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.") .... | ||||||
| 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...... | 224,125 | 222,503 | 224,616 | 205,462 | 208,117 | 1,084,823 |
| 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. | 224,125 | 222,503 | 224,616 | 205,462 | 208,117 | 1,084,823 |
| 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. | 78,571 | 80,724 | 81,775 | 85,401 | 85,163 | 411,634 |
| c | Add lines 7a and 7b.. | 78,571 | 80,724 | 81,775 | 85,401 | 85,163 | 411,634 |
| 8 | Public support (Subtract line 7c from line 6.) | 673,189 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 224,125 | 222,503 | 224,616 | 205,462 | 208,117 | 1,084,823 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 83 | 77 | 177 | 62 | 81 | 480 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 83 | 77 | 177 | 62 | 81 | 480 |
| 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.) .. | 105 | 17,507 | 18,535 | 36,147 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 224,208 | 222,580 | 224,898 | 223,031 | 226,733 | 1,121,450 |
| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | OTHER INCOME - 2012 AMOUNT: $ 105. 2013 AMOUNT: $ 186. 2014 AMOUNT: $ 50. LAUNDRY INCOME - 2013 AMOUNT: $ 5,033. 2014 AMOUNT: $ 4,877. CABLE INCOME - 2013 AMOUNT: $ 12,288. 2014 AMOUNT: $ 13,608. |
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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 6 | THE SOLE MEMBER OF TEL HAI APARTMENTS IS TEL HAI SERVICES, INC. (EIN: 23-2630672), A PENNSYLVANIA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | QUALIFICATION AND SELECTION: EACH DIRECTOR OF THE CORPORATION SHALL BE A NATURAL PERSON OF MAJORITY AGE, BUT NEED NOT BE A RESIDENT OF PENNSYLVANIA. IN THE CASE OF VACANCIES, NEW DIRECTORS, SUBJECT TO THE APPROVAL OF THE MEMBER, SHALL BE SELECTED BY THE BOARD. IF THE BOARD IS CLASSIFIED WITH RESPECT TO THE TERMS OF OFFICE AND IF, DUE TO A VACANCY OR VACANCIES OR OTHERWISE, DIRECTORS OF MORE THAN ONE CLASS ARE TO BE SELECTED, EACH CLASS OF DIRECTORS TO BE SELECTED SHALL BE NOMINATED AND SELECTED SEPARATELY. |
| FORM 990, PART VI, SECTION A, LINE 7B | LIMITATION ON BOARD OF DIRECTORS: WITHOUT THE APPROVAL OF THE MEMBER, THE BOARD MAY NOT: (A) UNLESS PREVIOUSLY APPROVED BY THE MEMBER IN THE ANNUAL BUDGET OF THE CORPORATION, BORROW MORE THAN $25,000 OR A SUM IN EXCESS OF SUCH OTHER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY THE MEMBER; (B) UNLESS PREVIOUSLY APPROVED BY THE MEMBER IN THE ANNUAL BUDGET OF THE CORPORATION, ENTER INTO ANY LEASES WHICH WOULD OBLIGATE THE CORPORATION TO MAKE RENTAL PAYMENTS IN EXCESS OF $10,000 PER YEAR, OR PAYMENTS IN EXCESS OF SUCH OTHER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY THE MEMBER; (C) PURCHASE INSURANCE POLICIES; (D) UNLESS PREVIOUSLY APPROVED BY THE MEMBER IN THE ANNUAL BUDGET OF THE CORPORATION, UNDERTAKE ANY CAPITAL EXPENDITURES IN EXCESS OF $20,000 OR IN EXCESS OF SUCH OTHER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY THE MEMBER; OR (E) ADOPT ANY ORIGINAL OR REVISED CAPITAL OR OPERATING BUDGETS. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS FIRST REVIEWED BY THE CEO AND CFO. ONCE THEY HAVE APPROVED THE INITIAL DRAFT, THE RETURN IS PRESENTED TO THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REVIEWS AND APPROVES THE FORM, THEN REPORTS TO THE BOARD OF DIRECTORS. A FINAL COPY OF THE RETURN IS PROVIDED TO EACH BOARD MEMBER BEFORE THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS AND THE EXECUTIVE TEAM ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. THE PRESIDENT REVIEWS ALL STATEMENTS AND ANY POTENTIAL CONFLICT IS BROUGHT TO THE ATTENTION OF THE CHAIRMAN OF THE BOARD. IF A CONFLICT EXISTS FOR A BOARD MEMBER, THE MEMBER IS ASKED TO ABSTAIN FROM ANY VOTE ASSOCIATED WITH THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE CONFLICT OF INTEREST POLICY WHEN ADDRESSING WHO IS AN INTERESTED PERSON. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD'S EXECUTIVE COMMITTEE REVIEWS THE LEADINGAGE PA ANNUAL WAGE SURVEY TO BENCHMARK THE EXECUTIVE TEAM'S SALARIES AGAINST INDUSTRY STANDARDS AND ENSURE SALARIES ARE WITHIN FAIR MARKET RANGE FOR THE INDUSTRY. THE BOARD PRESIDENT REVIEWS ALL SALARY RECOMMENDATIONS FOR OTHER KEY EMPLOYEES AND DECISIONS REGARDING COMPENSATION ARE SUBJECT TO BOARD APPROVAL. ALL EXECUTIVE COMMITTEE DISCUSSIONS ON COMPENSATION ARE RECORDED IN EXECUTIVE MINUTES. ALL OTHER SALARIES ARE DETERMINED BY THE HUMAN RESOURCES DEPARTMENT AND WITH THE APPROPRIATE DIRECTORS OF VICE PRESIDENTS AND ARE DETERMINED AFTER VARIOUS WAGE STUDIES ARE CONSULTED TO AFFIRM SALARIES ARE WITHIN FAIR MARKET VALUE FOR THE INDUSTRY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE LABOR: PROGRAM SERVICE EXPENSES 995. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 995. INSPECTION/SERVICE CONTRACTS/PURCHASING: PROGRAM SERVICE EXPENSES 10,009. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,009. TV SERVICE EXPENSE: PROGRAM SERVICE EXPENSES 3,502. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,502. TO ILU-APARTMENTS: PROGRAM SERVICE EXPENSES 10,016. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,016. TO TEL HAI SERVICES: PROGRAM SERVICE EXPENSES 975. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 975. TO ILU-APARTMENTS : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,924. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,924. CORPORATE COMPLIANCE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 76. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76. TO TEL HAI SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,944. PURCHASING/INV MGMT : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 868. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 868. |
| FORM 990, PAGE 5, PART V, LINE 2A | ALL EMPLOYEES OF TEL-HAI APARTMENTS ARE PAID BY TEL HAI RETIREMENT COMMUNITY (EIN: 23-2039189), A COMMON PAYMASTER. AS A RESULT, NO FORMS W-2 OR W-3 WERE FILED FOR TEL-HAI APARTMENTS. HOWEVER, THERE ARE 2 EMPLOYEES WHO ARE PAID THROUGH THE COMMON PAYMASTER AND HAVE THEIR SALARIES AND BENEIFTS RECORDED ON THE TEL-HAI APARTMENTS FORM 990. |
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