FURP.ORG / PUBLIC DATA EXPLORER

EVERGREEN RETIREMENT COMMUNITY INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
EVERGREEN RETIREMENT COMMUNITY INC (EIN 39-1081800)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-08-15
IRS object ID
201722279349300342
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)
Return2017-08-15T08:28:44-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18215 GREENWAY BOULEVARD SUITE 600AddressLine1Txt
CityMIDDLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53562ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391081800EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN RETIREMENT COMMUNITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEVERBusinessNameControlTxt
Phone9202332340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN M KRUEGERPersonNm
Person TitleCPAPersonTitleTxt
Phone9202332340PhoneNum
Signature2017-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKIMBERLY ANDERSON CPAPreparerPersonNm
PTINP00188889PTIN
Phone6086628600PhoneNum
Preparation2017-07-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-08-11IPDt
IP Tm14:52:24IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE698147828662A77FC368A1C9E67113FD81D946AAtSubmissionCreationDeviceId
At Submission Filing Device Id62E867D8DD54F5273CB28CDF546CBC41230BE266AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH A ARNESONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,712,339GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EVERGREENOSHKOSH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1965FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionGUIDED BY CHRISTIAN VALUES, WE ARE AN INDUSTRY LEADER IN PROVIDING A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 YEARS AND OLDER.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee430TotalEmployeeCnt
Total Volunteers150TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$561,007PYContributionsGrantsAmt
CY Contributions Grants$499,592CYContributionsGrantsAmt
PY Program Service Revenue$15,145,788PYProgramServiceRevenueAmt
CY Program Service Revenue$15,728,646CYProgramServiceRevenueAmt
PY Investment Income-$95,917PYInvestmentIncomeAmt
CY Investment Income-$205,970CYInvestmentIncomeAmt
PY Other Revenue$582,579PYOtherRevenueAmt
CY Other Revenue$484,101CYOtherRevenueAmt
PY Total Revenue$16,193,457PYTotalRevenueAmt
CY Total Revenue$16,506,369CYTotalRevenueAmt
PY Grants And Similar Paid$1,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,782,515PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,098,999CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,123,835PYOtherExpensesAmt
CY Other Expenses$7,482,953CYOtherExpensesAmt
PY Total Expenses$15,907,350PYTotalExpensesAmt
CY Total Expenses$16,581,962CYTotalExpensesAmt
PY Revenues Less Expenses$286,107PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$75,593CYRevenuesLessExpensesAmt
Total Assets BOY$25,941,423TotalAssetsBOYAmt
Total Assets EOY$26,186,926TotalAssetsEOYAmt
Total Liabilities BOY$15,246,665TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,481,434TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,694,758NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,705,492NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGUIDED BY CHRISTIAN VALUES, WE ARE AN INDUSTRY LEADER IN PROVIDING A CONTINUUM OF POSSIBILITIES FOR INDIVIDUALS 55 YEARS AND OLDER.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,741,163ExpenseAmt
Grant$10GrantAmt
Revenue$15,728,646RevenueAmt
DescEVERGREEN IS A NONPROFIT CONTINUING CARE RETIREMENT COMMUNITY (CCRC) SERVING OLDER ADULTS, AGES 55 AND OLDER. IDEAL FOR THOSE LOOKING FOR A LIFESTYLE OF CHOICE, FREEDOM, SAFETY, COMMUNITY AND VALUE, EVERGREEN IS MORE THAN JUST A SENIOR LIVING COMMUNITY.EVERGREEN'S 35-ACRE CAMPUS IS NOT ONLY HOME TO ALMOST 300 RESIDENTS, BUT IT IS ALSO A DESTINATION FOR FAMILIES, COMMUNITY MEMBERS, VOLUNTEERS, NONPROFIT GROUPS AND OTHER VISITORS.LOCATED IN A PLEASANT RESIDENTIAL NEIGHBORHOOD IN OSHKOSH, WISCONSIN AMONG BEAUTIFUL, NATURAL SURROUNDINGS AND BORDERED BY OUR OWN OAK SAVANNA WOODLANDS, EVERGREEN PROVIDES LIVELY OPPORTUNITIES FOR YOU AND YOUR FRIENDS TO LIVE AS YOU CHOOSE. CHOOSE FROM THREE STYLES OF INDEPENDENT LIVING ACCOMMODATIONS, FOUR LEVELS OF ASSISTED LIVING, SHORT-TERM REHAB AND POST SURGICAL CARE, LONG-TERM SKILLED NURSING, OR EVERGREEN AT HOME SERVICES TO MEET YOUR UNIQUE NEEDS.LIFE ENRICHMENT ABOUNDS AT EVERGREEN. THERAPEUTIC SWIMMING POOLS, AN AEROBIC STUDIO, LAPIDARY SHOP, AND SUPPERS WITH THE CHEF ARE JUST A FEW OF THE MANY OPPORTUNITIES THAT ENCOURAGE ACTIVE LIFESTYLES. PARTNERSHIPS WITH THE UNIVERSITY OF WISCONSIN OSHKOSH, LEARNING IN RETIREMENT AND THE OSHKOSH GALLERY WALK ALSO PROVIDE ENTERTAINING AND FULFILLING EXPERIENCES AND ENSURE THAT NO TWO DAYS ARE THE SAME. AT EVERGREEN, POSSIBILITIES AWAIT.Desc
