2017-09-01T15:56:52-05:00 2016-12-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2016-01-01 300021977 LITTLE STAR CENTER INC LITT 3172492242 12650 HAMILTON CROSSING BLVD CARMEL IN 46032 WILLIAM BOWER CHAIRMAN OF THE BOARD 3172492242 2017-08-22 1 SCOTT A SCHUSTER P00019243 3175802000 2017-08-22 64.132.79.19 2017-08-22 17:51:01 ED P C582CFFDC820BDBD0C0BBF31C4E1942BE5433CEA C582CFFDC820BDBD0C0BBF31C4E1942BE5433CEA 2016 2021-01-29 14:40:06Z WILLIAM BOWER 12650 HAMILTON CROSSING BLVD CARMEL IN 46032 13057533 0 X WWW.LITTLESTARCENTER.ORG X 2001 IN TO PROVIDE A STRUCTURED, SENSORY-FRIENDLY FACILITY WHERE CHILDREN WITH AUTISM RECEIVE INDIVIDUALIZED THERAPEUTIC INTERVENTION. BASED ON THE FUNDAMENTAL PRINCIPLES OF APPLIED BEHAVIOR ANALYSIS (ABA), LITTLE STAR PROVIDES AN ATMOSPHERE WHERE CHILDREN, THERAPISTS, AND FAMILIES CAN INTERACT, SUPPORT EACH OTHER AND RECEIVE ON-GOING TRAINING SO THAT EACH CHILD CAN REACH THEIR FULL POTENTIAL AT HOME AND IN A VARIETY OF SETTINGS OUTSIDE OF THERAPY. 5 5 355 0 0 0 70827 98155 9563360 12774344 -13741 21521 14197 27725 9634643 12921745 0 0 0 0 6916433 9006668 0 0 44216 2240397 3069578 9156830 12076246 477813 845499 3407452 4327904 50947 105671 3356505 4222233 X TO PROVIDE A STRUCTURED, SENSORY-FRIENDLY FACILITY WHERE CHILDREN WITH AUTISM RECEIVE INDIVIDUALIZED THERAPEUTIC INTERVENTION. BASED ON THE FUNDAMENTAL PRINCIPLES OF APPLIED BEHAVIOR ANALYSIS (ABA), LITTLE STAR PROVIDES AN ATMOSPHERE WHERE CHILDREN, THERAPISTS, AND FAMILIES CAN INTERACT, SUPPORT EACH OTHER AND RECEIVE ON-GOING TRAINING SO THAT EACH CHILD CAN REACH THEIR FULL POTENTIAL AT HOME AND IN A VARIETY OF SETTINGS OUTSIDE OF THERAPY. 0 0 10193878 12806219 PROVIDE YEAR-ROUND THERAPEUTIC INTERVENTION FOR CHILDREN DIAGNOSED WITH AUTISM SPECTRUM DISORDER BASED ON THE SCIENCE OF APPLIED BEHAVIOR ANALYSIS (ABA). 10193878 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 1 355 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 0 0 IN X DWAYNE MCCOY 3172492242 12650 HAMILTON CROSSING BLVD CARMEL IN 46032 WILLIAM BOWER CHAIRMAN 6.00 X X 0 0 0 MIKE BOATRIGHT BOARD MEMBER 1.00 X 0 0 0 ROSE WOLFIN BOARD MEMBER 1.00 X 0 0 0 MICHELE TRIVEDI BOARD MEMBER 2.00 X 0 0 0 JULIA CARPENTER BOARD MEMBER 1.00 X 0 0 0 MARY ROSSWURM EXECUTIVE DIRECTOR 50.00 X 200049 0 17231 DWAYNE MCCOY CHIEF FINANCIAL OFFICER 50.00 X 95860 0 6436 WILLIAM T COURTNEY CHIEF OPERATING OFFICER 50.00 X 104337 0 6900 BREANNE HARTLEY SENIOR CLINICAL DIRECTOR 45.00 X 105232 0 5392 505478 0 35959 3 0 1 0 0 20089 78066 98155 THERAPEUTIC SERVICES 621400 12774344 12774344 12774344 21223 21223 131936 131638 298 298 298 0 20089 4150 -4150 -4150 OTHER INCOME 900099 31875 31875 31875 12921745 12806219 0 17371 541437 176909 343434 21094 7877854 7299270 564715 13869 587377 489485 95967 1925 49241 49241 10925 10925 7700 7700 11175 11175 15131 15131 90101 75336 14522 243 98384 82262 15857 265 778513 700662 77851 81498 73348 8150 151529 