 1554 CAPITAL LEASE 16256 17810 33129394 33065899 63495 22675 22675 86170 33152069 22675 22675 33129394 0 33129394 33065899 0 33065899 0 33065899 PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENT 641. CHANGE IN CASH VALUE OF LIFE INSURANCE 22,034. TOTAL TO SCHEDULE D, PART XI, LINE 8: 22,675. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT INTEREST AGREEMENT 641. CHANGE IN CASH VALUE OF LIFE INSURANCE 22,034. X X 0 0 0 0 0 0 0 0 0 PAUL LIDSTROM 182262 0 0 0 0 0 0 0 5389 0 187651 0 0 0 LESTER NICHOLSON 178955 0 0 0 0 0 0 0 1057 0 180012 0 0 0 ERIC VAN LEUVEN 183177 0 0 0 0 0 0 0 4703 0 187880 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY MANAGEMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15 NORTHERN HUMAN SERVICES INC. HIRES AN INDEPENDENT CONSULTANT TO REVIEW COMPENSATION DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 NORTHERN HUMAN SERVICES INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN SPLIT INTEREST AGREEMENT 641. CHANGE IN CASH VALUE OF LIFE INSURANCE 22,034. TOTAL TO FORM 990, PART XI, LINE 5: 22,675. MANAGEMENT AND THE BOARD OF DIRECTORS ARE RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. SHALLOW RIVER PROPERTIES INC 87 WASHINGTON STREET CONWAY NH 03818 020426312 OWN & MANAGE REAL PROPERTY FOR NORTHERN HUMAN SERVICES NH 501(C)2 N/A 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 SHALLOW RIVER PROPERTIES C 352949 SHALLOW RIVER PROPERTIES J 753273