FAIR HAVEN FOUNDATION INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
FAIR HAVEN FOUNDATION INC (EIN 26-0866646)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-05-12
IRS object ID
202331329349307163
Schema version
2022v5.0
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)
Return2023-05-12T15:27:03-04:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351953811PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SIMONS BITZER & ASSOCIATES PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18350 S EMERSON AVE SUITE 100AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46237ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN260866646EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAIR HAVEN FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFAIRBusinessNameControlTxt
Phone3173483688PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11702 W 16TH STREETAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46202ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMANDA MILNERPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3179483688PhoneNum
Signature2023-04-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAMANDAPersonFirstNm
Person LastMILNERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrfalseIRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGREGORY L SIMONSPreparerPersonNm
PTINP00151354PTIN
Phone3177823070PhoneNum
Preparation2023-05-12PreparationDt
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerAMANDA MILNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line113974 WAKEFIELD PLACEAddressLine1Txt
CityFISHERSCityNm
State AbbreviationINStateAbbreviationCd
ZIP46038ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,092,755GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressFAIRHAVENFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTO PROVIDE FREE OR SUBSIDIZED HOUSING FOR LONG-TERM PATIENTS AND THEIR CAREGIVERS WHILE UNDERGOING TREATMENT AT HOSPITALS IN THE INDIANAPOLIS AREA; AND TO TRANSACT ANY AND ALL LAWFUL BUSINESS FOR WHICH NON-PROFIT CORPORATIONS MAY BE INCORPORATED.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee8TotalEmployeeCnt
Total Volunteers125TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,459,013PYContributionsGrantsAmt
CY Contributions Grants$1,092,652CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$662PYInvestmentIncomeAmt
CY Investment Income-$12CYInvestmentIncomeAmt
PY Other Revenue$4,653PYOtherRevenueAmt
CY Other Revenue$115CYOtherRevenueAmt
PY Total Revenue$1,464,328PYTotalRevenueAmt
CY Total Revenue$1,092,755CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$220,598PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$323,776CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$191,957CYTotalFundraisingExpenseAmt
PY Other Expenses$533,352PYOtherExpensesAmt
CY Other Expenses$666,830CYOtherExpensesAmt
PY Total Expenses$753,950PYTotalExpensesAmt
CY Total Expenses$990,606CYTotalExpensesAmt
PY Revenues Less Expenses$710,378PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$102,149CYRevenuesLessExpensesAmt
Total Assets BOY$3,315,371TotalAssetsBOYAmt
Total Assets EOY$2,870,870TotalAssetsEOYAmt
Total Liabilities BOY$902,874TotalLiabilitiesBOYAmt
Total Liabilities EOY$356,224TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,412,497NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,514,646NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE FREE OR SUBSIDIZED HOUSING FOR LONG-TERM PATIENTS AND THEIR CAREGIVERS WHILE UNDERGOING TREATMENT AT HOSPITALS IN THE INDIANAPOLIS AREA; AND TO TRANSACT ANY AND ALL LAWFUL BUSINESS FOR WHICH NON-PROFIT CORPORATIONS MAY BE INCORPORATED.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$717,525ExpenseAmt
DescTO PROVIDE FREE OR SUBSIDIZED HOUSING FOR LONG-TERM PATIENTS AND THEIR CAREGIVERS WHILE UNDERGOING TREATMENT AT HOSPITALS IN THE INDIANAPOLIS AREA.Desc
Total Program Service Expenses$717,525TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document15IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee8EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAIR HAVEN FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3173483688PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11702 W 16TH STREETAddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46202ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
AMANDA MILNER
EXECUTIVE DI40.00Yes (X)$81,000$0$0
JACQUELINE DAVIS
PRESIDENT1.00Yes (X)$0$0$0Yes (X)
CAROLE ROSNER
ADVISOR1.00$0$0$0Yes (X)
LAURA SMALL
ADVISOR1.00$0$0$0Yes (X)
TRICIA TRICK-ECKERT
VICE PRESIDE1.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$81,000TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$1,092,652AllOtherContributionsAmt
Total Contributions$1,092,652TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$12TotalRevenueColumnAmt
Exclusion-$12ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC. REVENUEDesc
Business900099BusinessCd
Total Revenue Column$115TotalRevenueColumnAmt
Exclusion$115ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$115OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,092,755TotalRevenueColumnAmt
Exclusion$103ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$81,000TotalAmt
Program Services$32,400ProgramServicesAmt
Management And General$4,050ManagementAndGeneralAmt
Fundraising$44,550FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$216,143TotalAmt
Program Services$134,275ProgramServicesAmt
Management And General$18,546ManagementAndGeneralAmt
Fundraising$63,322FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,107TotalAmt
