FANNY ALLEN CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FANNY ALLEN CORPORATION (EIN 22-2495808)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-06-20
IRS object ID
201321719349300617
Schema version
2012v2.1
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)
Timestamp2013-06-20T14:12:08-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN020383073EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAM STEELE & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line140 STARK STREETAddressLine1
CityMANCHESTERCity
StateNHState
ZIP Code03101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN222495808EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FANNY ALLEN CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFANNNameControl
Phone9786546363Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVE SUITE 102AddressLine1
CityTEWKSBURYCity
StateMAState
ZIP Code01876ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN AHLEName
TitleTREASURERTitle
Phone9786546363Phone
Date Signed2013-06-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM G STEELE JR CPAName
PTINP00233103PTIN
Phone6036228881Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN AHLENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVE SUITE 102AddressLine1
CityTEWSBURYCity
StateMAState
ZIP Code01876ZIPCode
FieldValueIRS element (for citing)
Gross Receipts555015GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileVTStateLegalDomicile
Activity Or Mission DescriptionTO CONTINUE THE MISSION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH BY SUPPORTING NONPROFIT ORGANIZATIONS THAT REFLECT THE COMPASSION OF CHRIST IN THEIR SERVICE TO THE SICK, POOR, MOST NEEDY AND SPIRITUALLY BROKEN.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year388827ProgramServiceRevenuePriorYear
Program Service Revenue CY399325ProgramServiceRevenueCY
Investment Income Prior Year199462InvestmentIncomePriorYear
Investment Income Current Year155690InvestmentIncomeCurrentYear
Other Revenue Prior Year1867OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year590156TotalRevenuePriorYear
Total Revenue Current Year555015TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year182028GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY205441GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year297198OtherExpensePriorYear
Other Expenses Current Year357916OtherExpensesCurrentYear
Total Expenses Prior Year479226TotalExpensesPriorYear
Total Expenses Current Year563357TotalExpensesCurrentYear
Revenues Less Expenses Prior Year110930RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-8342RevenuesLessExpensesCY
Total Assets BOY7166661TotalAssetsBOY
Total Assets EOY7655460TotalAssetsEOY
Total Liabilities BOY262601TotalLiabilitiesBOY
Total Liabilities EOY139339TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6904060NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7516121NetAssetsOrFundBalancesEOY
Mission DescriptionTO CONTINUE THE MISSION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH BY SUPPORTING NONPROFIT ORGANIZATIONS THAT REFLECT THE COMPASSION OF CHRIST IN THEIR SERVICE TO THE SICK, POOR, MOST NEEDY AND SPIRITUALLY BROKEN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense343661Expense
Grants205441Grants
DescriptionIN CONJUCTION WITH FANNY ALLEN HOLDINGS WE CONTINUE THE MISSION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH BY SUPPORTING NONPROFIT ORGANIZATIONS THAT REFLECT THE COMPASSION OF CHRIST IN THEIR SERVICE TO THE SICK, POOR, MOST NEEDY AND SPIRITUALLY BROKEN.Description
Total Program Service Expense343661TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN AHLEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9786546363TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 AMES POND DRIVE SUITE 102AddressLine1
CityTEWKSBURYCity
StateMAState
ZIP Code01862ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MICHAEL TOMKOWICZ
DIRECTOR/CHAIR3.00XX000
LAURA WARREN
DIRECTOR/SECRETARY1.00XX000
MICHAEL NEW
DIRECTOR1.00X000
CHRISTINE WERNEKE
DIRECTOR1.00X000
NADINE SCIBEK
DIRECTOR1.00X000
DAVID JILLSON
DIRECTOR1.00X000
HEIDI ST PETER
DIRECTOR1.00X000
ELLEN KANE
DIRECTOR/ PRESIDENT20.00XX06579127883
JOHN AHLE
TREASURER/ CHS1.00X0491296161726
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs557087TotalReportableCompFrmRltdOrgs
Total Other Compensation189609TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRENTAL INCOMEDescription
Business Code531120BusinessCode
Total Revenue Column399325TotalRevenueColumn
Exclusion$399,325ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue399325TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column53980TotalRevenueColumn
Exclusion$53,980ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities101710Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities101710Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column101710TotalRevenueColumn
Exclusion$101,710ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column555015TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$555,015ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total205441Total
Program Services205441ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total900Total
