2011-11-11T09:52:36-06:00 2010-12-31 LARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2010-01-01 721524988 ANNE CARLSEN CENTER FOUNDATION ANNE 8005685175 701 3RD STREET NE BOX 8000 JAMESTOWN ND 584028000 ERIC MONSON 8005685175 2011-11-10 XIAOYAN LUO 6123764500 2010 2016-03-07 17:11:31Z ERIC MONSON 701 3RD STREET NE BOX 8000 JAMESTOWN ND 584028000 2920747 0 X WWW.ANNECENTER.ORG X 2003 ND TO SUPPORT THE MISSION AND PURPOSE OF THE ANNE CARLSEN CENTER. 11 11 0 11 0 0 1134782 1731530 -2762 0 -900716 1172101 -14115 1133 217189 2904764 0 0 0 0 359842 219919 21788 20337 484065 297124 243809 678754 484065 -461565 2420699 27018897 31277972 2539327 202009 24479570 31075963 TO SUPPORT THE ANNE CARLSEN CENTER IN JAMESTOWN, NORTH DAKOTA BY SOLICITING, RECEIVING, HOLDING, INVESTING, ADMINISTERING, DISTRIBUTING AND DISBURSING DONATED FUNDS AND ANY AND ALL TYPES OF DONATED OR PERSONAL PROPERTY IN SUPPORT OF THAT MISSION. 0 0 0 0 0 TO SUPPORT THE MISSION AND PURPOSE OF THE ANNE CARLSEN CENTER. 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 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 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN WA ND WI X JUDY KULLA CFO 7019525101 701 3RD STREET NE BOX 8000 JAMESTOWN ND 584028000 X THOMAS ROHLEDER 2.00 X X 0 0 0 PAT TRAYNOR 1.00 X X 0 0 0 BRUCE ISERMAN 1.50 X X 0 0 0 HARVEY HUBER 1.50 X X 0 0 0 TIM FLAKOLL 1.00 X 0 0 0 JOEL FREMSTAD 1.00 X 0 0 0 PAT MCCULLOUGH 1.50 X 0 0 0 ROBERT MONTGOMERY 1.00 X 0 0 0 SUE OFFUTT 1.00 X 0 0 0 JANET SEAWORTH 1.00 X 0 0 0 REESA WEBB 1.00 X 0 0 0 ERIC MONSON 10.00 X 0 146593 8030 JUDY KULLA 10.00 X 0 92642 13736 0 239235 21766 0 0 1 0 0 27701 1703829 1731530 1172101 1172101 17116 27701 15983 1133 1133 2904764 0 0 1173234 192117 192117 2248 2248 11296 11296 14258 14258 20337 20337 28482 28482 79257 79257 18450 18450 21460 21460 78382 78382 MISCELLANEOUS 8490 8490 STAFF DEVELOPMENT 4649 4649 EQUIPMENT 4565 4565 GROCERIES 74 74 484065 0 0 484065 7315628 6543546 1192485 10700 15698539 20667845 1743617 4055881 1068628 27018897 31277972 18354 21610 2520973 180399 2539327 202009 X 22804751 26820694 743029 1513840 931790 2741429 24479570 31075963 27018897 31277972 X 2420699 4175694 X 0 1 1 X 0 X 2027994 1316127 1441144 1134782 1731530 7651577 2027994 1316127 1441144 1134782 1731530 7651577 7651577 983509 2815937 727013 645500 1172101 6344060 13995637 77702 0.54670 0.49450 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 957049 10000 239682 1206731 0.21950 0.78050 0.00000 0 0 0 TRUST INTERESTS 4055881 C 4055881 ANNUITIES PAYABLE 180399 180399 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO SUPPORT THE MISSION OF ANNE CARLSEN CENTER. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER AND FOUNDATION ARE ORGANIZED AS NORTH DAKOTA NONPROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ANNE CARLSEN UNDERGOES AN ANNUAL ANALYSIS OF ITS VARIOUS TAX POSITIONS, ASSESSING THE LIKELIHOOD OF THOSE POSITIONS BEING UPHELD UPON EXAMINATION WITH RELEVANT TAX AUTHORITIES, AS DEFINED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. ANNE CARLSEN BELIEVES THEY ARE COMPLIANT WITH ALL IRS REGULATIONS AND AS OF DECEMBER 31, 2010, HAS NOT RECORDED A TAX LIABILITY FOR A TAX UNCERTAINTY. ANNE CARLSEN'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. ANNE CARLSEN IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE TAX RETURNS FOR THE FISCAL YEARS 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. X X X 1 BBS & ASSOCIATES 130 SPRINGSIDE DRIVE 200 AKRON OH 44333 FUNDRAISING 0 0 20337 -20337 20337 -20337 MN ND WA WI GOLF TOURNAMENT 24332 17567 6765 2810 1808 10814 NEW YEAR'S EVE GALA 20485 10134 10351 1859 6367 400 5169 44817 27701 17116 1859 2810 8175 400 15983 29227 -12111 0 0 0 0 0 0 0 0 0 ERIC MONSON 0 146593 0 0 0 