Form990-EZ
Click to see attachment
Department of the Treasury
Internal Revenue Service
Short Form
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code
(except black lung benefit trust or private foundation)
bullet Sponsoring organizations of donor advised funds, organizations that operate one or more hospital facilities, and certain controlling organizations as defined in section 512(b)(13) must file Form 990 (see instructions).
All other organizations with gross receipts less than $200,000 and total assets less than $500,000 at the end of the year may use this form.
bulletThe organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-1150
2010
Open to Public
Inspection
A
For the 2010 calendar year, or tax year beginning 01-01-2010, and ending 12-31-2010
B
Check if applicable:
C Name of organization
WESLEYLIFE
 
Number and street (or P. O. box, if mail is not delivered to street address)5508 NORTHWEST 88TH STREET NO 120
  Room/suite
City or town, state or country, and ZIP + 4 JOHNSTON, IA50131
D Employer identification number

30-0577845
E Telephone number

(515) 271-6789
F Group Exemption
Number. . bullet  
G Accounting method: Other (specify) bullet   H Check bulletI Website:bulletWWW.WESLEYLIFE.ORGJ Tax-Exempt status(check only one)—Click to see attachment(   ) bullet(insert no.) or
K Check bullet A Form 990-EZ or Form 990 return is not required though Form 990-N (e-postcard) may be required (see instructions). But if the organization chooses to file a return, be sure to file a complete return.
L Add lines 5b, 6c, and 7b, to line 9 to determine gross receipts; If gross receipts are $200,000 or more, or if total assets (Part II, line 25, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ.. . bullet $ 0
Part IRevenue, Expenses, and Changes in Net Assets or Fund Balances (See the instructions for Part I.) Check if the organization used Schedule O to respond to any question in this Part I . . . . . . . .
VerticalRevenue 1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . 1  
2 Program service revenue including government fees and contracts . . . . . . . 2  
3 Membership dues and assessments . . . . . . . . . . . . . . 3  
4 Investment income . . . . . . . . . . . . . . . . . . 4  
5a Gross amount from sale of assets other than inventory . . . . 5a  
b Less: cost or other basis and sales expenses . . 5b  
c Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . 5c  
6 Gaming and fundraising events
a Gross income from gaming (attach Schedule G if greater than $15,000) 6a  
b Gross income from fundraising events (not including $   of contributions from fundraising events reported on line 1) (attach Schedule G if the sum of such gross income and contributions exceed $15,000) . . . . . . .
c Less: direct expenses from gaming and fundraising events . . . 6c  
d Net income or (loss) from gaming and fundraising events (Add lines 6a and 6b and subtract line 6c) 6d  
7a Gross sales of inventory, less returns and allowances . . . . 7a  
b Less: cost of goods sold . . . . . . . . . . 7b  
c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . 7c  
8 Other revenue (describe in Schedule O) . . . . . . . . . 8  
9 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . . . . . . . 9  
VerticalExpenses 10 Grants and similar amounts paid (list in Schedule O) . . . . . . . . 10  
11 Benefits paid to or for members . . . . . . . . . . . . . . . 11  
12 Salaries, other compensation, and employee benefits . . . . . . . . . . . 12  
13 Professional fees and other payments to independent contractors . . . . . . . . 13  
14 Occupancy, rent, utilities, and maintenance . . . . . . . . . . . . . 14  
15 Printing, publications, postage, and shipping . . . . . . . . . . . . 15  
16 Other expenses (describe in Schedule O) . . . . . . . . . . 16  
17 Total expenses. Add lines 10 through 16 . . . . . . . . . . . . 17  
VerticalNetAssets 18 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . 18  
19 Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
end-of-year figure reported on prior year’s return) . . . . . . . . . . . 19  
20 Other changes in net assets or fund balances (explain in Schedule O) . . . . . . . 20 0
21 Net assets or fund balances at end of year. Combine lines 18 through 20 . . . . . Bullet 21  
Part IIBalance Sheets Check if the organization used Schedule O to respond to any question in this Part II. . . . . . . . .

