Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 15,745,163 | 17,986,263 | 23,120,714 | 20,105,656 | 23,860,465 | 100,818,261 |
| 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 | 15,745,163 | 17,986,263 | 23,120,714 | 20,105,656 | 23,860,465 | 100,818,261 |
| 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. | 100,818,261 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 15,745,163 | 17,986,263 | 23,120,714 | 20,105,656 | 23,860,465 | 100,818,261 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 179,962 | 178,986 | 171,598 | 151,018 | 291,922 | 973,486 |
| 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 VI.).. | 180,116 | 204,680 | 193,521 | 235,548 | 159,739 | 973,604 |
| 11 | Total support Add lines 7 through 10. | 102,765,351 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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...... | ||||||
| 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. | ||||||
| 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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE GOVERNING BODY APPROVED A RESOLUTION TO AMEND THE BYLAWS WHICH CHANGED THE MINIMUM NUMBER OF DIRECTORS (FROM 20 TO 10), THE TENURE EACH BOARD MEMBER MAY SERVE (THREE FULL CONSECUTIVE TERMS RATHER THAN TWO), AND COMPOSITION OF THE MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD SHALL NOW INCLUDE ONE MEMBER WHO IS CURRENTLY EXPERIENCING HOMELESSNESS OR WHO HAS EXPERIENCED HOMELESSNESS IN THE PAST). |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CHIEF FINANCIAL OFFICER AND CONTROLLER REVIEW THE FORM 990 DRAFT AND ADDRESS ANY QUESTIONS OR CHANGES WITH THE PREPARER. THE RETURN IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR COMMENTS. AFTER ADDRESSING ANY COMMENTS, THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | NEW BOARD MEMBERS REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY DURING ORIENTATION. EXISTING BOARD MEMBERS ARE ASKED TO REVIEW AND SIGN THE CONFLICT OF INTEREST POLICY IN MAY OF EACH YEAR. ANNUALLY, THE FINANCE COMMITTEE REVIEWS A STATEMENT PREPARED INTERNALLY THAT LISTS ALL FINANCIAL ACTIVITIES RELATED TO BOARD MEMBERS INCLUDING BANKS. |
| FORM 990, PART VI, SECTION B, LINE 15 | BI-ANNUALLY HEARTLAND FAMILY SERVICE CONDUCTS A COMPREHENSIVE ANALYSIS OF ALL POSITIONS THAT INCLUDES DATA FROM AREA, REGIONAL, AND NATIONAL SOURCES. THIS DATA IS THEN USED BY THE LEADERSHIP TEAM TO SET SALARY RANGES THROUGHOUT THE AGENCY SUBJECT TO THE APPROVAL OF THE HUMAN RESOURCES TASK FORCE OF THE BOARD OF DIRECTORS. AS NEW POSITIONS ARE CREATED, TWO LISTS OF PROFESSIONAL ORGANIZATIONS ARE EMPLOYED TO ASSIST ON DETERMINING JOB DESCRIPTIONS AND COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | A PRESS RELEASE IS SUBMITTED TO LOCAL PAPERS UPON THE BOARD OF DIRECTORS ADOPTION OF THE ANNUAL AUDIT REPORT. COPIES OF THE FORM 990 AND THE ANNUAL AUDIT ARE AVAILABLE UPON REQUEST AND ARE SUBMITTED ANNUALLY TO MULTIPLE EXTERNAL SOURCES. THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 2C | THE FINANCE COMMITTEE SERVES AS THE AUDIT COMMITTEE. THE TREASURER IS CHAIR OF THE FINANCE COMMITTEE AND THE BOARD CHAIR SITS AS "EX-OFFICIO" ON THE FINANCE COMMITTEE. THEY FORMALLY APPROVE THE AUDITOR SELECTION PROCESS VIA SUBMITTED PROPOSALS AND THIS IS RECORDED IN THE MINUTES. THE TREASURER REVIEWS THE DRAFT OF THE AUDIT REPORT ALONG WITH THE PRESIDENT AND CEO, CHIEF FINANCIAL OFFICER, AND CONTROLLER. THE AUDITOR PRESENTS THE AUDIT REPORT IN DETAIL TO THE FINANCE COMMITTEE IN MAY OF EACH YEAR. THE FINANCE COMMITTEE FORMALLY ACCEPTS THE REPORT. THE TREASURER PRESENTS THE REPORT TO THE FULL BOARD OF DIRECTORS IN MAY AND AGAIN IT IS FORMALLY ACCEPTED. ALL MEMBERS OF THE BOARD RECEIVE A COMPLETE COPY OF THE REPORT WHICH IS ALSO MAILED TO AGENCIES AND FOUNDATIONS AS REQUIRED. |
| ADDITIONAL INFORMATION AS REQUIRED ATTACHMENT: | UNDER THE TERMS OF THE OPERATING AGREEMENT FOR 4318 FORT STREET HTC, LLC, A RELATED PARTY, HEARTLAND FAMILY SERVICE SHALL ATTACH A COPY OF THE FOLLOWING TAX ELECTION MADE BY 4318 FORT STREET HTC MANAGING MEMBER, LLC TO ITS FORM 990 TAX RETURN IN THE YEAR OF ELECTION. THE ELECTION IS EFFECTIVE IN THE YEAR ENDED DECEMBER 31, 2014 AND STATES THE FOLLOWING: 4318 FORT STREET HTC MANAGING MEMBER, LLC 2101 SOUTH 42ND STREET, OMAHA, NE 68105 EIN: 47-2446741 ELECTION NOT TO BE TREATED AS EXEMPT ENTITY IRC SECTION 168(H)(6)(F)(II) THE TAXPAYER HEREBY ELECTS TO HAVE ANY GAIN RECOGNIZED BY ITS TAX-EXEMPT PARENTS ON ANY DISPOSITION OF AN INTEREST IN THE TAXPAYER (AND TO TREAT ANY DIVIDENDS OR INTEREST RECEIVED OR ACCRUED FROM THE TAXPAYER) AS UNRELATED BUSINESS TAXABLE INCOME UNDER CODE SECTION 511 IN ORDER FOR THE TAXPAYER TO NOT BE TREATED AS A "TAX-EXEMPT ENTITY" (OR AS A SUCCESSOR TAX-EXEMPT ENTITY) UNDER IRC SECTION 168(H)(6)(F)(II). THIS ELECTION IS EFFECTIVE ON THE ENTITY'S ORGANIZATION DATE, NOVEMBER 14, 2014. THIS ELECTION IS IRREVOCABLE. |
| ADDITIONAL INFORMATION AS REQUIRED ATTACHMENT: | UNDER THE TERMS OF THE OPERATING AGREEMENT FOR 4318 FORT STREET, LLC, A RELATED PARTY, HEARTLAND FAMILY SERVICE SHALL ATTACH A COPY OF THE FOLLOWING TAX ELECTION MADE BY HFS QALICB HOLDINGS, LLC TO ITS FORM 990 TAX RETURN IN THE YEAR OF ELECTION. THE ELECTION IS EFFECTIVE IN THE YEAR ENDED DECEMBER 31, 2014 AND STATES THE FOLLOWING: HFS QALICB HOLDINGS, LLC 2101 SOUTH 42ND STREET, OMAHA, NE 68105 EIN: 47-2457194 ELECTION NOT TO BE TREATED AS EXEMPT ENTITY IRC SECTION 168(H)(6)(F)(II) THE TAXPAYER HEREBY ELECTS TO HAVE ANY GAIN RECOGNIZED BY ITS TAX-EXEMPT PARENT ON ANY DISPOSITION OF AN INTEREST IN THE TAXPAYER (AND TO TREAT ANY DIVIDENDS OR INTEREST RECEIVED OR ACCRUED FROM THE TAXPAYER) AS UNRELATED BUSINESS TAXABLE INCOME UNDER CODE SECTION 511 IN ORDER FOR THE TAXPAYER TO NOT BE TREATED AS A "TAX-EXEMPT ENTITY" (OR AS A SUCCESSOR TAX-EXEMPT ENTITY) UNDER IRC SECTION 168(H)(6)(F)(II). THIS ELECTION IS EFFECTIVE ON THE ENTITY'S ORGANIZATION DATE, NOVEMBER 14, 2014. THIS ELECTION IS IRREVOCABLE. |
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