FAIR HAVEN FOUNDATION INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FAIR HAVEN FOUNDATION INC (EIN 26-0866646)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-06-30
- IRS object ID
- 202201819349301335
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-06-30T15:09:36-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351953811 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIMONS BITZER & ASSOCIATES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8350 S EMERSON AVE SUITE 100 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260866646 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIR HAVEN FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAIR | BusinessNameControlTxt |
| Phone | 3173483688 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 441683 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46244 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMANDA MILNER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3179483688 | PhoneNum |
| Signature | 2022-06-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMANDA | PersonFirstNm |
| Person Last | MILNER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GREGORY L SIMONS | PreparerPersonNm |
| PTIN | P00151354 | PTIN |
| Phone | 3177823070 | PhoneNum |
| Preparation | 2022-06-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | AMANDA MILNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13974 WAKEFIELD PLACE | AddressLine1Txt |
| City | FISHERS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46038 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,464,328 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | FAIRHAVENFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | TO 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 Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $892,776 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,459,013 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,427 | PYInvestmentIncomeAmt |
| CY Investment Income | $662 | CYInvestmentIncomeAmt |
| CY Other Revenue | $4,653 | CYOtherRevenueAmt |
| PY Total Revenue | $900,203 | PYTotalRevenueAmt |
| CY Total Revenue | $1,464,328 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $187,737 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $220,598 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $180,335 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $349,252 | PYOtherExpensesAmt |
| CY Other Expenses | $533,352 | CYOtherExpensesAmt |
| PY Total Expenses | $536,989 | PYTotalExpensesAmt |
| CY Total Expenses | $753,950 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $363,214 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $710,378 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,706,655 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,315,371 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,536 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $902,874 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,702,119 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,412,497 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $473,226 | ExpenseAmt |
| Desc | TO 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 | $473,226 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIR HAVEN FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3173483688 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 441683 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46244 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|
| AMANDA MILNER | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $83,000 | $0 | $0 | |
| JACQUELINE DAVIS | ||||||
| ADVISOR | 1.00 | $0 | $0 | $0 | Yes (X) | |
| CAROLE ROSNER | ||||||
| ADVISOR | 1.00 | $0 | $0 | $0 | Yes (X) | |
| LAURA SMALL | ||||||
| ADVISOR | 1.00 | $0 | $0 | $0 | Yes (X) | |
| TRICIA TRICK-ECKERT | ||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $83,000 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $35,900 | GovernmentGrantsAmt |
| All Other Contributions | $1,423,113 | AllOtherContributionsAmt |
| Total Contributions | $1,459,013 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $662 | TotalRevenueColumnAmt |
| Exclusion | $662 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $4,653 | TotalRevenueColumnAmt |
| Exclusion | $4,653 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,653 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,464,328 | TotalRevenueColumnAmt |
| Exclusion | $5,315 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,000 | TotalAmt |
| Program Services | $20,750 | ProgramServicesAmt |
| Management And General | $4,150 | ManagementAndGeneralAmt |
| Fundraising | $58,100 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,351 | TotalAmt |
| Program Services | $63,065 | ProgramServicesAmt |
| Management And General | $7,772 | ManagementAndGeneralAmt |
| Fundraising | $50,514 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830 | TotalAmt |
| Management And General | $830 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,417 | TotalAmt |
| Program Services | $6,236 | ProgramServicesAmt |
| Management And General | $909 | ManagementAndGeneralAmt |
| Fundraising | $8,272 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,326 | TotalAmt |
| Program Services | $412 | ProgramServicesAmt |
| Management And General | $23,914 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400 | TotalAmt |
| Fundraising | $400 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,608 | TotalAmt |
| Program Services | $2,305 | ProgramServicesAmt |
| Fundraising | $40,303 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,533 | TotalAmt |
| Program Services | $350 | ProgramServicesAmt |
| Management And General | $4,244 | ManagementAndGeneralAmt |
