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 | |||||
| (A)
IMMANUEL LONG TERM CARE |
462582783 | Yes | 0 | 0 | ||
| (B)
IMMANUEL RETIREMENT COMMUNITIES |
470799108 | Yes | 0 | 0 | ||
| (C)
IMMANUEL HOME AND COMMUNITIES RESOURCES |
272628802 | Yes | 0 | 0 | ||
Total 3
|
0 | |||||
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 | 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
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) |
||||
| 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 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 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) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SECTION A, LINE 6: | IMMANUEL COMMUNITY VISION FOUNDATION'S (ICVF) PROGRAM SERVICE ACTIVITY IS TO HOLD, INVEST AND DISBURSE GIFTS, GRANTS, CONTRIBUTIONS AND FUNDS IN A MANNER THAT SUPPORTS THE PURPOSE AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS AND COMMUNITY ORGANIZATIONS WHOSE MISSIONS ALIGN WITH IMMANUEL, THE SOLE MEMBER OF ICVF. IN 2015, ICVF PROVIDED FINANCIAL SUPPORT TO HOPE LUTHERAN CHURCH, WHICH FURTHERS THE MISSION OF RECOGNIZING AND PROMOTING THE CORPORATION'S LUTHERAN HERITAGE AND THE MISSION AND THE NEBRASKA SYNOD OF THE EVANGELICAL LUTHERAN CHURCH. |
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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 2 | ERIC N. GURLEY IS THE PRESIDENT AND CEO OF IMMANUEL, A RELATED ORGANIZATION OF IMMANUEL COMMUNITY VISION FOUNDATION. ALL COMPENSATED BOARD MEMBERS, OFFICERS, AND OTHER EMPLOYEES ARE EMPLOYEES OF IMMANUEL. |
| FORM 990, PART VI, SECTION A, LINE 4 | ON MARCH 5, 2015 THE ARTICLES OF INCORPORATION WERE AMENDED TO CHANGE THE FOLLOWING: 1. ARTICLE VII (BOARD OF DIRECTORS): THE ARTICLES WERE RESTATED TO REDUCE THE MINIMUM NUMBER OF BOARD OF DIRECTORS FROM NINE (9) VOTING DIRECTORS TO SEVEN (7) VOTING DIRECTORS. ON MARCH 5, 2015 THE BYLAWS WERE AMENDED TO MAKE THE FOLLOWING CHANGES: 1. NUMBER, TENURE AND QUALIFICATIONS OF DIRECTORS: - REDUCED THE MINIMUM NUMBER OF BOARD OF DIRECTORS FROM NINE (9) VOTING DIRECTORS TO SEVEN (7) VOTING DIRECTORS. UNTIL CHANGED BY ACTION OF THE SOLE MEMBER, THE BOARD OF DIRECTORS SHALL CONSIST OF SEVEN (7) VOTING DIRECTORS, WHO SHALL BE APPOINTED BY THE SOLE MEMBER, INSTEAD OF THE PREVIOUSLY STATED SEVENTEEN (17) DIRECTORS. - THE FOLLOWING WORDING WAS INCLUDED TO DEFINE THE TERMS OF SERVICE: "EACH VOTING DIRECTOR WHO IS ALSO A MEMBER OF THE BOARD OF DIRECTORS OF A SUPPORTED ORGANIZATION OR IMMANUEL (AFFILIATED DIRECTOR) SHALL HAVE A TERM OF SERVICE ON THE BOARD OF DIRECTORS COTERMINOUS WITH HIS OR HER TERM ON THE BOARD OF DIRECTORS OF THE SUPPORTED ORGANIZATION OR IMMANUEL, UNLESS THE SOLE MEMBER MAKES A SUBSTITION." - CLARIFIED THAT THE PERSON SERVING AS VICE CHAIRPERSON OF THE SUPPORTED ORGANIZATIONS SHALL SERVE EX OFFICIO WITH VOTE ON THE IMMANUEL COMMUNITY VISION FOUNDATION'S BOARD INSTEAD OF THE CHAIRPERSON OF THE SUPPORTED ORGANIZATIONS, AS ORIGINALLY STATED. - REMOVED THE DESIGNATION OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AS AN EX OFFICIO NONVOTING DIRECTOR. 2. MEETINGS OF THE BOARD OF DIRECTORS "MANNER OF ACTING": - ADDED THE FOLLOWING WORDING: "A TWO-THIRDS (2/3) VOTE IS REQUIRED TO APPROVE A GRANT BY THE CORPORATION." 3. OFFICERS: - REMOVED THE CHAIRPERSON FROM THE ELECTED OFFICER LIST AND ADDED THE FOLLOWING WORDING: "THE CHAIRPERSON SHALL BE THE PERSON THEN SERVING AS THE VICE CHAIRPERSON OF THE SOLE MEMBER, WHO SHALL SERVE EX OFFICIO WITH VOTE. - REMOVED THE PARAGRAPH GIVING THE BOARD THE POWER TO REMOVE THE CHAIRPERSON WITH A TWO-THIRDS (2/3) VOTE. |
| FORM 990, PART VI, SECTION A, LINE 6 | IMMANUEL COMMUNITY VISION FOUNDATION HAS ONE MEMBER, IMMANUEL. |
| FORM 990, PART VI, SECTION A, LINE 7A | IMMANUEL, THE SOLE MEMBER OF IMMANUEL COMMUNITY VISION FOUNDATION, HAS THE RIGHT TO ELECT AND REMOVE DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | IMMANUEL, IMMANUEL COMMUNITY VISION FOUNDATION'S SOLE MEMBER, MUST APPROVE ANY AMENDMENT AND INITIATE OR ADOPT AMENDMENTS TO THE ARTICLES OR BYLAWS OF IMMANUEL COMMUNITY VISION FOUNDATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM WITH THE ASSISTANCE OF THE CONTROLLER, AND IS THEN REVIEWED BY THE CFO AND THE CONTROLLER. COPIES OF THE REVIEWED RETURN ARE PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | IMMANUEL COMMUNITY VISION FOUNDATION USES THE SAME POLICY AS IMMANUEL, A RELATED ORGANIZATION. THE POLICY STATES THAT THE BOARD OF DIRECTORS MUST SIGN THE CONFLICT OF INTEREST POLICY AND DISCLOSE ALL CONFLICTS. THE GOVERNANCE COMMITTEE SHALL DECIDE WHAT ACTIONS NEED TO BE TAKEN CONCERNING ANY CONFLICTS. BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY BUSINESS RELATED TO ANY CONFLICT THE GOVERNANCE COMMITTEE HAS IDENTIFIED. |
| FORM 990, PART VI, SECTION B, LINE 15 | IMMANUEL COMMUNITY VISION FOUNDATION DOES NOT HAVE A CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL OR ANY KEY EMPLOYEES THAT THE ORGANIZATION DIRECTLY COMPENSATES. THE ORGANIZATION WILL REIMBURSE IMMANUEL, A RELATED ORGANIZATION, FOR PORTIONS OF THE SALARIES OF IMMANUEL EMPLOYEES WHO PROVIDE NEEDED SERVICES IN THE FUTURE. THEREFORE, IT IS NOT NECESSARY TO HAVE A PROCESS TO DETERMINE COMPENSATION FOR THESE POSITIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | IMMANUEL COMMUNITY VISION FOUNDATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII | ALL COMPENSATION AND BENEFITS SHOWN FOR DIRECTORS ARE PAID BY IMMANUEL, A RELATED ORGANIZATION, FOR SERVICES PERFORMED FOR IMMANUEL, IMMANUEL COMMUNITY VISION FOUNDATION, OR OTHER RELATED ENTITIES. THE COMPENSATION IS NOT PAID FOR SERVICES IN CONNECTION WITH THE POSITION OF DIRECTOR FOR IMMANUEL COMMUNITY VISION FOUNDATION. |
| FORM 990, PART IX, LINE 11G | CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 42,298. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,298. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS OF IMMANUEL COMMUNITY VISION FOUNDATION ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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