Total Program Service Expenses$14,741,163TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document64IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee430EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN M KRUEGERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9202372110PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549023217ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
BARRY YARBRO
DIRECTOR1.00Yes (X)$0$0$0
DEIRDRE DEWITT
VICE CHAIR1.00Yes (X)$0$0$0Yes (X)
WILL DEPPIESSE
DIRECTOR1.00Yes (X)$0$0$0
VERNICE HAASE
DIRECTOR1.00Yes (X)$0$0$0
ELIZABETH HARTMAN
DIRECTOR1.00Yes (X)$0$0$0
GINI DAVIS
DIRECTOR1.00Yes (X)$0$0$0
RANDY HUSMAN
DIRECTOR1.00Yes (X)$0$0$01.00
STEVE DUNN
CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
SUE KREIBICH
DIRECTOR1.00Yes (X)$0$0$0
MARCIA LARSON
DIRECTOR1.00Yes (X)$0$0$0
FRED LILLY
DIRECTOR1.00Yes (X)$0$0$0
JAYNE LINDSAY
DIRECTOR1.00Yes (X)$0$0$0
ROY NEY
DIRECTOR1.00Yes (X)$0$0$0
CHRIS VANSTRATEN
DIRECTOR1.00Yes (X)$0$0$0
SUSAN BOETTCHER
DIRECTOR1.00Yes (X)$0$0$0
SANDY MUINDE
DIRECTOR1.00Yes (X)$0$0$0
JOHN NEWMAN
DIRECTOR1.00Yes (X)$0$0$0
BARBARA RAU
DIRECTOR1.00Yes (X)$0$0$0
LUELLA REMMEL
DIRECTOR1.00Yes (X)$0$0$0
KENNETH A ARNESON
PRESIDENT/CEO40.00$210,594$0$27,007Yes (X)1.00
JOHN M KRUEGER
VP OF FINANCE/IS & TREASURER40.00$107,661$0$43,057Yes (X)1.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$318,255TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$70,064TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHABCARE GROUP INC
BOX 277365ATLANTAGA30384THERAPY$1,016,756
NORTHCENTRAL CONSTRUCTION CORP
631 SOUTH HICKORY STREETFOND DU LACWI54935CONSTRUCTION$814,898
HEALTHCARE SERVICES GROUP
3220 TILLMAN DRIVEBENSALEMPA19020HOUSEKEEPING$481,952
A G ARCHITECTURE
1414 UNDERWOOD AVE 301WAUWATOSAWI53213CONSTRUCTION$442,130
PARASOL ALLIANCE LLC
5620 N KEDVALE AVENUECHICAGOIL60646INFORMATION TECHNOLOGY$274,281
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Related Organizations$499,592RelatedOrganizationsAmt
Total Contributions$499,592TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
RESIDENT SERVICE FEES623000$15,077,619$15,077,619
MANAGEMENT FEE INCOME900099$651,027$651,027
FieldValueIRS element (for citing)
Total Program Service Revenue$15,728,646TotalProgramServiceRevenueAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$205,970OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$205,970OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$205,970TotalRevenueColumnAmt
Exclusion-$205,970ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER SERVICE REVENUEDesc
Business900099BusinessCd
Total Revenue Column$484,101TotalRevenueColumnAmt
Exclusion$484,101ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$484,101OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,506,369TotalRevenueColumnAmt
Related Or Exempt Func Income$15,728,646RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$278,131ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10TotalAmt
Program Services$10ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$425,753TotalAmt
Program Services$374,663ProgramServicesAmt
Management And General$51,090ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,954,685TotalAmt
Program Services$6,120,123ProgramServicesAmt
Management And General$834,562ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$281,908TotalAmt
Program Services$248,079ProgramServicesAmt
Management And General$33,829ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$910,166TotalAmt
Program Services$800,946ProgramServicesAmt
Management And General$109,220ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$526,487TotalAmt
Program Services$463,309ProgramServicesAmt
Management And General$63,178ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$10,089TotalAmt
Program Services$8,878ProgramServicesAmt
Management And General$1,211ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,161TotalAmt
Program Services$28,302ProgramServicesAmt
Management And General$3,859ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,400,805TotalAmt
Program Services$2,112,708ProgramServicesAmt
Management And General$288,097ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$134,902TotalAmt
Program Services$118,714ProgramServicesAmt
Management And General$16,188ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$141,728TotalAmt
Program Services$124,721ProgramServicesAmt
