PILGRIM PLACE IN CLAREMONT: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PILGRIM PLACE IN CLAREMONT (EIN 95-1691301)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-08-13
IRS object ID
201232269349300883
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)
Timestamp2012-08-13T09:30:30-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN951691301EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PILGRIM PLACE IN CLAREMONT INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPILGNameControl
Phone9093995500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1625 MAYFLOWER ROADAddressLine1
CityCLAREMONTCity
StateCAState
ZIP Code917114299ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBERNARD M VALEKName
TitleCFOTitle
Phone9093995500Phone
Date Signed2012-07-31DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBERNARD M VALEKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1625 MAYFLOWER ROADAddressLine1
CityCLAREMONTCity
StateCAState
ZIP Code91711ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17221496GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitepilgrimplace.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1915YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionSenior Housing and ServicesActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members21NbrIndependentVotingMembers
Total Nbr Employees221TotalNbrEmployees
Total Nbr Volunteers1200TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1092735ContributionsGrantsPriorYear
Contributions Grants Current Year1731830ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11345966ProgramServiceRevenuePriorYear
Program Service Revenue CY11690662ProgramServiceRevenueCY
Investment Income Prior Year78545InvestmentIncomePriorYear
Investment Income Current Year599322InvestmentIncomeCurrentYear
Other Revenue Prior Year682862OtherRevenuePriorYear
Other Revenue Current Year1146903OtherRevenueCurrentYear
Total Revenue Prior Year13200108TotalRevenuePriorYear
Total Revenue Current Year15168717TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7539047SalariesEtcPriorYear
Salaries Etc Current Year8022408SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year253822TotalFundrsngExpCurrentYear
Other Expense Prior Year7093229OtherExpensePriorYear
Other Expenses Current Year7937436OtherExpensesCurrentYear
Total Expenses Prior Year14632276TotalExpensesPriorYear
Total Expenses Current Year15959844TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1432168RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-791127RevenuesLessExpensesCY
Total Assets BOY63303826TotalAssetsBOY
Total Assets EOY62471661TotalAssetsEOY
Total Liabilities BOY34074130TotalLiabilitiesBOY
Total Liabilities EOY34748180TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY29229696NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY27723481NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSenior living and short and long-term health care services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2633083Expense
Revenue5033086Revenue
DescriptionINDEPENDENT LIVING - PROVIDED INDEPENDENT HOUSING TO AN AVERAGE OF 275 INDEPENDENT LIVING RESIDENTS DURING 2011.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2000812Expense
Revenue1644997Revenue
DescriptionASSISTED LIVING - ASSISTED LIVING RESIDENTIAL CARE SERVICES FOR AN AVERAGE OF 70 RESIDENTS DURING 2011.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4759985Expense
Revenue5012579Revenue
DescriptionSKILLED NURSING - PROVIDED SKILLED NURSING CARE FOR AN AVERAGE OF 56 RESIDENTS DURING 2010.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense3136880Expense
DescriptionDining services, housekeeping & laundry services, and resident activity programs.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp3136880TotalOfOtherProgramServiceExp
Total Program Service Expense12530760TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArttrueCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
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 OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArttrueDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109635NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees221NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members21NumberIndependentVotingMembers
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 BodyfalseForm990ProvidedToGoverningBody
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 FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PILGRIM PLACEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9093995500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1625 MAYFLOWER ROADAddressLine1
CityCLAREMONTCity
StateCAState
ZIP Code917114299ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DIANA OWINGS
Chair5.00XX000
CRAIG STUBBLEBINE
Vice-Chair5.00XX000
LESLIE ADAMS
Secretary5.00XX000
ANDRE ELLIS
Treasurer5.00XX000
CHRIS ALDWORTH
Director1.00X000
ARTHUR CRIBBS
Director1.00X000
DAVID CRIST
Director1.00X000
LYNNE DIAMOND
Director1.00X000
DAVID EDWARDS
Director1.00X000
GINGER ELLIOTT
Director1.00X000
JOHN HOWLANS
Director1.00X000
BARBARA JEFFERSON
Director1.00X000
PAUL KITTLAUS
Director1.00X000
ELEANOR SCOTT MEYERS
Director1.00X000
JOHN ROGERS
Director1X
KATHERINE HAUSER RUBEL
Director1X
SHIRLEY RUDE
Director1X
VICKI SHEA
Director1X
BARBARA TROXELL
Director1X
JANET VANDEVENDER
Director1X
NORM WERTHWEIN
Director1X
WILLIAM CUNITZ
CEO40X10484726000XX
BERNARD VALEK
CFO40115146X
STEVE ROGERS
VP/Campus Services40106655X
SUE FAIRLEY
VP/Health Services40102782X
FieldValueIRS element (for citing)
Total Reportable Comp From Org429430TotalReportableCompFromOrg
Total Other Compensation26000TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions1731830AllOtherContributions
Noncash Contributions15378NoncashContributions
Total Contributions1731830TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumn
Independent Living6230005033086
Assisted Living6230001644997
Skilled Nursing6230005012579
FieldValueIRS element (for citing)
Total Program Service Revenue11690662TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column152999TotalRevenueColumn
Exclusion$152,999ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2434416Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1988093Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities446323Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column446323TotalRevenueColumn
Related Or Exempt Function Income446323RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events267144GrossIncomeFundraisingEvents
Fundraising Direct Expenses64686FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column202458TotalRevenueColumn
Exclusion$202,458ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionEntrance FeesDescription
Business Code623000BusinessCode
Total Revenue Column944445TotalRevenueColumn
Related Or Exempt Function Income944445RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue944445TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15168717TotalRevenueColumn
Related Or Exempt Function Income13081430RelatedOrExemptFunctionIncome
Exclusion$355,457ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total429429Total
Program Services209437ProgramServices
Management And General219992ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4987924Total
Program Services4244993ProgramServices
Management And General620976ManagementAndGeneral
Fundraising121955Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2171730Total
Program Services1849623ProgramServices
Management And General294101ManagementAndGeneral
Fundraising28006Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total433325Total
Program Services365869ProgramServices
Management And General57315ManagementAndGeneral
Fundraising10141Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3537Total
Program Services0ProgramServices
Management And General3537ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58173Total
Program Services4800ProgramServices
Management And General53373ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total365737Total
Program Services335429ProgramServices
Management And General21942ManagementAndGeneral
Fundraising8366Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total313294Total
Program Services313044ProgramServices
Management And General250ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total6848Total
Program Services4151ProgramServices
Management And General1893ManagementAndGeneral
Fundraising804Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13118Total
Program Services2682ProgramServices
Management And General10436ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1444267Total
Program Services40532ProgramServices
Management And General1403735ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1717937Total
Program Services1595925ProgramServices
Management And General122012ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Food & Contract Services1074057107405700
Purchased Services75160660433812758719681
Med Supp & Equip328033280300
Registry Fees6402340230000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2149657Total
Program Services1849675ProgramServices
Management And General235113ManagementAndGeneral
Fundraising64869Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15959844Total
Program Services12530760ProgramServices
Management And General3175262ManagementAndGeneral
Fundraising253822Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1307181BOY
EOY1792097EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8842192BOY
EOY5715190EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1527358BOY
EOY1526249EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY44499BOY
EOY50233EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY33552BOY
EOY59815EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis66217833LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22044889LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY42269857BOY
EOY44172944EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6936735BOY
EOY6892732EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2342452BOY
EOY2262401EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY63303826BOY
EOY62471661EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2367362BOY
EOY1132325EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3610227BOY
EOY5406682EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY25675490BOY
EOY25675490EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY320000BOY
EOY400000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2101051BOY
EOY2133683EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY34074130BOY
EOY34748180EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY20356228BOY
EOY18942259EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3070195BOY
EOY2993627EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5803273BOY
EOY5787595EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY29229696BOY
EOY27723481EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY63303826BOY
EOY62471661EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-791127ReconcilationRevenueExpenses
Reconcilation Other Changes-715088ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years1636874CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1773069CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1166069CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1092735CurrentTaxYearMinus1Year
Current Tax Year1731830CurrentTaxYear
Total7400577Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10657111CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11019882CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11144806CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11563605CurrentTaxYearMinus1Year
Current Tax Year11836154CurrentTaxYear
Total56221558Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12293985CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12792951CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12310875CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12656340CurrentTaxYearMinus1Year
Current Tax Year13567984CurrentTaxYear
Total63622135Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years167379CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years208272CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years134277CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year127857CurrentTaxYearMinus1Year
Current Tax Year148812CurrentTaxYear
Total786597Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years167379CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years208272CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years134277CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year127857CurrentTaxYearMinus1Year
Current Tax Year148812CurrentTaxYear
Total786597Total
FieldValueIRS element (for citing)