Management And General$4,107ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$22,526TotalAmt
Program Services$13,655ProgramServicesAmt
Management And General$1,819ManagementAndGeneralAmt
Fundraising$7,052FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$45,228TotalAmt
Program Services$5,222ProgramServicesAmt
Management And General$40,006ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,976TotalAmt
Fundraising$31,976FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$12,473TotalAmt
Program Services$76ProgramServicesAmt
Management And General$1,903ManagementAndGeneralAmt
Fundraising$10,494FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,205TotalAmt
Management And General$20ManagementAndGeneralAmt
Fundraising$3,185FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$132,668TotalAmt
Program Services$132,668ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$354TotalAmt
Management And General$178ManagementAndGeneralAmt
Fundraising$176FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$43,917TotalAmt
Program Services$43,917ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$170,265TotalAmt
Program Services$170,265ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$14,876TotalAmt
Program Services$13,054ProgramServicesAmt
Management And General$1,822ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
UTILITIES$63,600$63,600
CLEANING$47,397$47,397
FURNISHINGS & SUPPLIES$24,205$24,205
OUTSIDE CONTRACT SERVICES$17,350$17,350

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$59,316TotalAmt
Program Services$36,791ProgramServicesAmt
Management And General$8,673ManagementAndGeneralAmt
Fundraising$13,852FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$990,606TotalAmt
Program Services$717,525ProgramServicesAmt
Management And General$81,124ManagementAndGeneralAmt
Fundraising$191,957FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$805,599BOYAmt
EOY$484,267EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$73,752BOYAmt
EOY$57,936EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$13,078BOYAmt
EOY$2,082EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,612,591LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$289,566LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,419,382BOYAmt
EOY$2,323,025EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,560BOYAmt
EOY$3,560EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,315,371BOYAmt
EOY$2,870,870EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$4,528EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$892,933BOYAmt
EOY$342,934EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,941BOYAmt
EOY$8,762EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$902,874BOYAmt
EOY$356,224EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$2,412,497BOYAmt
EOY$2,514,646EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,412,497BOYAmt
EOY$2,514,646EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,315,371BOYAmt
EOY$2,870,870EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$102,149ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteefalseAuditCommitteeInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,397,413CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$601,498CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$892,776CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,459,013CurrentTaxYearMinus1YearAmt
Current Tax Year$1,092,652CurrentTaxYearAmt
Total$5,443,352TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,397,413CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$601,498CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$892,776CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,459,013CurrentTaxYearMinus1YearAmt
Current Tax Year$1,092,652CurrentTaxYearAmt
Total$5,443,352TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$5,443,352PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$63CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,689CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,427CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$662CurrentTaxYearMinus1YearAmt
Current Tax Year-$12CurrentTaxYearAmt
Total$10,829TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$3,653CurrentTaxYearMinus1YearAmt
Total$3,653TotalAmt
FieldValueIRS element (for citing)
Total Support$5,457,834TotalSupportAmt
Public Support CY1700.99730PublicSupportCY170Pct
Public Support PY1700.99690PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$177,370OtherCostOrOtherBasisAmt
Book Value$177,370BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,107,773OtherCostOrOtherBasisAmt
Depreciation$190,199DepreciationAmt
Book Value$1,917,574BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$327,448OtherCostOrOtherBasisAmt
Depreciation$99,367DepreciationAmt
Book Value$228,081BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,323,025TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCREDIT CARD PAYABLEDesc
Amt$8,762Amt
FieldValueIRS element (for citing)
Total Liability$8,762TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONTO PROVIDE FREE OR SUBSIDIZED HOUSING FOR LONG-TERM PATIENTS AND THEIR CAREGIVERS WHILE UNDERGOING TREATMENT AT HOSPITALS IN THE INDIANAPOLIS AREA; AND TO TRANSACT ANY AND ALL LAWFUL BUSINESS FOR WHICH NON-PROFIT CORPORATIONS MAY BE INCORPORATED.
FORM 990, PAGE 6, PART VI, LINE 11BALL VOTING MEMBERS OF THE FULL BOARD WILL RECEIVE A COPY OF THE FORM 990 BEFORE IT IS FILED. THE BOARD WILL VOTE TO APPROVE. THE APPROVAL WILL BE DOCUMENTED.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

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