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
2012
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
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—2011.
If the organization did not check a 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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
5,229,778
5,208,932
6,088,966
6,861,958
8,859,562
32,249,196
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......
8,242,319
8,382,640
8,442,845
8,561,894
7,985,222
41,614,920
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
0
-3,293
4,641
-56,512
-55,164
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.
13,472,097
13,591,572
14,528,518
15,428,493
16,788,272
73,808,952
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
7,560
10,086
9,153
6,557
7,790
41,146
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..
7,560
10,086
9,153
6,557
7,790
41,146
8
Public support (Subtract line 7c from line 6.)
73,767,806
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
13,472,097
13,591,572
14,528,518
15,428,493
16,788,272
73,808,952
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,980
262
475
265
35
3,017
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.
1,980
262
475
265
35
3,017
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.)
..
38,147
71,186
59,173
12,382
18,670
199,558
13
Total support. (Add lines 9, 10c, 11, and 12.)..
13,512,224
13,663,020
14,588,166
15,441,140
16,806,977
74,011,527
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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
99.671 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.637 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.004 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.006 %
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012
Additional Data
Software ID:
12000197
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
2012
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 documents 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 IRS 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 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, financial reports and IRS Form 990 available upon request to Government regulatory bodies, funders, donors, clients and the public.
F990_P11_S00_L09
Form 990, Part XI, Line 9
Decrease in temporarily restricted net assets of $447,498.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
12000197
Software Version:
v1.00
-
TIN:
TY 2012 ReasonableCauseExplanation
Name:
LUTHERAN FAMILY SERVICES OF NE INC
EIN: 23-7267972
Software ID:12000197
Software Version:v1.00
Explanation:
Lutheran Family Services of NE Inc filed Form 8868, Application for Extension of Time to File an Exempt Organization Return with the Internal Revenue Service Center, and received an extension to November 15, 2013, to allow the LFS Board of Directors to review and approve for filing the IRS Form 990 at the board meeting scheduled September 9, 2013.