STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

CLARK-LINDSEY VILLAGE INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CLARK-LINDSEY VILLAGE INC (EIN 37-1017284)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-10
IRS object ID
201241319349301324
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-10T14:22:17-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

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 Signed2012-05-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHAD KUNZEName
PTINP00639380PTIN
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
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 Receipts14689776GrossReceipts
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 Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees289TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year21069ContributionsGrantsPriorYear
Contributions Grants Current Year51720ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12860979ProgramServiceRevenuePriorYear
Program Service Revenue CY13530880ProgramServiceRevenueCY
Investment Income Prior Year888575InvestmentIncomePriorYear
Investment Income Current Year338007InvestmentIncomeCurrentYear
Other Revenue Prior Year195321OtherRevenuePriorYear
Other Revenue Current Year222242OtherRevenueCurrentYear
Total Revenue Prior Year13965944TotalRevenuePriorYear
Total Revenue Current Year14142849TotalRevenueCurrentYear
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 Year6643783SalariesEtcPriorYear
Salaries Etc Current Year6715873SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6219010OtherExpensePriorYear
Other Expenses Current Year6678161OtherExpensesCurrentYear
Total Expenses Prior Year12862793TotalExpensesPriorYear
Total Expenses Current Year13394034TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1103151RevenuesLessExpensesPriorYear
Revenues Less Expenses CY748815RevenuesLessExpensesCY
Total Assets BOY26054770TotalAssetsBOY
Total Assets EOY26823054TotalAssetsEOY
Total Liabilities BOY13547900TotalLiabilitiesBOY
Total Liabilities EOY13990553TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12506870NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12832501NetAssetsOrFundBalancesEOY
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
Expense11952031Expense
Revenue13530880Revenue
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 2011, CLARK- LINDSEY VILLAGE PROVIDED HOUSING AND SERVICES TO 465 ELDERLY PEOPLE, RESULTING IN 81,678 DAYS OF CARE. IN ADDITION, CLARK-LINDSEY PROVIDED 151,325 HOURS OF NURSING CARE, 31,665 SESSIONS OF THERAPY, AND MORE THAN 400 SENIOR PROGRAMS DESIGNED TO PROMOTE CONTINUED LEARNING AND SUCCESSFUL AGING. FURTHERMORE, IN 2011, CLARK-LINDSEY INCURRED A TOTAL COST OF $88,275 FOR CHARITY CARE PROVIDED AT A REDUCED COST OR NO COST TO THE ELDERLY.Description
Total Program Service Expense11952031TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109653NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees289NumberOfEmployees
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
Taxable Distributions0TaxableDistributions
Distribution To Donor0DistributionToDonor
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
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 (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
THOMAS B BERNS
CHAIRMAN1.00XX001072
GLEN C PAINE
VICE-CHAIRMAN1.00XX60500
CATHERINE A MURPHY
TREASURER1.00XX000
E PHILLIPS KNOX
SECRETARY1.00XX000
CHRISTOPHER MOYER
BOARD MEMBER1.00X000
CAMILLE S HARMON
BOARD MEMBER1.00X000
MICHAEL B PROVENZANO
BOARD MEMBER1.00X000
MICHAEL W LYON
BOARD MEMBER1.00X00274
ROLAND WHITE
BOARD MEMBER1.00X78700
DAVID W HOOD
BOARD MEMBER1.00X72400
ELIZABETH H TYLER
BOARD MEMBER1.00X000
DEBRA S REARDANZ
PRESIDENT / CEO40.00X177677028435
TIMOTHY P MAST
CFO40.00X93946016641
FieldValueIRS element (for citing)
Total Reportable Comp From Org273739TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation46422TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
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 SERVICES654342
ADVANCED WAYNE CAIN & SONS
1207 E UNIVERSITY AVEURBANAIL61802CONSTRUCTION SERVICES201600
MTK TECHNOLOGIES INC
701 DEVONSHIRE DRIVECHAMPAIGNIL61820TECHNOLOGY CONSULTING AND HARDWARE159276
BARBER & DEATLEY INC
6111 N GOODWINURBANAIL61801CONSTRUCTION SERVICES123698
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions51720AllOtherContributions
Total Contributions51720TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENT SERVICES6230001224684112246841
AMORTIZATION OF DEFERR62300011294751129475
MISCELLANEOUS PROGRAM900099154564154564
FieldValueIRS element (for citing)
Total Program Service Revenue13530880TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column271682TotalRevenueColumn
Exclusion$271,682ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities609050Securities
Other4202Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities546927Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities62123Securities
Other4202Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column66325TotalRevenueColumn
Exclusion$66,325ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MEAL REVENUE900099114675$114,675
HAIR SALON SERVICES90009982149$82,149
MISCELLANEOUS REVENUE90009925418$25,418
FieldValueIRS element (for citing)
Total Other Revenue222242TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14142849TotalRevenueColumn
Related Or Exempt Function Income13530880RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$560,249ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total320161Total
Management And General320161ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5370300Total
Program Services4880110ProgramServices
Management And General490190ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total152209Total
Program Services134040ProgramServices
Management And General18169ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total438930Total
Program Services399526ProgramServices
Management And General39404ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total434273Total
Program Services384469ProgramServices
Management And General49804ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total100077Total
Management And General100077ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total43085Total
Management And General43085ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total59328Total
Management And General59328ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12250Total
Management And General12250ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total53928Total
Management And General53928ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total15767Total
Program Services15767ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total173954Total
Program Services149977ProgramServices
Management And General23977ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total489280Total
Program Services483982ProgramServices
Management And General5298ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total31536Total
Program Services8007ProgramServices
Management And General23529ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total18161Total
Program Services4156ProgramServices
Management And General14005ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total212359Total
Program Services212359ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1569416Total
Program Services1552423ProgramServices
Management And General16993ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total233259Total
Program Services230733ProgramServices
Management And General2526ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
THERAPY, NURSING SUPPLI12918661291866
DIETARY795248795248
MAINTENANCE AND GROUNDS4903814850715310
REAL ESTATE TAXES3953243910444280

