2013-04-22T13:23:05-05:00 2012-06-30 420732909 RYUN GIVENS & COMPANY PLC 2900 100TH STREET SUITE 301 URBANDALE IA 50322 990 2011-07-01 421308032 ON WITH LIFE INC ONWI 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 JULIE FIDLER DIXON 5159651339 2013-04-15 1 CURTIS E BRAND CPA P00299230 5152253141 2011 2016-03-07 17:11:31Z JULIE FIDLER DIXON 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 7747891 0 X ON-WITH-LIFE.ORG X 1987 IA JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. 15 15 166 100 11098 -278 24000 45329 7701754 7632085 89556 70358 23422 0 7838732 7747772 0 0 0 0 5570871 5672555 0 0 0 1912787 1668235 7483658 7340790 355074 406982 8000348 8284348 3470510 3324489 4529838 4959859 X JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE. WE PROVIDE COMPREHENSIVE IN-PATIENT AND COMMUNITY-BASED REHABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES, AND THEIR FAMILIES, AND PROVIDE EDUCATION REGARDING THE PREVENTION OF BRAIN INJURIES. 0 0 5256683 7556704 FUNCTIONAL EXPENSES WERE INCURRED IN PROVIDING 8,502 DAYS OF SPECIALIZED CARE AND REHABILITATION SERVICES TO INDIVIDUALS WHO HAVE SUSTAINED A TRAUMATIC BRAIN INJURY OR OTHER NEUROLOGICAL DISABILITY. 5256683 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 41 0 1 166 1 1 1 0 0 0 0 0 0 0 0 1 0 X 15 15 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JULIE FIDLER DIXON 5159651339 715 SOUTHWEST ANKENY ROAD ANKENY IA 50023 VILIA TARVYDAS 0.60 X X 0 0 0 CARL HARRIS 0.60 X X 0 0 0 KAY HINES 0.60 X X 0 0 0 DONNA WALTER 0.60 X X 0 0 0 GAIL BOLIVER 0.60 X 0 0 0 THOMAS CARLSTROM 0.60 X 0 0 0 TROY DEJOODE 0.60 X 0 0 0 CHARLES DENHART 0.60 X 0 0 0 ARTHUR FILEAN 0.60 X 0 0 0 THOMAS FRIEDMAN 0.60 X 0 0 0 MARC HARDING 0.60 X 0 0 0 KATE BENSON LARSON 0.60 X 0 0 0 JEFFREY LAMBERTI 0.60 X 0 0 0 ELI WIRTZ 0.60 X 0 0 0 DAVID ZIELKE 0.60 X 0 0 0 DAVID DEMAREST 40.00 X 112287 0 7592 112287 0 7592 2 0 0 0 0 45329 41829 45329 PATIENT SERVICES 623000 4474506 4474506 MEDICARE/MEDICAID PAYM 623000 3074986 3074986 DIETARY/COBRA/MISC 900099 64283 64283 DIETARY CONSULTING 541900 11098 11098 SUPPORTIVE HOUSING 623990 7212 7212 7632085 69427 69427 1050 119 931 931 931 7747772 7556704 11098 134641 327157 327157 4419809 3432816 986993 168014 114265 53749 386048 281254 104794 371527 272780 98747 7650 7650 26751 10801 15950 4022 4022 2080 2080 149969 9319 140650 156498 156498 2509 2509 137284 27913 109371 94328 57035 37293 36344 11487 24857 124475 124475 293568 264211 29357 6696 6696 SUPPLIES, MEDICAL SUPPL 287500 287500 SERVICE FEES 234021 143277 90744 EQUIPMENT RENTAL & MAIN 145219 145219 FOOD AND DIETARY 119846 117768 2078 -160525 81038 -241563 7340790 5256683 2084107 0 1205 1205 1198991 1629088 1196274 1057504 31400 28750 1000 30914 5956459 3053600 3088076 2902859 8826 12016 1341464 1410344 1133112 1211668 8000348 8284348 472248 532698 92568 0 2485000 2300000 420694 491791 3470510 3324489 X 4529838 4959859 4529838 4959859 8000348 8284348 X 406982 23039 X X 0 1 1 X 0 X 129300 28350 13131 24000 45329 240110 5949675 6671005 7064004 7555710 7556704 34797098 96676 89959 64283 250918 6078975 6699355 7173811 7669669 7666316 35288126 0 0 0 35288126 86962 91359 76933 81691 69427 406372 86962 91359 76933 81691 69427 406372 3479 3479 6169416 6790714 7250744 7751360 7735743 35697977 0.98850 0.98630 0.01140 0.01360 X 0 0 0 0 0 0 1 4000 0 1 22 4022 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: $4,000 WAS PAID FOR DIRECT CONTACT WITH LEGISLATORS, AND $22 WAS PAID FOR FORMS AND COPIES. 