2018-05-14T12:17:46-05:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-01-01 721524988 ANNE CARLSEN CENTER FOUNDATION ANNE 8005685175 701 3RD STREET NW BOX 8000 JAMESTOWN ND 58402 TIM EISSINGER CEO 8005685175 2018-05-10 1 KAREN GRIES P00078514 6123764500 2017 2022-09-23 18:48:47Z TIM EISSINGER 701 3RD STREET NW BOX 8000 JAMESTOWN ND 58402 9674278 0 X WWW.ANNECENTER.ORG X 2003 ND TO SUPPORT THE MISSION AND PURPOSE OF THE ANNE CARLSEN CENTER. 10 10 0 67 0 0 1835786 3444722 0 0 1151089 1504758 15796 2964 3002671 4952444 95915 60120 0 0 505915 533721 0 0 1062622 414603 528901 1016433 1122742 1986238 3829702 47371715 53482167 102253 76950 47269462 53405217 TO SUPPORT THE ANNE CARLSEN CENTER, NORTH DAKOTA BY SOLICITING, RECEIVING, HOLDING, INVESTING, ADMINISTERING, DISTRIBUTING AND DISBURSING DONATED FUNDS AND ANY AND ALL TYPES OF DONATED OR PERSONAL PROPERTY IN SUPPORT OF THAT MISSION. 0 0 60120 60120 TO SUPPORT THE MISSION AND PURPOSE OF THE ANNE CARLSEN CENTER. 60120 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN WA ND WI X DANIEL JOHNSON 7013642663 701 3RD ST NW JAMESTOWN ND 58401 CASEY STOUDT BOARD CHAIR 2.00 2.00 X X 0 0 0 BRUCE FURNESS BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 NICOLE POOLMAN TREASURER 1.50 1.50 X X 0 0 0 MATTHEW HANSON SECRETARY 1.50 1.50 X X 0 0 0 HARVEY HUBER IMMEDIATE PAST CHAIR 1.00 1.00 X X 0 0 0 THOMAS ROLFSTAD BOARD MEMBER 1.00 1.00 X 0 0 0 DR TAMARA MATHISON BOARD MEMBER 1.00 1.00 X 0 0 0 ALEX SCHWEITZER BOARD MEMBER 1.00 1.00 X 0 0 0 KRISTI MISHLER-WILFAHRT BOARD MEMBER 1.00 1.00 X 0 0 0 DR MYRA QUANRUD EX-OFFICIO 1.00 1.00 X 0 0 0 TIMOTHY EISSINGER CEO 10.00 41.00 X 0 203267 39866 ERIC MONSON CEO 10.00 40.00 X 0 273688 35721 STEPHANIE NELSON COO 10.00 41.00 X 0 131820 8171 DANIEL JOHNSON CFO 10.00 41.00 X 0 99078 28570 PATRICK KIRBY CHIEF DEVELOPMENT OFFICER 10.00 40.00 X 91009 0 3709 ERIC WILKIE CHIEF DEVELOPMENT OFFICER 10.00 40.00 X 0 0 0 PATRICIA OLSON CHIEF HUMAN RESOURCES OFFICER 10.00 41.00 X 0 89808 8528 KRESHA WIEST DIRECTOR OF MGMT SYSTEMS 10.00 40.00 X 0 123467 6338 91009 921128 130903 12 0 1 0 0 54044 3390678 8655 3444722 1759784 1759784 4444005 4699031 -255026 -255026 -255026 25767 54044 22803 2964 2964 4952444 0 0 1507722 60120 60120 94718 94718 334382 334382 13164 13164 58202 58202 33255 33255 108741 108741 53907 53907 43101 43101 4480 4480 21272 21272 88 88 3150 3150 BAD DEBT EXPENSE 147000 147000 ALLOCATION OF CENTER EX 80816 80816 MICELLANEOUS EXPENSES 50715 50715 REPAIRS AND MAINTENANCE 14132 14132 1499 1499 1122742 60120 0 1062622 19415 729173 137713 995060 100784 95192 0 5592 23561430 22961873 5690274 5308471 17962883 23481998 47371715 53482167 27361 25537 74892 51413 102253 76950 X 40148916 44044433 1440971 2312355 5679575 7048429 47269462 53405217 47371715 53482167 X 3829702 2155777 150276 X 0 1 X 1 0 X 1470746 2451161 