Management And General$17,007ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$16,012TotalAmt
Program Services$14,091ProgramServicesAmt
Management And General$1,921ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$692,654TotalAmt
Program Services$609,536ProgramServicesAmt
Management And General$83,118ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,604TotalAmt
Program Services$6,692ProgramServicesAmt
Management And General$912ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$72,359TotalAmt
Program Services$63,676ProgramServicesAmt
Management And General$8,683ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$320,341TotalAmt
Program Services$281,900ProgramServicesAmt
Management And General$38,441ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,663,983TotalAmt
Program Services$1,464,305ProgramServicesAmt
Management And General$199,678ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$119,406TotalAmt
Program Services$105,077ProgramServicesAmt
Management And General$14,329ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
FOOD SUPPLIES$976,566$976,566
GENERAL SUPPLIES$286,004$251,684$34,320
RESIDENT SUPPLIES$265,369$265,369
BAD DEBTS$60,000$52,800$7,200

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$282,970TotalAmt
Program Services$249,014ProgramServicesAmt
Management And General$33,956ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$16,581,962TotalAmt
Program Services$14,741,163ProgramServicesAmt
Management And General$1,840,799ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,501,414BOYAmt
EOY$2,314,744EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$175,441BOYAmt
EOY$192,961EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,526,211BOYAmt
EOY$1,654,624EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$789,744BOYAmt
EOY$671,852EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$103,734BOYAmt
EOY$105,830EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$190,191BOYAmt
EOY$251,297EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$45,056,862LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$24,742,986LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$18,765,005BOYAmt
EOY$20,313,876EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$74,998EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,889,683BOYAmt
EOY$606,744EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,941,423BOYAmt
EOY$26,186,926EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,658,509BOYAmt
EOY$3,070,359EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,888,338BOYAmt
EOY$1,860,845EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,806,679BOYAmt
EOY$10,352,735EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$5,888BOYAmt
EOY$6,250EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$9,679BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$877,572BOYAmt
EOY$191,245EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,246,665BOYAmt
EOY$15,481,434EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,694,758BOYAmt
EOY$10,705,492EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,694,758BOYAmt
EOY$10,705,492EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,941,423BOYAmt
EOY$26,186,926EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$75,593ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$86,327NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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$602,837CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$590,240CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$520,351CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$561,007CurrentTaxYearMinus1YearAmt
Current Tax Year$499,592CurrentTaxYearAmt
Total$2,774,027TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,662,621CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,992,354CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$14,781,236CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,145,788CurrentTaxYearMinus1YearAmt
Current Tax Year$15,728,646CurrentTaxYearAmt
Total$73,310,645TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$14,265,458CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,582,594CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,301,587CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,706,795CurrentTaxYearMinus1YearAmt
Current Tax Year$16,228,238CurrentTaxYearAmt
Total$76,084,672TotalAmt

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$76,084,672PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$106,820CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,777CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$73,749CurrentTaxYearMinus2YearsAmt