Public Support Total50962835538PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years353485CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years203274CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years-219172CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year78545CurrentTaxYearMinus1Year
Current Tax Year599322CurrentTaxYear
Total1015454Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years353485CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years203274CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years-219172CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year78545CurrentTaxYearMinus1Year
Current Tax Year599322CurrentTaxYear
Total1015454Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Total64637589Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97210PublicSupportPercentage509
Prior Year Support Percentage0.97560PriorYearSupportPercentage
Investment Income Percentage0.01570InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.01200PriorYrInvestIncomePercentage
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

FieldValueIRS element (for citing)
Collect Used For Public ExhibitionXCollectUsedForPublicExhibition
Collect Used For Scholar ResearchXCollectUsedForScholarResearch
Collect Used For PreservationXCollectUsedForPreservation
Collect Used For Loan Or Exch PrgrmsXCollectUsedForLoanOrExchPrgrms
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6579319BeginningOfYearBalance
Contributions19025Contributions
Investment Earnings Or Losses-45291InvestmentEarningsOrLosses
Other Expenditures255735OtherExpenditures
Administrative Expenses36630AdministrativeExpenses
End Of Year Balance6260688EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5948702BeginningOfYearBalance
Contributions231133Contributions
Investment Earnings Or Losses706265InvestmentEarningsOrLosses
Other Expenditures274789OtherExpenditures
Administrative Expenses31992AdministrativeExpenses
End Of Year Balance6579319EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4280348BeginningOfYearBalance
Contributions258042Contributions
Investment Earnings Or Losses1726160InvestmentEarningsOrLosses
Other Expenditures292480OtherExpenditures
Administrative Expenses23368AdministrativeExpenses
End Of Year Balance5948702EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.42000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.58000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1529334InvestmentCostOrOtherBasis
Book Value1529334BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis58764482InvestmentCostOrOtherBasis
Depreciation18706490Depreciation
Book Value40057992BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1072525InvestmentCostOrOtherBasis
Depreciation586025Depreciation
Book Value486500BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis3956982InvestmentCostOrOtherBasis
Depreciation2752374Depreciation
Book Value1204608BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis894510InvestmentCostOrOtherBasis
Book Value894510BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings44172944TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Annuities Payable$849,995
Deposits$528,703
Taxable bonds$754,985
FieldValueIRS element (for citing)
Total Of Amounts2133683TotalOfAmounts
Total Revenue15168717TotalRevenue
Total Expenses15959844TotalExpenses
Excess Or Deficit For Year-791127ExcessOrDeficitForYear
Excess Or Deficit Per FS-791127ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt15168717TotRevenueEtcAuditedFinclStmt
Revenue Subtotal15168717RevenueSubtotal
Total Revenue Per Form99015168717TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15959844TotExpensesEtcAuditedFinclStmt
Expenses Subtotal15959844ExpensesSubtotal
Total Expenses Per Form99015959844TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (9 entries)

IdentifierIdentifierExplanationExplanation
Pt III Line 4Collections are open to the community. There are
also exchange programs with local exempt organizations for the purpose of education.
Pt IV Line 2bEntrance fee deposits held in escrow.
Pt V Line 4Endowment funds are used as reserves for future
operations of both general and restricted funds.
Pt XPilgrim Place has evaluated its tax positions and
THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED
IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO PILGRIM PLACE'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE IS UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS ARE MORE LIKELY THAN NOT (>50%) OF BEING SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION;THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE RE
Pt XI Line 8Present value adjustment of gift annuities payable.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CAL MUNI FIN AUTHBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN201563466IssuerEIN
CUSIP Number13049RAD8CUSIPNumber
Date Issued2009-08-19DateIssued
Issue Price25675490IssuePrice
Description Of PurposeNew constructionDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds25675490TotalProceeds
Amount In Reserve Fund2006475AmountInReserveFund
Refunding Escrow2327958RefundingEscrow
Issuance Costs From Proceeds2306630IssuanceCostsFromProceeds
Other Spent Proceeds19030812OtherSpentProceeds
Year Of Subst Completion2011YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions39NumberOfContributions
Noncash Contribs Rptd F99015378NoncashContribsRptdF990
Method Of Determining RevenuesDonor estimateMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 12cThrough corporate compliance policies and procedures.
Pt VI, Line 15Through review by Board executive committee composed
of independent directors.
Pt VI, Line 19Documents are available upon request.
Pt VI, Line 11aBoard of Directors decides how best to review pertinent
information in the form 990 and make it available to
other interested parties after filing.
Form 990, Part III, Line 4dDINING SERVICES, HOUSEKEEPING & LAUNDRY SERVICES, 3136880. 0. 0.
Form 990, Part IX, Line 24fPROF MED SERVICES 845685. 845060. 0. 625. STAFF DEVELOPMENT 13359. 7165. 6194. 0. PUBLIC RELATIONS 66511. 22177. 37818. 6516. UTILITIES 596568. 577307. 18011. 1250. EMP. ADVERTISING 3115. 0. 3115. 0. RHSP TRANSFERS PIANO LIBRARY INVESTMENT FEES MISCELLANEOUS 53477. 15931. 2742. 34804. RES. ACTIVITIES 20961. 20961. 0. 0. BEAUTY SHOP 17164. 17164. 0. 0. EQUIPMENT RENTAL 32669. 18660. 14009. 0. POSTAGE 16092. 1420. 11529. 3143. PRINTING 26788. 2256. 10232. 14300. REPAIRS & MAINTENANCE 247587. 24620

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