MOUNTAIN VIEW NURSING HOME: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MOUNTAIN VIEW NURSING HOME (EIN 54-0722037)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-06
IRS object ID
201321269349300612
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)
Timestamp2013-05-06T06:27:26-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1King Shores & Preston CPAsBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12707 Brambleton Ave SWAddressLine1
CityRoanokeCity
StateVAState
ZIP Code24015ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN540722037EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mountain View Nursing Home IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMOUNNameControl
Phone5409486831Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11776 Elly RoadAddressLine1
CityArodaCity
StateVAState
ZIP Code22709ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEldon HochstetlerName
TitleTreasurer/AdminTitle
Date Signed2013-05-06DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCJ KingName
PTINP01353771PTIN
Phone5407760771Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonEldon HochstetlerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11552 Elly RdAddressLine1
CityArodaCity
StateVAState
ZIP Code22709ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2550875GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.mvnursing.netWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileVAStateLegalDomicile
Activity Or Mission DescriptionTo provide nursing care for the elderly in a church-affiliated nursing home and to support world evangelism.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees97TotalNbrEmployees
Total Nbr Volunteers35TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year9636ContributionsGrantsPriorYear
Contributions Grants Current Year5115ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2418665ProgramServiceRevenuePriorYear
Program Service Revenue CY2497403ProgramServiceRevenueCY
Investment Income Prior Year461InvestmentIncomePriorYear
Investment Income Current Year-77InvestmentIncomeCurrentYear
Other Revenue Prior Year47647OtherRevenuePriorYear
Other Revenue Current Year47486OtherRevenueCurrentYear
Total Revenue Prior Year2476409TotalRevenuePriorYear
Total Revenue Current Year2549927TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year100000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY110000GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1066223SalariesEtcPriorYear
Salaries Etc Current Year1069108SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1176969OtherExpensePriorYear
Other Expenses Current Year1121644OtherExpensesCurrentYear
Total Expenses Prior Year2343192TotalExpensesPriorYear
Total Expenses Current Year2300752TotalExpensesCurrentYear
Revenues Less Expenses Prior Year133217RevenuesLessExpensesPriorYear
Revenues Less Expenses CY249175RevenuesLessExpensesCY
Total Assets BOY3971058TotalAssetsBOY
Total Assets EOY3750596TotalAssetsEOY
Total Liabilities BOY678449TotalLiabilitiesBOY
Total Liabilities EOY208812TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3292609NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3541784NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide nursing care for the elderly in a church-affiliated nursing home and to support world evangelism.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense1803865Expense
Revenue2497403Revenue
DescriptionProvide intermediate care nursing services for the elderly. There are 40 beds available with approximately 14,469 patient days provided to approximately 48 residents throughout the year.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense110000Expense
Grants110000Grants
DescriptionSupport world evangelism through sharing of resources and active participation.Description
FieldValueIRS element (for citing)
Total Program Service Expense1913865TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
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 EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
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 With109613NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees97NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
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 Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
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 ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Annual Disclosure Covered PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonThe CorporationNamePerson
Telephone Number5409486831TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11776 Elly RoadAddressLine1
CityArodaCity
StateVAState
ZIP Code22709ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Clifford Bontrager
Secretary1.000.00XX000
Joseph Summy
Vice Chairman1.000.00XX000
Ray Shank
Chairman1.000.00XX000
Eldon Hochstetler
Treasurer/Admin40.000.00X8435902000
FieldValueIRS element (for citing)
Total Reportable Comp From Org84359TotalReportableCompFromOrg
Total Other Compensation2000TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions5115AllOtherContributions
Total Contributions5115TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNursing ServicesDescription
Business Code623000BusinessCode
Total Revenue Column2497403TotalRevenueColumn
Related Or Exempt Function Income2497403RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue2497403TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column179TotalRevenueColumn
Exclusion$179ExclusionAmount

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)
Real3325Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real3325Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column3325TotalRevenueColumn
Exclusion$3,325ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other692Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other948Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-256Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-256TotalRevenueColumn
Exclusion-$256ExclusionAmount

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

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionStaff Room & Board, etc.Description
Business Code623000BusinessCode
Total Revenue Column44161TotalRevenueColumn
Exclusion$44,161ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue44161TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2549927TotalRevenueColumn
Related Or Exempt Function Income2497403RelatedOrExemptFunctionIncome
Exclusion$47,409ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total110000Total
Program Services110000ProgramServices