(See the instructions for Part II.)(A) Beginning of year(B) End of year
22Cash, savings, and investments . . . . . . . . . .
 
22
 
23Land and buildings . . . . . . . . . . . . .
 
23
 
24Other assets (describe in Schedule O) . . . . . .
 
24
 
25Total assets . . . . . . . . . . . . . .
0
25
0
26
Total liabilities (describe in Schedule O) . . . . .
 
26
 
27Net assets or fund balances (line 27 of column (B) must agree with line 21) .
0
27
0
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10642I Form 990-EZ (2010)
Form 990-EZ (2010)
Page 2
Part IIIStatement of Program Service Accomplishments Check if the organization used Schedule O to respond to any question in this Part III . Expenses
(Required for section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts; optional for others.)
What is the organization's primary exempt purpose? WESLEYLIFE IS THE SUPPORTING ORGANIZATION FOR ITS AFFILIATES WHO PROVIDE SENIOR HOUSING, ASSISTED LIVING, SKILLED NURSING SERVICES, HOME AND COMMUNITY BASED SERVICES AND DESIGN AND DEVELOPMENT.
Describe what was achieved in carrying out the organization's exempt purposes. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 WESLEYLIFE WAS ESTABLISHED IN DECEMBER 2010 AS A SUPPORTING ORGANIZATION FOR WESLEY RETIREMENT SERVICES, INC. (WRS) AND WESLEY COMMUNITY SERVICES, INC. (WCS). WRS WAS ESTABLISHED IN 1947 AS A FAITH-BASED, NON-PROFIT ORGANIZATION AND HAS SINCE DEDICATED ITSELF TO PROVIDING HOUSING, HEALTH CARE, AND SUPPORT SERVICES EXCLUSIVELY TO OLDER ADULTS IN WAYS THAT PROMOTE INDEPENDENCE AND A HEALTHY, ACTIVE LIFESTYLE FOR EVERYONE WE SERVE. WCS WAS ESTABLISHED IN 2006 WITH THE FOCUS OF PROVIDING SERVICES TO OLDER ADULTS AND THE INDIGENT REGARDLESS OF FINANCIAL MEANS THROUGH IN-HOME SUPPORT, ASSISTANCE, MEALS, AND COMPANIONSHIP FOR OLDER ADULTS. OUR MISSION IS TO PROMOTE THE INDEPENDENCE, HEALTH, AND WELL-BEING OF OLDER ADULTS WHEREVER THEY CALL HOME. AS TRENDS IN RETIREMENT LIVING CONTINUE TO CHANGE, WE HAVE RESPONDED WITH AN ARRAY OF SERVICES THAT PROMOTE AND DELIVER FRIENDSHIP AND FELLOWSHIP, A SLATE OF MEANINGFUL ACTIVITIES, LIFELONG LEARNING, AND COMPREHENSIVE HEALTH AND WELLNESS PROGRAMS TO ACCOMMODATE THE EXPECTATIONS OF OUR CUSTOMERS. OUR CORE MISSION SUPPORTS OLDER ADULTS WHEREVER THEY CALL HOME. WESLEYLIFE CURRENTLY OWNS AND OPERATES SEVEN RETIREMENT COMMUNITIES IN IOWA THROUGH WESLEY RETIREMENT SERVICES, INC. (WRS) THAT OFFER A FULL CONTINUUM OF SERVICES. THOSE RETIREMENT COMMUNITIES ARE: WESLEY ACRES IN DES MOINES; HALCYON HOUSE IN WASHINGTON; HERITAGE HOUSE IN