INTERFAITH CAREGIVERS OF POLK CNTY: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- INTERFAITH CAREGIVERS OF POLK CNTY (EIN 39-1837906)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-09
- IRS object ID
- 202243139349305394
- Schema version
- 2021v4.0
- Note
- A later return for the same period supersedes this one.
- 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 | 2022-11-09T17:22:40-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 411562398 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARLSONSV LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 KELLER AVE S | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 540011283 | 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 | 391837906 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERFAITH CAREGIVER OF POLK COUNTY | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INTE | BusinessNameControlTxt |
| Phone | 7154838500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 833 | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAN CARLSON | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 7154838500 | PhoneNum |
| Signature | 2022-11-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAN | PersonFirstNm |
| Person Last | CARLSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIRK A PRINDLE CPA | PreparerPersonNm |
| PTIN | P00456916 | PTIN |
| Phone | 7159544995 | PhoneNum |
| Preparation | 2022-11-08 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| 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 | JAN CARLSON | PrincipalOfficerNm |
| Gross Receipts | $279,363 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | INTERFAITHPOLK.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | COORDINATING VOLUNTEERS TO HELP SENIORS & ADULTS WITH DISABILITIES TO MAINTAIN THEIR INDEPENDENCE AT HOME IN POLK COUNTY WI | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 5 | TotalEmployeeCnt |
| Total Volunteers | 116 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $272,126 | PYContributionsGrantsAmt |
| CY Contributions Grants | $274,200 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,611 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,163 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $291,737 | PYTotalRevenueAmt |
| CY Total Revenue | $279,363 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $167,175 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $176,821 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $37,569 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $57,719 | PYOtherExpensesAmt |
| CY Other Expenses | $63,965 | CYOtherExpensesAmt |
| PY Total Expenses | $224,894 | PYTotalExpensesAmt |
| CY Total Expenses | $240,786 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $66,843 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $38,577 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $466,352 | TotalAssetsBOYAmt |
| Total Assets EOY | $551,068 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $43,419 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,888 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $422,933 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $539,180 | NetAssetsOrFundBalancesEOYAmt |
| Mission | COORDINATING VOLUNTEERS TO HELP SENIORS & ADULTS WITH DISABILITIES TO MAINTAIN THEIR INDEPENDENCE AT HOME IN POLK COUNTY WI | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $111,436 | ExpenseAmt |
| Desc | STAFF PROVIDES SUPPORT, EDUCATION, REFERRALS & COORDINATION OF VOLUNTEER SERVICES FOR SENIORS, ADULTS WITH DISABILITIES, AND THEIR CAREGIVERS. THESE NON-MEDICAL SERVICES WERE PROVIDED AT NO COST TO 286 RESIDENTS OF POLK COUNTY, WI. OUR SERVICES ALLOW ADULTS TO MAINTAIN THEIR INDEPENDENCE, DIGNITY, AND QUALITY OF LIFE AT HOME, EVEN DURING COVID-19. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $39,148 | ExpenseAmt |
| Desc | COORDINATION OF VOLUNTEERS TO PROVIDE 4,439 RIDES FOR ACCESS TO FOOD, MEDICAL, GOVERNMENT SERVICES & OTHER LOCAL & REGIONAL TRIPS - INCLUDING GROCERIES, DIALYSIS, CANCER, MEDICAL, DENTAL, COUNSELING, ERRANDS, FOOD SHELF, HAIRCUTS, TAX PREP, & MORE AT NO CHARGE. OUR VOLUNTEERS DONATED 3,949 HRS, & 65,590 MILES DURING 2021, WHILE ABIDING BY COVID-19 MANDATE PRECAUTIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $22,181 | ExpenseAmt |
| Desc | COORDINATION OF VOLUNTEERS TO PROVIDE 3,311 SERVICES, INCLUDING FRIENDLY VISITS, RESPITE CARE, PHONE SUPPORT, MINOR REPAIRS, LIGHT HOUSEKEEPING, SEASONAL YARD WORK, DELIVERY OF FOOD BOXES & MEDICATIONS, ERRANDS, READING, RISE AND SHINE CHECK IN CALLS & MORE AT NO COST. OUR VOLUNTEERS DONATED 979 HOURS & 6,660 MILES TO HELP PEOPLE AGE IN PLACE AT HOME EVEN THROUGHOUT COVID-19. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $172,765 | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5 | 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 |
| 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LUANN OLSON | PersonNm |
| Phone | 7154838500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 US HWY 8 STE 1 | AddressLine1Txt |
| City | ST CROIX FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54024 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| LESLIE LARSEN | |||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARJEAN SIEBERER | |||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CHARVEY SPENCER | |||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAN CARLSON | |||||||
| VICE PRESIDE | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CINDY GLOCKE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRYAN SHOBE | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GURINE GALL | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $274,200 | AllOtherContributionsAmt |
| Total Contributions | $274,200 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,163 | TotalRevenueColumnAmt |
| Exclusion | $5,163 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $279,363 | TotalRevenueColumnAmt |
| Exclusion | $5,163 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,140 | TotalAmt |
| Program Services | $123,105 | ProgramServicesAmt |
| Management And General | $16,414 | ManagementAndGeneralAmt |
| Fundraising | $24,621 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,681 | TotalAmt |
| Program Services | $8,623 | ProgramServicesAmt |
| Management And General | $2,283 | ManagementAndGeneralAmt |
| Fundraising | $1,775 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455 | TotalAmt |
| Management And General | $455 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,437 | TotalAmt |
| Management And General | $1,437 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,487 | TotalAmt |
| Program Services | $5,615 | ProgramServicesAmt |