0 0 0 0 8030 0 154623 0 0 SUPPLEMENTAL INFORMATION PART III THE FOUNDATION RELIED ON A RELATED ORGANIZATION TO DETERMINE THE COMPENSATION FOR THE CEO WHICH INCLUDED THE FOLLOWING PRACTICES: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 THE FOUNDATION'S SOLE MEMBER IS ANNE CARLSEN CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, ANNE CARLSEN CENTER APPOINTS THE BOARD OF TRUSTEES OF THE FOUNDATION. THE SOLE MEMBER DETERMINES THE NUMBER OF, APPOINTS, AND MAY REMOVE, WITH OR WITHOUT CAUSE, ALL OF THE OFFICERS OF THE FOUNDATION, EXCEPT THE BOARD CHAIR AND VICE CHAIR, WHO SHALL BE ELECTED BY THE BOARD OF TRUSTEES OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER MUST APPROVE ALL BYLAWS AND AMENDMENTS TO BYLAWS AND AMENDMENTS TO ARTICLES OF INCORPORATION OF THE FOUNDATION; APPROVES THE FOUNDATION'S ANNUAL BUDGET; AND APPROVES ALL DISTRIBUTIONS AND DISBURSEMENTS FROM THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 THE CFO PROVIDES THE FORM 990 ELECTRONICALLY TO ALL BOARD MEMBERS FOR THEIR REVIEW. THE FINANCE COMMITTEE, CFO AND CEO DOES A FINAL REVIEW AND APPROVAL OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY BY THE BOARD. THE PURPOSE OF THIS POLICY IS TO ENSURE IDENTIFICATION AND RESOLUTION OF THOSE INSTANCES IN WHICH GOVERNING BOARD MEMBERS, OFFICERS, EMPLOYEES AND OTHER AGENTS OR REPRESENTATIVES OF THE FOUNDATION (AND ITS AFFILIATES AND SUBSIDIARIES) MAY FIND THEMSELVES IN CIRCUMSTANCES GIVING RISE TO A POTENTIAL OR ACTUAL CONFLICT OF INTEREST. TO PROTECT THE FOUNDATION'S INTEREST IN SUCH SITUATIONS, AND TO PROVIDE FOR ADEQUATE REPORTING MECHANISMS, THE FOUNDATION SHOULD NOT ENTER INTO ANY TRANSACTION OR ARRANGEMENT WITH ANY ENTITY IN WHICH ANY BOARD MEMBER, OFFICER, EMPLOYEE OR AGENT THAT HAS A FINANCIAL INTEREST UNLESS SUCH TRANSACTION OR ARRANGEMENT IS FULLY DISCLOSED TO, AND APPROVED BY THE PRESIDENT/CEO (OR THE BOARD, IF THE PRESIDENT/CEO OR A BOARD MEMBER HAS THE FINANCIAL INTEREST). FORM 990, PART VI, SECTION A, LINES 15A AND 15B: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION TO DETERMINE COMPENSATION FOR THE CEO AND OTHER OFFICERS. THE RELATED ORGANIZATION UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT AND A SURVEY OF COMPENSATION WAS COMPLETED IN 2010 THAT THE BOARD APPROVED FOR USE TO DETERMINE COMPENSATION. THE ORGANIZATION WILL COMPLETE A STUDY IN 2011 FOR BOTH THE CEO AND OTHER OFFICER POSITIONS. THE GOVERNANCE COMMITTEE OF THE BOARD ACTS AS THE COMPENSATION COMMITTEE AND IS CHARGED WITH DETERMINING COMPENSATION FOR THE CEO BASED ON THE STUDY CONDUCTED. THIS PROCESS WAS UNDERTAKEN IN 2010 FOR THE CEO, E. MONSON. THE CEO DETERMINES COMPENSATION FOR OTHER OFFICERS BASED ON THE STUDY CONDUCTED, WITH FINAL APPROVAL FROM THE GOVERNANCE COMMITTEE OF THE BOARD. THIS PROCESS WAS UNDERTAKEN IN 2010 FOR THE CFO, J. KULLA AND THE COO, M. GUMS. 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. EXPLANATION OF HOURS WORKED PART VII ERIC MONSON, CEO, AND JUDY KULIA, CFO, WORK AN AVERAGE OF 50 HOURS WEEKLY AND ALLOCATE THEIR TIME BETWEEN ANNE CARLSEN CENTER (ACC) AND ANNE CARLSEN CENTER FOUNDATION (ACCF) AS FOLLOWS: ERIC MONSON ACC: 40 HOURS ACCF: 10 HOURS JUDY KULIA ACC: 40 HOURS ACCF: 10 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,269,554. PRIOR PERIOD ADJUSTMENTS: 2,550,449. CHANGE IN VALUE OF TRUSTS 355,691. TOTAL TO FORM 990, PART XI, LINE 5: 4,175,694. ANNE CARLSON CENTER 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 870694180 EDUCATIONAL, RESIDENTIAL, MEDICAL AND THERAPY SERVICES FOR CHILDREN ND 501(C)(3) LINE 2 N/A 0 NIERLING ANNE CARLSEN CENTER TRUST 701 3RD STREET NE BOX 8000 JAMESTOWN ND 58402 912004887 PRIVATE FOUNDATION ND 501(C)(3) LINE 4 ANNE CARLSEN CENTER 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0