FAIR HAVEN FOUNDATION INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- FAIR HAVEN FOUNDATION INC (EIN 26-0866646)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201923189349307167
- Schema version
- 2018v3.1
- 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 | 2019-11-14T12:59:36-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | 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 | 2018-01-01 | 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 | 2019-11-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JASON W SAUNDERS | PreparerPersonNm |
| PTIN | P01017602 | PTIN |
| Phone | 3177823070 | PhoneNum |
| Preparation | 2019-11-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.82.40.165 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-14 | IPDt |
| IP Tm | 12:59:36 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 4D07A41E99FCDF2E3A882532393B9A26997348EC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 4D07A41E99FCDF2E3A882532393B9A26997348EC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | 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 | $1,397,476 | 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 | 6 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $485,778 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,397,413 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $401 | PYInvestmentIncomeAmt |
| CY Investment Income | $63 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $486,179 | PYTotalRevenueAmt |
| CY Total Revenue | $1,397,476 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $117,851 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $165,615 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $22,850 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $284,010 | PYOtherExpensesAmt |
| CY Other Expenses | $291,385 | CYOtherExpensesAmt |
| PY Total Expenses | $401,861 | PYTotalExpensesAmt |
| CY Total Expenses | $457,000 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $84,318 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $940,476 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $361,037 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,301,431 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $82 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $360,955 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,301,431 | 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 | $365,599 | 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 | $365,599 | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 6 | 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 | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| LAURA SMALL | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY LUEBKER | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TRICIA TRICK-ECKERT | ||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JACQUELINE DAVIS | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AMANDA MILNER | ||||||
| EXECUTIVE DI | 40.00 | $76,000 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $76,000 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $1,397,413 | AllOtherContributionsAmt |
| Noncash Contributions | $885,000 | NoncashContributionsAmt |
| Total Contributions | $1,397,413 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63 | TotalRevenueColumnAmt |
| Exclusion | $63 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,397,476 | TotalRevenueColumnAmt |
| Exclusion | $63 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,000 | TotalAmt |
| Program Services | $60,800 | ProgramServicesAmt |
| Management And General | $11,400 | ManagementAndGeneralAmt |
| Fundraising | $3,800 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,177 | TotalAmt |
| Program Services | $61,741 | ProgramServicesAmt |
| Management And General | $11,577 | ManagementAndGeneralAmt |
| Fundraising | $3,859 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $760 | TotalAmt |
| Program Services | $608 | ProgramServicesAmt |
| Management And General | $114 | ManagementAndGeneralAmt |
| Fundraising | $38 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,678 | TotalAmt |
| Program Services | $9,342 | ProgramServicesAmt |
| Management And General | $1,752 | ManagementAndGeneralAmt |
| Fundraising | $584 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,925 | TotalAmt |
| Program Services | $13,540 | ProgramServicesAmt |
| Management And General | $2,539 | ManagementAndGeneralAmt |
| Fundraising | $846 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,219 | TotalAmt |
| Program Services | $26,575 | ProgramServicesAmt |
| Management And General | $4,983 | ManagementAndGeneralAmt |
| Fundraising | $1,661 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,448 | TotalAmt |
| Program Services | $38,759 | ProgramServicesAmt |
| Management And General | $7,267 | ManagementAndGeneralAmt |
| Fundraising | $2,422 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,093 | TotalAmt |
| Program Services | $7,274 | ProgramServicesAmt |
| Management And General | $1,364 | ManagementAndGeneralAmt |
| Fundraising | $455 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,193 | TotalAmt |
| Program Services | $7,354 | ProgramServicesAmt |
| Management And General | $1,379 | ManagementAndGeneralAmt |
| Fundraising | $460 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,520 | TotalAmt |
| Program Services | $86,016 | ProgramServicesAmt |
| Management And General | $16,128 | ManagementAndGeneralAmt |
| Fundraising | $5,376 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,059 | TotalAmt |
| Program Services | $1,647 | ProgramServicesAmt |
| Management And General | $309 | ManagementAndGeneralAmt |
| Fundraising | $103 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207 | TotalAmt |
| Program Services | $166 | ProgramServicesAmt |
| Management And General | $31 | ManagementAndGeneralAmt |
| Fundraising | $10 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,490 | TotalAmt |
| Program Services | $1,991 | ProgramServicesAmt |
| Management And General | $374 | ManagementAndGeneralAmt |
| Fundraising | $125 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,856 | TotalAmt |
| Program Services | $1,485 | ProgramServicesAmt |
| Management And General | $278 | ManagementAndGeneralAmt |
| Fundraising | $93 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| UTILITIES | $33,578 | $26,862 | $5,037 | $1,679 |
| CLEANING | $7,265 | $5,812 | $1,090 | $363 |
| EDUCATION | $4,028 | $3,223 | $604 | $201 |
| FURNISHINGS | $3,288 | $2,631 | $493 | $164 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,216 | TotalAmt |
| Program Services | $9,773 | ProgramServicesAmt |
| Management And General | $1,832 | ManagementAndGeneralAmt |
| Fundraising | $611 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,000 | TotalAmt |
| Program Services | $365,599 | ProgramServicesAmt |
| Management And General | $68,551 | ManagementAndGeneralAmt |
| Fundraising | $22,850 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $273,782 | BOYAmt |
| EOY | $217,144 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,071 | BOYAmt |
| EOY | $179,913 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $15,259 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $915,959 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,154 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,794 | BOYAmt |
| EOY | $886,805 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,390 | BOYAmt |
| EOY | $2,310 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $361,037 | BOYAmt |
| EOY | $1,301,431 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $360,955 | BOYAmt |
| EOY | $1,301,431 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $360,955 | BOYAmt |
| EOY | $1,301,431 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $361,037 | BOYAmt |
| EOY | $1,301,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $940,476 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
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 | $344,636 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $391,702 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $461,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $485,778 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,397,413 | CurrentTaxYearAmt |
| Total | $3,081,010 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $344,636 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $391,702 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $461,481 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $485,778 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,397,413 | CurrentTaxYearAmt |
| Total | $3,081,010 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $3,081,010 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$204 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $401 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $63 | CurrentTaxYearAmt |
| Total | $451 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,081,461 | TotalSupportAmt |
| Public Support CY170 | 0.99990 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99980 | 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 | $709,489 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,516 | DepreciationAmt |
| Book Value | $707,973 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,100 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,638 | DepreciationAmt |
| Book Value | $1,462 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $886,805 | TotalBookValueLandBuildingsAmt |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $885,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | APPRAISAL | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 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. |
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