Total$264,346TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$106,820CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$83,777CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$73,749CurrentTaxYearMinus2YearsAmt
Total$264,346TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,602,500CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$767,701CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$446,429CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$582,579CurrentTaxYearMinus1YearAmt
Current Tax Year$484,101CurrentTaxYearAmt
Total$3,883,310TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,974,778CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,434,072CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,821,765CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,289,374CurrentTaxYearMinus1YearAmt
Current Tax Year$16,712,339CurrentTaxYearAmt
Total$80,232,328TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.94830PublicSupportCY509Pct
Public Support PY5090.93750PublicSupportPY509Pct
Investment Income CY0.00330InvestmentIncomeCYPct
Investment Income PY0.00470InvestmentIncomePYPct
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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,079,792BeginningYearBalanceAmt
Contributions$7,810ContributionsAmt
Investment Earnings Or Losses$363,749InvestmentEarningsOrLossesAmt
Other Expenditures$49,744OtherExpendituresAmt
Administrative Expenses$25,701AdministrativeExpensesAmt
End Year Balance$6,375,906EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,358,425BeginningYearBalanceAmt
Contributions-$6,352ContributionsAmt
Investment Earnings Or Losses-$186,639InvestmentEarningsOrLossesAmt
Other Expenditures$60,173OtherExpendituresAmt
Administrative Expenses$25,570AdministrativeExpensesAmt
End Year Balance$6,079,792EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,209,001BeginningYearBalanceAmt
Contributions$61,620ContributionsAmt
Investment Earnings Or Losses$169,491InvestmentEarningsOrLossesAmt
Other Expenditures$57,134OtherExpendituresAmt
Administrative Expenses$24,553AdministrativeExpensesAmt
End Year Balance$6,358,425EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,589,110BeginningYearBalanceAmt
Contributions$154,659ContributionsAmt
Investment Earnings Or Losses$544,488InvestmentEarningsOrLossesAmt
Other Expenditures$55,706OtherExpendituresAmt
Administrative Expenses$23,550AdministrativeExpensesAmt
End Year Balance$6,209,001EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,228,355BeginningYearBalanceAmt
Contributions$3,850ContributionsAmt
Investment Earnings Or Losses$474,768InvestmentEarningsOrLossesAmt
Other Expenditures$96,676OtherExpendituresAmt
Administrative Expenses$21,185AdministrativeExpensesAmt
End Year Balance$5,589,112EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.37200BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.61300PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.01500TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$404,489OtherCostOrOtherBasisAmt
Book Value$404,489BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,477,401OtherCostOrOtherBasisAmt
Depreciation$13,396,948DepreciationAmt
Book Value$14,080,453BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,447,730OtherCostOrOtherBasisAmt
Depreciation$1,049,284DepreciationAmt
Book Value$398,446BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,750,898OtherCostOrOtherBasisAmt
Depreciation$10,296,754DepreciationAmt
Book Value$2,454,144BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,976,344OtherCostOrOtherBasisAmt
Book Value$2,976,344BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$20,313,876TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLIABILITY ON INTEREST SWAP AGREEMENTDesc
Amt$191,245Amt
FieldValueIRS element (for citing)
Total Liability$191,245TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:FOR 2016, THERE WAS A RESIDENT FUNDS SAVINGS ACCOUNT IN THE AMOUNT OF $4,638 AND A RESIDENT CHECKING FUND WITH A BALANCE OF $1,612.
PART V, LINE 4:THE ENDOWMENT FUNDS ARE HELD BY THE RELATED FOUNDATION FOR THE BENEVOLENT NEEDS FOR RESIDENTS OF EVERGREEN RETIREMENT COMMUNITY WHO HAVE EXHAUSTED THEIR PERSONAL RESOURCES, WOODLANDS PRESERVATION, LIFECARE LEARNING, PASTORAL CARE, CREATIVE ARTS, AND GROUNDS BEAUTIFICATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KENNETH A ARNESON
PRESIDENT/CEO$201,929$0$8,568$0$97$0$0$0$27,007$0$237,601$0$0$0
JOHN M KRUEGER
VP OF FINANCE/IS & TREASURER$104,821$0$2,563$0$277$0$0$0$43,057$0$150,718$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES.