ATLANTIC; THE VILLAGE IN INDIANOLA; PARK CENTRE IN NEWTON; EDGEWATER, AN ACTIVE LIFE COMMUNITY IN WEST DES MOINES; AND HEARTHSTONE, A MINISTRY OF WESLEYLIFE IN PELLA. WESLEYLIFE ALSO OPERATES HOME AND COMMUNITY BASED SERVICES THROUGH WESLEY COMMUNITY SERVICES, INC. (WCS) THAT AUGMENT OUR TOTAL SERVICE OFFERING. OUR HOME AND COMMUNITY BASED SERVICES ARE FOCUSED ON PROVIDING SERVICES TO OLDER ADULTS AND INDIGENT REGARDLESS OF FINANCIAL MEANS. WE CONTINUE TO RESPOND TO STUDIES EXPRESSING A GROWING DESIRE AND NEED OF OLDER ADULTS TO RECEIVE SERVICES IN THEIR HOMES BY PROVIDING MEDICARE, MEDICAID, AND PRIVATE PAY HOME CARE SERVICES; MEALS ON WHEELS (MOW), PERSONAL AND ENVIRONMENTAL SERVICES, AND OTHER VOLUNTEER SERVICES WHICH HELP KEEP INDIVIDUALS INDEPENDENT AND ACTIVE IN THEIR HOMES AND THE COMMUNITY. WESLEY ALSO OPERATES TWO ADULT DAY CENTERS - WILLOWBROOK ADULT DAY SERVICES IN NEWTON; AND WESLEY ADULT DAY SERVICES IN DES MOINES. FOR THOSE COMMUNITY MEMBERS APPROACHING END OF LIFE AND NEEDING END OF LIFE CARE, WCS ALSO PROVIDES HOSPICE CARE, WHICH ALLOWS US TO EXTEND OUR MINISTRY AND QUALITY OF CARE.IN 2010, WESLEYLIFE'S SUPPORTING ORGANIZATIONS, WRS AND WCS, PROVIDED HOUSING AND SERVICES FOR MORE THAN 5,000 OLDER IOWANS WHO RECEIVED INDIVIDUALIZED ATTENTION FROM OUR MORE THAN 1,300 PASSIONATE TEAM MEMBERS. AS PART OF OUR MISSION, WE BELIEVE IT IS OUR RESPONSIBILITY TO MAKE THE CITIES AND COMMUNITIES IN WHICH WE OPERATE A BETTER PLACE TO LIVE. WE ARE GUIDED BY OUR CORE VALUES TO PROVIDE QUALITY SERVICES, DEMONSTRATE INTEGRITY, MAINTAIN DIGNITY, FOSTER COMMUNITY, AND DELIVER RESPONSIBLE STEWARDSHIP. WE SERVE OLDER IOWAN'S BY PROVIDING THEM THE QUALITY SERVICES THEY NEED WITH A SERVANT'S HEART. WE ARE COMMITTED TO QUALITY, EXCELLENCE, HOSPITALITY, AND INNOVATION. WHILE ALSO FIRMLY BELIEVING THAT IT IS OUR RESPONSIBILITY TO BE GOOD STEWARDS OF THE MISSION AND ONLY USE THE RESOURCES WE HAVE BEEN PROVIDED IN WAYS THAT WILL BETTER THE LIVES OF OUR CUSTOMERS. AS A NON-PROFIT ORGANIZATION, WE UNDERSTAND THAT OUR RESPONSIBILITY AND OBLIGATION TO OUR COMMUNITIES IS TO OPERATE WITH TOTAL TRANSPARENCY, HONESTY, INTEGRITY, AND THE BEST CARE POSSIBLE. BELOW REFLECTS SOME OF OUR COMMUNITY BENEFITS FROM 2010.