2016-02-15T10:37:55-06:00 2015-03-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2014-04-01 352187477 INDIANA MASONIC HOME INC INDI 3177366141 690 STATE STREET FRANKLIN IN 46131 MIKE SPENCER EXECUTIVE DIRECTOR 3177366141 2016-02-12 1 SCOTT A SCHUSTER P00019243 3175802000 2016-02-12 2014 2016-08-17 19:52:53Z MIKE SPENCER 690 STATE STREET FRANKLIN IN 46131 24283833 0 X WWW.INDIANAMASONS.ORG/IMH X 2003 IN TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 19 17 166 70 0 0 17046628 5076332 13469078 14594427 1362257 744759 236552 286516 32114515 20702034 0 0 0 0 21357072 8900839 0 0 0 8869749 8528185 30226821 17429024 1887694 3273010 122674927 120120550 8107732 7561847 114567195 112558703 TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 0 0 14622322 14594427 PROVIDE CARE FOR THE AGED 14622322 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 278 0 1 166 1 0 0 0 0 0 0 0 0 0 0 X 19 17 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X MIKE HAYDEN 3177366141 690 STATE STREET FRANKLIN IN 46131 WILLIAM REINERS DEPUTY GRAND MASTER 1.00 X X 0 0 0 DAN BARENIE GRAND MASTER 1.00 X X 0 0 0 JEFF SAUNDERS BOARD MEMBER 1.00 X 0 0 0 JOHN FREELAND BOARD MEMBER 1.00 X 0 0 0 RON BUSKIRK BOARD MEMBER 1.00 X 0 0 0 GEORGE INGLES BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER COX BOARD MEMBER 1.00 X 0 0 0 MICHAEL D BRUMBACK BOARD MEMBER 1.00 X 0 0 0 ROBERT R STEVENS BOARD MEMBER 1.00 X 0 0 0 GARY BRINLEY BOARD MEMBER 1.00 X 0 0 0 RICHARD LENTZ BOARD MEMBER 1.00 X 0 0 0 ROBERT BLACKBURN BOARD MEMBER 1.00 X 0 0 0 RODNEY A MANN PRESIDENT 1.00 X X 0 0 0 LINVILLE CONNER BOARD MEMBER 1.00 X 0 0 0 LORETTA RIEHL BOARD MEMBER 1.00 X 0 0 0 RICHARD ELMAN GRAND SECRETARY 1.00 40.00 X X 0 89141 0 MARK GENUNG BOARD MEMBER 1.00 X 0 0 0 GARY LEWIS BOARD MEMBER 1.00 X 0 0 0 JEFF ZARING BOARD MEMBER 1.00 40.00 X 0 104994 0 DAWN WENDEL THROUGH OCT 2014 EXECUTIVE DIRECTOR 40.00 X 129547 0 208 ROB DEVRIES THROUGH AUG 2015 CFO 40.00 X 58522 0 0 JOHN ELEY THROUGH DEC 2015 ADMINISTRATOR 40.00 X 109319 0 0 297388 194135 208 2 0 0 0 SHIEL SEXTON 902 N CAPITOL AVE INDIANAPOLIS IN 46204 CONSTRUCTION CONTRACTOR 5217875 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICE 2846586 THERACARE 9957 ALLISONVILLE RD FISHERS IN 46038 THERAPY 945918 BROWNING DAY MULLINS DIERDORF ARCHITECTS 626 N ILLINOIS ST INDIANAPOLIS IN 46204 ARCHITECTURE 688345 PHARMERICA PO BOX 409251 ATLANTA IN 303849251 PHARMACY SERVICES 443027 11 867567 31355 3837820 339590 5076332 RESIDENCE SERVICES 623000 14594427 14594427 14594427 179392 179392 28476 0 28476 28476 28476 4101418 3536051 565367 565367 565367 540 31355 45748 -45208 -45208 OTHER INCOME 623990 303248 303248 303248 20702034 14594427 0 1031275 265015 265015 6361635 5804391 557244 64064 41545 22519 1639649 1574147 65502 570476 478871 91605 73244 73244 138826 138826 89607 89607 288405 81842 206563 91830 91830 542527 24194 518333 150575 7602 142973 8729 3078 5651 406132 406132 OUTSIDE SERVICES 2566478 2511330 55148 MEDICAL FEES, DRUGS, SU 1659915 1659915 UTILITIES 1149795 1048297 101498 REPAIRS AND MAINTENANCE 788805 788805 573317 506475 66842 17429024 14622322 2806702 0 1548518 999737 11902910 6343465 1481156 3033173 31274 31274 170454 167794 6275750 6293274 1028808 852346 100236057 102399487 122674927 120120550 1752983 1779362 5758118 5322135 