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
2011
Open to Public Inspection
Name of the organization
LUTHERAN FAMILY SERVICES OF NE INC
Employer identification number
23-7267972
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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—2011.
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—2010.
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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
4,972,120
5,229,778
5,208,932
6,088,966
6,861,958
28,361,754
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......
7,625,557
8,242,319
8,382,640
8,442,845
8,561,894
41,255,255
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
0
0
-3,293
4,641
1,348
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
0
0
0
0
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
0
0
0
0
0
6
Total. Add lines 1 through 5.
12,597,677
13,472,097
13,591,572
14,528,518
15,428,493
69,618,357
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
9,743
7,560
10,086
9,153
6,557
43,099
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
0
0
0
0
0
c
Add lines 7a and 7b..
9,743
7,560
10,086
9,153
6,557
43,099
8
Public Support (Subtract line 7c from line 6.)
69,575,258
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
12,597,677
13,472,097
13,591,572
14,528,518
15,428,493
69,618,357
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
972
1,980
262
475
265
3,954
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
0
0
0
0
0
c
Add lines 10a and 10b.
972
1,980
262
475
265
3,954
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
0
0
0
0
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
25,850
38,147
71,186
59,173
12,382
206,738
13
Total support (Add lines 9, 10c, 11 and 12.).
12,624,499
13,512,224
13,663,020
14,588,166
15,441,140
69,829,049
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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
99.637 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
99.596 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
0.006 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
0.006 %
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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
Other miscellaneous income is related to Lutheran Family Services' exempt purpose.
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
11000129
Software Version:
v1.00
-
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
2011
Open to Public Inspection
Name of the organization
LUTHERAN FAMILY SERVICES OF NE INC
Employer identification number
23-7267972
Identifier
Return Reference
Explanation
F990_P06_S0A_L02
Form 990, Part VI, Section A, Line 2
Ruth A Henrichs, President & CEO, is related by marriage to Richard A Henrichs, Vice President Finance. Performance review and salary determination for the Vice President Finance is performed by the Board of Directors' Treasurer & Chair of Finance / Audit Committee.
F990_P06_S0A_L06
Form 990, Part VI, Section A, Line 6
Members include the Evangelical Lutheran Church in America (ELCA), Nebraska Synod, and the Lutheran Church - Missouri Synod (LCMS), Nebraska District.
F990_P06_S0A_L07a
Form 990, Part VI, Section A, Line 7a
Voting members of the Board of Directors are elected by two Corporate Members, the ELCA, Nebraska Synod (9), and the LCMS, Nebraska District (7), and by the Board of Directors itself (4).
F990_P06_S0A_L07b
Form 990, Part VI, Section A, Line 7b
Significant changes to the Organization's organizational structure and organizational doucments made by the Board of Directors (governing body) require approval by the Members, ELCA, Nebraska Synod and LCMS, Nebraska District.
F990_P06_S0B_L11b
Form 990, Part VI, Section B, Line 11b
The Vice President Finance (a CPA) prepares a draft of the Form 990 for review by the Organization President & CEO and the Organization Vice President for Development. A final draft is prepared and presented to the Lutheran Family Services Board of Directors for approval to be filed with the Internal Revenue Service Center.
F990_P06_S0B_L12c
Form 990, Part VI, Section B, Line 12c
Annually all members of the Board of Directors and key employees are required to review the Conflict of Interest Policy and sign a statement of compliance/disclosure. Lutheran Family Services Board of Directors meetings begin by a review of the agenda and a call for disclosure of any conflict of interest as declared by any Board Member.
F990_P06_S0B_L15
Form 990, Part VI, Section B, Line 15
Lutheran Family Services' Compensation Administration Scale is reviewed bi-annually by the Board of Directors. The Compensation Administration Scale is updated bi-annually by the LFS Human Resources Department by using local, regional and national salary surveys and other data.
F990_P06_S0C_L19
Form 990, Part VI, Section C, Line 19
Lutheran Family Services makes its governing documents, conflict of interest policy and financial reports available upon request to Government regulatory bodies, funders, donors, clients and the public.
F990_P11_S00_L05
Form 990, Part XI, Line 5
Decrease in temporarily restricted net assets = $153,247. Decrease in permanently restricted net assets = $357,258. Total decrease in net assets equals $510,505.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
11000129
Software Version:
v1.00
-
TIN:
TY 2011 ReasonableCauseExplanation
Name:
LUTHERAN FAMILY SERVICES OF NE INC
EIN: 23-7267972
Software ID:11000129
Software Version:v1.00
Explanation:
Lutheran Family Service of Nebraska Inc was approved by the Internal Revenue Service Center for an extention to file IRS Form 990 until November 15, 2012 in order for the LFS Board of Directors to review and approve for filing the Form 990 at the board meeting scheduled September 10, 2012.