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CHEYENNE H A V E N INC: Form 990EZ, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CHEYENNE H A V E N INC (EIN 83-0306362)
Tax period
2016-07-01 to 2017-06-30
Filed
2017-12-15
IRS object ID
201733499349200233
Schema version
2016v3.0
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

FieldValueIRS element (for citing)
Return2017-12-15T15:27:41-06:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010724563PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ANTON COLLINS MITCHELL LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1505 SOUTH 3RD STREET SUITE 100AddressLine1Txt
CityLARAMIECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82070ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN830306362EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHEYENNE HAVEN INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHEYBusinessNameControlTxt
Phone3076378869PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11780 WESTLAND ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82001ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFF GARDNERPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3076378869PhoneNum
Signature2017-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROLF PETERSONPreparerPersonNm
PTINP00297941PTIN
Phone3077551040PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.241.164.20IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-12-05IPDt
IP Tm15:39:28IPTm
IP TimezoneMSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4D4F778EF74C1C2CE2DF814272F449BFFD3CC691AtSubmissionCreationDeviceId
At Submission Filing Device Id4D4F778EF74C1C2CE2DF814272F449BFFD3CC691AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Website AddressN/AWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$39,074GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$22,461ContributionsGiftsGrantsEtcAmt
Program Service Revenue$15,909ProgramServiceRevenueAmt
Investment Income$6InvestmentIncomeAmt
Other Revenue Total$698OtherRevenueTotalAmt
Total Revenue$39,074TotalRevenueAmt
Fees And Other Pymt To Ind Cntrct$11,094FeesAndOtherPymtToIndCntrctAmt
Other Expenses Total$31,292OtherExpensesTotalAmt
Total Expenses$42,386TotalExpensesAmt
Excess Or Deficit For Year-$3,312ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$127,734NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$124,422NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$764BOYAmt
EOY$14,914EOYAmt

Land And Buildings LandAndBuildingsGrp

FieldValueIRS element (for citing)
BOY$40,920BOYAmt
EOY$40,920EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$91,487BOYAmt
EOY$69,645EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$133,171BOYAmt
EOY$125,479EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,437BOYAmt
EOY$1,057EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$127,734BOYAmt
EOY$124,422EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeHOUSING FOR HANDICAPPED ADULTSPrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomHOUSING FACILITIES FOR HANDICAPPED ADULTS, ESPECIALLY LOW INCOME.DescriptionProgramSrvcAccomTxt
Grants And Allocations$0GrantsAndAllocationsAmt
Program Service Expenses$42,386ProgramServiceExpensesAmt
FieldValueIRS element (for citing)
Total Program Service Expenses$42,386TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
JEFF GARDNER
PRESIDENT1.00$0$0$0
WAYNE HANSEN
CHAIRMAN1.00$0$0$0
BOB GODFREY
VICE CHAIRMAN1.00$0$0$0
TERRI LORENZON
SECRETARY/ TREASURER1.00$0$0$0
JIM O'CONNOR
BOARDMEMBER1.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAGIC CITY ENTERPRISESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11780 WESTLAND ROADAddressLine1Txt
CityCHEYENNECityNm
State AbbreviationWYStateAbbreviationCd
ZIP82001ZIPCd
FieldValueIRS element (for citing)
Phone3076378869PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,591CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,248CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,112CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$18,919CurrentTaxYearMinus1YearAmt
Current Tax Year$22,461CurrentTaxYearAmt
Total$96,331TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,707CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,599CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,018CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,190CurrentTaxYearMinus1YearAmt
Current Tax Year$15,915CurrentTaxYearAmt
Total$80,429TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,298CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,847CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,130CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,109CurrentTaxYearMinus1YearAmt
Current Tax Year$38,376CurrentTaxYearAmt
Total$176,760TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$176,760PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,298CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,847CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$36,130CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,109CurrentTaxYearMinus1YearAmt
Current Tax Year$38,376CurrentTaxYearAmt
Total$176,760TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOMEDESCRIPTION: FINANCIAL REVENUE. AMOUNT: 6.
FORM 990-EZ, PART I, LINE 8 - OTHER REVENUEDESCRIPTION: PRIOR PERIOD ADJUSTMENTS. AMOUNT: 698.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: MISC. VACANCIES. AMOUNT: 20. DESCRIPTION: OFFICE EXPENSES. AMOUNT: 3,865. DESCRIPTION: MANAGEMENT FEES. AMOUNT: 1,678. DESCRIPTION: MISC. ADMIN EXPENSES. AMOUNT: 25. DESCRIPTION: UTILITIES. AMOUNT: 5,272. DESCRIPTION: CONTRACTS. AMOUNT: 5,150. DESCRIPTION: GARBAGE AND TRASH REMOVAL. AMOUNT: 586. DESCRIPTION: SUPPLIES. AMOUNT: 344. DESCRIPTION: NON-INVESTMENT DEPRECIATION EXPENSE. AMOUNT: 11,799. DESCRIPTION: PROPERTY INSURANCE. AMOUNT: 2,553. TOTAL TO FORM 990-EZ, LINE 16: 31,292.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETSDESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 9,888. END OF YEAR AMOUNT: 0. DESCRIPTION: TENNANT DEPOSITS. BEG. OF YEAR AMOUNT: 1,253. END OF YEAR AMOUNT: 1,526. DESCRIPTION: REPLACEMENT RESERVES. BEG. OF YEAR AMOUNT: 8,780. END OF YEAR AMOUNT: 8,347. DESCRIPTION: RESIDUAL RECEIPTS. BEG. OF YEAR AMOUNT: 16,863. END OF YEAR AMOUNT: 16,868. DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 54,703. END OF YEAR AMOUNT: 42,904.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIESDESCRIPTION: ACCOUNTS PAYABLE AND ACCRUED EXPENSES. BEG. OF YEAR AMOUNT: 3,772. END OF YEAR AMOUNT: 0. DESCRIPTION: TENANT SECURITY DEPOSITS. BEG. OF YEAR AMOUNT: 1,665. END OF YEAR AMOUNT: 1,057.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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