2017-11-02T10:55:58-05:00 2017-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2016-07-01 261710013 MOSAIC HOUSING CORPORATION 17 MOSA 4028963884 4980 SOUTH 118TH STREET OMAHA NE 68137 KRISTIN ROSSOW PRESIDENT 4028963884 2017-10-30 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2017-10-30 16:14:58 CD P 283418A69B405FF99BFD473E52D2AE202F92D27A FCEDDD786A52D146CD6D5AF04BB3D8B974087028 2016 2021-01-29 14:40:06Z KRISTIN ROSSOW 4980 SOUTH 118TH STREET OMAHA NE 68137 58526 0 X WWW,MOSAICINFO.ORG X 2008 NE THE ORGANIZATION PROVIDES LOW INCOME AFFORDABLE HOUSING UNDER HUD SECTION 811 GUIDELINES. 5 5 0 0 0 0 2781 5242 48928 53218 54 66 159 0 51922 58526 0 0 0 0 0 0 0 0 0 102739 108823 102739 108823 -50817 -50297 1287642 1232017 16523 11195 1271119 1220822 THE ORGANIZATION PROVIDES LOW INCOME AFFORDABLE HOUSING UNDER HUD SECTION 811 GUIDELINES. 0 0 93556 53218 THE ORGANIZATION PROVIDES LOW INCOME HOUSING IN ACCORDANCE WITH HUD SECTION 811 GUIDELINES. 93556 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X KRISTIN ROSSOW 4028963884 4980 S 118 STREET OMAHA NE 68137 DEANNA WAGNER CHAIRPERSON 0.10 2.40 X X 0 0 0 JOAN NIEDFELDT VICE CHAIRPERSON 0.10 2.40 X X 0 0 0 ELIZABETH WOLLMAN DIRECTOR 0.10 2.00 X 0 0 0 BARBARA PETSKA DIRECTOR 0.10 2.00 X 0 0 0 MARY LASH ANDERSON DIRECTOR 0.10 2.00 X 0 0 0 CONRAD JAMES JR DIRECTOR THRU 10/1/16 0.10 2.40 X 0 0 0 KRISTIN ROSSOW PRESIDENT 0.50 39.50 X 0 144118 25894 DOLORES BANGERT PRESIDENT THRU 9/5/16 0.50 39.50 X 0 141293 15640 GREG PASKACH TREASURER/SECRETARY 0.50 39.50 X 0 80289 13334 0 365700 54868 0 0 1 0 0 5242 5242 RENTAL INCOME 531110 53218 53218 53218 66 66 58526 53218 0 66 X 5208 5208 91 91 7463 7463 17363 17363 4761 4761 17663 17663 196 196 50506 50506 3263 3263 2309 2309 108823 93556 15267 0 6566 3128 1562289 394995 1217800 1167294 63276 61595 1287642 1232017 12361 6805 4162 4390 16523 11195 X -178081 -228378 1449200 1449200 1271119 1220822 1287642 1232017 -50297 0 X X 0 1 X 1 1 1 X 205 198 2781 5242 8426 52864 47366 47442 48928 53218 249818 53069 47564 47442 51709 58460 258244 0 0 0 258244 50 55 58 54 66 283 50 55 58 54 66 283 9 159 168 53128 47619 47500 51922 58526 258695 0.99830 0.99820 0.00110 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 51727 51727 1510562 394995 1115567 1167294 TENANT SECURITY DEPOSITS 4390 4390 X 58526 0 58526 0 58526 108823 0 108823 0 108823 PART X, LINE 2: THE FOLLOWING FOOTNOTE IS TAKEN FROM THE CONSOLIDATED FINANCIAL STATEMENTS: ALL CONSOLIDATED AFFILIATED ENTITIES, EXCEPT FOR MOSAIC HOUSING CORP V, INC. AND EASE-E MEDICAL, INC., ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN MOSAIC'S TAX EXEMPT STATUS. MOSAIC RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. SUCH TAX POSITIONS, WHICH ARE MORE THAN 50% LIKELY OF BEING REALIZED, ARE MEASURED AT THEIR HIGHEST VALUE. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2017 AND 2016, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN DESCRIBED PREVIOUSLY. 1 0 0 0 0 0 0 0 0 KRISTIN ROSSOW PRESIDENT 0 142090 0 1525 0 503 0 4078 0 21816 0 170012 0 0 DOLORES BANGERT PRESIDENT THRU 9/5/16 0 75357 0 0 0 65936 0 1965 0 13675 0 156933 0 0 PART I, LINE 3 THE SALARIES OF DOLORES BANGERT AND KRISTIN ROSSOW ARE PAID BY MOSAIC, A RELATED ORGANIZATION. MOSAIC'S BOARD AND COMPENSATION COMMITTEE USE AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, AND A COMPENSATION SURVEY IN ESTABLISHING THEIR COMPENSATION. PART I, LINE 4A DOLORES BANGERT RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $65,499. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF MOSAIC, A RELATED ENTITY, APPOINTS BOARD MEMBERS FOR THIS ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY THE PRESIDENT AND TREASURER OF THE ORGANIZATION AND THEN SHARED WITH THE BOARD OF DIRECTORS PRIOR TO THE FORM 990 BEING ELECTRONICALLY FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER AND OFFICER ANNUALLY COMPLETES A CONFLICT OF INTEREST FORM. THE FORM IS PROVIDED TO MOSAIC'S SENIOR VP OF HUMAN RESOURCES FOR REVIEW AND POSSIBLE REPORTING TO MOSAIC'S BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC, UPON REQUEST, ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS. FORM 990, PART IX, LINE 11G REPAIRS CONTRACT: PROGRAM SERVICE EXPENSES 7,551. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,551. GROUNDS CONTRACT: PROGRAM SERVICE EXPENSES 4,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,870. PEST CONTROL CONTRACT: PROGRAM SERVICE EXPENSES 810. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 810. FIRE SYSTEM MONITORING & INSPECTION: PROGRAM SERVICE EXPENSES 4,012. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,012. UNIT TURNOVER EXPENSE: PROGRAM SERVICE EXPENSES 120. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120. FORM 990, PART XII, LINE 2C: THE BOARD ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND THE SELECTION PROCESS OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MOSAIC 4980 S 118 STREET OMAHA NE 68137 113669999 SERVICES FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES NE 501(C)(3) LINE 10 N/A 0 MOSAIC FOUNDATION 4980 S 118 STREET OMAHA NE 68137 363837360 FUNDRAISING & INVESTMENT ASSET MANAGEMENT NE 501(C)(3) LINE 12A, I MOSAIC 1 THE OAKS OF DUNN COUNTY 4980 S 118 STREET OMAHA NE 68137 391913323 SENIOR LIVING SERVICES WI 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION I 4980 S 118 STREET OMAHA NE 68137 363756911 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION II 4980 S 118 STREET OMAHA NE 68137 470773689 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION III 4980 S 118 STREET OMAHA NE 68137 470788396 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IV 4980 S 118 STREET OMAHA NE 68137 911823422 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VII 4980 S 118 STREET OMAHA NE 68137 470828015 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION VIII 4980 S 118 STREET OMAHA NE 68137 470828012 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION IX 4980 S 118 STREET OMAHA NE 68137 742838413 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION X 4980 S 118 STREET OMAHA NE 68137 742908789 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XI 4980 S 118 STREET OMAHA NE 68137 311706640 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XII 4980 S 118 STREET OMAHA NE 68137 481297244 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIII 4980 S 118 STREET OMAHA NE 68137 421626679 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIV 4980 S 118 STREET OMAHA NE 68137 204417891 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XV 4980 S 118 STREET OMAHA NE 68137 205765691 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVI 4980 S 118 STREET OMAHA NE 68137 205765731 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XVIII 4980 S 118 STREET OMAHA NE 68137 261710184 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XIX 4980 S 118 STREET OMAHA NE 68137 261710259 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XX 4980 S 118 STREET OMAHA NE 68137 264555206 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXI 4980 S 118 STREET OMAHA NE 68137 264555313 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXII 4980 S 118 STREET OMAHA NE 68137 273483415 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC HOUSING CORPORATION XXIII 4980 S 118 STREET OMAHA NE 68137 710875364 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING I 4980 S 118 STREET OMAHA NE 68137 202997161 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING II 4980 S 118 STREET OMAHA NE 68137 204417645 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF MACOMB I 4980 S 118 STREET OMAHA NE 68137 204841909 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC ILLINOIS HOUSING OF ROCKFORD I 4980 S 118 STREET OMAHA NE 68137 204841856 LOW INCOME HOUSING NE 501(C)(3) LINE 10 MOSAIC 1 MOSAIC VEBA 4980 S 118 STREET OMAHA NE 68137 383831874 EMPLOYEE WELFARE BENEFIT PLAN NE 501(C)(9) N/A MOSAIC 1 MOSAIC RESIDENTIAL SERVICES OF NEBRASKA LLC 4980 S 118 ST OMAHA NE 68137 271695051 LOW INCOME HOUSING NE N/A EASE-E MEDICALINC 731 SOUTH 8TH STREET CANON CITY CO 81212 470842353 SALE OF MEDICAL EQUIPMENT & SUPPLIES NE N/A C 1 MOSAIC HOUSING CORPORATION V 4980 S 118 ST OMAHA NE 68137 470805545 LOW INCOME HOUSING NE N/A C 1 BICO 4980 S 118 ST OMAHA NE 68137 CAPTIVE INSURANCE BD N/A C 1 CHARITABLE REMAINDER TRUSTS (4) INVESTMENT MANAGEMENT NE N/A T 1 CHARITABLE REMAINDER TRUST (1) INVESTMENT MANAGEMENT FL N/A T 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0