FURP.ORG / PUBLIC DATA EXPLORER

LUTHERAN BRETHREN WOODLAND LODGE INC: Form 990PF, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
LUTHERAN BRETHREN WOODLAND LODGE INC (EIN 45-3342446)
Tax period
2023-05-01 to 2024-04-30
Filed
2025-03-14
IRS object ID
202530739349100218
Schema version
2023v6.0
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)
Return2025-03-14T18:26:34-05:00ReturnTs
Tax Period End2024-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2023-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453342446EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Lutheran Brethren Woodland Lodge IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLUTHBusinessNameControlTxt
Phone2189981400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1824 South Sheridan StreetAddressLine1Txt
CityFergus FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56537ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLeland R RognessPersonNm
Person TitleChairman/PresidentPersonTitleTxt
Phone2189981400PhoneNum
Signature2025-03-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDeb Nelson CPAPreparerPersonNm
PTINP01264758PTIN
Phone6122536500PhoneNum
Preparation2025-03-13PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$3,181,242FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Schedule B Not RequiredYes (X)ScheduleBNotRequiredInd
Interest On Sav Rev And Expnss$23InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$23InterestOnSavNetInvstIncmAmt
Interest On Savings Adj Net Incm$23InterestOnSavingsAdjNetIncmAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$0NetSTCapitalGainAdjNetIncmAmt
Other Income Rev And Expnss$622,772OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$0OtherIncomeNetInvstIncmAmt
Other Income Adj Net Incm$622,772OtherIncomeAdjNetIncmAmt
Total Rev And Expnss$622,795TotalRevAndExpnssAmt
Total Net Invst Incm$23TotalNetInvstIncmAmt
Total Adj Net Incm$622,795TotalAdjNetIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$9,493CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Adj Net Incm$9,493CompOfcrDirTrstAdjNetIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$662,252OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$0OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$678,545OthEmplSlrsWgsDsbrsChrtblAmt
Pension Empl Bnft Rev And Expnss$90,220PensionEmplBnftRevAndExpnssAmt
Pension Empl Bnft Net Invst Incm$0PensionEmplBnftNetInvstIncmAmt
Pension Empl Bnft Adj Net Incm$90,220PensionEmplBnftAdjNetIncmAmt
Pension Empl Bnft Dsbrs Chrtbl$0PensionEmplBnftDsbrsChrtblAmt
Legal Fees Rev And Expnss$4,275LegalFeesRevAndExpnssAmt
Legal Fees Net Invst Incm$0LegalFeesNetInvstIncmAmt
Legal Fees Adj Net Incm$4,275LegalFeesAdjNetIncmAmt
Legal Fees Dsbrs Chrtbl$0LegalFeesDsbrsChrtblAmt
Accounting Fees Rev And Expnss$10,172AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$0AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$10,172AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$0AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$112,748OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$0OtherProfFeesNetInvstIncmAmt
Other Prof Fees Adj Net Incm$112,748OtherProfFeesAdjNetIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Interest Rev And Expnss$36,148InterestRevAndExpnssAmt
Interest Net Invst Incm$0InterestNetInvstIncmAmt
Interest Adj Net Incm$36,148InterestAdjNetIncmAmt
Interest Dsbrs Chrtbl$0InterestDsbrsChrtblAmt
Taxes Rev And Expnss$49,697TaxesRevAndExpnssAmt
Taxes Net Invst Incm$0TaxesNetInvstIncmAmt
Taxes Adj Net Incm$49,697TaxesAdjNetIncmAmt
Taxes Dsbrs Chrtbl$0TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$110,440DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Deprec And Dpltn Adj Net Incm$110,440DeprecAndDpltnAdjNetIncmAmt
Occupancy Rev And Expnss$105,264OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$0OccupancyNetInvstIncmAmt
Occupancy Adj Net Incm$105,264OccupancyAdjNetIncmAmt
Occupancy Dsbrs Chrtbl$0OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$1,167TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$1,167TravConfMeetingAdjNetIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$0TravConfMeetingDsbrsChrtblAmt
Other Expenses Rev And Expnss$38,857OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$0OtherExpensesNetInvstIncmAmt
Other Expenses Adj Net Incm$127,258OtherExpensesAdjNetIncmAmt