596631 460350 8107732 7561847 X 2416435 3789299 110094607 106654225 2056153 2115179 114567195 112558703 122674927 120120550 X 3273010 -204122 -5077380 X X 0 1 X 1 0 X 7247941 8634423 4962539 17046628 5044977 42936508 16623131 15260272 15299964 13469078 14594427 75246872 23871072 23894695 20262503 30515706 19639404 118183380 5648388 6518562 3511780 15665192 3837820 35181742 0 5648388 6518562 3511780 15665192 3837820 35181742 83001638 377966 383384 363667 315494 207868 1648379 377966 383384 363667 315494 207868 1648379 22872 4253 21749 235104 303248 587226 24271910 24282332 20647919 31066304 20150520 120418985 0.68930 0.69530 0.01370 0.01510 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2010 AMOUNT: $ 22,872. 2011 AMOUNT: $ 4,253. 2012 AMOUNT: $ 21,749. 2013 AMOUNT: $ 235,104. 2014 AMOUNT: $ 303,248. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 INTEREST IN NET ASSETS OF FOUNDATION 100256411 BENEFICIAL INTEREST IN TRUSTS 2143076 102399487 RESIDENT DEPOSIT 107428 REFUNDABLE ADVANCE FEES 352922 460350 X 20624611 45880 45880 20578731 89607 33696 123303 20702034 17385165 45748 45748 17339417 89607 89607 17429024 PART X, LINE 2: THE HOME IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SIMILAR PROVISIONS OF INDIANA TAX LAWS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, THE HOME 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 FOR THE YEARS ENDED MARCH 31, 2015 AND 2014. THE HOME FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. IT IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 45,748. NET ASSETS RELEASED FROM RESTRICTIONS 132. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN TEMPORARILY RESTRICTED NET ASSETS-CONTRIBUTIONS 33,696. FOUNDATION CONTRIBUTIONS PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 45,748. GOLF OUTING 31895 31355 540 45748 31895 31355 540 45748 45748 -45208 FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT WILL REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C REVIEW NOTATIONS ON CONFLICT OF INTEREST POLICY AND DISCUSS AND RESOLVE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS APPROVED BY THE BOARD FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. ANNUAL STATE DISCLOSURE STATEMENT THAT IS AVAILABLE TO ALL POTENTIAL NEW RESIDENTS. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -3,837,820. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 5,938,959. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -7,240,810. CHANGE IN BENEFICIAL INTEREST IN TRUST 62,291. FORM 990, PART XII, LINE 2C THE PROCESS HAD NOT CHANGED. FORM 990, PART VI, SECTION B, LINE 14 RECORD RETENTION AND DESTRUCTION POLICY MEDICAL RECORDS OF THE ORGANIZATION ARE GOVERNED BY A RETENTION AND STORAGE POLICY, AS WELL AS A CLOSED CHART POLICY. INDIANA MASONIC HOME FOUNDATION INC 525 N ILLINOIS ST INDIANAPOLIS IN 46204 351091997 PROVIDE SUPPORT TO THE INDIANA MASONIC HOME IN 501(C)(3) LINE 11A, I 0 IMH REALTY INC 690 STATE STREET FRANKLIN IN 46131 364513246 PROVIDE PROPERTY TO ENSURE THE RESIDENTIAL AND MEDIAL CARE FOR THE ELDERLY IN 501(C)(2) 0 GRAND LODGE 525 N ILLINOIS ST INDIANAPOLIS IN 46204 350300010 FRATERNAL ORGANIZATION IN 501(C)(8) & (C)(10) 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 IMH REALTY I 7240810 FAIR MARKET VALUE INDIANA MASONIC HOME FOUNDATION C 3837820 CASH