2013-11-15T09:53:47-06:00 2012-12-31 351476702 BRADY WARE & SCHOENFELD INC 10 WEST BROAD SUITE 1500 COLUMBUS OH 43215 990 2012-01-01 341200331 CHAMPAIGN RESIDENTIAL SERVICES INC CHAM 9376531320 1150 SCIOTO STREET NO 100 URBANA OH 43078 SCOTT A DELONG 9376531320 2013-11-12 1 BETTY COLLINS P00602371 6148857407 2012 2016-02-25 16:41:14Z SCOTT A DELONG 1150 SCIOTO ST SUITE 100 URBANA OH 43078 38287723 0 X WWW.CRSI-OH.COM X 1977 OH TO PROVIDE RESIDENTIAL AND HABILITATION SERVICES FOR INDIVIDUALS WITH CHALLENGES. TO PROVIDE VOCATIONAL, RESIDENTIAL AND ASSOCIATED SERVICES TO THOSE IN NEED. TO EMPOWER AND SUPPORT INDIVIDUALS WITH CHALLENGES TO PROVIDE AN OPPORTUNITY TO DEVELOP THEIR MAXIMUM LEVEL OF INDEPENDENCE AS THEY CHOOSE. INHERENT IN THIS COMMITMENT IS THE ESTABLISHMENT OF QUALITY SUPPORT SYSTEMS FOR THOSE AT RISK THAT ENHANCE PHYSICAL, INTELLECTUAL, EMOTIONAL, COMMUNICATION, VOCATIONAL AND SOCIAL SKILLS ACCORDING TO THE INDIVIDUAL'S NEEDS, ABILITIES AND CHOICES. 18 18 1910 0 0 0 78753 71825 38145086 38126067 16372 71581 2094 0 38242305 38269473 0 0 0 0 27963291 28922428 0 0 40638 8122998 8260798 36086289 37183226 2156016 1086247 20774065 22001010 5040025 5179631 15734040 16821379 X TO PROVIDE RESIDENTIAL AND HABILITATION SERVICES FOR INDIVIDUALS WITH CHALLENGES. TO PROVIDE VOCATIONAL, RESIDENTIAL AND ASSOCIATED SERVICES TO THOSE IN NEED. TO EMPOWER AND SUPPORT INDIVIDUALS WITH CHALLENGES TO PROVIDE AN OPPORTUNITY TO DEVELOP THEIR MAXIMUM LEVEL OF INDEPENDENCE AS THEY CHOOSE. INHERENT IN THIS COMMITMENT IS THE ESTABLISHMENT OF QUALITY SUPPORT SYSTEMS FOR THOSE AT RISK THAT ENHANCE PHYSICAL, INTELLECTUAL, EMOTIONAL, COMMUNICATION, VOCATIONAL AND SOCIAL SKILLS ACCORDING TO THE INDIVIDUAL'S NEEDS, ABILITIES AND CHOICES. 0 0 32347975 38178840 PROVIDED RESIDENTIAL AND HABILITATION SERVICES FOR INDIVIDUALS WITH CHALLENGES IN OHIO. LONG-TERM CARE FACILITIES AND SEMI-INDEPENDENT LIVING APARTMENTS ARE OPERATED PROVIDING DIETARY, HABILITATION, MEDICAL AND OTHER DAILY LIVING SERVICES. SERVED APPROXIMATELY 759 DISABLED INDIVIDUALS RESIDING IN 28 OHIO COUNTIES THROUGH STATE LICENSED HOMES AND SUPPORTED LIVING ARRANGEMENTS. ALSO PROVIDED ADULT DAY SERVICES FOR 39 INDIVIDUALS IN CHAMPAIGN COUNTY AND PROVIDED SOCIAL AND VOCATIONAL SERVICES TO 96 OTHER INDIVIDUALS IN 6 COUNTIES. NONE 32347975 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 96 0 1 1910 1 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 0 0 0 X SCOTT DELONG 9376531320 1150 SCIOTO STREET SUITE 100 URBANA OH 43078 PHILLIP EDWARDS 2.00 X 0 0 0 RICHARD ANDERSON 2.00 X 0 0 0 CHRISTINE GLESSNER 2.00 X 0 0 0 MARY ANN METHERD 2.00 X 0 0 0 JEFF MCCULLA 2.00 X 0 0 0 WILLIAM DENKEWALTER 2.00 X 0 0 0 JERRY SCHLAEGEL 2.00 X 0 0 0 MARVIN STEVENS 2.00 X 0 0 0 EDWIN CORWIN 2.00 X 0 0 0 ALICE SCHLEMMER 2.00 X 0 0 0 TERRY HOWELL 2.00 X 0 0 0 RICHARD DIETZ DDS 2.00 X 0 0 0 PHYLLIS WHITE 2.00 X 0 0 0 DAN STOWE DDS 2.00 X 0 0 0 ROSEMARY SAUNDERS 2.00 X 0 0 0 JORJA NIEMI 2.00 X 0 0 0 ED KAUFMAN 2.00 X 0 0 0 MIKE CAREY 2.00 X 0 0 0 THAN JOHNSON 40.00 X 257653 0 1083 BARBARA KELLER 40.00 X 172970 0 8785 SCOTT DELONG 40.00 X 161978 0 1083 MARTY FAGANS 40.00 X 46767 0 9441 