ON WITH LIFE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: ON WITH LIFE INC (EIN 42-1308032)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-01-28
IRS object ID: 201130289349301013
Schema version: 2009v1.4
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-01-28T15:00:38-06:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RYUN GIVENS & COMPANY PLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2900 100TH STREET SUITE 301	AddressLine1
City	URBANDALE	City
State	IA	State
ZIP Code	50322	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	421308032	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	On With Life Inc	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ONWI	NameControl
Phone	5159651339	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	715 Southwest Ankeny Road	AddressLine1
City	Ankeny	City
State	IA	State
ZIP Code	50023	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JULIE FIDLER DIXON	Name
Title	Executive Director	Title
Phone	5159651339	Phone
Date Signed	2010-11-08	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	STEVE D GIVENS CPA	Name
Phone	5152253141	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JULIE FIDLER DIXON	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	715 Southwest Ankeny Road	AddressLine1
City	Ankeny	City
State	IA	State
ZIP Code	50023	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	7401827	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	ON-WITH-LIFE.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1987	YearFormation
State Legal Domicile	IA	StateLegalDomicile
Activity Or Mission Description	JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	174	TotalNbrEmployees
Total Nbr Volunteers	75	TotalNbrVolunteers
Total Gross UBI	26083	TotalGrossUBI
Net Unrelated Business Txbl Income	-12	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	28350	ContributionsGrantsPriorYear
Contributions Grants Current Year	13131	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	6702068	ProgramServiceRevenuePriorYear
Program Service Revenue CY	7186763	ProgramServiceRevenueCY
Investment Income Prior Year	90853	InvestmentIncomePriorYear
Investment Income Current Year	77163	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	6821271	TotalRevenuePriorYear
Total Revenue Current Year	7277057	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	5123316	SalariesEtcPriorYear
Salaries Etc Current Year	5420455	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	1583332	OtherExpensePriorYear
Other Expenses Current Year	1502889	OtherExpensesCurrentYear
Total Expenses Prior Year	6706648	TotalExpensesPriorYear
Total Expenses Current Year	6923344	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	114623	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	353713	RevenuesLessExpensesCY
Total Assets BOY	7209395	TotalAssetsBOY
Total Assets EOY	8028933	TotalAssetsEOY
Total Liabilities BOY	3691526	TotalLiabilitiesBOY
Total Liabilities EOY	4105565	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3517869	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	3923368	NetAssetsOrFundBalancesEOY
Mission Description	JOINING HANDS, HEARTS, AND MINDS TO HELP PERSONS LIVING WITH BRAIN INJURY GET ON WITH LIFE.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	5086503	Expense
Revenue	7064004	Revenue
Description	FUNCTIONAL EXPENSES WERE INCURRED IN PROVIDING 9,087 DAYS OF SPECIALIZED CARE AND REHABILITATION SERVICES TO INDIVIDUALS WHO HAVE SUSTAINED A TRAUMATIC BRAIN INJURY OR OTHER NEUROLOGICAL DISABILITY.	Description
Total Program Service Expense	5086503	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Balance Sheet Amounts Reported	1	BalanceSheetAmountsReported
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	35	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	174	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Nbr Voting Governing Body Members	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JULIE FIDLER DIXON	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5159651339	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	715 SOUTHWEST ANKENY ROAD	AddressLine1
City	ANKENY	City
State	IA	State
ZIP Code	50023	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
thomas j FRIEDMAN
PRESIDENT	2.00	X	X	0	0	0
VILIA TARVYDAS
VICE PRESIDENT	2.00	X	X	0	0	0
KAY HINES
secretary	2.00	X	X	0	0	0
DONNA WALTER
TREASURER	2.00	X	X	0	0	0
GAIL BOLIVER
DIRECTOR	2.00	X		0	0	0
BETTY BUITENWERF
DIRECTOR	2.00	X		0	0	0
THOMAS CARLSTROM MD
DIRECTOR	2.00	X		0	0	0
R JERRY CARSPECKEN
DIRECTOR	2.00	X		0	0	0
CHARLES DENHART MD
DIRECTOR	2.00	X		0	0	0
ARTHER FILEAN
DIRECTOR	2.00	X		0	0	0
CARL HARRIS
DIRECTOR	2.00	X		0	0	0
MARC HARDING
DIRECTOR	2.00	X		0	0	0
JEFFREY LAMBERTI
dIRECTOR	2.00	X		0	0	0
DAVE OLSON
DIRECTOR	2.00	X		0	0	0
MIKKI STIER
diRECTOR	2.00	X		0	0	0
ELI WIRTZ
DIRECTOR	2.00	X		0	0	0
JULIE FIDLER DIXON
EXECUTIVE DIRECTOR	40.00		X	103983	0	8794
CYNTHIA EWALD
CHIEF FINANCIAL OFFICER	40.00		X	74969	0	5658
DAVID DEMAREST
NEUROPSYCHOLOGIST	40.00			105282	0	6403	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	284234	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	20855	TotalOtherCompensation
Number Individuals GT100 K	2	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	13131	AllOtherContributions
Total Contributions	13131	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES	623000	3859934	3859934
MEDICARE/MEDICAID PAYM	623000	3197171	3197171
DIETARY/COBRA/MISC	900099	96676		$96,676
DIETARY CONSULTING	541900	26083			26083
SUPPORTIVE HOUSING	623990	6899	6899

Field	Value	IRS element (for citing)
Total Program Service Revenue	7186763	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	76933	TotalRevenueColumn
Exclusion	$76,933	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	125000	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	122990	Securities
Other	1780	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	2010	Securities
Other	-1780	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	230	TotalRevenueColumn
Exclusion	$230	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	7277057	TotalRevenueColumn
Related Or Exempt Function Income	7064004	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	26083	UnrelatedBusinessRevenue
Exclusion	$173,839	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	302117	Total
Management And General	302117	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	4265345	Total
Program Services	3397038	ProgramServices
Management And General	868307	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	101237	Total
Program Services	80625	ProgramServices
Management And General	20612	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	395183	Total
Program Services	295904	ProgramServices
Management And General	99279	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	356573	Total
Program Services	267163	ProgramServices
Management And General	89410	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	14765	Total
Program Services	189	ProgramServices
Management And General	14576	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	27341	Total
Program Services	10850	ProgramServices
Management And General	16491	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	86966	Total
Program Services	7153	ProgramServices
Management And General	79813	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	161989	Total
Management And General	161989	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	4904	Total
Management And General	4904	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	128446	Total
Program Services	38257	ProgramServices
Management And General	90189	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	85300	Total
Program Services	59015	ProgramServices
Management And General	26285	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	32328	Total
Program Services	12346	ProgramServices
Management And General	19982	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	142387	Total
Management And General	142387	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	259724	Total
Program Services	233752	ProgramServices
Management And General	25972	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
SUPPLIES, MEDICAL SUPPL	320677	320677
EQUIPMENT RENTAL AND MA	130603	130603
SERVICE FEES	125493	30455	95038
FOOD AND DIETARY	124645	123257	1388
WORKERS COMPENSATION	65209	15930	49279

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	-207888	Total
Program Services	63289	ProgramServices
Management And General	-271177	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	6923344	Total
Program Services	5086503	ProgramServices
Management And General	1836841	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1107	BOY
EOY	1205	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	907408	BOY
EOY	566652	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	887479	BOY
EOY	1466286	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	46800	BOY
EOY	38345	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	20314	BOY
EOY	1620	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	5484271	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	2515396	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	2976746	BOY
EOY	2968875	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1132134	BOY
EOY	1288709	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1237407	BOY
EOY	1697241	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	7209395	BOY
EOY	8028933	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	542519	BOY
EOY	795546	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	2830000	BOY
EOY	2660000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	319007	BOY
EOY	650019	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	3691526	BOY
EOY	4105565	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3517869	BOY
EOY	3923368	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3517869	BOY
EOY	3923368	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	7209395	BOY
EOY	8028933	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	9615	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	13000	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	129300	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	28350	CurrentTaxYearMinus1Year
Current Tax Year	13131	CurrentTaxYear
Total	193396	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5847415	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6233428	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	5949675	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6671005	CurrentTaxYearMinus1Year
Current Tax Year	7064004	CurrentTaxYear
Total	31765527	Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

Field	Value	IRS element (for citing)
Current Tax Year	96676	CurrentTaxYear
Total	96676	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5857030	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6246428	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6078975	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6699355	CurrentTaxYearMinus1Year
Current Tax Year	7173811	CurrentTaxYear
Total	32055599	Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Amts From Subst Contributors AmtsFromSubstContributors

Field	Value	IRS element (for citing)
Total	0	Total

Support From DQ Ps Etc SupportFromDQPsEtc

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Total509	32055599	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	105338	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	106514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	86962	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	91359	CurrentTaxYearMinus1Year
Current Tax Year	76933	CurrentTaxYear
Total	467106	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	105338	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	106514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	86962	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	91359	CurrentTaxYearMinus1Year
Current Tax Year	76933	CurrentTaxYear
Total	467106	Total

Net Income From Other UBI NetIncomeFromOtherUBI

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	3479	CurrentTaxYearMinus2Years
Total	3479	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	5962368	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6352942	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6169416	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6790714	CurrentTaxYearMinus1Year
Current Tax Year	7250744	CurrentTaxYear
Total	32526184	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98550	PublicSupportPercentage509
Prior Year Support Percentage	0.98540	PriorYearSupportPercentage
Investment Income Percentage	0.01440	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01450	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	154240	OtherCostOrOtherBasis
Book Value	154240	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4095964	OtherCostOrOtherBasis
Depreciation	1815351	Depreciation
Book Value	2280613	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	403128	OtherCostOrOtherBasis
Depreciation	172039	Depreciation
Book Value	231089	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	830939	OtherCostOrOtherBasis
Depreciation	528006	Depreciation
Book Value	302933	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	2968875	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
CASEY'S GENERAL STORES, INC.	6919	F
VANGUARD GROUP - PRIME MONEY MARKET	5975	F
VANGUARD GROUP - INFLATION PRO	102995	F
VANGUARD GROUP - GNMA	510439	F
VANGUARD GROUP - SHORT TERM	662381	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	1288709	TotalOfBookValueSecurities

