FAIR HAVEN FOUNDATION INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- FAIR HAVEN FOUNDATION INC (EIN 26-0866646)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-06-04
- IRS object ID
- 201811559349300631
- Schema version
- 2017v2.3
- 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 | 2018-06-04T14:20:17-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 2017-01-01 | 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 | 2018-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID M WINTERS | PreparerPersonNm |
| PTIN | P01084493 | PTIN |
| Phone | 3177823070 | PhoneNum |
| Preparation | 2018-06-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | 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 | $486,179 | 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 | 3 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $461,481 | PYContributionsGrantsAmt |
| CY Contributions Grants | $485,778 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21 | PYInvestmentIncomeAmt |
| CY Investment Income | $401 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $461,502 | PYTotalRevenueAmt |
| CY Total Revenue | $486,179 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $95,110 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $117,851 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $20,092 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $278,537 | PYOtherExpensesAmt |
| CY Other Expenses | $284,010 | CYOtherExpensesAmt |
| PY Total Expenses | $373,647 | PYTotalExpensesAmt |
| CY Total Expenses | $401,861 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $87,855 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $84,318 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $276,637 | TotalAssetsBOYAmt |
| Total Assets EOY | $361,037 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $82 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $276,637 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $360,955 | 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 | $321,491 | 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 | $321,491 | 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 | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 3 | 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 |
| 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 (6 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| LAURA SMALL | ||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JEFFREY LUEBKER | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TRICIA TRICK-ECKERT | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JACQUELINE DAVIS | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AARON T HACHERL | ||||||
| ADVISOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AMANDA MILNER | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $76,000 | $0 | $0 | |
| 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 | $485,778 | AllOtherContributionsAmt |
| Noncash Contributions | $400 | NoncashContributionsAmt |
| Total Contributions | $485,778 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $401 | TotalRevenueColumnAmt |
| Exclusion | $401 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $486,179 | TotalRevenueColumnAmt |
| Exclusion | $401 | 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 | $32,833 | TotalAmt |
| Program Services | $26,266 | ProgramServicesAmt |
| Management And General | $4,925 | ManagementAndGeneralAmt |
| Fundraising | $1,642 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $738 | TotalAmt |
| Program Services | $590 | ProgramServicesAmt |
| Management And General | $111 | ManagementAndGeneralAmt |
| Fundraising | $37 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,280 | TotalAmt |
| Program Services | $6,624 | ProgramServicesAmt |
| Management And General | $1,242 | ManagementAndGeneralAmt |
| Fundraising | $414 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,105 | TotalAmt |
| Program Services | $14,484 | ProgramServicesAmt |
| Management And General | $2,716 | ManagementAndGeneralAmt |
| Fundraising | $905 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,281 | TotalAmt |
| Program Services | $9,825 | ProgramServicesAmt |
| Management And General | $1,842 | ManagementAndGeneralAmt |
| Fundraising | $614 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,788 | TotalAmt |
| Program Services | $53,431 | ProgramServicesAmt |
| Management And General | $10,018 | ManagementAndGeneralAmt |
| Fundraising | $3,339 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,103 | TotalAmt |
| Program Services | $4,882 | ProgramServicesAmt |
| Management And General | $916 | ManagementAndGeneralAmt |
| Fundraising | $305 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,262 | TotalAmt |
| Program Services | $7,410 | ProgramServicesAmt |
| Management And General | $1,389 | ManagementAndGeneralAmt |
| Fundraising | $463 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,415 | TotalAmt |
| Program Services | $82,732 | ProgramServicesAmt |
| Management And General | $15,512 | ManagementAndGeneralAmt |
| Fundraising | $5,171 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41 | TotalAmt |
| Program Services | $33 | ProgramServicesAmt |
| Management And General | $6 | ManagementAndGeneralAmt |
| Fundraising | $2 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200 | TotalAmt |
| Program Services | $160 | ProgramServicesAmt |
| Management And General | $30 | ManagementAndGeneralAmt |
| Fundraising | $10 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,303 | TotalAmt |
| Program Services | $3,443 | ProgramServicesAmt |
| Management And General | $645 | ManagementAndGeneralAmt |
| Fundraising | $215 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,512 | TotalAmt |
| Program Services | $2,809 | ProgramServicesAmt |
| Management And General | $527 | ManagementAndGeneralAmt |
| Fundraising | $176 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| UTILITIES | $31,103 | $24,883 | $4,665 | $1,555 |
| CLEANING | $8,902 | $7,122 | $1,335 | $445 |
| SUPPLIES | $4,909 | $3,928 | $736 | $245 |
| EDUCATION | $3,813 | $3,050 | $572 | $191 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,273 | TotalAmt |
| Program Services | $9,019 | ProgramServicesAmt |
| Management And General | $1,691 | ManagementAndGeneralAmt |
| Fundraising | $563 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,861 | TotalAmt |
| Program Services | $321,491 | ProgramServicesAmt |
| Management And General | $60,278 | ManagementAndGeneralAmt |
| Fundraising | $20,092 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,215 | BOYAmt |
| EOY | $273,782 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,935 | BOYAmt |
| EOY | $84,071 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,458 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,664 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,097 | BOYAmt |
| EOY | $1,794 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,390 | BOYAmt |
| EOY | $1,390 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,637 | BOYAmt |
| EOY | $361,037 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $82 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $82 | 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 | $276,637 | BOYAmt |
| EOY | $360,955 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,637 | BOYAmt |
| EOY | $360,955 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,637 | BOYAmt |
| EOY | $361,037 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $84,318 | 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 | $274,574 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $344,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $391,702 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $461,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $485,778 | CurrentTaxYearAmt |
| Total | $1,958,171 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $274,574 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $344,636 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $391,702 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $461,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $485,778 | CurrentTaxYearAmt |
| Total | $1,958,171 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,958,171 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $55 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $170 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | -$204 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $401 | CurrentTaxYearAmt |
| Total | $443 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,958,614 | TotalSupportAmt |
| Public Support CY170 | 0.99980 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,458 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,664 | DepreciationAmt |
| Book Value | $1,794 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,794 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RETIREMENT PLAN PAYABLE | Desc |
| Amt | $82 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $82 | TotalLiabilityAmt |
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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