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total692942Total
Program Services533253ProgramServices
Management And General159689ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13394034Total
Program Services11952031ProgramServices
Management And General1442003ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY500BOY
EOY500EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1812851BOY
EOY1202368EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1125347BOY
EOY994627EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY27272BOY
EOY29336EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY133829BOY
EOY93555EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis30867574LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16928725LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14830626BOY
EOY13938849EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8124345BOY
EOY10563819EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY26054770BOY
EOY26823054EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1312292BOY
EOY1419104EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY7620867BOY
EOY8244128EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4215347BOY
EOY4071843EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY318500BOY
EOY173000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY80894BOY
EOY82478EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13547900BOY
EOY13990553EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12130719BOY
EOY12477885EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY357065BOY
EOY335530EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY19086BOY
EOY19086EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12506870BOY
EOY12832501EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26054770BOY
EOY26823054EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses748815ReconcilationRevenueExpenses
Reconcilation Other Changes-423184ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years253515CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years354943CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years95282CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21069CurrentTaxYearMinus1Year
Current Tax Year51720CurrentTaxYear
Total776529Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12034438CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11626029CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11951946CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12860979CurrentTaxYearMinus1Year
Current Tax Year13530880CurrentTaxYear
Total62004272Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year195321CurrentTaxYearMinus1Year
Current Tax Year222242CurrentTaxYear
Total417563Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12287953CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11980972CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12047228CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13077369CurrentTaxYearMinus1Year
Current Tax Year13804842CurrentTaxYear
Total63198364Total

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 Total50963198364PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years322411CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years236724CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years129044CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year206025CurrentTaxYearMinus1Year
Current Tax Year271682CurrentTaxYear
Total1165886Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years322411CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years236724CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years129044CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year206025CurrentTaxYearMinus1Year
Current Tax Year271682CurrentTaxYear
Total1165886Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12610364CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12217696CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12176272CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13283394CurrentTaxYearMinus1Year
Current Tax Year14076524CurrentTaxYear
Total64364250Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98190PublicSupportPercentage509
Prior Year Support Percentage0.98030PriorYearSupportPercentage
Investment Income Percentage0.01810InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01970PriorYrInvestIncomePercentage
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 Balance1975526BeginningOfYearBalance
Contributions10000Contributions
Investment Earnings Or Losses-36476InvestmentEarningsOrLosses
Other Expenditures41076OtherExpenditures
Administrative Expenses12540AdministrativeExpenses
End Of Year Balance1895434EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

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 Balance0.90550BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.01010PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.08440TermEndowmentEOYBalance
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 Basis23969327OtherCostOrOtherBasis
Depreciation11899061Depreciation
Book Value12070266BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6489358OtherCostOrOtherBasis
Depreciation5029664Depreciation
Book Value1459694BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis183889OtherCostOrOtherBasis
Book Value183889BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13938849TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
FUNDS HELD FOR OTHERS$27,308
DEFERRED COMPENSATION$55,170
FieldValueIRS element (for citing)
Total Of Amounts82478TotalOfAmounts
Total Revenue14142849TotalRevenue
Total Expenses13394034TotalExpenses
Excess Or Deficit For Year748815ExcessOrDeficitForYear
Net Unrealized GL On Investments-423184NetUnrealizedGLOnInvestments
Total Adjustments-423184TotalAdjustments
Excess Or Deficit Per FS325631ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt13656134TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-423184NetUnrealizedGainsInvestments
Revenue Not Rptd F990-423184RevenueNotRptdF990
Revenue Subtotal14079318RevenueSubtotal
Investment Expenses Not Included59328InvestmentExpensesNotIncluded
Other Revenues Not Included4203OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt63531RevenueNotRptdOnFinStmt
Total Revenue Per Form99014142849TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13330503TotExpensesEtcAuditedFinclStmt
Other Expenses Included-4203OtherExpensesIncluded
Expenses Not Rptd F990-4203ExpensesNotRptdF990
Expenses Subtotal13334706ExpensesSubtotal
Investment Expenses Not Included259328InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt59328ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013394034TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 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: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 2010, 2009 AND 2008 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GAIN ON DISPOSAL OF ASSET 4,202. ROUNDING DIFFERENCE 1.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:GAIN DISPOSAL OF ASSETS -4,202. ROUNDING DIFFERENCE -1.

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
Base Compensation Filing Org174677BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org3000BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org11340DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org17095NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org206112TotalCompensationFilingOrg
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 2011.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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)
Amount Retired928157AmountRetired
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)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
E PHILLIPS KNOX
BOARD SECRETARY59328INVESTMENT MANAGEMENT FEES PAID TO BUSEY WEALTH MANAGEMENT. MR. KNOX IS A DIRECTOR AT THE PARENT COMPANY, FIRST BUSEY CORPORATION.0
E PHILLIPS KNOX
BOARD SECRETARY350195LOAN PAYMENTS MADE TO BUSEY BANK. MR. KNOX IS A DIRECTOR AT THE PARENT COMPANY, FIRST BUSEY CORPORATION.0
DEBRA REARDANZ
PRESIDENT/CEO11805DUES PAID TO LIFE SERVICES NETWORK (LSN), ON WHICH, MS. REARDANZ IS A BOARD MEMBER.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 PRESIDNET 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 5:NET UNREALIZED LOSSES ON INVESTMENTS: -423,184.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.