| Fundraising | $6,939 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,248 | TotalAmt |
| Fundraising | $4,248 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,037 | TotalAmt |
| Program Services | $137,037 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140 | TotalAmt |
| Management And General | $140 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $817 | TotalAmt |
| Management And General | $454 | ManagementAndGeneralAmt |
| Fundraising | $363 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,465 | TotalAmt |
| Program Services | $14,465 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,320 | TotalAmt |
| Program Services | $14,134 | ProgramServicesAmt |
| Management And General | $40,186 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,091 | TotalAmt |
| Program Services | $17,091 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| UTILITIES | $42,805 | $42,805 |
| LANDSCAPING & SNOW REMOVA | $41,177 | $41,177 |
| FURNISHINGS & SUPPLIES | $34,919 | $34,919 |
| HOTEL PROGRAM | $21,309 | $21,309 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,157 | TotalAmt |
| Program Services | $57,171 | ProgramServicesAmt |
| Management And General | $17,790 | ManagementAndGeneralAmt |
| Fundraising | $11,196 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,950 | TotalAmt |
| Program Services | $473,226 | ProgramServicesAmt |
| Management And General | $100,389 | ManagementAndGeneralAmt |
| Fundraising | $180,335 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $596,232 | BOYAmt |
| EOY | $805,599 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,428 | BOYAmt |
| EOY | $73,752 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,260 | BOYAmt |
| EOY | $13,078 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,538,684 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $119,302 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $939,785 | BOYAmt |
| EOY | $2,419,382 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,950 | BOYAmt |
| EOY | $3,560 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,706,655 | BOYAmt |
| EOY | $3,315,371 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $892,933 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,536 | BOYAmt |
| EOY | $9,941 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,536 | BOYAmt |
| EOY | $902,874 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,702,119 | BOYAmt |
| EOY | $2,412,497 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,702,119 | BOYAmt |
| EOY | $2,412,497 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,706,655 | BOYAmt |
| EOY | $3,315,371 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $710,378 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAuditedInd |
| Audit Committee | false | AuditCommitteeInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $485,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,397,413 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $601,498 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $892,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,459,013 | CurrentTaxYearAmt |
| Total | $4,836,478 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $485,778 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,397,413 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $601,498 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $892,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,459,013 | CurrentTaxYearAmt |
| Total | $4,836,478 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,836,478 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $401 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $63 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,689 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,427 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $662 | CurrentTaxYearAmt |
| Total | $11,242 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $3,653 | CurrentTaxYearAmt |
| Total | $3,653 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,851,373 | TotalSupportAmt |
| Public Support CY170 | 0.99690 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99720 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $177,370 | OtherCostOrOtherBasisAmt |
| Book Value | $177,370 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,070,048 | OtherCostOrOtherBasisAmt |
| Depreciation | $78,907 | DepreciationAmt |
| Book Value | $1,991,141 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $291,266 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,395 | DepreciationAmt |
| Book Value | $250,871 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,419,382 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CREDIT CARD PAYABLE | Desc |
| Amt | $9,941 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,941 | TotalLiabilityAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO 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 11B | ALL 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 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 24E | CLEANING 19,077 0 0 LOAN EXPENSES - ADA'S PLA 11,223 4,795 0 OUTSIDE CONTRACT SERVICES 0 10,250 5,400 SOFTWARE 8,800 0 0 REPAIR AND MAINTENANCE 6,120 0 0 LAUNDRY SERVICE 4,034 0 0 BANK FEES 1,203 104 1,927 CAPITAL CAMPAIGN EXPENSES 0 0 2,577 EDUCATION 148 1,533 596 PATIENT AND FAMILY CARE 2,132 0 0 PAYROLL PROCESSING 1,941 0 0 TELEPHONE 772 674 0 TRASH 535 0 0 ADMIN FEES 404 100 0 SECURITY 481 0 0 SUPPLIES 0 0 380 SPONSORS EXPENSE 0 0 199 LICENSES AND PERMITS 0 167 0 BOOKS, SUBSCRIPTIONS & RE 0 167 0 MEMBERSHIPS 0 0 117 MOVING EXPENSE 113 0 0 EQUIPMENT RENTAL 112 0 0 LICENSING AND INSPECTIONS 76 0 0 TOTAL 57,171 17,790 11,196 |
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