1940823 1835786 3444722 11143238 1470746 2451161 1940823 1835786 3444722 11143238 1280633 9862605 1084257 1400219 1006085 1159690 1759784 6410035 17553273 170186 0.56190 0.54200 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2354282 191083 2545365 2158913 95000 100369 2354282 1850104 351866 -43057 2158913 1486613 316302 47189 1850104 1279919 95200 111494 1486613 0.14980 0.28490 0.56530 0 0 100784 95192 5592 5592 TRUST INTERESTS 4914740 F TIMBER 307731 F MINERAL RIGHTS 86000 C 5308471 RELATED PARTY RECEIVABLES 22864288 BEQUEST RECEIVABLE 617710 23481998 ANNUITIES PAYABLE 51413 51413 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT THE MISSION OF ANNE CARLSEN CENTER. PART X, LINE 2: THE CENTER AND FOUNDATION ARE ORGANIZED AS NORTH DAKOTA NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). ANNE CARLSEN UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. ANNE CARLSEN BELIEVES THEY ARE COMPLIANT WITH ALL IRS REGULATIONS AND AS OF DECEMBER 31, 2017, HAS NOT RECORDED A TAX LIABILITY FOR A TAX UNCERTAINTY. ANNE CARLSEN'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. ANNE CARLSEN IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES REVENUE FROM AFFILATE REPORTED ON SEPARATE RETURN CHANGE IN VALUE OF ANNUITIES CHANGE IN VALUE OF TRUSTS PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES EXPENSES FROM AFFILIATE REPORTED ON SEPARATE RETURN GOLF TOURNAMENT 29725 20325 9400 653 5500 1650 903 545 SUITS & SANDALS 25313 11741 13572 350 1346 3362 1370 75 3 24773 21978 2795 755 2231 2504 733 826 79811 54044 25767 1758 9077 7516 3006 1446 22803 2964 0 ANNE CARLSEN CENTER 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 870694180 501(C)(3) 60120 N/A N/A OPERATIONAL SUPPORT 1 0 0 0 0 0 0 0 0 0 0 TIMOTHY EISSINGER CEO 0 203267 0 0 0 0 0 8344 0 31522 0 243133 0 0 ERIC MONSON CEO 0 273688 0 0 0 0 0 8873 0 26848 0 309409 0 0 PART I, LINE 3 THE FOUNDATION RELIED ON A RELATED ORGANIZATION TO DETERMINE THE COMPENSATION FOR THE CEO WHICH INCLUDED THE FOLLOWING PRACTICES: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. FORM 990, PART I, LINE 1 FOR A READER TO FULLY UNDERSTAND THE ACTIVITY AND PROGRAMS OF THE ANNE CARLSEN CENTER FOUNDATION, MANAGEMENT RECOMMENDS THAT THE READER ALSO REVIEW THE ANNE CARLSEN CENTER FORM 990. FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNANCE COMMITTEE CONSISTS OF THE CHAIR, VICE CHAIR, PAST CHAIR, CORPORATE TREASURER AND CORPORATE SECRETARY. THE GOVERNANCE COMMITTEE HAS THE POWER TO TRANSACT ALL BUSINESS OF THE FOUNDATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION SO TAKEN DOES NOT CONFLICT WITH THE POLICIES AND EXPRESS WISHES OF THE BOARD OF TRUSTEES, AND THE COMMITTEE REFERS ALL MATTERS OF MAJOR IMPORTANCE TO THE FULL BOARD. MINUTES ARE TAKEN BY THE GOVERNANCE COMMITTEE AND SUBMITTED TO THE FULL BOARD. THE COMMITTEE SHALL BE RESPONSIBLE FOR BOARD DEVELOPMENT, NOMINATING BOARD MEMBERS, AND GOVERNANCE POLICIES. FORM 990, PART VI, SECTION A, LINE 6 THE FOUNDATION'S SOLE MEMBER IS ANNE CARLSEN CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, ANNE CARLSEN CENTER, APPOINTS THE BOARD OF TRUSTEES OF THE FOUNDATION. THE SOLE MEMBER DETERMINES THE NUMBER OF, APPOINTS, AND MAY REMOVE, WITH OR WITHOUT CAUSE, ALL OF THE OFFICERS OF THE FOUNDATION, EXCEPT THE BOARD CHAIR AND VICE CHAIR, WHO SHALL BE ELECTED BY THE BOARD OF TRUSTEES OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER MUST APPROVE ALL BYLAWS AND AMENDMENTS TO BYLAWS AND AMENDMENTS TO ARTICLES OF INCORPORATION OF THE FOUNDATION; APPROVES THE FOUNDATION'S ANNUAL BUDGET; AND APPROVES ALL DISTRIBUTIONS AND DISBURSEMENTS FROM THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD CHAIR, CEO AND CFO CONDUCTED A DETAILED REVIEW OF THE FORM 990. THE FORM 990 IS THEN ELECTRONICALLY FORWARDED TO THE FULL BOARD FOR REVIEW AND APPROVAL BEFORE IT IS FILED WITH IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD. THE PURPOSE OF THIS POLICY IS TO ENSURE IDENTIFICATION AND RESOLUTION OF THOSE INSTANCES IN WHICH GOVERNING BOARD MEMBERS, OFFICERS, EMPLOYEES AND OTHER AGENTS OR REPRESENTATIVES OF THE FOUNDATION (AND ITS AFFILIATES AND SUBSIDIARIES) MAY FIND THEMSELVES IN CIRCUMSTANCES GIVING RISE TO A POTENTIAL OR ACTUAL CONFLICT OF INTEREST. TO PROTECT THE FOUNDATION'S INTEREST IN SUCH SITUATIONS, AND TO PROVIDE FOR ADEQUATE REPORTING MECHANISMS, THE FOUNDATION WILL NOT ENTER INTO ANY TRANSACTION OR ARRANGEMENT WITH ANY ENTITY IN WHICH ANY BOARD MEMBER, OFFICER, EMPLOYEE OR AGENT THAT HAS A FINANCIAL INTEREST UNLESS SUCH TRANSACTION OR ARRANGEMENT IS FULLY DISCLOSED TO, AND APPROVED BY THE PRESIDENT/CEO (OR THE BOARD, IF THE PRESIDENT/CEO OR A BOARD MEMBER HAS THE FINANCIAL INTEREST). AFTER DISCLOSURE OF THE FINANCIAL INTEREST OR FIDUCIARY RESPONSIBILITY AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINAL DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ALL PROCEEDINGS RELATED TO CONFLICTS OF INTEREST ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF TRUSTS 200,492. CHANGE IN VALUE OF GIFT ANNUITIES -73,019. SPECIAL EVENT EXPENSE 22,803. ANNE CARLSEN CENTER 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 870694180 EDUCATIONAL, RESIDENTIAL, MEDICAL AND THERAPY SERVICES FOR CHILDREN ND 501(C)(3) LINE 2 N/A 0 NIERLING ANNE CARLSEN CENTER TRUST 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 912004887 PRIVATE FOUNDATION ND 501(C)(3) PF ANNE CARLSEN CENTER 0 BRIGHT BEGINNINGS LEARNING CENTER 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 474746436 CHILD CARE CENTER ND 501(C)(3) LINE 10 ANNE CARLSEN CENTER 0 PERPETUAL TRUSTS (2) 701 3RD STREET NW BOX 8000 JAMESTOWN ND 58402 INVESTMENT ND N/A T 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1