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.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
WESTMINSTER VILLAGE MUNCIE INC
Employer identification number
31-1002845
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(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
Total
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
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
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.") .
85,343
100,485
94,596
117,607
92,795
490,826
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......
9,492,168
10,076,483
9,593,968
9,777,925
10,511,817
49,452,361
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.
9,577,511
10,176,968
9,688,564
9,895,532
10,604,612
49,943,187
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
0
c
Add lines 7a and 7b..
0
8
Public Support (Subtract line 7c from line 6.)
49,943,187
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...
9,577,511
10,176,968
9,688,564
9,895,532
10,604,612
49,943,187
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
98,136
68,594
55,093
56,616
38,082
316,521
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
98,136
68,594
55,093
56,616
38,082
316,521
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.)
5,851
1,323
7,174
13
Total support (Add lines 9, 10c, 11 and 12.).
9,681,498
10,246,885
9,743,657
9,952,148
10,642,694
50,266,882
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
99.360 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.230 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0.630 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
0.740 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
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:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
WESTMINSTER VILLAGE MUNCIE INC
Employer identification number
31-1002845
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION B, LINE 11
THE 990 IS PREPARED BY OUR CPA FIRM. THE PRESIDENT (WHO IS ALSO A CPA) THEN REVIEWS THE RETURN. A COPY IS ALSO GIVEN TO ALL BOARD MEMBERS, INCLUDING THE TREASURER, TO REVIEW. THE ORGANIZATION HAS AN AUDIT AND FINANCE COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT. THE BOARD OF DIRECTORS MEETS BI-MONTHLY RECEIVING UPDATES FROM MANAGEMENT ON FINANCES, CENSUS, OPERATIONS AND FUTURE PLANNING. ON NON-MEETING MONTHS THE BOARD IS UPDATED ON FINANCES, CENSUS AND OPERATIONS IN WRITTEN FORM. THE BOARD OF DIRECTORS IS COMPRISED OF MEMBERS OF THE LOCAL COMMUNITY WITH THE FOLLOWING EXPERTISE: LEGAL, FINANCIAL/ACCOUNTING, BUSINESS MANAGEMENT, FACILITIES MANAGEMENT, TECHNOLOGY, PERSONNEL, MEDICAL, COMMUNITY, WELLNESS AND GERONTOLOGY.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION'S PRESIDENT AND THE CHAIRMAN OF THE BOARD ARE PROVIDED A SCHEDULE OF ALL DIRECTORS' CONFLICTS OF INTEREST STATEMENTS PRIOR TO EACH BOARD MEETING FOR THEIR REVIEW. EACH DIRECTOR AND KEY EMPLOYEE COMPLETES A CONFLICT OF INTEREST STATEMENT ANNUALLY. ALL BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. IF A POSSIBLE CONFLICT OF INTEREST DOES ARISE, THE ISSUE IS VOTED ON BY ALL MEMBERS THAT DO NOT HAVE AN INTEREST IN THE OUTCOME.
FORM 990, PART VI, SECTION B, LINE 15
COMPARABLE SALARY DATA FOR SIMILAR POSITIONS FROM SEVERAL SOURCES (INDIANA ASSOCIATION OF HOMES AND SERVICES FOR THE AGING, AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING, AND 11 COMPARABLY SIZED CONTINUING CARE RETIREMENT COMMUNITIES) IS REVIEWED BY THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS FOR THE PRESIDENT, VICE PRESIDENT, AND FIVE OTHER TOP MANAGEMENT POSITIONS TO DETERMINE FAIR MARKET, REASONABLE COMPENSTAION. SALARY AMOUNTS ARE THEN BASED UPON THIS SURVEY INFORMATION, AS WELL AS THE INDIVIDUAL'S EXPERIENCE, AND THE ACCOMPLISHMENTS OF THE MANAGEMENT TEAM DURING THE PAST YEAR, IN ADDITION TO THE RESULS OF THE ORGANIZATION'S OPERATIONS.
FORM 990, PART VI, SECTION C, LINE 19
A PUBLIC INSPECTION FILE IS MAINTAINED BY THE ORGANIZATION SHOULD ANYONE REQUEST THIS INFORMATION. THE ORGANIZATION'S FORM 990 IS ALSO ON THE GUIDESTAR WEBSITE (WWW.GUIDESTAR.ORG) THE ORGANIZATION IS A CONTINUING CARE RETIREMENT COMMUNTY REGISTERD WITH THE SECURITIES DIVISION OF THE INDIANA SECRETARY OF STATE AS REQUIRED, THE ORGANIZATION COMPLETES AND SUBMITS AN ANNUAL DISCLOSURE STATEMENT WITH THEIR OFFICE, WHICH INCLUDES THE ANNUAL AUDITED FINANCIAL STATEMENTS, IN ADDITION TO TO OTHER REQUIRED INFORMATION. THIS DISCLOSURE STATEMENT IS GIVEN TO ALL NEW RESIDENTS, AS WELL AS ANYONE REQUESTING A COPY.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 124,570.
NO CHANGE IN THE AUDIT OVERSIGHT PROCESS FROM PRIOR YEARS. THE AUDIT COMMITTEE ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.