154240 154240 4428234 2155266 2272968 643155 397249 245906 730830 501085 229745 2902859 VANGUARD GROUP GNMA 715976 F VANGUARD GROUP SHORT TERM 528087 F VANGUARD GROUP PRIME MMKT 3081 F VANGUARD INFLATION PRO 107598 F VANGUARD INFL. P ALLOW 16049 F VANGUARD GNMA ALLOWANCE UNREALIZED 31124 F VANGUARD SHORT TERM ALLOWANCE UNR 8429 F 1410344 DUE FROM COMMUNITY SERVICES 444412 DUE FROM GLENWOOD 87078 LOAN TO GLENWOOD 182299 DUE FROM CORPORATE 47379 DEBT SERVICE RESERVE FUND 170885 SERIES A BOND FUND 212527 SERIES B BOND-OLD PROJECT FUND 13132 BOND ISSUANCE COSTS 114326 BOND ISSUANCE COSTS-AMORTIZED -60370 1211668 DUE TO ANKENY DIVISION 458323 DUE TO CORPORATE 33468 491791 7747772 7340790 406982 23039 23039 430021 7769880 23039 23039 7746841 931 931 7747772 7339859 -931 -931 7340790 0 7340790 PART XII, LINE 4B - OTHER ADJUSTMENTS: GAIN ON SALE OF ASSET 931. PART XIII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON SALE OF ASSET -931. CITY OF ANKENY IOWA - SERIES 2004A 426004235 035362AZ5 2004-07-29 2840000 REFUNDING SERIES 1994 BONDS 0 0 0 CITY OF ANKENY IOWA - SERIES 2004B 426004235 035362AY8 2004-07-29 600000 EXPANDING AND MAKING IMPROVEMENTS ON HEALTH CARE FACILITY 0 0 0 2840000 169732 2616312 53956 2004 0 1 1 1 600000 13132 600000 2004 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 41829 APPRAISAL 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIP BETWEEN JULIE FIDLER DIXON AND BOARD MEMBERS OF ON WITH LIFE, INC. WHO ARE ALSO BOARD MEMBERS OF RELATED ORGANIZATIONS. BUSINESS RELATIONSHIP BETWEEN JEFFREY LAMBERTI WHO IS ON THE BOARD OF DIRECTORS OF CASEY'S GENERAL STORES, INC. AND ELI WIRTZ WHO IS EMPLOYED AS A VICE PRESIDENT OF CORPORATE COUNCIL AT CASEY'S GENERAL STORES, INC. FORM 990, PART VI, SECTION B, LINE 11 AN ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. ANY QUESTIONS AND CLARIFICATIONS ARE DIRECTED TO THE FINANCE COMMITTEE CHAIR. FORM 990, PART VI, SECTION B, LINE 12C EVERY BOARD MEETING BEGINS WITH A REVIEW OF THE AGENDA ITEMS, AND DIRECTORS ARE PROMPTED TO DISCLOSE ANY CONFLICTS OF INTEREST RELATED TO THOSE ITEMS. FORM 990, PART VI, SECTION B, LINE 15 WAGES ARE COMPARED TO SALARIES PUBLISHED IN BUSINESS RECORD FOR SIMILAR POSITIONS. THE BOARD ALSO USES WAGE SURVEYS FROM IOWA WORKFORCE, IOWA HEALTH CARE ASSOCIATION, AND SIMILAR ASSOCIATIONS. THE EXECUTIVE COMMITTEE COMPLETES PERFORMANCE REVIEW REVIEWS AND MAKES RECOMMENDATIONS TO THE FULL BOARD FOR THE EXECUTIVE DIRECTOR'S SALARY. THE EXECUTIVE DIRECTOR RECOMMENDS SALARIES FOR OTHER STAFF. FORM 990, PART VI, SECTION C, LINE 19 ARTICLES OF INCORPORATION ARE PUBLISHED ON THE SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICT OF INTEREST POLICIES ARE AVAILABLE UPON REQUEST. THE CONSOLIDATED FINANCIAL STATEMENT SUMMARY INCLUDED IN THE ANNUAL REPORT IS ON THE ORGANIZATION'S WEBSITE, AND FORM 990 IS AVAILABLE ON GUIDESTAR. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 23,039. OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT AUDITORS FORM 990. PART XI, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF INDEPENDENT AUDITORS AND ARE ALSO RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT. THIS PROCESS HAS REMAINED UNCHANGED FROM THE PRIOR YEARS. ON WITH LIFE EXTENDED SERVICES LTD 715 SW ANKENY RD ANKENY IA 50023 421521198 PROVIDE SKILLED CARE AND REHAB SERVICES FOR INDIVIDUALS WITH BRAIN INJURIES IA 501(C)(3) 9 0 ON WITH LIFE FOUNDATION 715 SW ANKENY RD ANKENY IA 50023 421399777 TO SUPPORT ON WITH LIFE, INC. AND ON WITH LIFE EXTENDED SERVICES, LTD. IA 501(C)(3) 11B 0 ON WITH LIFE SUPPORTIVE HOUSING CORPORATION 715 SW ANKENY RD ANKENY IA 50023 460516882 SUBSIDIZED HOUSING FOR INDIVIDUALS WHO HAVE EXPERIENCED A BRAIN INJURY IA 501(C)(3) 9 0 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 1 0 0 ON WITH LIFE FOUNDATION C 3500 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD D 36043 ACTUAL ON WITH LIFE FOUNDATION M 2400 ACTUAL ON WITH LIFE FOUNDATION & EXTENDED SERVICES LTD N 29072 ACTUAL ON WITH LIFE EXTENDED SERVICES LTD P 369817 ACTUAL ON WITH LIFE SUPPORTIVE HOUSING CORPORATION K 10520 ACTUAL