PART I, LINE 6PRESIDENT/CEO (KEN ARNESON), VP OF FINANCE/IS & TREASURER (JOHN KRUEGER), AND EXECUTIVE ASSISTANT/SECRETARY (BROOKE KNOLL) OF EVERGREEN RETIREMENT COMMUNITY, AS MEMBERS OF THE MANAGEMENT TEAM, RECEIVE AN ANNUAL BONUS, PART OF WHICH RELATES TO THE NET INCOME OF THE ORGANIZATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ELDERLY HOUSING AUTHORITY OF THE CITY OF OSHKOSH
A3912517772003-11-25$6,600,000CONSTRUCTION OF SKILLED NURSING FACILITY AND FITNESS & AQUATIC CENTER000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY
B3913378552013-12-20$7,000,000CAMPUS REMODEL (REPOSITIONING)000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY
C3913378552016-12-01$14,150,000CONSTRUCTION OF 62 APARTMENTS AND A WORSHIP AND PERFORMING ARTS CENTER000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndUnspentUnspentAmt
A$3,354,000$6,600,000$6,600,0002004Yes (1)0Yes (1)Yes (1)
B$7,000,000$7,000,0002014000Yes (1)
C$14,150,000$50,056000Yes (1)$14,099,944

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B000000Yes (1)
C0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
ASSOCIATED BANK NA
A00Yes (1)0Yes (1)Yes (1)9.58333330000000000
(no name)
B000Yes (1)Yes (1)000Yes (1)
(no name)
C000Yes (1)Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR AND VICE CHAIR OF THE BOARD AND THE CHAIRS OF THE THREE OTHER STANDING BOARD COMMITTEES. THE CHAIR SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. A QUORUM SHALL CONSIST OF THREE MEMBERS. THE COMMITTEE SHALL MEET AT THE CALL OF THE CHAIR OR ANY TWO EXECUTIVE COMMITTEE MEMBERS. THE COMMITTEE SHALL HAVE FULL AUTHORITY TO ACT ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD, EXCEPT THE ELECTION OF OFFICERS OR THE AUTHORITY TO DECLARE OR FILL ANY VACANCY ON THE BOARD. ALL ACTIONS OF THE COMMITTEE SHALL BE REPORTED AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD. THE COMMITTEE SHALL PERFORM SUCH OTHER FUNCTIONS AS MAY BE DELEGATED TO IT BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11BTHE ORGANIZATION'S TREASURER WILL REVIEW THE 990 IN DETAIL. AN ELECTRONIC VERSION OF THE FORM 990 WILL BE POSTED ON THE BOARD WEB PAGE WITH MEMBERS GIVEN THE OPPORTUNITY TO REVIEW IT PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL EMPLOYEES AND IT HAS A CODE OF CONDUCT POLICY THAT APPLIES TO ALL BOARD MEMBERS. BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST AND TO CONDUCT BUSINESS WITH EVERGREEN IN A MANNER THAT SUPPORTS THE INTERESTS OF EVERGREEN AND AVOIDS UNFAIR PERSONAL ADVANTAGE. NON-COMPLIANCE WITH THE CODE OF CONDUCT MAY RESULT IN REMOVAL FROM THE BOARD FOLLOWING AN OPPORTUNITY FOR EXPLANATION TO THE FULL BOARD.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATIONAL PERFORMANCE COMMITTEE (OPC) OF THE BOARD IS RESPONSIBLE FOR CONDUCTING THE PERFORMANCE REVIEW OF THE CEO AND MAKING A WAGE RECOMMENDATION TO THE FULL BOARD OF DIRECTORS. THE OPC IS PROVIDED COMPARATIVE WAGE DATA ANNUALLY BY THE VICE PRESIDENT OF HUMAN RESOURCES. THE REVIEW PROCESS IS DOCUMENTED IN EXECUTIVE SESSION MINUTES. VICE PRESIDENTS ARE REVIEWED BY THE PRESIDENT/CEO. THE SECRETARY OF THE BOARD IS THE EXECUTIVE ASSISTANT TO THE PRESIDENT/CEO AND IS REVIEWED BY THE PRESIDENT/CEO. PERIODIC WAGE & SALARY SURVEYS ARE CONDUCTED TO ASSURE COMPENSATION IS COMPARABLE TO INDUSTRY/AREA MARKET. FORMS ARE USED TO DOCUMENT ACCOMPLISHMENTS.
FORM 990, PART VI, SECTION C, LINE 19EVERGREEN RETIREMENT COMMUNITY, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. REQUESTED DOCUMENTS ARE PROVIDED WITHIN A REASONABLE TIME FRAME.
FORM 990, PART IX, LINE 11GCONTRACTS AND OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,072,932. MANAGEMENT AND GENERAL EXPENSES 282,673. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,355,605. CONSULTING FEES: PROGRAM SERVICE EXPENSES 39,776. MANAGEMENT AND GENERAL EXPENSES 5,424. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,200.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54902ZIPCd
FieldValueIRS element (for citing)
EIN391388991EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EVERGREEN VILLAGE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11130 NORTH WESTFIELD STREETAddressLine1Txt
CityOSHKOSHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54901ZIPCd
FieldValueIRS element (for citing)
EIN391505337EIN
Primary ActivitiesCO-OPERATIVEPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
EVERGREEN FOUNDATION INC
Q$499,592BOOK
EVERGREEN FOUNDATION INC
L$154,028BOOK