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
ROSELLE SENIOR CITIZEN'S HOUSING CO
Employer identification number
11-2315141
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.") .
231,589
213,459
237,589
280,809
1,084,880
2,048,326
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......
832,302
850,114
896,183
873,518
886,483
4,338,600
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
16,925
15,361
16,815
17,481
16,903
83,485
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.
1,080,816
1,078,934
1,150,587
1,171,808
1,988,266
6,470,411
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.)
6,470,411
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...
1,080,816
1,078,934
1,150,587
1,171,808
1,988,266
6,470,411
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
7,201
746
461
309
754
9,471
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
7,201
746
461
309
754
9,471
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.)
1,785
788
638
96
12,391
15,698
13
Total support (Add lines 9, 10c, 11 and 12.).
1,089,802
1,080,468
1,151,686
1,172,213
2,001,411
6,495,580
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
99.610 %
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
99.470 %
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 %
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
1.000 %
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
Schedule A (Form 990 or 990-EZ) 2011
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
2011
Open to Public Inspection
Name of the organization
ROSELLE SENIOR CITIZEN'S HOUSING CO
Employer identification number
11-2315141
Identifier
Return Reference
Explanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
ALL OFFICERS AND DIRECTORS OF THE BOARD ARE VOLUNTEERS.
MANAGEMENT DELEGATED
FORM 990, PAGE 6, PART VI, LINE 3
COUGHLIN MANAGEMENT COMPANY, INC. PROVIDES ONSITE MANAGEMENT SERVICES TO THE ORGANIZATION.
CLASSES OF MEMBERS OR STOCKHOLDERS
FORM 990, PAGE 6, PART VI, LINE 6
THE ORGANIZATION HAS BOARD MEMBERS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE MANAGEMENT COMPANY REVIEWS THIS RETURN WITH THE PREPARER. THE RETURN IS THEN DISTRIBUTED TO THE GOVERNING BODY. A REASONABLE AMOUNT OF TIME IS ALLOWED FOR BOARD MEMBERS TO REVIEW THE RETURN. ONCE THAT TIME HAS PASSED, THE RETURN IS SIGNED BY AN AUTHORIZED BOARD MEMBER AND THE RETURN IS SUBMITTED.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
PER THE CONFLICT OF INTEREST POLICY, THE VENDOR LISTS ARE REVIEWED PERIODICALLY WITH THE BOARD OF DIRECTORS TO ENSURE THERE ARE NO CONFLICTS OF INTEREST. IF THERE ARE ANY CONFLICTS OF INTEREST WITH A SPECIFIC BOARD MEMBER, THE BOARD MEMBER WILL ABSTAIN FROM VOTING ON ANY APPROVALS FOR SUCH CONTRACTOR OR PAYMENT SUBMISSIONS. ANY POTENTIAL CONFLICT OF INTEREST IS DISCUSSED OPENLY AT BOARD MEETINGS.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
NO COMPENSATION IS PAID TO BOARD MEMBERS OR DIRECTORS.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
IN 1998 THE ORGANIZATION TERMINATED ALL EMPLOYEES AND REPLACED THEM WITH LEASED EMPLOYEES FROM A LEASING COMPANY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
A COPY OF THE IRS FORM 1023, ANNUAL FINANCIAL STATEMENT AND IRS FORM 990 ARE AVAILABLE UPON REQUEST FROM THE ORGANIZATION. IN ADDITION, THE ANNUAL FINANCIAL STATEMENT AND FORM 990 CAN BE OBTAINED ON THE INTERNET AT WWW.GUIDESTAR.ORG.
OTHER EXPENSES
FORM 990, PART IX, LINE 24E
5812 FEES AND CHARGES 19,431 5490 OTHR MAINT. CONTRACT 15,386 5323 PLUMBING 12,862 5460 EXTERMINATING (CONTR 11,763 5350 MISC MAINTENANCE SUP 11,177 5160 COMPUTER CHARGES/DAT 10,500 5440 PAINT/DECOR. (CONTRA 9,685 5195 MISC. ADMIN. EXPENSE 8,149 5156 SOCIAL SERVICES 7,519 5413 SECURITY 5,700 5425 ELEVATOR (CONTRACT) 4,578 5340 PAINTING AND DECORAT 3,789 5324 ELECTRICAL 3,689 5123 DUES AND SUBSCRIPTIO 3,671 5342 JANITORIAL SUPPLIES 3,053 5325 KITCHEN EQUIPMENT 2,620 5432 GRNDS/LANDS (CONTRAC 2,613 5152 OTHER PROFESSIONAL F 2,583 5330 SNOW REMOVAL 900 5127 INSPECTION AND OTHE 736 5154 CREDIT CHECK FEES 659 5414 FIRE SYSMONITOR (CON 594 6100 AMORTIZATION COSTS 586 5341 SMALL EQUIPMENT & TO 370
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.