136377 15152 726806 421467 303681 1658 MARKETING & AWARENESS 206111 184214 21534 363 BAD DEBT EXPENSE 165365 165365 CONTRACT SERVICES 140479 130105 10374 CENTER SUPPLIES 131077 131077 405543 293366 107378 4799 12076246 10193878 1838152 44216 1291097 778586 1215110 1228677 0 35656 24776 71713 1479660 548766 680754 930894 195715 1282378 3407452 4327904 50947 105671 50947 105671 X 3356505 4222233 3356505 4222233 3407452 4327904 845499 20229 0 X 1 X 0 0 0 X 5536 18468 44038 70827 98155 237024 6196418 5894412 6829448 9563360 12774344 41257982 6201954 5912880 6873486 9634187 12872499 41495006 0 0 0 41495006 45659 41067 29033 8175 21223 145157 45659 41067 29033 8175 21223 145157 3684 13405 11705 16934 31875 77603 6251297 5967352 6914224 9659296 12925597 41717766 0.99470 0.99440 0.00350 0.00420 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2012 AMOUNT: $ 3,684. 2013 AMOUNT: $ 13,405. 2014 AMOUNT: $ 11,705. 2015 AMOUNT: $ 16,934. 2016 AMOUNT: $ 31,875. 1113050 440785 672265 144836 60519 84317 221774 47462 174312 930894 X PART X, LINE 2: LITTLE STAR IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, LITTLE STAR HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME DURING 2016 AND 2015. LITTLE STAR FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION TAX RETURNS. LITTLE STAR IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2013. BOARD BREAKFAST 20089 20089 2790 1360 20089 20089 2790 1360 4150 -4150 X X 1 0 0 0 0 0 0 0 0 MARY ROSSWURM EXECUTIVE DIRECTOR 193049 0 7000 0 0 0 0 0 17231 0 217280 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE REVIEWED BY THE CHAIRMAN OF THE BOARD AND EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 12C IN ORDER TO MONITOR AND ENFORCE THE CONFLICT OF INTEREST POLICY, LITTLE STAR CENTER OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CERTIFICATION AND DISCLOSURE FORM ANNUALLY. SPECIFICALLY, EACH PERSON IS CERTIFYING THAT HE/SHE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS THAT LITTLE STAR CENTER IS A CHARITABLE ORGANIZATION AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION STATUS IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES AND NOT ENGAGE IN ACTIVITIES AND TRANSACTIONS THAT PROVIDE IMPERMISSIBLE BENEFITS TO INDIVIDUALS OR ENTITIES. FURTHER, THE CERTIFICATION AND DISCLOSURE FORM REQUIRES THAT EACH INDIVIDUAL EITHER CERTIFY THAT HE/SHE HAS NO ACTUAL OR POSSIBLE CONFLICT OF INTEREST TO REPORT OR TO DESCRIBE ANY RELATIONSHIP, TRANSACTIONS OR OTHER CIRCUMSTANCES, INCLUDING THOSE OF AN IMMEDIATE FAMILY MEMBER, THAT COULD RESULT IN A CONFLICT BETWEEN THE ORGANIZATION'S INTERESTS AND HIS/HER PERSONAL FINANCIAL OR OTHER INTERESTS. THESE FORMS ARE RETAINED IN THE ORGANIZATION'S FILES. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION FOR THE EXECUTIVE DIRECTOR IS DETERMINED BY THE MARKET RATE COMPARABLE TO OTHER SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE PROVIDED UPON REQUEST.