Management And General900ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7268Total
Management And General7268ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total330Total
Program Services330ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1482Total
Program Services1482ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total22247Total
Program Services22247ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17796Total
Program Services17796ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1222Total
Program Services1222ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
DUES21154315211528
ADMINISTRATIVE FESS4961049610
REPAIRS AND SUPPLIES4551845518

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total563357Total
Program Services343661ProgramServices
Management And General219696ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY32106BOY
EOY245853EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY75377BOY
EOY10999EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis538791LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec382004LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY174584BOY
EOY156787EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4813795BOY
EOY5164633EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY6875BOY
EOY6875EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2063924BOY
EOY2070313EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7166661BOY
EOY7655460EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY64000BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY198601BOY
EOY139339EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY262601BOY
EOY139339EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4972524BOY
EOY5572105EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY1362279EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1931536BOY
EOY581737EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6904060BOY
EOY7516121EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7166661BOY
EOY7655460EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-8342ReconcilationRevenueExpenses
Reconciliation Unrealized Invest552299ReconciliationUnrealizedInvest
Reconcilation Other Changes68104ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee0AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1FLETCHER ALLEN HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN030219305EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1865323BeginningOfYearBalance
Contributions1283586Contributions
Investment Earnings Or Losses65651InvestmentEarningsOrLosses
Other Expenditures1283586OtherExpenditures
End Of Year Balance1930974EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1931536BeginningOfYearBalance
Investment Earnings Or Losses-66213InvestmentEarningsOrLosses
End Of Year Balance1865323EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1901991BeginningOfYearBalance
Investment Earnings Or Losses29545InvestmentEarningsOrLosses
End Of Year Balance1931536EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2017668BeginningOfYearBalance
Investment Earnings Or Losses-115687InvestmentEarningsOrLosses
End Of Year Balance1901991EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1968399BeginningOfYearBalance
Investment Earnings Or Losses49269InvestmentEarningsOrLosses
End Of Year Balance2017668EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.29900PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.70100TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis538791OtherCostOrOtherBasis
Depreciation382004Depreciation
Book Value156787BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings156787TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionPROVIDENTIA PRIMA TRUSTDescription
Book Value5164633BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities5164633TotalOfBookValueSecurities

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
RESTRICTED FUNDS, CVS, SPLIT INTEREST ACCOUNT1930974
DEFERRED COMPENSATION139339
FieldValueIRS element (for citing)
Total Book Value Other Assets2070313TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDEFERRED COMPENSATIONDescription
Amount$139,339Amount
FieldValueIRS element (for citing)
Total Of Amounts139339TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt1107314TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments552299NetUnrealizedGainsInvestments
Revenue Not Rptd F990552299RevenueNotRptdF990
Revenue Subtotal555015RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990555015TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt563357TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal563357ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990563357TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:JOHN J. FLYNN TRUST WAS CONVERTED TO TEMPORARILY RESTRICTED FUND DURING 2012.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS IS THE FOLLOWING "TAX EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION FOR INCOME TAXES AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS INCLUDING UNRELATED BUSINESS INCOME OR TAX STATUS. THE SYSTEM HAS EVALUATED THE POSITIONS TAKEN ON ITS FILED TAX RETURNS, AND HAS CONCLUDED NO UNCERTAIN INCOME TAX POSITIONS EXIST AT DECEMBER 31, 2012."