- EVERY YEAR OUR STAFF, RESIDENTS, VOLUNTEERS, COMMUNITY MEMBERS, AND BUSINESSES GIVE GENEROUSLY OF THEMSELVES TO BENEFIT THE WELL-BEING OF FELLOW IOWANS. UNIQUE TO WESLEY RETIREMENT SERVICES IS OUR GOOD SAMARITAN/SHEPHERD PROGRAMS. ESTABLISHED MORE THAN 40 YEARS AGO, THIS PROGRAM IS A MEANS OF KEEPING OUR PROMISE TO ASSIST RESIDENTS WHO HAVE OUTLIVED THEIR FINANCIAL RESOURCES. - DURING 2010, THE GOOD SAMARITAN/SHEPHERD PROGRAMS PROVIDED APPROXIMATELY $445,000 WORTH OF CARE AND ASSISTANCE TO IOWA SENIORS WHO HAVE FINANCIAL NEED. BECAUSE OF THIS PROGRAM AND THE GRACIOUS GENEROSITY OF THE COMMUNITY THAT SUPPORTS IT, WESLEY HAS NEVER ASKED ANYONE TO LEAVE THEIR HOME DUE TO LACK OF FUNDS. - WE ALSO FUNDED APPROXIMATELY $436,000 OF GOOD SAMARITAN/SHEPHERD EXPENSES IN CCRC COMMUNITIES WHERE THERE WERE NOT SUFFICIENT GIFTS AND BENEVOLENT FUNDS AVAILABLE TO COVER THE NEEDS OF RESIDENTS WITH LIMITED MEANS. - IN 2010, SERVING OUR REACH TO UNDERSERVED COMMUNITY MEMBERS IN MEDICAID DAYS INCREASED BY 25% OVER LAST YEAR TO 25,000 DAYS. WE INCURRED ALMOST $291,000 IN UNCOMPENSATED CHARITY CARE.- WE PROVIDED OVER $267,000 OF SERVICES TO INDIVIDUALS WHO REQUIRED OUR HELP FOR HOME AND COMMUNITY BASED SERVICES IN WCS BUT HAD LIMITED MEANS TO PAY.- OUR CCRCS CREATED AND CONDUCTED VARIOUS EDUCATIONAL SESSIONS AIMED AT IMPROVING HEALTH OF OLDER ADULTS BY PROMOTING NUTRITION, WELLNESS, AND QUALITY OF LIFE. IN TOTAL, OVER 1,700 OLDER ADULTS LIVING OUTSIDE OUR WESLEY COMMUNITIES PARTICIPATED IN THESE SERVICES. - WE HAVE REACHED MORE THAN 600 OLDER ADULTS WITH 120 OF OUR LIVING WELL SERIES OF LECTURES, EDUCATIONAL TOPICS, AND EVENTS WHICH FOCUS ON ASSISTING COMMUNITY CONSUMERS AND RESIDENTS TO AGE ACTIVELY AND HAVE CONTROL OF THEIR LIFE CHOICES. THROUGH PARTNERSHIPS WITH AREA COLLEGES AND UNIVERSITIES, LOCAL AND REGIONAL AUTHORS, POETS, AND OTHER HEALTH CARE PROVIDERS, WESLEY STAFF WAS AIDED WITH ALMOST 2,500 VOLUNTEER HOURS TO HELP EXECUTE THESE SERVICES EFFECTIVELY.- WE PROVIDED A TRAINING SITE FOR OVER 176 STUDENT NURSES, WELLNESS AND OTHER INTERNS, EQUIPPING THEM WITH ALMOST 6,826 HOURS OF PRACTICAL EXPERIENCE IN THE HEALTHCARE FIELD AND HELPING THEM TO GAIN A BETTER UNDERSTANDING OF SENIOR HEALTH AND WELLNESS.- WE PROVIDED A GATHERING SPACE IN OUR RETIREMENT COMMUNITIES AT NO CHARGE TO LOCAL GROUPS ON 263 OCCASIONS, SERVING ALMOST 4,165 INDIVIDUALS. ADDITIONALLY, OUR COMMUNITIES SERVED AS LOCATIONS TO HOLD SUPPORT GROUP SESSIONS FROM - VISUALLY IMPAIRED TO ALZHEIMER'S TO GRIEF - 93 SESSIONS IN ALL, SERVING 506 FROM THE GREATER COMMUNITY.- WE COORDINATED AND FACILITATED INTERGENERATIONAL ACTIVITIES WITH GRADE SCHOOL-AGE CHILDREN PROMOTING READING AND MENTORING RELATIONSHIPS.- WE CONTINUE TO PROMOTE COMMUNITY LEADERSHIP IN CIVIC AND PROFESSIONAL ORGANIZATIONS.- OUR MEALS ON WHEELS IN WCS PROGRAMS HAS CONTINUED TO SERVE MORE PEOPLE, WITH OVER 254,000 MEALS SERVED IN 2010. APPROXIMATELY 81% OF THESE ARE COST-SUBSIDIZED FOR CLIENTS WHO WOULD NOT OTHERWISE HAVE ACCESS TO A BALANCED, NUTRITIOUS MEAL. THOSE SUPPORTING MEALS ON WHEELS INCLUDE RESOURCE ASSETS FROM WESLEY, PUBLIC FUNDING, UNITED WAY, AND INDIVIDUAL AND CORPORATE DONATIONS. - OUR COMMUNITY BASED SERVICES IN WCS HAS A VOLUNTEER VISITOR PROGRAM AND OVER 3,800 VOLUNTEER HOURS WERE DEDICATED TO THE CORRESPONDING PROGRAM ACTIVITIES. THESE PROGRAMS IMPROVE THE QUALITY LIFE FOR THE MANY OLDER ADULTS WHO DEPEND ON US TO MEET SOME OF THEIR MOST BASIC HUMAN NEEDS. THESE PROGRAMS ENABLE MANY TO STAY IN THEIR OWN HOMES FOR MANY YEARS DELAYING OR ELIMINATING THE NEED FOR INSTITUTIONALIZATION. THE MOST COMMON SERVICES INCLUDE: - TRANSPORTATION - VOLUNTEERS HELP WITH GROCERY SHOPPING AND MEAL DELIVERY FOR THOSE WHO ARE CONFINED TO THEIR HOMES. VOLUNTEERS ALSO ASSIST WITH ERRANDS AND RIDES TO MEDICAL OR OTHER ESSENTIAL APPOINTMENTS.- PHONE - VOLUNTEERS CALL HOMEBOUND ELDERLY AND DISABLED CLIENTS TO MAINTAIN REGULAR CONTACT AND SOCIALIZATION AND CHECK-IN ON THEIR WELL-BEING. - MONEY MANAGEMENT - TRAINED VOLUNTEERS ARE MATCHED WITH FINANCIALLY VULNERABLE OLDER ADULTS TO HELP THEM MAINTAIN THEIR INDEPENDENCE, BE FREE OF FINANCIAL EXPLOITATION, AND INCREASE THEIR FINANCIAL LITERACY. - WCS REACHED OUT TO THE GREATER COMMUNITY TO PROVIDE AND CONDUCT OVER 99 HEALTH/BLOOD PRESSURE SCREENINGS AND EDUCATIONAL SESSIONS THAT REACHED OVER 2,200 OLDER ADULTS. - WCS SERVICE TO THE COMMUNITY ALSO INCLUDED ADMINISTERING 1,100 FREE FLU AND H1N2 VACCINATIONS THROUGHOUT VARIOUS CENTRAL IOWA LOCATIONS. WE ALSO DONATED 1,000 VACCINE DOSES TO HAITI AND 400 DOSES TO THE BLESSMAN MINISTRIES IN AFRICA.- THE WCS HOSPICE PROGRAM ALSO HAS A VOLUNTEER BASE OF 86 TRAINED VOLUNTEERS, OF WHICH 40 WERE ACTIVELY ENGAGED WITH PATIENTS. HOSPICE VOLUNTEERS CONTRIBUTED OVER 1,200 HOURS TO PROVIDE ASSISTANCE TO FAMILIES AND PATIENTS.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 28a 0
29 - OTHER COMMUNITY BASED VOLUNTEER PROJECTS IN WCS (BELOW) CONSIST OF PROGRAMS DESIGNED TO MAINTAIN CLIENT INDEPENDENCE AND KEEPING OLDER ADULTS IN THEIR OWN HOMES.- MEALS ON WHEELS ALLOWS EMPLOYEES OF LOCAL BUSINESSES TO VOLUNTEER THEIR TIME TO DELIVER MEALS TO THE HOMES OF LOW INCOME, FRAIL SENIORS, IN POLK COUNTY. THE PROGRAM HAD 11 BUSINESSES PARTICIPATE WITH OVER 2,300 HOURS CONTRIBUTED BY THEIR EMPLOYEES.- MOW BLIZZARD BAGS ARE DELIVERED TO CLIENTS IN THE EVENT OF INCLEMENT WEATHER OR OTHER EMERGENCY SITUATIONS. A STUDENT ORGANIZATION AND CHURCH GROUP VOLUNTEERED THEIR TIME TO ASSEMBLE AT LEAST 500 BAGS. - COLLECTING PERSONAL CARE ITEMS FOR THOSE IN THE HOME CARE AND HOSPICE PROGRAMS. NEARLY 175 HOURS WERE CONTRIBUTED BY 168 VOLUNTEERS.- CHRISTMAS ADOPT-A-CLIENT HAD 34 VOLUNTEERS CONTRIBUTE IN ORDER TO MAKE THE HOLIDAY SEASON SPECIAL FOR A NUMBER OF LOW-INCOME CLIENTS. THESE INDIVIDUALS CONTRIBUTED NEARLY 150 HOURS TO ASSIST WITH THIS SERVICE.