Other Expenses Dsbrs Chrtbl$0OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$1,230,733TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$0TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$656,882TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$678,545TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$0ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$0ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$1,230,733TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$0TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$656,882TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$678,545TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$607,938ExcessRevenueOverExpensesAmt
Net Investment Income$23NetInvestmentIncomeAmt
Adjusted Net Income$0AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Sav And Temp Cash Invst BOY$900SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$7,704SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$7,704SavAndTempCashInvstEOYFMVAmt
Acct Rcvbl$154,854AcctRcvblAmt
Acct Rcvbl BOY$33,500AcctRcvblBOYAmt
Acct Rcvbl EOY$154,854AcctRcvblEOYAmt
Acct Rcvbl EOYFMV$154,854AcctRcvblEOYFMVAmt
Prepaid Expenses BOY$4,846PrepaidExpensesBOYAmt
Prepaid Expenses EOY$23,621PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$23,621PrepaidExpensesEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$4,083,895LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,478,230LandBldgEquipAccumDeprecAmt
Land BOY$2,716,105LandBOYAmt
Land EOY$2,605,665LandEOYAmt
Land EOYFMV$2,605,665LandEOYFMVAmt
Other Assets BOY$389,398OtherAssetsBOYAmt
Other Assets EOY$389,398OtherAssetsEOYAmt
Other Assets EOYFMV$389,398OtherAssetsEOYFMVAmt
Total Assets BOY$3,144,749TotalAssetsBOYAmt
Total Assets EOY$3,181,242TotalAssetsEOYAmt
Total Assets EOYFMV$3,181,242TotalAssetsEOYFMVAmt
Accounts Payable BOY$190,682AccountsPayableBOYAmt
Accounts Payable EOY$222,992AccountsPayableEOYAmt
Mortgages And Notes Payable BOY$1,203,569MortgagesAndNotesPayableBOYAmt
Other Liabilities BOY$4,730,225OtherLiabilitiesBOYAmt
Other Liabilities EOY$6,551,187OtherLiabilitiesEOYAmt
Total Liabilities BOY$6,124,476TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,774,179TotalLiabilitiesEOYAmt
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind
No Donor Rstr Net Assests BOY-$2,979,727NoDonorRstrNetAssestsBOYAmt
No Donor Rstr Net Assests EOY-$3,592,937NoDonorRstrNetAssestsEOYAmt
Tot Net Ast Or Fund Balances BOY-$2,979,727TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY-$3,592,937TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$3,144,749TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$3,181,242TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY-$2,979,727TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$607,938ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal-$3,587,665SubtotalAmt
Other Decreases$5,272OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY-$3,592,937TotNetAstOrFundBalancesEOYAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$0InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$0SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$0TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$0EstimatedPlusOvpmtIncmTxAmt
Exempt Frgn Org Tax Wthld At Srce$0ExemptFrgnOrgTaxWthldAtSrceAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$0TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$0TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr Satisfied0Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateMNOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating FoundationYes (1)PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website Addresslbhomes.orgWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1JoAnne SeegerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2189981400PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1824 South Sheridan StreetAddressLine1Txt
CityFergus FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56537ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
John Zwiers
824 South Sheridan StreetFergus FallsMN56537CEO2.00$8,510$341$642
Leland Rogness
824 South Sheridan StreetFergus FallsMN56537Chairman/President0.20$0$0$0
Tom Moline
824 South Sheridan StreetFergus FallsMN56537Vice Chairman0.20$0$0$0
Gaylord Folder
824 South Sheridan StreetFergus FallsMN56537Director0.20$0$0$0
Paul Larson
824 South Sheridan StreetFergus FallsMN56537Director0.20$0$0$0
John Austin
824 South Sheridan StreetFergus FallsMN56537Secretary/Treasurer0.20$0$0$0

Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee BenefitsEmployeeBenefitsAmtExpense AccountExpenseAccountAmt
Hallie Olson
824 South Sheridan StreetFergus FallsMN56537Assisted Living Dire35.00$99,652$16,820$0
Stephanie Anderson
824 South Sheridan StreetFergus FallsMN56537RN Assisted Living35.00$69,772$12,843$0
FieldValueIRS element (for citing)
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Lutheran Brethren Homes IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1824 South Sheridan StreetAddressLine1Txt
CityFergus FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56537ZIPCd
FieldValueIRS element (for citing)
Service TypeManagement FeesServiceTypeTxt
Compensation$96,000CompensationAmt
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1Assisted Living.Description1Txt
Expenses1$656,882Expenses1Amt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$9,688AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$9,688TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$9,688AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$145CashDeemedCharitableAmt
Net Vl Noncharitable Assets$9,543NetVlNoncharitableAssetsAmt
Minimum Investment Return$477MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Sect4942j3j5 Fndtn And Frgn OrgYes (X)Sect4942j3j5FndtnAndFrgnOrgInd

PF Qualifying Distributions PFQualifyingDistributionsGrp

FieldValueIRS element (for citing)
Expenses And Contributions$678,545ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$678,545QualifyingDistributionsAmt

Private Operating Foundations PrivateOperatingFoundationsGrp

FieldValueIRS element (for citing)
Section4942j3Yes (X)Section4942j3Ind

Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Year1$724Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$724TotalAmt

Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Year1$615Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$615TotalAmt

Qualifying Distributions QualifyingDistributionsGrp

FieldValueIRS element (for citing)
Current Year$678,545CurrentYearAmt
Year1$618,948Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$1,297,493TotalAmt

Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Year1$0Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$0TotalAmt

Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp

FieldValueIRS element (for citing)
Current Year$678,545CurrentYearAmt
Year1$618,948Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$1,297,493TotalAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp

FieldValueIRS element (for citing)
Current Year$318CurrentYearAmt
Year1$483Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$801TotalAmt

Total Support TotalSupportGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Public Support Type PublicSupportType

FieldValueIRS element (for citing)
Total$0TotalAmt

Largest Support From EO LargestSupportFromEOGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Investment Income GrossInvestmentIncomeGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Only Contri To PreselectedYes (X)OnlyContriToPreselectedInd
Total Grant Or Contri Pd Dur Yr$0TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Program Service Revenue Dtl ProgramServiceRevenueDtl (2 entries)

DescDescRelated Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt
Assisted and Independent Living$613,711
Other Revenue$9,061

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$23ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$23ExclusionAmt
Related Or Exempt Function Incm$622,772RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$622,795TotalIncomeProducingActyAmt

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (2 entries)

Line NumberLineNumberTxtRelationship StatementRelationshipStatementTxt
1aPayment from Residents for Assisted Living Care
1bOther revenues are from resident payments for vending, beauty shop and other anciliary goods and services.

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryAccounting FeesCategoryTxt
Amt$10,172Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$10,172AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtcGrp (3 entries)

Category Or ItemCategoryOrItemTxtCost Or Other BasisCostOrOtherBasisAmtAccumulated DepreciationAccumulatedDepreciationAmtBook ValueBookValueAmtEOYFMVEOYFMVAmt
Land$102,218$0$102,218$102,218
Buildings & Improvements$3,803,240$1,306,225$2,497,015$2,497,015
Equipment & Furnishings$178,437$172,005$6,432$6,432

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFeesGrp

FieldValueIRS element (for citing)
CategoryLegal FeesCategoryTxt
Legal Fees$4,275LegalFeesAmt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$4,275AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp

FieldValueIRS element (for citing)
DescERC ReceivableDesc
BOY Book Value$389,398BOYBookValueAmt
EOY Book Value$389,398EOYBookValueAmt
EOYFMV$389,398EOYFMVAmt

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases Detail OtherDecreasesDetail

FieldValueIRS element (for citing)
DescPrior Period AdjustmentsDesc
Amt$5,272Amt

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (7 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Advertising Expense$1,500$0$1,500$0
Office Expense$18,382$0$18,382$0
Insurance Expense$25,100$0$25,100$0
Medical Supplies$339$0$339$0
Repairs and Maintenance$13,777$0$13,777$0
Food$60,434$0$60,434$0
Miscellaneous Expenses-$80,675$0$7,726$0

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail (2 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtAdjusted Net IncomeAdjustedNetIncomeAmt
Assisted and Independent Living$613,711$613,711
Other Revenue$9,061$9,061

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities Detail OtherLiabilitiesDetail

FieldValueIRS element (for citing)
DescDue to AffiliatesDesc
BOY Book Value$4,730,225BOYBookValueAmt
EOY Book Value$6,551,187EOYBookValueAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
Management Fees$95,826$0$95,826$0
Purchased Services$13,375$0$13,375$0
Other Fees$3,547$0$3,547$0

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail

FieldValueIRS element (for citing)
CategoryFICA TaxCategoryTxt
Amt$49,697Amt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$49,697AdjustedNetIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt