2011-08-09T11:19:47-05:00 2010-09-30 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2009-10-01 411459252 GUARDIAN ANGELS OF ELK RIVER INC GUAR 7632414445 280 EVANS AVENUE NW ELK RIVER MN 55330 JAMES C BARTZ 7632414445 2011-07-07 1 GORDON VETSCH CPA 6123764500 2009 2016-02-24 21:20:13Z DANIEL C DIXON 280 EVANS AVENUE NW ELK RIVER MN 55330 1099193 0 X www.guardianangelsmn.org X 1984 MN PROMOTION AND ADMINISTRATION OF EVANS PARK, INC.; ANGEL RIDGE, INC.; GUARDIAN ANGELS HOMES, INC.; GUARDIAN ANGELS HEALTH SERVICES, INC.; AND PINE CONE MANOR, INC. ORGANIZATIONS THAT PROVIDE HOUSING AND NURSING SERVICES FOR THE ELDERLY AND HANDICAPPED AND ARE EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 15 15 105 10 0 0 62986 75755 1002927 976533 19555 2643 8148 20827 1093616 1075758 34430 39609 0 592832 622650 0 22688 481171 329549 1108433 991808 -14817 83950 3605629 4177141 170538 130541 3435091 4046600 PROMOTION AND ADMINISTRATION OF EVANS PARK, INC.; ANGEL RIDGE, INC.; GUARDIAN ANGELS HOMES, INC.; PINE CONE MANOR, INC.; AND GUARDIAN ANGELS HEALTH SERVICES, INC. - ORGANIZATIONS THAT PROVIDE HOUSING AND NURSING SERVICES TO THE ELDERLY AND HANDICAPPED AND ARE EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 0 0 805274 976533 PROMOTION AND ADMINISTRATION OF EVANS PARK, INC.; ANGEL RIDGE, INC.; GUARDIAN ANGELS HOMES, INC.; PINE CONE MANOR, INC.; AND GUARDIAN ANGELS HEALTH SERVICES, INC. - ORGANIZATIONS THAT PROVIDE HOUSING AND NURSING SERVICES TO THE ELDERLY AND HANDICAPPED AND ARE EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 805274 1 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 105 1 0 0 0 0 0 0 0 0 0 0 0 15 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JAMES C BARTZ 7632414445 280 EVANS AVE NW ELK RIVER MN 55330 LINDA M KRIEGER 1.00 X 0 0 0 JOAN M NICHOLS 1.00 X 0 0 0 MARION C MARSHALL 1.00 X 0 0 0 JOHN W HINES 1.00 X 0 0 0 JAMES BERG 1.00 X 0 0 0 ROSEMARY SOBALVARRO 1.00 X 0 0 0 JAMES E NORD 1.00 X 0 0 0 KATE HANSEN 1.00 X 0 0 0 CYNTHIA L DOLS 1.00 X 0 0 0 SALLY A LUBRANT 1.00 X 0 0 0 JANE E HOULTON 1.00 X 0 0 0 GAIL WEBER 1.00 X 0 0 0 KEITH HOLME 1.00 X 0 0 0 DENNIS WOLD 1.00 X 0 0 0 RONALD F STRICKER 1.00 X 0 0 0 MARILYN BINA 1.00 X 0 0 0 WALTER KAMINSKY 1.00 X 0 0 0 JAMES C BARTZ 40.00 X 106584 0 17693 DANIEL C DIXON 40.00 X 138876 0 20611 245460 0 38304 2 0 1 0 0 57239 18516 75755 MANAGEMENT FEES 541610 903663 903663 NET INCOME-GA ELIM HOM 900003 72870 72870 976533 5599 5599 2956 -2956 -2956 -2956 11440 57239 20479 -9039 -9039 MISCELLANEOUS INCOME 900099 29866 29866 29866 1075758 976533 0 23470 39609 39609 298216 298216 248642 248642 10424 10424 30361 30361 35007 35007 2355 2355 11447 11447 15598 146 15452 39633 39633 62889 19 62870 37908 37908 7847 6748 1099 14171 14171 43501 43501 46859 46859 4085 4085 MISCELLANEOUS EXPENSE 22688 22688 LOSS ON EARLY DISTING O 6985 6985 CHARITABLE DONATIONS 4418 4418 MISCELLANEOUS EXPENSE 4394 4394 DUES & SUBSCRIPTIONS 3702 3702 1069 849 220 991808 805274 163846 22688 313009 198709 980245 1532912 6998 5410 86563 -13813 47507 1824638 370881 1390228 1453757 627230 701393 215169 237453 3605629 4177141 148331 129731 22207 810 170538 130541 X 3260471 3871980 174620 174620 3435091 4046600 3605629 4177141 X 0 1 1 X 0 X X X 0 0 0 GUARDIAN ANGELS HEALTH SERVICES INC 410858938 9 0 1 1 0 GUARDIAN ANGELS HOMES INC 411358761 9 0 1 1 35904 ANGEL RIDGE INC 411726974 9 0 1 1 0 EVANS PARK INC 411542976 9 0 1 1 0 PINE CONE MANOR INC 411871435 9 0 1 1 0 5 35904 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 219483 15053 24413 1000 257949 228625 4609 -11751 2000 219483 1.00000 0 0 1284208 1284208 12855 6902 5953 498331 346432 151899 29244 17547 11697 1453757 SECURITIES AND OTHER INVESTMENTS 44138 C INVESTMENT IN GUARDIAN ANGELS - ELIM HOME CARE 657255 C 701393 DUE FROM RELATED PARTIES 235131 Accrued Interest Receivable 2322 237453 DUE TO RELATED PARTIES 810 810 1075758 991808 83950 27559 500000 527559 611509 Part V, Line 4: Description of Intended Use of Endowment Funds: All Endowments are used for providing innovative health, housing and support services for seniors and their families through active communities, individualized services and staff educational scholarships. Part X: Description of Uncertain Tax Positions Under FIN 48: The organization has adopted the standard related to income taxes regarding The recognition and measurement of uncertain tax provisions. The implementation of the accounting standard regarding uncertain tax provisions had no impact on the consolidated financial statements. THE ORGANIZATIONS' TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX FILINGS FOR THE FISCAL YEARS 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES Part XI, Line 8 - Other Adjustments: NET ASSETS TRANSFER FROM GUARDIAN ANGELS HEALTH SERVICES: 500000. DINNER DANCE 68679 57239 11440 500 762 900 6532 8247 PRESIDENTS DINNER 3538 68679 57239 11440 500 762 900 6532 11785 20479 -9039 1 GUARDIAN ANGELS HOMES INC 280 EVANS AVE NW ELK RIVER MN 55330 411358761 501(C)(3) 35904 N/A N/A CARE FOR THE ELDERLY 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: THE ORGANIZATION GIVES THE INCOME FROM ITS FUNDRAISERS TO ORGANIZATIONS THAT ARE RELATED TO THEM SO THE USE OF THE FUNDS IS EASILY MONITORED. X X X 0 0 0 0 0 0 0 0 0 DANIEL C DIXON 126175 0 7386 0 5315 0 8115 0 12496 0 159487 0 0 0 Form 990, Part VI, Section A, line 6 The membership of the corporation shall consist of the members in good standing of the Parish of the Church of the Holy Trinity. Form 990, Part VI, Section A, line 7a All Directors are elected by the members at the annual meeting or at a special meeting called for that purpose. Form 990, Part VI, Section B, line 11 Prior to being filed with the IRS, a copy of the IRS Form 990 and related schedules are reviewed by the Vice President of Finance & Operations and the President/CEO, including a confirmation of the accuracy of every answer and oversight of appropriate changes. Upon completion of the Vice President of Finance & Operation's and President/CEO's review, the forms are reviewed and approved at a board meeting prior to submittal to the IRS. Form 990, Part VI, Section B, line 12c Each Board Member and Director fill out a Conflict of Interest form. If a conflict exist it is addressed by the Board and manangement on a case by case basis. Form 990, Part VI, Section B, line 15 THE PROCESS USED TO SET TOP MANAGEMENT'S ANNUAL SALARY IS BASED ON A COMBINATION OF COMPARISON TO COMPARABLE ORGANIZATIONS THROUGH THE USE OF OUR TRADE ORGANIZATION'S ANNUAL COMPENSATION SURVEY AND ATTAINMENT IN THE CURRENT YEAR OF PREDEFINED PERFORMANCE OBJECTIVES SET FOR TOP MANAGEMENT PERSONALLY AND THE ORGANIZATION. THIS PROCESS IS PERFORMED BY HUMAN RESOURCES AND THE CEO/PRESIDENT. THE CEO'S COMPENSATION IS REVIEWED AND SET BY THE EXECUTIVE COMMITTEE AND THEN VOTED ON BY THE BOARD. THIS PROCESS IS NORMALLY DONE PRIOR TO THE FISCAL YEAR START OF OCTOBER 1ST EACH YEAR. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. Guardian Angels Health Services Inc 280 EVANS AVE NW ELK RIVER MN 55330 410858938 Nursing Home, Housing and Adult Day Care MN 501(C)(3) 9 GUARDIAN ANGELS OF ELK RIVER Evans Park Inc 280 EVANS AVE NW ELK RIVER MN 55330 411542976 HOUSING FOR THE ELDERING MN 501(C)(3) 9 GUARDIAN ANGELS OF ELK RIVER Angel Ridge Inc 280 EVANS AVE NW ELK RIVER MN 55330 411726974 HOUSING FOR THE ELDERING MN 501(C)(3) 9 GUARDIAN ANGELS OF ELK RIVER Pine Cone Manor Inc 280 EVANS AVE NW ELK RIVER MN 55330 411871435 HOUSING FOR THE ELDERING MN 501(C)(3) 9 GUARDIAN ANGELS OF ELK RIVER Guardian Angels Homes Inc 280 EVANS AVE NW ELK RIVER MN 55330 411358761 HOUSING FOR THE ELDERING MN 501(C)(3) 9 GUARDIAN ANGELS OF ELK RIVER 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 ANGEL RIDGE N 66249 EVANS PARK INC N 1321354 EVANS PARK INC K 183875 eVANS PARK INC P 108614 GUARDIAN ANDELS HEALTH SERVICES INC K 496999 GUARDIAN ANDELS HEALTH SERVICES INC P 137394 GUARDIAN ANDELS HEALTH SERVICES INC N 200226 GUARDIAN ANDELS HEALTH SERVICES INC O 158952 gUARDIAN ANDELS HEALTH SERVICES INC R 400000