(Grants $ 0) If this amount includes foreign grants, check here ...MediumBullet		 29a 0
30
(Grants $   ) If this amount includes foreign grants, check here ...MediumBullet 		30a
31 Other program services (describe in Schedule O) . . . . . . . . . . . .
(Grants $   ) If this amount includes foreign grants, check here...MediumBullet		 31a
32 Total program service expenses (add lines 28a through 31a) . . . . . . . . . bullet 32  
Part IVList of Officers, Directors, Trustees, and Key Employees. List each one even if not compensated. (See the instructions for Part IV.) Check if the organization used Schedule O to respond to any question in this Part IV . . . . . . . .
(a) Name and address (b) Title and average
hours per week
devoted to position		 (c) Compensation
(If not paid,
enter -0-.) 		(d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
CARROLL BENNETT
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 CHAIR2.00 0 0 0
BOB RUCH
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 VICE CHAIR1.00 0 0 0
JODY LORENCE
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 SECRETARY / TREASURER1.00 0 0 0
JIM VICKERY
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 PAST CHAIR1.00 0 0 0
ANN COWNIE
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
JOHN MOENCK
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
CHAD RASMUSSEN
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
DAN RENEKER
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
DAVID STOUT
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
KIRK TYLER
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
TERESA WAHLERT
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 BOARD MEMBER1.00 0 0 0
ROB KRETZINGER
5508 NORTHWEST 88TH STREET
JOHNSTON,IA50131
 CEO1.00 0 0 0
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 3
Part VOther Information(Note the statement requirements in the instructions for Part V.)YesNo Check if the organization used Schedule O to respond to any question in this Part V . . . .
33
Did the organization engage in any activity not previously reported to the IRS? If "Yes," provide a detailed description of each activity in Schedule O ..............
33
 
