Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (1)
ACTS SIGNATURE COMMUNITY SERVICES INC |
264573131 | 9 | Yes | Yes | Yes | 0 | |||
| (2)
ACTS MISSION FOUNDATION |
264573334 | 7 | Yes | Yes | Yes | 0 | |||
| (3)
ACTS MANAGEMENT SERVICES INC |
264573412 | 509(A)(3) | Yes | Yes | Yes | 0 | |||
| (4)
ACTS RETIREMENT-LIFE COMMUNITIES INC |
231900132 | 9 | Yes | Yes | Yes | 0 | |||
| Total | 0 | ||||||||
| 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. | ||||||
| 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). | ||||||






| 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.) | ||||||
| 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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THERE HAS BEEN NO ACTIVITY FOR THE CALENDAR YEAR. IN THE FUTURE, AFTER REVIEW BY THE CFO AND CEO, THE FORM 990 WILL BE REVIEWED BEFORE FILING BY THE BOARD OF DIRECTORS' AUDIT COMMITTEE. THE FORM 990 IS THEN PROVIDED TO THE OTHER MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST QUESTIONNAIRE WILL BE COMPLETED ON AN ANNUAL BASIS BY THE ORGANIZATION'S OFFICERS, DIRECTORS AND TRUSTEES. THE RESPONSES ARE REVIEWED BY THE CEO AND CHAIRMAN OF THE BOARD OF DIRECTORS TO DETERMINE IF CONFLICTS ARE PRESENT AND IF SO, THE EXTENT OF THE CONFLICT. FOR CONFLICTS THAT ARISE, THE OFFICER, DIRECTOR OR TRUSTEE MUST RECUSE THEMSELVES FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS THAT INVOLVE THE DETERMINED CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | IT HAS BEEN THE COMPANY'S AFFILIATES' PRACTICE TO ENGAGE AN INDEPENDENT COMPENSATION CONSULTANT ON AN APPROXIMATELY BIENNIAL BASIS FOR THE PURPOSE OF REVIEWING THE COMPENSATION PROGRAM FOR THE COMPANY'S TOP POSITIONS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE FILED WITH NUMEROUS REGULATORY AUTHORITIES AND THEREFORE, ARE AVAILABLE TO THE PUBLIC. IN ADDITION, UPON RECEIPT OF A REQUEST AND ITS REVIEW, THE ORGANIZATION WILL MAKE AVAILABLE SUCH DOCUMENTS, AS DEEMED APPROPRIATE. THERE WERE NO FINANCIAL STATEMENTS FOR THE ORGANIZATION IN 2010 AS IT WAS INACTIVE. | |
| FORM 990, PART VII, SECTION A, (B): | AVERAGE HOURS PER WEEK LISTED IN PART VII ARE FOR THIS LEGAL ENTITY ONLY. BOARD MEMBERS AND OFFICERS ALSO DEVOTE TIME TO THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. AVERAGE HOURS PER WEEK FOR ALL OTHER RELATED ORGANIZATIONS ARE AS FOLLOWS: MARVIN MASHNER 56.50 GERALD T. GRANT 56.50 J. MARK VANDERBECK 56.50 | |
| FORM 990, PART VI, GOVERNING BODY AND MANAGEMENT | ACTS RETIREMENT SERVICES, INC. WAS INCORPORATED IN MARCH OF 2009 AS PART OF A RESTRUCTURE OF ACTS RETIREMENT-LIFE COMMUNITIES, INC. (EIN 23-1900132), AN ENTITY THAT HAS BEEN GRANTED TAX EXEMPT-STATUS AS A PUBLIC CHARITY DESCRIBED IN SECTIONS 509(A)(2) OF THE INTERNAL REVENUE CODE. ACTS RETIREMENT SERVICES, INC. HAS NOT YET BEGUN OPERATIONS AND THEREFORE: 1)HAS NOT YET SELECTED CORPORATE OFFICERS OR MEMBERS OF ITS GOVERNING BODY; 2)HAS NOT YET ADOPTED CORPORATE POLICIES THAT WILL BE IN PLACE ONCE THE ORGANIZATION BEGINS TO OPERATE; AND 3)DID NOT HAVE ANY REVENUE OR EXPENSES, AND DID NOT COMPENSATE ANY EMPLOYEES, OFFICERS, OR DIRECTORS, IN 2010. | |
| FORM 990, PART VII, COMPENSATION OF OFFICERS* | OTHER COMPENSATION FOR GERALD T. GRANT AND J. MARK VANDERBECK INCLUDES ACCRUALS FOR A DEFERRED, NON-VESTED, SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. |
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