FURP.ORG / PUBLIC DATA EXPLORER

BETHANY HOME SOCIETY FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BETHANY HOME SOCIETY FOUNDATION INC (EIN 91-1787884)
Tax period
2012-11-01 to 2013-10-31
Filed
2014-03-17
IRS object ID
201420769349300337
Schema version
2012v2.0
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)
Timestamp2014-03-17T17:33:29-07:00Timestamp
Tax Period End Date2013-10-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GENSKE MULDER AND CO - MODESTOBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14803 SISK RD STE 201AddressLine1
CitySALIDACity
StateCAState
ZIP Code953689445ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-11-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN911787884EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BETHANY HOME SOCIETY FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBETHNameControl
Phone2095994221Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1930 W MAIN STAddressLine1
CityRIPONCity
StateCAState
ZIP Code95366ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGERALD DE VRIESName
TitleTreasurerTitle
Date Signed2014-03-17DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePAUL ANEMA CPAName
PTINP01228912PTIN
Phone2095233573Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts1450112GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO RECEIVE AND RAISE FUNDS FOR A PERPETUAL ENDOWMENT FUND FOR THE PURPOSE OF USING THE INCOME THEREFROM TO RENDER ASSISTANCE TOWARD THE SUPPORT OF RESIDENTS OF THE RETIREMENT HOME OPERATED BY BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC., A CALIFORNIA NONPROFIT CORPORATION AND TO PROVIDE FOR THE CONTINUITY OF EXISTENCE OF BETHANY SOCIETY OF SAN JOAQUIN COUNTY, INC. BY PROMOTING THE WELFARE OF SAID NONPROFIT CORPORATION THROUGH DISTRIBUTION OF FUND NET INCOME FOR THE EXEMPT PURPOSES OF BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year152155ContributionsGrantsPriorYear
Contributions Grants Current Year1161527ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year107739InvestmentIncomePriorYear
Investment Income Current Year117610InvestmentIncomeCurrentYear
Other Revenue Prior Year7OtherRevenuePriorYear
Other Revenue Current Year-2168OtherRevenueCurrentYear
Total Revenue Prior Year259901TotalRevenuePriorYear
Total Revenue Current Year1276969TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year46455GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY113882GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year50174SalariesEtcPriorYear
Salaries Etc Current Year51483SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year291159TotalFundrsngExpCurrentYear
Other Expense Prior Year70875OtherExpensePriorYear
Other Expenses Current Year259652OtherExpensesCurrentYear
Total Expenses Prior Year167504TotalExpensesPriorYear
Total Expenses Current Year425017TotalExpensesCurrentYear
Revenues Less Expenses Prior Year92397RevenuesLessExpensesPriorYear
Revenues Less Expenses CY851952RevenuesLessExpensesCY
Total Assets BOY2290053TotalAssetsBOY
Total Assets EOY3119207TotalAssetsEOY
Total Liabilities BOY96022TotalLiabilitiesBOY
Total Liabilities EOY73224TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2194031NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3045983NetAssetsOrFundBalancesEOY
Mission DescriptionTO RECEIVE AND RAISE FUNDS FOR A PERPETUAL ENDOWMENT FUND FOR THE PURPOSE OF USING THE INCOME THEREFROM TO RENDER ASSISTANCE TOWARD THE SUPPORT OF RESIDENTS OF THE RETIREMENT HOME OPERATED BY BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC., A CALIFORNIA NONPROFIT CORPORATION AND TO PROVIDE FOR THE CONTINUITY OF EXISTENCE OF BETHANY SOCIETY OF SAN JOAQUIN COUNTY, INC. BY PROMOTING THE WELFARE OF SAID NONPROFIT CORPORATION THROUGH DISTRIBUTION OF FUND NET INCOME FOR THE EXEMPT PURPOSES OF BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense113882Expense
Grants113882Grants
Revenue1275406Revenue
DescriptionSUPPORT OF RESIDENTS OF THE RETIREMENT HOME OPERATED BY BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC., A CALIFORNIA NONPROFIT CORPORATIONDescription
Total Program Service Expense113882TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonANDREW LEENamePerson
Telephone Number2095994221TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1930 W MAIN ST RIPON CAAddressLine1
CityRIPONCity
StateCAState
ZIP Code95366ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JACK COPELAND
Secretary1.000.00XX000
GERALD DE VRIES
Treasurer1.000.00XX000
JAKE SONKE
President1.000.00XX000
WARD SCHEMPER
Vice President1.000.00XX000
RON VAN ESSEN
Trustee1.000.00X000
WILLIE BYLSMA
Trustee1.000.00X000
KENT VAN GRONINGEN
Trustee1.000.00X000
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants79000GovernmentGrants
All Other Contributions1082527AllOtherContributions
Total Contributions1161527TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column84564TotalRevenueColumn
Related Or Exempt Function Income84564RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal25475Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Personal27643Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Personal-2168Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-2168TotalRevenueColumn
Exclusion-$2,168ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities178546Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities145500Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities33046Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column33046TotalRevenueColumn
Related Or Exempt Function Income33046RelatedOrExemptFunctionIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1276969TotalRevenueColumn
Related Or Exempt Function Income117610RelatedOrExemptFunctionIncome
Exclusion-$2,168ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total113882Total
Program Services113882ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total32389Total
Fundraising32389Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16126Total
Fundraising16126Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2968Total
Fundraising2968Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3650Total
Management And General3650ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total16127Total
Management And General16127ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total838Total
Fundraising838Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total1052Total
Fundraising1052Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total477Total
Fundraising477Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total1721Total
Fundraising1721Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraising
DUES & SUBSCRIPTIONS19781978
Printing and Publications62416241
CONTRACTED LABOR1833318333
50 ANNIVERSARY GALA208199208199