Other Assets OtherAssets (10 entries)

DescriptionDescription	Book ValueBookValue
BOND ISSUANCE COSTS (NET OF AMORTIZATION)	69220
BOND FUND 1994	206810
DEBT SERVICE RESERVE 1994	165465
DUE FROM COMMUNITY SERVICES	620481
DUE FROM CORPORATE DIVISION	29538
DUE FROM GLENWOOD	14319
PROJECT FUND	13130
LOAN TO GLENWOOD	397647
PROJECT ACCOUNT - POOL	5000
CONSTRUCTION IN PROCESS	175631

Field	Value	IRS element (for citing)
Total Book Value Other Assets	1697241	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
DUE TO ANKENY DIVISION	$595,303
DUE TO CORPORATE	$54,716

Field	Value	IRS element (for citing)
Total Of Amounts	650019	TotalOfAmounts
Total Revenue	7277057	TotalRevenue
Total Expenses	6923344	TotalExpenses
Excess Or Deficit For Year	353713	ExcessOrDeficitForYear
Other	$51,786	OtherAmount
Total Adjustments	51786	TotalAdjustments
Excess Or Deficit Per FS	405499	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	7328613	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	51786	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	51786	RevenueNotRptdF990
Revenue Subtotal	7276827	RevenueSubtotal
Other Revenues Not Included	230	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	230	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	7277057	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	6923114	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	-230	OtherExpensesIncluded
Expenses Not Rptd F990	-230	ExpensesNotRptdF990
Expenses Subtotal	6923344	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	6923344	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifier	ExplanationExplanation
Part XI, Line 8 - Other Adjustments:	UNREALIZED GAIN/LOSS ON INVESTMENTS: 51786.
Part XII, Line 4b - Other Adjustments:	GAIN ON SALE OF ASSET: 230.
Part XIII, Line 2d - Other Adjustments:	REVENUE OFFSET AGAINST EXPENSE ON F/S: 0. GAIN ON SALE OF ASSET: -230.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer
CITY OF ANKENY IOWA - SERIES 2004A
426004235	035362AZ5	2004-07-29	2840000	REFUNDING SERIES 1994 BONDS	0	0
CITY OF ANKENY IOWA - SERIES 2004B
426004235	035362AY8	2004-07-29	600000	EXPANDING AND MAKING IMPROVEMENTS ON HEALTH CARE FACILITY	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Amount DefeasedAmountDefeased	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Capital ExpendituresCapitalExpenditures
2840000	159325	2616538	64137	2004	0	1	1	1
600000				2004	0	0	1	1	600000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
0	0	0	0	0	0
0	0	0	0	0	0

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
0	0	0	0	0	0	0
0	0	0	0	0	0	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Form 990, Part VI, Section A, line 2	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	THE BOARD OF DIRECTORS WILL BE GIVEN A COPY OF FORM 990 TO BE APPROVED BEFORE BEING FILED. THE BOARD WILL BE PROVIDED WITH A CHECKLIST FROM THE FIRM'S FORM 990 PREPARER TO HELP REVIEW FORM 990.
Form 990, Part VI, Section B, line 12c	ALL SENIOR STAFF AND DIRECTORS ANNUALLY SUBMIT A DISCLOSURE OF INTEREST STATEMENT. THE DISCLOSURE STATEMENT IS THEN REVIEWED BY THE EXECUTIVE DIRECTOR AND THE BOARD AFFAIRS COMMITTEE ANNUALLY FOR ANY POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Section B, line 15	THE BOARD APPROVES SALARIES FOR THE EXECUTIVE DIRECTOR, OFFICERS, AND KEY EMPLOYEES BASED ON RECOMENDATIONS BY THE HUMAN RESOURCE COMMITTEE. HUMAN RESOURCE COMMITTEE COMPILES WAGE SURVEYS AND OTHER INFORMATION TO BASE WAGE RECOMMENDATIONS TO THE BOARD.
Form 990, Part VI, Section C, line 18	FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S BUSINESS OFFICE.
Form 990, Part VI, Section C, line 19	ALL GOVERNING DOCUMENTS INCLUDING THE ARTICLES OF INCORPORATION, BYLAWS, FORM 501(C)(3), FINANCIAL STATEMENTS, AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE BUSINESS OFFICE. THE CONFLICT OF INTEREST POLICY IS CURRENTLY NOT AVAILABLE TO THE PUBLIC.
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.	OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT AUDITORS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus
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
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

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved
ON WITH LIFE FOUNDATION
C	13131
ON WITH LIFE EXTENDED SERVICES LTD
D	50540
ON WITH LIFE FOUNDATION
M	24000
ON WITH LIFE FOUNDATION
N	11700
ON WITH LIFE EXTENDED SERVICES LTD
N	38443
ON WITH LIFE EXTENDED SERVICES LTD
P	27820