GOOD SAMARITAN NETWORK OF HAMILTONCOUNTY INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
GOOD SAMARITAN NETWORK OF HAMILTONCOUNTY INC (EIN 20-4371453)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-05-12
IRS object ID
201211339349300106
Schema version
2011v1.2
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)
Timestamp2012-05-12T07:01:00-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WAGNERCPAGROUPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18335 BROOKS FARM LNAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code462379489ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204371453EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GOOD SAMARITAN NETWORK OF HAMILTON COUNTY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGOODNameControl
Phone3177531293Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1382 WOODVIEW DRIVEAddressLine1
CityNOBLESVILLECity
StateINState
ZIP Code46060ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNANCY CHANCEName
TitleEXECUTIVE DIRECTORTitle
Phone3177531293Phone
Date Signed2012-05-02DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDEBORAH L WAGNERName
Phone3178891769Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonNANCY CHANCENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line112993 PARKSIDE DRAddressLine1
CityFISHERSCity
StateINState
ZIP Code46038ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6644830GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionFood and clothing distribtution and education to those in need.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1TotalNbrEmployees
Total Nbr Volunteers50TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3454972ContributionsGrantsPriorYear
Contributions Grants Current Year6644830ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year3454972TotalRevenuePriorYear
Total Revenue Current Year6644830TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year128705GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY39708GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49640SalariesEtcPriorYear
Salaries Etc Current Year37205SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year17055TotalFundrsngExpCurrentYear
Other Expense Prior Year3245102OtherExpensePriorYear
Other Expenses Current Year6515707OtherExpensesCurrentYear
Total Expenses Prior Year3423447TotalExpensesPriorYear
Total Expenses Current Year6592620TotalExpensesCurrentYear
Revenues Less Expenses Prior Year31525RevenuesLessExpensesPriorYear
Revenues Less Expenses CY52210RevenuesLessExpensesCY
Total Assets BOY86067TotalAssetsBOY
Total Assets EOY136107TotalAssetsEOY
Total Liabilities EOY-2170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY86067NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY138277NetAssetsOrFundBalancesEOY
Mission DescriptionFood and clothing distribtution and education to those in needMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense98371Expense
Revenue246468Revenue
DescriptionEDUCATION AND FINANCIAL SUPPORT - WORKSHOPS THAT FOCUES ON NEEDED LIFE SKILLS, SELF-ESTEEM, AND PROMOTES RELATIONSHIP BUILDING. ALSO PROVIDES TEMPORARY SUPPORT AND "EVERYDAY ASSISTANCE" TO FAMILIES IN NEED THROUGH PAYMENTS OF NECESSARY BASIC LIVING EXPENSES UNTIL FAMILIES CAN SUPPORT THEMSELVES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense6398362Expense
Revenue6398362Revenue
DescriptionHOLIDAY PROGRAMS/SPECIAL PROJECTS - THE SOLICITATION, COLLECTION TEMPORARY STORAGE AND DISTRIBUTION OF DONATED FOOD TO HELP THE ILL, NEEDY, AND AT-RISK RESIDENTS OF HAMILTON COUNTY.Description
FieldValueIRS element (for citing)
Total Program Service Expense6496733TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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 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 IndividualstrueGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
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 AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARSHA TRESTRAILNamePerson
Telephone Number3178422603TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112993 PARKSIDE DRAddressLine1
CityFISHERSCity
StateINState
ZIP Code46038ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirector
RALPH MILLER
President5.00X000
MIKE THOMAS
Vice-president5.00X000
BRENT DOUTHIT
2nd Vice President5.00X000
PATTI PEAPER
Secretary5.00X000
MARSHA TRESTRAIL
Treasurer5.00X000
BRIDGETTE DAWSON-JONES
Member5.00000
NICOLE FINELLI
Member5.00000X
DAVID RICHARDSON
Member5.00000X
TERRY WEST
Member5.00000X
AMANDA TRESTRAIL
Treasurer 25.00X000
DAN SHIELDS
Member5.00000X
RYAN WILMERING
Member5.00000X
NANCY CHANCE
Executive/Volunteers5.00X000
FieldValueIRS element (for citing)
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events14536FundraisingEvents
All Other Contributions6630294AllOtherContributions
Noncash Contributions6398362NoncashContributions
Total Contributions6644830TotalContributions
Cntrbtns Rprtd Fundraising Events14536CntrbtnsRprtdFundraisingEvents

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6644830TotalRevenueColumn

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total39708Total
Program Services39708ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total37205Total
Program Services0ProgramServices
Management And General37205ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6931Total
Program Services0ProgramServices
Management And General6931ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total542Total
Program Services542ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12366Total
Program Services6183ProgramServices
Management And General6183ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2058Total
Program Services1103ProgramServices
Management And General955ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total34960Total
Program Services13984ProgramServices
Management And General13984ManagementAndGeneral
Fundraising6992Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2491Total
Program Services0ProgramServices
Management And General2491ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4163Total
Program Services4163ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3110Total
Program Services1555ProgramServices
Management And General1555ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Dues & Membership4612046120
Postage2260904904452
Misc.3643182218210
Printing50604654654130

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6433511Total
Program Services6426304ProgramServices
Management And General1726ManagementAndGeneral
Fundraising5481Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6592620Total
Program Services6496733ProgramServices
Management And General78832ManagementAndGeneral
Fundraising17055Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY71496BOY
EOY125699EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17000LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6592LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY14571BOY
EOY10408EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY86067BOY
EOY136107EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY-2170EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY-2170EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY86067BOY
EOY138277EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86067BOY
EOY138277EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86067BOY
EOY136107EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses52210ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3315564CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5459088CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2818978CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3326682CurrentTaxYearMinus1Year
Current Tax Year6610033CurrentTaxYear
Total21530345Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1492CurrentTaxYearMinus4Years
Total1492Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3317056CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5459088CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2818978CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3326682CurrentTaxYearMinus1Year
Current Tax Year6610033CurrentTaxYear
Total21531837Total
FieldValueIRS element (for citing)
Public Support Total50921531837PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years411CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years76CurrentTaxYearMinus3Years
Total487Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years411CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years76CurrentTaxYearMinus3Years
Total487Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total21532324Total
FieldValueIRS element (for citing)
Public Support Percentage5091.00000PublicSupportPercentage509
Prior Year Support Percentage1.00000PriorYearSupportPercentage
Investment Income Percentage0InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00000PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis17000InvestmentCostOrOtherBasis
Depreciation6592Depreciation
Book Value10408BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10408TotalOfBookValueLandBuildings

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 2The board of directors review grant funds distributed on a periodic basis.
Pt I Line 2There is follow up with the recipients assessing receipts and needs.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11aBoard of Directors and Administrative Director review Form 990 before filing.
Pt VI, Line 12cBoard of Directors review conflict of interest policy on a periodic basis and are required to disclose any conflicts noted.
Pt VI, Line 15Compensation is reviewed and evaluated by the Board. Amounts are compared with industry averages.
Pt VI, Line 19Documents are available upon request.
Form 990, Part IX, Line 24fVEHICLE EXPENSES 3453. 1727. 1726. 0. DISTRIBUTIONS - FOOD, CLOTHING, ETC. 6424577. 6424577. 0. 0. VOLUNTEER EXPENSES 3210. 0. 0. 3210. STORAGE FEES 2271. 0. 0. 2271.

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