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1036Total
Management And General199ManagementAndGeneral
Fundraising837Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total425017Total
Program Services113882ProgramServices
Management And General19976ManagementAndGeneral
Fundraising291159Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY67648BOY
EOY151098EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis663800LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec54283LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY610255BOY
EOY609517EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1612150BOY
EOY2358592EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2290053BOY
EOY3119207EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY96022BOY
EOY73224EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY96022BOY
EOY73224EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2194031BOY
EOY3045983EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2194031BOY
EOY3045983EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2290053BOY
EOY3119207EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses851952ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewtrueAccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
FS AuditedfalseFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1BETHANY HOME SOCIETY OF SAN JOAQUINBusinessNameLine1
FieldValueIRS element (for citing)
EIN941546850EIN
Type Of Organization501 (C)(3)TypeOfOrganization
Listed In Governing DocfalseListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$113,882Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts113882SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1968566BeginningOfYearBalance
Contributions1093821Contributions
Investment Earnings Or Losses345010InvestmentEarningsOrLosses
Grants Or Scholarships52684GrantsOrScholarships
Other Expenditures11105OtherExpenditures
Administrative Expenses317750AdministrativeExpenses
End Of Year Balance3025858EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1938749BeginningOfYearBalance
Contributions152155Contributions
Investment Earnings Or Losses168807InvestmentEarningsOrLosses
Grants Or Scholarships46455GrantsOrScholarships
Other Expenditures129341OtherExpenditures
Administrative Expenses115349AdministrativeExpenses
End Of Year Balance1968566EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1860281BeginningOfYearBalance
Contributions156682Contributions
Investment Earnings Or Losses98947InvestmentEarningsOrLosses
Grants Or Scholarships115792GrantsOrScholarships
Other Expenditures3007OtherExpenditures
Administrative Expenses58362AdministrativeExpenses
End Of Year Balance1938749EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1656163BeginningOfYearBalance
Contributions158814Contributions
Investment Earnings Or Losses247590InvestmentEarningsOrLosses
Grants Or Scholarships124162GrantsOrScholarships
Other Expenditures6857OtherExpenditures
Administrative Expenses71267AdministrativeExpenses
End Of Year Balance1860281EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1580149BeginningOfYearBalance
Contributions284316Contributions
Investment Earnings Or Losses-150238InvestmentEarningsOrLosses
Administrative Expenses58064AdministrativeExpenses
End Of Year Balance1656163EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis212500InvestmentCostOrOtherBasis
Book Value212500BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis451300InvestmentCostOrOtherBasis
Depreciation54283Depreciation
Book Value397017BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings609517TotalOfBookValueLandBuildings

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1BETHANY HOME SOCIETY OF SAN JOAQBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1930 W MAIN STREETAddressLine1
CityRIPONCity
StateCAState
ZIP Code95366ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient941546850EINOfRecipient
Amount Of Cash Grant113882AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantSupport of organizations exempt purposePurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableAll governing documents, policies, and financial statements are available upon request
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe board is required to sign a confirmation of understanding of policy and disclose any conflicts annually.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessThe treasurer will review the return and confer with management or the accountants regarding any questions or comments. The treasurer will also be responsbible for signing the return.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Bethany Home Society of San Joaquin IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1930 W Main StreetAddressLine1
CityRiponCity
StateCAState
ZIP Code95366ZIPCode
FieldValueIRS element (for citing)
EIN941546850EIN
Primary ActivitiesNursing HomePrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Bethany Home Society of San Joaquin Inc
p398342DIRECT COSTS
Bethany Home Society of San Joaquin Inc
o32389DIRECT COSTS
Bethany Home Society of San Joaquin Inc
m63064DIRECT COSTS
Bethany Home Society of San Joaquin Inc
b113882FMV