2011-09-23T08:33:51-05:00 2010-12-31 EIDE BAILLY LLP 200 EAST 10TH STREET SUITE 500 SIOUX FALLS SD 57104 990 2010-01-01 201115155 WINFIELD GOOD SAMARITAN HOUSING INC WINF 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 RAYE NAE NYLANDER 6053623100 2011-09-14 1 N DEAN BUCKNEBERG 6053391999 2011-09-14 2010 2016-03-07 17:11:31Z WHEAT RIDGE HEIGHTS RAYE NAE NYLANDER 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 104777 0 X WWW.GOOD-SAM.COM X 2004 SD TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 8 8 0 11 0 0 8895 0 108720 104535 300 242 0 0 117915 104777 0 0 0 0 0 0 0 0 0 162299 164154 162299 164154 -44384 -59377 1776443 1707095 31479 21508 1744964 1685587 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 0 0 116799 104535 TO PROVIDE LOW INCOME HOUSING FOR ELDERLY AND DISABLED PERSONS. 6,545 RESIDENT DAYS IN 2010. 116799 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 1 1 1 0 0 0 0 1 0 0 1 1 0 0 0 X RAYE NAE NYLANDER 6053623100 4800 WEST 57TH STREET PO BOX 5038 SIOUX FALLS SD 571175038 X DAVID J HORAZDOVSKY 1.00 X X 0 521501 12669 SUSAN E NICKERSON 1.00 X X 0 0 0 PAUL R BINDER 1.00 X X 0 0 0 SCOTT N PETERS 1.00 X X 0 0 0 PATRICIA K HAUGEN 1.00 X 0 0 0 REV JOHN F HOLT 1.00 X 0 0 0 BECKY LONG 1.00 X 0 0 0 MIKE MILDFELT 1.00 X 0 0 0 DON ZIEGLER 1.00 X 0 0 0 JOHN C PENN 1.00 X 0 0 0 LARRY W WALTER 1.00 X 0 0 0 RAYE NAE NYLANDER 1.00 X 0 259663 16369 0 781164 29038 0 0 1 0 0 RENTAL CHARGES 624100 102057 102057 ANCILLARY CHARGES 624100 2478 2478 104535 242 242 104777 104535 0 242 11012 11012 528 528 5600 5600 6171 6171 2382 2382 7012 250 6762 28084 28084 3164 3164 69586 69586 6296 6296 CONTRACTS - PERSONNEL S 23946 6412 17534 MISC EXPENSES 286 286 BAD DEBT 87 87 164154 116799 47355 0 11642 4871 126 8 35 402 1934273 287695 1715822 1646578 48818 55236 1776443 1707095 18939 9982 45 6977 6977 5518 4549 31479 21508 X -233936 -293313 1978900 1978900 1744964 1685587 1776443 1707095 -59377 0 X 0 1 0 X 1 1 X 8895 8895 1234 46360 88069 108720 104535 348918 1234 46360 88069 117615 104535 357813 0 5871 9062 14933 5871 9062 14933 342880 5 123 308 300 242 978 5 123 308 300 242 978 1239 46483 88377 117915 104777 358791 0.95570 0.00270 X 91203 91203 1725778 262126 1463652 37271 11158 26113 80021 14411 65610 1646578 TENANT SECURITY DEPOSITS 4549 4549 104777 164154 -59377 0 -59377 104777 0 104777 0 104777 164154 0 164154 0 164154 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PROJECT HAS ADOPTED THE PROVISIONS OF FASB ACCOUNTING STANDARDS CODIFICATION TOPIC ASC 740-10 (PREVIOUSLY FINANCIAL INTERPRETATION NO. 48 ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES), ON JANUARY 1, 2009. THE PROJECT UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES. THE PROJECT IS SUBJECT TO FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES. 0 0 0 0 0 0 0 0 0 DAVID J HORAZDOVSKY 0 400842 0 0 0 120659 0 0 0 16404 0 537905 0 0 RAYE NAE NYLANDER 0 185593 0 0 0 74070 0 0 0 18357 0 278020 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE MANAGEMENT DUTIES OF THE PROJECT HAVE BEEN DELEGATED TO THE PROJECT'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (TELGSS). TELGSS IS PAID A MANAGEMENT FEE EQUAL TO A PERCENTAGE OF REVENUE OTHER THAN INVESTMENT AND GIFT INCOME. THE FEE HAS BEEN APPROVED BY THE US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD MEMBERS ARE APPOINTED BY THE DIRECTORS OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION A, LINE 7B ARTICLES OF INCORPORATION AND BY-LAW CHANGES REQUIRE THE APPROVAL OF THE BOARD OF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES THAT HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 ACCOUNTANTS WITH THE MANAGING AGENT, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, REVIEW THE 990 IN DETAIL PRIOR TO IT BEING FILED. ANY QUESTIONS ARE RESOLVED WITH THE TREASURER AND/OR THE PRESIDENT OF THE CORPORATION PRIOR TO THE 990 BEING FILED. A COPY OF THE 990 IS PROVIDED TO THE CORPORATION'S OFFICERS PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12 THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE. THE ORGANIZATION ASKS THAT ALL OFFICERS AND DIRECTORS COMPLY WITH THE IRS CONFLICT OF INTEREST AND DISCLOSURE CERTIFICATION, BUT HAVE NOT REQUIRED THE INDIVIDUAL TO PROVIDE A SIGNED COPY TO THE CORPORATION'S MAIN OFFICE. THE ORGANIZATION IS ADOPTING A CHANGE IN POLICY IN 2011 THAT WILL PROVIDE FOR ANNUAL UPDATES TO THE CONFLICT OF INTEREST AND DISCLOSURE CERTIFICATION. FORM 990, PART VI, SECTION C, LINE 19 THE PROJECT MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. COLUMN (B), AVERAGE HOURS PER WEEK FORM 990, PART VII DAVID J. HORAZDOVSKY AND RAYE NAE NYLANDER WORK APPROXIMATELY 55 HOURS PER WEEK FOR RELATED ORGANIZATIONS AS LISTED ON SCHEDULE R. FORM 990, PART VI, LINES 15A AND 15B THE ORGANIZATION DOES NOT EMPLOY A CEO, AN EXECUTIVE DIRECTOR, A TOP MANAGEMENT OFFICIAL, OR ANY KEY EMPLOYEES. THE MANAGEMENT FUNCTIONS OF THE ORGANIZATION HAVE BEEN OUTSOURCED TO THE ORGANIZATION'S SPONSOR, THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY. GOOD