TY 2015 Form 990

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(1) Dale Rudlang......................................................................
President

2.00
.................
0.00

(2) Crystal Thompson......................................................................
Secretary

2.00
.................
0.00

(3) Doug Cadwell......................................................................
Trustee

2.00
.................
0.00

(4) Rick Sawyer......................................................................
Vice President

2.00
.................
0.00

(5) Jerry Peterson......................................................................
Treasurer

5.00
.................
0.00

575

(6) Todd Penkhus......................................................................
Trustee

2.00
.................
0.00

(7) Kevin Kleiner......................................................................
Fire Chief

10.00
.................
0.00

(8) Tamara Hansen......................................................................
Mayor

2.00
.................
0.00

(9) Tammy Hamilton......................................................................
Council Person

2.00
.................
0.00

(A)
Name and Title

(B)
Average hours per week (list any hours for related organizations below dotted line)

(D)
Reportable compensation from the organization (W- 2/1099-MISC)

(E)
Reportable compensation from related organizations (W- 2/1099-MISC)

(F)
Estimated amount of other compensation from the organization and related organizations

(A)
Name and business address

(B)
Description of services

Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1	52,024
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................	2e
3	Subtract line 2e from line 1..................	3	52,024
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	4,014
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................	4c	4,014
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5	56,038

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........	1	22,984
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................	2e
3	Subtract line 2e from line 1...................	3	22,984
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	4,014
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................	4c	4,014
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......	5	26,998

- 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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Pine River Firefighters Relief Assn

Employer identification number

41-6036887

Return Reference	Explanation
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	Members are the active volunteer firefighters of the Pine River Fire Department
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	Board of Trustees are members of the Association and are elected by the members - two trustees elected every year for three-year terms
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	Monthly meetings are held with major decisions voting. Any amendments to the Bylaws are approved by the members.
Form 990, Part VI, Line 11b: Form 990 Review Process	Form 990 is reviewed before filing
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Annual documentation is maintained by the Association. Each trustee completes a Statement of Economic Interest annually.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Upon request
Form 990, Part IX, Line 24e: Other Expenses	Dinners/Meetings/Events: Column (A) - Total = $564; Column (B) - Program Services = $564; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Donations: Column (A) - Total = $256; Column (B) - Program Services = $256; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Dues: Column (A) - Total = $137; Column (B) - Program Services = $137; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	EMS Supplies: Column (A) - Total = $752; Column (B) - Program Services = $752; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Fire Safety: Column (A) - Total = $60; Column (B) - Program Services = $60; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Funerals: Column (A) - Total = $105; Column (B) - Program Services = $105; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Scholarships: Column (A) - Total = $300; Column (B) - Program Services = $300; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Supplies: Column (A) - Total = $1049; Column (B) - Program Services = $1049; Column (C) - Management & General = $0; Column (D) - Fundraising = $0
Form 990, Part IX, Line 24e: Other Expenses	Training: Column (A) - Total = $332; Column (B) - Program Services = $332; Column (C) - Management & General = $0; Column (D) - Fundraising = $0

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000324
Software Version:	2015v2.0

1	Briefly describe the organization’s mission or most significant activities: Provide Retirement Benefits to Volunteer Firefighters
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	24
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	74,269	68,074
9	Program service revenue (Part VIII, line 2g) .........		0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	32,555	-14,601
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	389	2,565
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	107,213	56,038
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	273,132	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,025	575
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 2,871
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	27,735	26,423
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	301,892	26,998
19	Revenue less expenses. Subtract line 18 from line 12.......	-194,679	29,040
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	660,697	689,737
21	Total liabilities (Part X, line 26).............		0
22	Net assets or fund balances. