2012-11-15T11:59:12-06:00 2012-06-30 020417217 LEONE MCDONNELL & ROBERTS PA 645 SOUTH MAIN STREET WOLFEBORO NH 03894 990 2011-07-01 020481836 MONADNOCK REGIONAL FOUNDATION FOR FAMILY SERVICES INC MONA 6033555316 64 MAIN STREET KEENE NH 03431 GIGI BATCHELDER 6033555316 2012-10-31 1 JOHN J DAIGNEAULT CPA P00433512 6035691953 2011 2016-02-24 21:20:13Z GIGI BATCHELDER 64 MAIN STREET KEENE NH 03431 964079 0 X N/A X 1995 NH THE SPECIFIC OBJECTIVES AND PURPOSE OF THE CORPORATAION SHALL BE TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF AND TO FURTHER THE PURPOSES OF MONADNOCK FAMILY SERVICES, INC. 8 8 0 0 0 0 500 0 0 0 95805 105927 5032 -4555 101337 101372 40000 777083 0 0 0 0 0 0 0 30623 36162 70623 813245 30714 -711873 1802720 953411 20826 16597 1781894 936814 TO OPERATE EXCLUSIVELY OF THE BENEFIT OF AND TO FURTHER THE PURPOSES OF MONADNOCK FAMILY SERVICES, INC. 0 0 813245 101372 TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF AND TO FURTHER THE PURPOSES OF MONADNOCK FAMILY SERVICES, INC. 813245 1 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NH X GIGI BATCHELDER 6033555316 64 MAIN STREET KEENE NH 03431 X JANE STABLER 2.00 X 0 0 0 JOHN G BURK CPA 2.00 X 0 0 0 ROBERT ROONEY 2.00 X 0 0 0 JILL BATTY 2.00 X 0 0 0 PETER WHITTEMORE 2.00 X 0 0 0 MARY LOU CAFFREY 2.00 X 0 0 0 GREG TEWKSBURY 2.00 X 0 0 0 PETER SKALABAN 2.00 X 0 0 0 0 0 0 0 0 0 0 0 31362 31362 937272 862707 74565 74565 74565 SPLIT-INTEREST AGREEME 624100 -4555 -4555 -4555 101372 101372 0 0 777083 777083 6340 6340 4750 4750 10376 10376 DUES AND SUBSCRIPTIONS 14696 14696 813245 813245 0 0 19809 111980 2083 275000 1505828 841431 1802720 953411 20826 16597 20826 16597 X 1700680 855600 81214 81214 1781894 936814 1802720 953411 X -711873 -133207 X 0 1 1 X 0 X X 0 0 0 MONADNOCK FAMILY SERVICES INC 026012230 11A 1 1 1 777083 1 777083 81214 2323 2323 81214 81214 4284 4284 81214 81214 2676 2676 81214 81214 81214 0.08500 0 0 0 U.S. GOVERNMENT AND AGENCY BONDS 157020 F CORPORATE AND FOREIGN BONDS 53723 F COMMON EQUITY SECURITIES 347355 F INTERNATIONAL EQUITY FUNDS 1480 F DOMESTIC EQUITY MUTUAL FUNDS 7932 F CLOSED END MUTUAL FUNDS 110101 F FIXED INCOME FUNDS 163820 F 841431 DUE TO AFFILIATE 10279 ANNUITY PAYMENT LIABILITY 6318 16597 101372 813245 -711873 -133207 -133207 -845080 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS WILL BE USED AS DONOR HAS SPECIFIED DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION HAS MAINTAINED ITS TAX-EXEMPT STATUS, DOES NOT HAVE ANY SIGNIFICANT UNRELATED BUSINESS INCOME AND HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. 0 MONADNOCK FAMILY SERVICES INC 64 MAIN STREET KEENE NH 03431 026012230 501(C)(3) 777083 BOOK VALUE NOT APPLICABLE TO FURTHER THE PURPOSE OF MDS IN TREATING MENTAL HEALTH PATIENTS AND ALSO PROVIDE AID FOR ANCILLARY SERVICES PROVIDED BY MDS.DIRECT ASSISTANCE IN ACCORDANCE WITH MISSION 1 FORM 990, PART VI, SECTION B, LINE 11 BOARD OF DIRECTORS APPROVED THE FINANCIAL STATEMENTS AND FORM 990 PRIOR TO FINALIZING. FORM 990, PART VI, SECTION B, LINE 12C BOARD PRESIDENT MONITORS. FORM 990, PART VI, SECTION C, LINE 18 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -133,207. MONADNOCK FAMILY SERVICES INC 64 MAIN STREET KEENE NH 03431 026012230 PROVIDOR OF MENTAL HEALTH SERVICES NH 501 170 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 MONADNOCK FAMILY SERVICES INC B 777083 ACTUAL AMOUNT MONADNOCK FAMILY SERVICES INC D 175000 ACTUAL AMOUNT MONADNOCK FAMILY SERVICES INC M 0 FMV MONADNOCK FAMILY SERVICES INC N 0 FMV