| Management And General | $1,123 | ManagementAndGeneralAmt |
| Fundraising | $749 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,837 | TotalAmt |
| Program Services | $4,694 | ProgramServicesAmt |
| Management And General | $720 | ManagementAndGeneralAmt |
| Fundraising | $423 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,322 | TotalAmt |
| Program Services | $15,242 | ProgramServicesAmt |
| Management And General | $3,048 | ManagementAndGeneralAmt |
| Fundraising | $2,032 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,600 | TotalAmt |
| Program Services | $7,200 | ProgramServicesAmt |
| Management And General | $1,440 | ManagementAndGeneralAmt |
| Fundraising | $960 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281 | TotalAmt |
| Program Services | $212 | ProgramServicesAmt |
| Management And General | $42 | ManagementAndGeneralAmt |
| Fundraising | $27 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,545 | TotalAmt |
| Management And General | $2,545 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| FUNDRAISING EXPENSES | $6,982 | $6,982 | ||
| HOUSEKEEPING EXPENSE | $4,069 | $4,069 | ||
| VOLUNTEER RETENTION | $3,346 | $3,346 | ||
| OTHER BUSINESS FEES | $945 | $945 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $659 | TotalAmt |
| Program Services | $659 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,786 | TotalAmt |
| Program Services | $172,765 | ProgramServicesAmt |
| Management And General | $30,452 | ManagementAndGeneralAmt |
| Fundraising | $37,569 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,927 | BOYAmt |
| EOY | $88,194 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,423 | BOYAmt |
| EOY | $88,740 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,685 | BOYAmt |
| EOY | $16,813 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $259,317 | BOYAmt |
| EOY | $357,321 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,352 | BOYAmt |
| EOY | $551,068 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,019 | BOYAmt |
| EOY | $11,888 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,400 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,419 | BOYAmt |
| EOY | $11,888 | 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 | $422,933 | BOYAmt |
| EOY | $539,180 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,933 | BOYAmt |
| EOY | $539,180 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,352 | BOYAmt |
| EOY | $551,068 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $38,577 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $14,070 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $63,600 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,666 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $215,352 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $337,147 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $272,126 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $274,200 | CurrentTaxYearAmt |
| Total | $1,328,491 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $301 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,451 | CurrentTaxYearMinus2YearsAmt |
| Total | $2,752 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,666 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $215,653 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $339,598 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $272,126 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $274,200 | CurrentTaxYearAmt |
| Total | $1,331,243 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,331,243 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,930 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,805 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,380 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,611 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,653 | CurrentTaxYearAmt |
| Total | $35,379 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,930 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,805 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,380 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,611 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,653 | CurrentTaxYearAmt |
| Total | $35,379 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $231,596 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $217,458 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $345,978 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $291,737 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $279,853 | CurrentTaxYearAmt |
| Total | $1,366,622 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97410 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97580 | PublicSupportPY509Pct |
| Investment Income CY | 0.03000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Invst Program Related Org InvstProgramRelatedOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CDS - VARIOUS | $214,543 | F |
| THRIVENT CHARITABLE INVESTMENT | $126,488 | F |
| ST CROIX VALLEY FOUNDATION | $16,290 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $357,321 | TotalBookValueProgramRltdAmt |
| Total Rev Etc Audited Fincl Stmt | $279,363 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $279,363 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $279,363 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $240,786 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $240,786 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $240,786 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 4, PART XIII | FormAndLineReferenceDesc |
| Explanation | FOR THE CONTINUED ABILITY TO SERVE THE AGING AND DISABLED COMMUNITIES OF POLK COUNTY WITH SERVICES TO ENABLE THEM TO REMAIN IN THEIR HOMES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | ORGANIZATION'S PROCESS IS TO REVIEW FORM 990 BY FINANCE COMMITTEE AND PRESENTED TO BOARD FOR APPROVAL PRIOR TO FILING |
| FORM 990, PAGE 6, PART VI, LINE 12C | ENFORCEMENT OF CONFLICTS POLICY ANNUAL REVIEW AND DISCLOSURE SIGNED BY OFFICERS, DIRECTORS AND EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION PROCESS FOR TOP OFFICIAL ANNUAL SALARY, INCREASES AND BONUSES RECOMMENDED BY PERSONNEL COMMITTEE TO FINANCE COMMITTEE TO BOARD OF DIRECTORS FOR APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION PROCESS FOR OFFICERS ANNUAL SALARY, INCREASES AND BONUSES RECOMMENDED BY PERSONNEL COMMITTEE TO FINANCE COMMITTEE TO BOARD OF DIRECTORS FOR APPROVAL |
| FORM 990, PAGE 6, PART VI, LINE 19 | FINANCIAL STATEMENTS AVAILABLE AT ANNUAL MEETING & MONTHLY BOARD MEETINGS, OTHER DOCUMENTS AVAILABLE AT MONTHLY MEETINGS AND BY REQUEST. |
| FORM 990, PART XI, LINE 9 | PPP FORGIVENESS 63,600 |
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