NEW BERLIN RETIREE HEALTH CARE SUBSIDY TR: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NEW BERLIN RETIREE HEALTH CARE SUBSIDY TR (EIN 39-1860172)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-13
IRS object ID
201301339349303040
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)
Timestamp2013-05-13T15:17:47-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JAMES L HINTZKE CPA SCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line115855 W NATIONAL AVE STE 103AddressLine1
CityNEW BERLINCity
StateWIState
ZIP Code531515159ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391860172EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CITY OF NEW BERLIN RETIREE HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNEWBNameControl
Phone2627826640Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line116300 W NATIONAL AVENUEAddressLine1
CityNEW BERLINCity
StateWIState
ZIP Code53151ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEFF HERROName
TitleTrusteeTitle
Date Signed2013-05-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES L HINTZKE CPAName
PTINP00311364PTIN
Phone2627978442Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts145883GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1997YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTHE TRUST WILL MAINTAIN AND INVEST PRINCIPAL,ACCUMULATE ASSETS AND MAKE DISTRIBUTIONS ON BEHALF OF PARTICIPANTS IN THE FORM OF SUBSIDIES TOWARD THEIR RETIREE HEALTH CARE. PARTICIPANTS ARE RETIRED POLICE OFFICERS.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year72116ProgramServiceRevenuePriorYear
Program Service Revenue CY73198ProgramServiceRevenueCY
Investment Income Prior Year89416InvestmentIncomePriorYear
Investment Income Current Year18363InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year161532TotalRevenuePriorYear
Total Revenue Current Year91561TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year53824OtherExpensePriorYear
Other Expenses Current Year53101OtherExpensesCurrentYear
Total Expenses Prior Year53824TotalExpensesPriorYear
Total Expenses Current Year53101TotalExpensesCurrentYear
Revenues Less Expenses Prior Year107708RevenuesLessExpensesPriorYear
Revenues Less Expenses CY38460RevenuesLessExpensesCY
Total Assets BOY551419TotalAssetsBOY
Total Assets EOY589879TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY551419NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY589879NetAssetsOrFundBalancesEOY
Mission DescriptionTHE TRUST WILL MAINTAIN AND INVEST PRINCIPAL,ACCUMULATE ASSETS AND MAKE DISTRIBUTIONS ON BEHALF OF PARTICIPANTS IN THE FORM OF SUBSIDIES TOWARD THEIR RETIREE HEALTH CARE. PARTICIPANTS ARE RETIRED POLICE OFFICERS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense53101Expense
Revenue73198Revenue
DescriptionON A MONTHLY BASIS, THE TRUST SUBSIDIZES MONTHLY RETIREE HEALTH BENEFITS.DURING 2012, THERE WERE 82 PARTICIPANTS, 17 OF WHICH RECEIVED SUBSIDY PAYMENTS.Description
Total Program Service Expense53101TotalProgramServiceExpense
Described In501 C3falseDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
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 OrganizationsfalseGrantsToOrganizations
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 EntityfalseRelatedEntity
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
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 Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
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 AddresstrueOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Annual Disclosure Covered PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJEFF HERRONamePerson
Telephone Number2627826640TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line116300 W NATIONAL AVEAddressLine1
CityNEW BERLINCity
StateWIState
ZIP Code53151ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (2 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JEFF HERRO
Trustee6.000.00X000
RALPH CHIPMAN
Trustee0.500.00X000
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionCITY OF NEW BERLINDescription
Business Code525100BusinessCode
Total Revenue Column73198TotalRevenueColumn
Related Or Exempt Function Income73198RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue73198TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column17370TotalRevenueColumn
Related Or Exempt Function Income17370RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities52360Securities
Other2955Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities54322Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-1962Securities
Other2955Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column993TotalRevenueColumn
Related Or Exempt Function Income993RelatedOrExemptFunctionIncome

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 Column91561TotalRevenueColumn
Related Or Exempt Function Income91561RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

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)
Total570Total
Program Services570ProgramServices

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)
Total6988Total
Program Services6988ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
FOREIGN TAXES PAID7777
SUBSIDIZED HLTH INS PREM4546645466

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total53101Total
Program Services53101ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4550BOY
EOY731EOY

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

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY546869BOY
EOY589148EOY

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)
BOY551419BOY
EOY589879EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY551419BOY
EOY589879EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY551419BOY
EOY589879EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY551419BOY
EOY589879EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses38460ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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 AvailableTHE ORGANIZATION DOES MAKE AVAILABLE ITS GOVERNING DOCUMENTS, FORM 990, AND ORIGINAL TAX DETERMINATION LETTER/EXEMPTION APPLICATION FORM, TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT HAVE A WEBSITE TO POST THESE ITEMS, BUT THERE IS A FILE AT THE ORGANIZATIONS OFFICE WITH THESE ITEMS IN IT, AVAILABLE FOR PUBLIC INSPECTION, BY APPOINTMENT.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessTHE FINAL FORM 990 IS REVIEWED WITH THE TRUSTEE PRIOR TO FILING THE TAX RETURN WITH THE IRS. DURING THIS REVIEW, THE ANNUAL INCOME AND EXPENSES REPORTED ON THE TAX RETURN ARE REVIEWED WITH THE TRUSTEE AS WELL AS THE APPLICABLE YES/NO QUESTIONS.A SIGNED COPY OF THE TAX RETURN IS PROVIDED TO THE TRUSTEE IMMEDIATELY UPON COMPLETION BY THE TAX PREPARER AND A COPY OF THE TAX RETURN IS PROVIDED TO THE BOARD FOR A SUBSEQUENT REVIEW AND THEN PLACED IN THEIR PERMANENT FILE FOR PUBLIC INSPECTION.
Form 990, Part VI, Line 9Form 990, Part VI, Line 9: Officer, Director, Trustee, Key Employee Mailing AddressRALPH CHIPMAN- (City of New Berlin Treasurer)- 3805 S. CASPER DR, NEW BERLIN, WI 53151

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.