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
CAMP EXCLAMATION POINT INC
PO BOX 91RICHMONTVT0547703032956836000DAY CAMP FOR LOW INCOME CHILDERN
CHITTENDEN HOUSING CORP
PO BOX 1157CABOTVT05647030340615310000YOUTH ENRICHMENT PROGRAM
COMMITTEE ON TEMPORARY SHELTER
PO BOX 1616BURLINGTONVT05401030285606317000HOMELESS PREVENTION FUND AND DAY SHELTER
FAITH IN ACTION
2 COMMON WAY PO BOX 157CABOTVT05647208406050310000PROVIDE BASIC NEEDS TO SENIORS AND THE DISABLED
DISMAS HOUSE
96 BUELL STREETBURLINGTONVT0540103036944237000HOUSING FOR FORMER PRISONERS
HUNGER FREE VERMONT
180 FLYNN AVENUEBURLINGTONVT0540103033635735000CHILDERN NUTRITION OUTREACH PROGRAM
JOHN GRAHAM EMERGENCY CENTER
69 MAIN STREETVERGENNESVT05401030275219314000HOMELESS SHELTER PROGRAMS
JOINT URBAN MINISTRY PROJECT
38 SOUTH WINOOSKI AVENUEBURLINGTONVT0540120205511338000EMERGENCY ASSITANCE DIRECT AID
KING STREET YOUTH CENTER
PO BOX 1615BURLINGTONVT05402237236312310000DAY CAMP FOR LOW INCOME CHILDERN
LEROYER EMPLYEE ASSISTANCE
C/O FLECTHER ALLEN HEALTH CAREBURLINGTONVT0540403021930935000EMERGENCY ASSISTANCE TO FLETCHER ALLEN EMPLOYEES AND THEIR FAMILIES
SAMARITIAN HOUSE
20 KIGMAN ST SUITE 1ST ALBANSVT05478030330331310000SHELTER AND TRANSITIONAL HOUSING FOR THE HOMELESS
CHAMPLAIN SENIOR CENTER
241 NO WINOOSKI AVENUEBURLINGTONVT0540123705638335000SENIOR LUNCH PROGRAM
CHILD CARE RESOURCE
181 COMMERCE STREETWILLISTONVT05495030301330310000ECONOMICALLY DISADVANTAGED CHIDERN
GREEN MOUNTIAN HABITAT FOR HUMANITY
300 CORNERSTONE DRIVE STE 300WILLISTONVT0549522255892337500HABITAT FOR HUMANITY
MIDDLEBURY COMMUNITY CARE COALITION
PO BOX 344MIDDLEBURYVT0574056253180237500HOMELESS ASSISTANCE
OPPORTUNITIES CREDIT UNION
PO BOX 67WINOOSKIVT0540403032171237000EMERGENCY LOAN ASSISTANCE
PACE VERMONT INC
786 COLLEGE PARKWAYCOLCHESTERVT054466114743513HELP SUPPORT THEIR ELDERLY PROGRAMS32831FMVGRANTED PARTIAL RENT ABATEMENT DURING 2012
UNITED WAY OF CHITTENDEN COUNTY
412 FARRELL ST STE 200BURLINGTONVT05403030217229310000TRANSPORTATION FOR SENIORS AND DISABLED
VERMONT CATHOLIC CHARITIES INC
55 JOY DRIVEBURLINGTONVT05403030181216310000EMERGENCY ASSITANCE FOR ECOMOMICALLY DISADVANTAGED
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants19TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: INTERVIEW GRANTEE ORGANIZATIONS SEEKING DONATIONS AND MONITOR THEIR ACTIVITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonJOHN AHLENamePerson
TitleTREASURER/ CHSTitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs327760CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs118124BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs45412OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs130000DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs31726NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs653022TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs118124CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4BTHE RELATED ORGANIZATION, COVENANT HEALTH SYSTEMS, MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM FOR CERTAIN EXECUTIVES UNDER WHICH THE ORGANIZATION MAKES A CONTRIBUTION TO A GRANTOR TRUST FOR THE BENEFIT OF THE EXECUTIVE THAT IS INTENDED TO PROVIDE A SPECIFIED LEVEL OF RETIREMENT BENEFITS AT RETIREMENT AGE COMMENSURATE WITH RETIREMENT BENEFITS PROVIDED TO EXECUTIVES IN COMPARABLE POSITIONS BY SIMILARLY SITUATED ORGANIZATIONS. AMOUNTS CONTRIBUTED TO THE GRANTOR TRUST ARE HELD FOR THE BENEFIT OF THE EXECUTIVE UNTIL HE OR SHE REACHES AGE 60, AT WHICH TIME THEY ARE RELEASED TO THE EXECUTIVE. THE FULL AMOUNT PAID INTO THE GRANTOR TRUST IS TAXABLE TO THE EXECUTIVE WHEN SO PAID, AND IS INCLUDED IN THE EXECUTIVE'S REPORTED COMPENSATION.
PART I, LINE 6THE RELATED ORGANIZATION, COVENANT HEALTH SYSTEMS, MAINTAINS AN INCENTIVE COMPENSATION PLAN FOR EXECUTIVES THAT IS ADMINISTERED BY THAT ORGANIZATION'S COMPENSATION COMMITTEE. THE PLAN PROVIDES EXECUTIVES WITH THE OPPORTUNITY TO EARN REASONABLE INCENTIVE COMPENSATION BASED ON THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE INDIVIDUAL EXECUTIVE, AS MEASURED AGAINST GOALS THAT ARE SET AT THE BEGINNING OF THE YEAR. THE ENTITLEMENT TO AWARDS FOR A PARTICULAR YEAR IS NOT DETERMINED UNTIL EARLY THE FOLLOWING YEAR. THE ORGANIZATION PAID INCENTIVE COMPENSATION AWARDS TO JOHN AHLE IN 2012 BASED ON PERFORMANCE DURING 2011. DURING 2012, THE ORGANIZATION PAID $118,464 OF ACCRUED INCENTIVE COMPENSATION FOR MR. AHLE.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6COVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ACOVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION AND AS SUCH HAS CERTAIN RESERVED RIGHTS.
FORM 990, PART VI, SECTION A, LINE 7BCOVENANT HEALTH SYSTEMS, INC. IS THE SOLE MEMBER OF FANNY ALLEN CORPORATION AND AS SUCH HAS CERTAIN RESERVED RIGHTS TO APPROVE CERTAIN DECISIONS.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED IN DETAIL BY THE GOVERNING BODY PRIOR TO BEING FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS AN OPERATIONAL INTEGRITY OFFICER THAT MONITORS ALL AREAS FOR POTENTIAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15FOR THE RELATED PARTY, COVENANT HEALTH SYSTEMS, INC. - EVERY TWO TO THREE YEARS THE COMPENSATION COMMITTEE OF THE COVENANT HEALTH SYSTEMS BOARD OF DIRECTORS ENGAGES AN EXTERNAL CONSULTANT TO PROVIDE COMPETITIVE MARKET DATA FROM VARIOUS SURVEY SOURCES, WHICH IS USED TO DEVELOP RECOMMENDATIONS FOR CHANGES TO THE COMPENSATION PROGRAM. SINCE 2003, THE COMPENSATION COMMITTEE HAS ENGAGED MERCER HUMAN RESOURCES CONSULTING TO CONDUCT THIS ANALYSIS. THE SPECIFIC OBJECTIVES OF THIS ANALYSIS ARE TO: - ASSESS THE COMPETITIVENESS OF THE CURRENT TOTAL CASH COMPENSATION LEVELS FOR THE SENIOR LEADERSHIP TEAM. - DEVELOP MARKET BASED COMPETITIVE SALARY RANGES FOR ALL EXECUTIVE POSITIONS. - ENSURE THAT THE ANNUAL INCENTIVE OPPORTUNITIES, IF THERE ARE ANY, ARE COMPETITIVE AND REASONABLE.
FORM 990, PART VI, SECTION C, LINE 19ALL POLICIES AND FORM 990'S ARE MAINTAINED WITH THE BOOKS AND RECORDS AND ARE AVAILABLE TO THE PUBLIC FOR INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:TRANSFER AMONG AFFILIATES 55,625. INVESTMENT INCOME ENDOWNMENT FUNDS 12,479.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990 PART VII & SCHEDULE JTHE REPORTABLE AND OTHER COMPENSATION PAID BY A RELATED ORGANIZATION TO JOHN AHLE WAS PAID BY COVENANT HEALTH SYSTEM, INC.COMPENSATION BY RELATED ORGANIZATION

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
FANNY ALLEN HOLDINGS
101 COLLEGE PARKWAYCOLCHESTERVT05446030181052FOUNDATIONVT501(C) 3509(A) 2CHS0
COVENANT HEALTH SYSTEMS INC
100 AMES POND DRIVETEWKSBURYMA01876222484505HEALTH CARE MANAGEMENT AND RESOURCE ORGANIZATIONMA501(C) 3501(A) 2CHS0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
COVENANT HEALTH SYSTEMS INC
M211528ACCRUAL
FANNY ALLEN HOLDINGS
S55625ACCRUAL
COVENANT HEALTH SYSTEMS INC
O46837ACCRUAL

Comments

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