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)
Total86359Total
Management And General86359ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total837820Total
Program Services742696ProgramServices
Management And General95124ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total17978Total
Program Services14448ProgramServices
Management And General3530ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total55512Total
Program Services44611ProgramServices
Management And General10901ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total71439Total
Program Services57410ProgramServices
Management And General14029ManagementAndGeneral

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)
Total21298Total
Management And General21298ManagementAndGeneral

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)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total6133Total
Management And General6133ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total46427Total
Program Services6964ProgramServices
Management And General39463ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11273Total
Program Services2818ProgramServices
Management And General8455ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total156326Total
Program Services132877ProgramServices
Management And General23449ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total20798Total
Program Services17678ProgramServices
Management And General3120ManagementAndGeneral

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)
Total259667Total
Program Services220717ProgramServices
Management And General38950ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total60381Total
Program Services51324ProgramServices
Management And General9057ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Mission Outreach1706917069
Professional Services2066020660
Repairs & Maintenance730786211610962
Supplies402181402181

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total26353Total
Program Services10296ProgramServices
Management And General16057ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2300752Total
Program Services1913865ProgramServices
Management And General386887ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY101714BOY
EOY64942EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY75032BOY
EOY90021EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY132279BOY
EOY142840EOY

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)
BOY56582BOY
EOY66437EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY7514BOY
EOY9840EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5354298LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1999786LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3582064BOY
EOY3354512EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

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)
BOY15873BOY
EOY22004EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3971058BOY
EOY3750596EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY218925BOY
EOY186808EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY443651BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15873BOY
EOY22004EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY678449BOY
EOY208812EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3292609BOY
EOY3541784EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3292609BOY
EOY3541784EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3971058BOY
EOY3750596EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses249175ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Oak Grove Mennonite ChurchBusinessNameLine1
FieldValueIRS element (for citing)
EIN541301492EIN
Type Of OrganizationChurchTypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis99399InvestmentCostOrOtherBasis
Other Cost Or Other Basis20728OtherCostOrOtherBasis
Book Value120127BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3916227OtherCostOrOtherBasis
Depreciation1165962Depreciation
Book Value2750265BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis359969OtherCostOrOtherBasis
Depreciation220203Depreciation
Book Value139766BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis880427OtherCostOrOtherBasis
Depreciation571916Depreciation
Book Value308511BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis77548OtherCostOrOtherBasis
Depreciation41705Depreciation
Book Value35843BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3354512TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionPatient FundsDescription
Amount$22,004Amount
FieldValueIRS element (for citing)
Total Of Amounts22004TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt3120559TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities570632DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990570632RevenueNotRptdF990
Revenue Subtotal2549927RevenueSubtotal
Total Revenue Per Form9902549927TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt2871384TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities570632DonatedServicesUseOfFacilities
Expenses Not Rptd F990570632ExpensesNotRptdF990
Expenses Subtotal2300752ExpensesSubtotal
Total Expenses Per Form9902300752TotalExpensesPerForm990

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Mission Interest Committee
PO Box 189MiddleburyIN46540486119343501(c)(3)70000Mission Support
Mission Interest Committee
13200 CR 20MiddleburyIN46540486119343501(c)(3)180000Mission Support
Costa Rica Missions
1047 Orange RoadPrattsVA22731541301492501(c)(3)180000Mission Support
Amish Mennonite Aid
8916 Mission Home LaneFree UnionVA22940540803181501(c)(3)240000Mission Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe Organization does not make its governing documents and financial statements available to the public.
Form 990, Part VI, Line 15aForm 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementThe Administrator's compensation is set by the Board of Directors.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessReviews of Form 990 have not customarily been performed in the past.
Form 990, Part VI, Line 7bForm 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersExpenditures in excess of threshold amounts require the approval of the congregation of the sponsoring organization, the Oak Grove Mennonite Church.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Oak Grove Mennonite ChurchBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11008 Shiffletts Corner LaneAddressLine1
CityRochelleCity
StateVAState
ZIP Code22738ZIPCode
FieldValueIRS element (for citing)
EIN541301492EIN
Primary ActivitiesChurchPrimaryActivities
Legal Domicile StateVALegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status1PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
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 OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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