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
APOSTOLIC CHRISTIAN HOME
Employer identification number
37-0716056
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.") .
797,186
343,418
298,879
1,075,251
793,075
3,307,809
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......
4,714,617
4,718,013
5,038,169
5,512,758
5,687,159
25,670,716
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
9,946
10,063
20,009
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.
5,511,803
5,061,431
5,337,048
6,597,955
6,490,297
28,998,534
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.)
28,998,534
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...
5,511,803
5,061,431
5,337,048
6,597,955
6,490,297
28,998,534
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9,772
18,906
19,111
17,512
17,968
83,269
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
9,772
18,906
19,111
17,512
17,968
83,269
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.)..
5,521,575
5,080,337
5,356,159
6,615,467
6,508,265
29,081,803
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
99.710 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.710 %
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 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
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
Schedule A (Form 990 or 990-EZ) 2012
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
2012
Open to Public Inspection
Name of the organization
APOSTOLIC CHRISTIAN HOME
Employer identification number
37-0716056
Identifier
Return Reference
Explanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
VOLUNTEERS PARTICIPATE IN RESIDENT ACTIVITIES AND PROGRAMS, MAINTENANCE OF THE BUILDING AND GROUNDS & SERVE ON THE BOARD OF TRUSTEES.
CLASSES OF MEMBERS OR STOCKHOLDERS
FORM 990, PAGE 6, PART VI, LINE 6
THE ORGANIZATION IS A NONPROFIT CORPORATION THAT HAS FORU CLASSES OF MEMBERS WITH VARYING RIGHTS AND POWERS.
ELECTION OF MEMBERS AND THEIR RIGHTS
FORM 990, PAGE 6, PART VI, LINE 7A
THE CORPORATION'S BOARD OF TRUTEES NOMINATE SEVEN SUCESSOR TRUSTEES FROM CLASS A MEMBERS. THE APOSTOLIC CHRISTIAN CHURCH OF PRINCEVILLE'S ELDER NOMINATES TWO SUCESSOR TRUSTEES FROM THE CLASS D MEMBERS. THE CLASS B MEMBERS NOMINATE ONE SUCESSOR TRUSTEE FROM THE CLASS B MEMBERS. CLASS B MEMBERS - APPOINT THE CORPORTATION'S TRUSTEES. ANY TRUSTEE WHOSE TERM EXTENDS OVER ONE YEAR IS SUBJECT TO REAPPOINTMENT ANNUALLY BY THE CLASS B MEMBERS AND APPROVAL BY THE CLASS C MEMBER.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS
FORM 990, PAGE 6, PART VI, LINE 7B
THE MEMBERS OF THE APOSTOLIC CHRISTIAN CHURCH OF PEORIA (CLASS A MEMBER), THE APOSTOLIC CHRISTIAN CHURCH OF PEORIA'S BOARD OF TRUSTEES (CLASS B MEMBER AND THE ELDER OF THE APOSTOLIC CHRISTIAN CHURCH OF PEORIA (CLASS C MEMBER) APPROVE OR REJECT EXPENDITURES IN EXCESS OF 50,000. THE CLASS B AND CLASS C MEMBERS APPROVE OR REJECT AN BY-LAW AMENDMENTS.
OFFICERS WHO CANNOT BE REACHED
FORM 990, PAGE 6, PART VI, LINE 9
MIKE WAIBEL 11036 N. BUCKSKIN CT. PEORIA, IL 61615 BOB GANGLOFF 240 KARAGEN CIRCLE GERMANTOWN HILLS, IL 61548 GEOFF GINZEL 601 W SCOTTWOOD DR PEORIA, IL 61615 RONALD RUMBOLD 1901 E 2850 ST GALVA, IL 61434 MARK SCEGGEL 823 S. BAER ROAD PEORIA, IL 61604 DALE ENDRESS 901 W CEDAR HILLS DRIVE DUNLAP, IL 61525 KEITH KNOBLOCH 14705 STATE ROUTE 17 WYOMING, IL 61491 ROBERT HOERR 206 SURREY LANE EAST PEORIA, IL 61611 MARK HOHULIN 211 S. OHIO MORTON, IL 61550 RALPH HOFSTETTER 22223 GROSENBACH RD WASHINGTON, IL 61571
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE RETURN WAS PREPARED BY OUR EXTERNAL ACCOUNTING FIRM AND REVIEWED BY OUR CONTROLLER.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE BOARD OF TRUSTEES ANNUALLY MAKES CONFLICT OF INTEREST DISCLOSURES. ANY MATTERS THAT INVOLVE A CONFLICT OF INTEREST REQUIRE BOARD ACTION; THE INDIVIDUAL WITH A CONFLICT IS REQUIRED TO EXCUSE THEMSELVES FROM ANY VOTE ON THE MATTER.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE COMPENSATION OF THE ADMINISTRATOR IS DETERMINED BY THE BOARD OF TRUSTEES. THE BOARD OF TRUSTEES CONDUCTS A REVIEW OF THE ADMINISTRATOR'S PERFORMANCE AND SALARY ON AN ANNUAL BASIS. THE BOARD OF TRUSTEES VOTES ON SALARY ADJUSTMENTS FOR THE ADMINISTRATOR AND DOCUMENTS SALARY DISCUSSIONS AND DECISIONS IN THE BOARD MINUTES.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION'S CONFILICT OF INTEREST POLICY, GOVERNING DOCUMENTS SUCH AS BY LAWS, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.