STEVE LOFFING 40.00 X 90789 0 0 730157 0 20392 3 0 1 0 ARC OF ALLEN COUNTY 546 S COLLET ST LIMA OH 45805 LEASE OF HOME 120000 1 37268 34557 31785 71825 RESIDENTIAL SERVICES 623000 37997885 37997885 RENT FROM 501(C)3 623000 106920 106920 OTHER REVENUE 623000 11172 11172 TRANSPORTATION 623000 10090 10090 38126067 18808 18808 71023 18250 52773 52773 52773 0 37268 0 0 38269473 38178840 0 18808 730157 730157 23660691 22263450 1387351 9890 2126988 1905591 220451 946 2404592 2186165 217397 1030 109862 6462 103400 71085 24750 46335 999111 993695 5416 67962 61242 6720 266248 62509 191546 12193 328455 328455 1293774 898473 395301 629474 626554 2920 196467 99114 97353 103277 23511 79766 1089850 675760 414090 298648 228391 70257 GOV'T FRANCHISE FEE 723277 723277 DIETARY 710011 710011 PROGRAM SUPPLIES 460426 451823 410 8193 TELEPHONE 373944 187568 186376 538927 280871 256390 1666 37183226 32347975 4794613 40638 494552 890994 6827639 6945978 31815 33204 4509099 4544465 226556 260158 17218712 8998048 7599214 8220664 347780 406882 737410 698665 20774065 22001010 3012567 3366507 2027458 1813124 5040025 5179631 X 15693283 16790786 40757 30593 15734040 16821379 20774065 22001010 1086247 1092 0 X X 1 X 1 X 1 0 X 15493 56446 284134 78753 71825 506651 33840353 35890880 36525329 38147180 38178840 182582582 33855846 35947326 36809463 38225933 38250665 183089233 0 0 0 183089233 145196 28053 24378 16372 18808 232807 145196 28053 24378 16372 18808 232807 34001042 35975379 36833841 38242305 38269473 183322040 0.99870 0.99800 0.00130 X 532055 532055 8174786 2911190 5263596 1304878 1053284 251594 6717393 5033574 1683819 489600 489600 8220664 X 38280729 1092 10164 11256 38269473 0 38269473 37193390 10164 10164 37183226 0 37183226 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: BASED ON ITS REVIEW, MANAGEMENT DOES NOT BELIEVE CRSI HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, INCLUDING ANY POSITION THAT WOULD PLACE CRSI'S EXEMPT STATUS IN JEOPARDY AS OF DECEMBER 31, 2012. PART XI LINE 2D AND PART XII LINE 2D: NET ASSETS RELEASED FROM RESTRICTIONS GOLF OUTING 37268 37268 0 37268 37268 X 0 0 0 0 0 0 0 0 0 THAN JOHNSON 257653 0 0 0 0 0 0 0 1083 0 258736 0 0 0 BARBARA KELLER 172970 0 0 0 0 0 0 0 8785 0 181755 0 0 0 SCOTT DELONG 161978 0 0 0 0 0 0 0 1083 0 163061 0 0 0 X RE - RENTAL 2 31785 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE OFFICERS OF THE ORGANIZATION PRIOR TO FILING. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGES IN THE OVERSIGHT PROCESS OR SELECTION PROCESS. FORM 990 ADDITIONAL INFORMATION: RELATED PARTY TRANSACTIONS THE BOARD CHAIRMAN IS AN OFFICER OF A BANK THAT WAS OWED $3,077 AT DECEMBER 31,2012 FOR A MASTERCARD BALANCE. CRSI ALSO HAS A DEPOSITORY RELATIONSHIP WITH THE BANK TOTALING $1,257,912 AT DECEMBER 31,2012. THE BOARD TREASURER IS AN OFFICER OF ANOTHER BANK THAT HAS A DEPOSITORY RELATIONSHIP OF $120,199 WITH CRSI AT DECEMBER 31,2012. CRSI MANAGEMENT BELIEVES THE LOANS AND DEPOSITIORY RELATIONSHIPS HAVE BEEN MADE ON SUBSTANTIALLY THE SAME TERMS AND CONDITIONS, INCLUDING INTEREST RATES AND COLLATERAL, AS THOSE PREVAILING AT THE TIME FOR COMPARABLE TRANSACTIONS WITH OTHER CUSTOMERS.