HAVEN: Form 990EZ, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HAVEN (EIN 82-3765753)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-10
- IRS object ID
- 202222839349200527
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-10T17:17:26-04:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 472590304 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Balance Tax & Accounting | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3212 14th Avenue South Suite 1 | AddressLine1Txt |
| City | Fargo | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 823765753 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Haven | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HAVE | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 8th St S STE 110 | AddressLine1Txt |
| City | Fargo | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jen Burgard | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 7012001194 | PhoneNum |
| Signature | 2022-10-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Jen | PersonFirstNm |
| Person Last | Burgard | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aimee Schwartzwalter CPA | PreparerPersonNm |
| PTIN | P00351809 | PTIN |
| Phone | 7013650319 | PhoneNum |
| Preparation | 2022-10-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Name Change | Yes (X) | NameChangeInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Website Address | www.havenmidwest.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $185,100 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $54,859 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $95,728 | ProgramServiceRevenueAmt |
| Fundraising Gross Income | $22,813 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $11,074 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $11,739 | SpecialEventsNetIncomeLossAmt |
| Other Revenue Total | $11,700 | OtherRevenueTotalAmt |
| Total Revenue | $174,026 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $63,762 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $100 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $11,350 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $777 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $33,586 | OtherExpensesTotalAmt |
| Total Expenses | $109,575 | TotalExpensesAmt |
| Excess Or Deficit For Year | $64,451 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | -$5,675 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $58,776 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,612 | BOYAmt |
| EOY | $18,362 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $838 | BOYAmt |
| EOY | $60,154 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,450 | BOYAmt |
| EOY | $78,516 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,125 | BOYAmt |
| EOY | $19,740 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,675 | BOYAmt |
| EOY | $58,776 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | To provide support for grieving parents | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | Sent 93 Hope Gifts, hosted 605 attendees during 25 safe and supportive events, hosted 5 Honor + Rise Events to celebrate and remember the children we carry in our hearts. | DescriptionProgramSrvcAccomTxt |
| Program Service Expenses | $19,659 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $19,659 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (4 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Jennifer Burgard | ||||
| Member | 40.00 | $35,000 | $0 | $0 |
| Jessica Bontjes | ||||
| Treasurer | 1.00 | $0 | $0 | $0 |
| Max Kringen | ||||
| Board Chair | 1.00 | $0 | $0 | $0 |
| Logan Little | ||||
| Member | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | Yes (true) | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | Yes (true) | Form1120PolFiledInd |
| Made Loans To From Officers | Yes (true) | MadeLoansToFromOfficersInd |
| Loans To From Officers | $60,807 | LoansToFromOfficersAmt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jennifer Burgard | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 8th St S | AddressLine1Txt |
| City | Fargo | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7012001194 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
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 Minus2 Years | $26,273 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,859 | CurrentTaxYearAmt |
| Total | $105,444 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $26,273 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $54,859 | CurrentTaxYearAmt |
| Total | $105,444 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $8,982 | SubstantialContributorsTotAmt |
| Public Support Total170 | $96,462 | PublicSupportTotal170Amt |
| Total Support | $105,444 | TotalSupportAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
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 G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
| Licensed States | ND | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Hope Forward | Event1Nm |
| Gross Receipts Event1 | $22,813 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $22,813 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $1,526 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $268 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $6,874 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,406 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $22,813 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $22,813 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,526 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $268 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $6,874 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,406 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,074 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $11,739 | NetIncomeSummaryAmt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kayla Sorum | PersonNm |
| Relationship With Org | Former Director | RelationshipWithOrgTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $60,807 | OriginalPrincipalAmt |
| Balance Due | $60,807 | BalanceDueAmt |
| Default | Yes (true) | DefaultInd |
| Board Or Committee Approval | false | BoardOrCommitteeApprovalInd |
| Written Agreement | false | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $60,807 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Description of other revenue Part I line 8 | Description AmountPPP Loan Forgiveness 11,700 |
| Description of other expenses Part I line 16 | Description AmountAdvertising 5,590Bank Fee 71Gifts 115Insurance 350Meal 1,065Office/Merchandise 755Parking 91Software 4,561License 661Interest 114Program Expenses 19,659Computer/Internet 554 |
| Description of other assets Part II line 24 | Category Beginning of Year End of YearLoans 838 60,154 |
| Description of total liabilities Part II line 26 | Category Beginning of Year End of YearCredit Cards 13,668 3,453Payroll Liabilities 2,757 16,287PPP Loan 11,700 0 |
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