No
34
Were any significant changes made to the organizing or governing documents? If "Yes," attach a conformed copy of the amended documents if they reflect a change to the organization’s name. Otherwise, explain the change on Schedule O (see instructions). ...................
34
 
No
35
If the organization had income from business activities, such as those reported on lines 2, 6a, and 7a (among others), but not reported on Form 990-T, explain in Schedule O why the organization did not report the income on Form 990-T. ........................
a
Did the organization have unrelated business gross income of $1,000 or more or was it a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax requirements?
35a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year? (see instructions) ........
35b
 
 
36
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If “Yes,” complete applicable parts of Schedule N .............
36
 
No
37a
Enter amount of political expenditures, direct or indirect, as described in the instructions. bullet
37a
0
b
Did the organization file Form 1120-POL for this year? ...............
37b
 
 
38a
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were
any such loans made in a prior year and still outstanding at the end of the tax year covered by this return?
38a
 
No
b
If “Yes,” complete Schedule L, Part II and enter the total amount involved .
38b
 
39
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on line 9 ......
39a
 
b
Gross receipts, included on line 9, for public use of club facilities ....
39b
 
40a
Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 bullet0 ; section 4912 bullet0 ; section 4955 bullet0
b
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I. ....
40b
 
No
c
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 ..bullet0
d
Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the organization ...................bullet0
e
All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes," complete Form 8886-T. .................
40e
 
No
41List the states with which a copy of this return is filed. bullet
42aThe organization's books are in care of bulletFRANK TALLERICO CFO Telephone no. bullet (515) 271-6559
Located at bullet5508 NW 88TH STREET SUITE 120
JOHNSTON,IA ZIP + 4bullet50131
b
At any time during the calendar year, did the organization have an interest in or a signature or other authority over a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
Yes
No
42b
 
No
If “Yes,” enter the name of the foreign country: bullet  
See the instructions for exceptions and filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
c
At any time during the calendar year, did the organization maintain an office outside of the U.S.?
42c
 
No
If “Yes,” enter the name of the foreign country: bullet  
43.......bullet
and enter the amount of tax-exempt interest received or accrued during the tax year . . . bullet43
 
44a
Did the organization maintain any donor advised funds? If "Yes", Form 990 must be completed instead of
Yes
No
Form 990-EZ.. . . . . . . . . . . . . . . . . . . .
44a
 
No
b
Did the organization operate one or more hospital facilities during the year? If ‘Yes,’ Form 990 must be completed instead of Form990-EZ. . . . . . . . .
44b
 
No
c
Did the organization receive any payments for indoor tanning services during the year? . . . . . . .
44c
 
No
d
If 'Yes' to line 44c, has the organization filed a Form 720 to report these payments? If ‘No,’ provide an explanation in Schedule O. . . . . . . . .
44d
 
 
45
Is any related organization a controlled entity of the organization within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. . . . . . . . .
45
 
No
45a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If ‘Yes,’ Form 990 and Schedule R must be completed instead of Form990-EZ. .
45a
 
No
46
Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I. . . . . . . . . .
46
 
No
Form 990-EZ (2010)
Form 990-EZ (2010)
Page 4
Part VI
Section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts must answer questions 47-49b and 52. Check if the organization used Schedule O to respond to any question in this Part VI . . . . . . . .
Yes
No
47
Did the organization engage in lobbying activities? If "Yes," complete Schedule C, Part II . . . .
47
 
No
48
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E . . .
48
 
No
49a
Did the organization make any transfers to an exempt non-charitable related organization? . . . .
49a
 
No
b
If "Yes," was the related organization a section 527 organization? . . . . . . . . .
49b
 
 
50
Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each employee paid more than $100,000 (b) Title and average
hours per week
devoted to position		 (c) Compensation
 (d) Contributions to
employee benefit plans &
deferred compensation		 (e) Expense
account and
other allowances
NONE
50(f)
Total number of other employees paid over $100,000 . . . . . . . . . . . . . bullet  

51
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."
(a) Name and address of each independent contractor paid more than $100,000 (b) Type of service (c) Compensation
NONE
51(d)
Total number of other independent contractors each receiving over $100,000 . . . . . . . bullet  
52
Did the organization complete Schedule A? NOTE: All Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable trusts must attach a completed Schedule A ....................
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(See instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
Form 990-EZ (2010)

Additional Data


Software ID:  
Software Version:  

Form 990-EZ, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
WESLEYLIFE
 
Employer identification number

30-0577845
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
No
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
(1) WESLEY COMMUNITY SERVICES INC
  		203970256 501(C)(3) Yes   Yes   Yes   0
(2) WESLEY RETIREMENT SERVICES INC
  		420680440 501(C)(3) Yes   Yes   Yes   0
Total                 0

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  

TY 2010 TransferPrsnlBnftContractsDecl
Name:
WESLEYLIFE
EIN: 30-0577845
Declaration:
THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.