SAMARITAN HOLDINGS LLC 4800 W 57TH STREET SIOUX FALLS SD 57117 752979560 OWNER OF GOOD SAMARITAN HERITAGE, LLC SD 501(C)(3) LINE 11A, I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 GOOD SAMARITAN SOCIETY INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460349951 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 BOISE GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 363370371 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 SIOUX FALLS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460385187 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 LOVINGTON GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460392944 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 PROPHETSTOWN GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460392943 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 MILLARD GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460396332 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 OLATHE GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460396398 GENERAL PARTNER OF OLATHE GOOD SAMARITAN HOUSING, LP SD 501(C)(3) LINE 11A, I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 JASONVILLE GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460396355 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 KEARNEY GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460421846 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 HASTINGS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460434693 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 BROOKINGS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460439509 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 GRANTS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460439511 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 EL PASO GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 272876627 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 VALENTINE GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 911751139 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 JEFFERSONTOWN GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 911751137 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 GOLDBECK TOWERS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 911751135 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 WISCONSIN GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460447338 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 SOUTH DAYTONA BEACH GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460461264 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 INVER GROVE HEIGHTS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 760789504 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 LEMARS GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 204714415 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 ALLIANCE GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 204714573 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 SIOUX FALLS 57 GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 204714647 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION 4800 W 57TH STREET SIOUX FALLS SD 57117 460422866 ASSIST TELGSS IN PROVIDING SENIOR CARE MN 501(C)(3) LINE 11A, I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 4800 W 57TH STREET SIOUX FALLS SD 57117 450228055 PROVIDE SENIOR CARE ND 501(C)(3) LINE 9 0 HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC 4800 W 57TH STREET SIOUX FALLS SD 57117 271212446 GENERAL PARTNER OF HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING, LP SD 501(C)(3) LINE 11A, I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 GREELEY GOOD SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460456087 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD 501(C)(3) LINE 9 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 OLATHE GOOD SAMARITAN HOUSING LIMITED PARTNERSHIP 4800 W 57TH STREET SIOUX FALLS SD 57117 205297369 PROVIDE HOUSING FOR LOW-INCOME TENANTS SD N/A HOBBS GOOD SAMARITAN HOUSING LIMITED PARTNERSHIP 4800 W 57TH STREET SIOUX FALLS SD 57117 261817167 PROVIDE HOUSING FOR LOW-INCOME TENANTS SD N/A HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP 4800 W 57TH STREET SIOUX FALLS SD 57117 271212511 PROVIDE HOUSING FOR LOW-INCOME TENANTS SD N/A MILLARD GOOD SAMARITAN HOUSING LIMITED PARTNERSHIP 4800 W 57TH STREET SIOUX FALLS SD 57117 271212324 PROVIDE HOUSING FOR LOW-INCOME TENANTS SD N/A GOOD SAMARITAN HUMANITARIAN SERVICE INC 4800 W 57TH STREET SIOUX FALLS SD 57117 205533741 MANAGEMENT AND UNBUNDLED SERVICES; UNRELATED BUSINESS ACTIVITIES SD N/A C GOOD SAMARITAN SOCIETY INSURANCE LTD 4800 W 57TH STREET SIOUX FALLS SD 57117 INSURANCE CJ N/A C IDAHO SAMARITAN HOUSING INC 4800 W 57TH STREET SIOUX FALLS SD 57117 460424311 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A C HOBBS GOOD SAMARITAN HOUSING GP INC 4800 W 57TH STREET SIOUX FALLS SD 57117 261817059 PROVIDE LOW INCOME HOUSING TO ELDERLY AND DISABLED PERSONS SD N/A C 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0