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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Lutheran Social Services Housing Inc
Employer identification number
26-2358686
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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—2012.
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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
1,214,916
1,367,262
513,421
7,575,870
3,079,724
13,751,193
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......
481,188
549,152
806,400
1,446,469
3,376,564
6,659,773
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.
1,696,104
1,916,414
1,319,821
9,022,339
6,456,288
20,410,966
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
285,878
16,601
302,479
c
Add lines 7a and 7b..
285,878
16,601
302,479
8
Public support (Subtract line 7c from line 6.)
20,108,487
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
1,696,104
1,916,414
1,319,821
9,022,339
6,456,288
20,410,966
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
91
75
77
77,597
77,840
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
91
75
77
77,597
77,840
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.)
..
20,000
20,000
13
Total support. (Add lines 9, 10c, 11, and 12.)..
1,696,104
1,916,505
1,339,896
9,022,416
6,533,885
20,508,806
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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
98.050 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.380 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Lutheran Social Services Housing Inc
Employer identification number
26-2358686
Return Reference
Explanation
Form 990, Part III, line 2
Lutheran Social Services Housing created the Isaiah Investments Fund, which is a mechanism that will help support the work of LSSH by providing funding for projects that help create affordable housing and related spaces (specifically child care). Through Isaiah Investments, Lutheran Social Services Housing connects socially responsible investors - community-minded individuals and businesses - to opportunities that directly support the creation and preservation of affordable housing. Isaiah Investments does this by making loans to LSSH-developed projects. The capital for Isaiah Investments comes from financial institutions, utilities, businesses and individuals who share an interest in improving the lives of North Dakotans. Investors make loans of $5,000 or more to the Fund for a period of at least three years.
Form 990, Part V, Line 2a, Part VII Column D, & Part IX Lines 5-10
Compensation: The compensation reported in Part VII, Column D, and Part IX, Lines 5-10 represents the amount of compensation paid by Lutheran Social Services of ND, a related organization, that was reimbursed by Lutheran Social Services Housing, Inc. for services provided to Lutheran Social Services Housing, Inc. Since all payroll documents including the W-3 and W-2s are issued by Lutheran Social Services ND, a related organization, Lutheran Social Services Housing, Inc. does not issue a W-3 and reported 0 in Part V, Line 2a.
Form 990, Part VI, Section A, line 1
The Board may establish an Executive Committee consisting of the officers of the Corporation and such Board Members as may be appointed by the Board. The Executive Committee will have authority to meet and take action on items between board meetings provided such actions are consistent with directions and authorizations by the Board to the Executive Committee. During the fiscal year the Board did not utilize and Executive Committee although it was authorized to do so.
Form 990, Part VI, Section A, line 2
Jessica Thomasson, Robert Sanderson and Joan Penner have a business relationship with Rev Patrick O'Brien, David Walth, Bishop Mark Narum and Melanie Stillwell.
Form 990, Part VI, Section A, line 3
The relationship between Lutheran Social Services Housing, Inc (LSS Housing) and Lutheran Social Services of North Dakota (LSS ND) is detailed in a memorandum of agreement (MOA) reviewed and approved by each organization's board of directors annually. In brief, LSS Housing contracts with LSS ND for several administrative support services (Ex. Payroll, Information Technology, Office Space). Both the President/CEO and CFO functions of LSS Housing are contracted to LSS ND employees (covered under the aforementioned MOA). See part VII for compensation paid to the President/CEO, Robert Sanderson, and CFO, Joan Penner, by LSS ND. The Executive Director, Jessica Thomasson, is paid by LSS ND, however the compensation is reimbursed by LSS Housing Inc. for services provided to LSS Housing Inc. See part VII for amounts of compensation received by the Executive Director for services provided to LSS Housing Inc.
Form 990, Part VI, Section A, line 6
The sole member is Lutheran Social Services of North Dakota.
Form 990, Part VI, Section A, line 7a
The governing body of Lutheran Social Services Housing, Inc consists of 3 board members that are selected by Lutheran Social Services of North Dakota, and 4 board members that are selected by the board of Lutheran Social Services Housing and approved by Lutheran Social Services of North Dakota.
Form 990, Part VI, Section A, line 7b
The member (Lutheran Social Services of North Dakota) must approve a resolution to dissolve the corporation.
Form 990, Part VI, Section A, line 8b
The bylaws allow for an Executive Committee but there was no such committee during the year or other committee with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11
The organizational staff will review and assist in preparation of the Form 990. Prior to being filed, the Form 990 will also be given to the board of directors for their approval.
Form 990, Part VI, Section B, line 12c
The conflict of interest policy covers members of the board of directors, staff, volunteers and consultants of the organization. Board members having a conflict of interest may not participate or act with respect to the contract or transaction unless the contract or transaction is shown to be fair and reasonable; the material facts and the board member interest are fully disclosed; and, the transaction is approved in good faith by two-thirds of the board members entitled to vote, not counting any vote of the interested board member. Determinations of whether a conflict exists are made at the program director level. If the conflict of interest involved the program director, it would be determined by the CEO. Actual conflicts are reviewed by the program director, CEO and if necessary, the board of directors.
Form 990, Part VI, Section B, line 15
Compensation is determined by the related organization, LSS of ND. The LSS of ND President of the Board works with the Human Resources manager on a format for electronic review of compensation by board members. This review could also include some employees and/or outside interests such as peers and pastors. Human Resources also does compensation comparability studies. The LSS of ND President of the Board receives the overall organization increase percentage and the highest percentage given to all other staff. The LSS of ND Executive Committee meets to discuss review results, percentage increase and any other potential increase such as bonus or merit pay. The CEO's compensation is discussed with the full board of directors at the October meeting. The compensation package agreed upon at the October meeting goes into effect on the CEO's anniversary date. Form 990, Part VI, Line 16: Joint Venture Policies All joint ventures in which the Organization participates are governed by operating agreements or limited partnership agreements that restrict those entities to purposes that conform to those of an organization operated exclusively for charitable purposes within the meaning of Section 501(c)(3) of the Internal Revenue Service Code as amended from time to time.
Form 990, Part VI, Section C, line 19
The organization does not make its governing documents, conflict of interest policy or financial statements available to the public.
Form 990, Part XI, line 9:
Net Asset Transfer to LSS Housing Jamestown -13,762.
Form 990, Part XI, Line 8:
The organization is reporting a prior period adjustment in the amount of $2,887,033. When the Form 990 was filed for FYE 6/30/13, the financial information for LSS Housing Jamestown Inc. was inadvertently included with that of LSS Housing Inc. The Prior period adjustment is being recorded to remove the net assets of LSS Housing Jamestown Inc. which will be reported on their Form 990.
Form 990, Part XII, Line 2c:
The audit committee of Lutheran Social Services of North Dakota reviews the consolidated financial statements which include Lutheran Social Services Housing, Inc. The Lutheran Social Services of North Dakota Board Audit Committee was established at the January 20, 2014, board meeting.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.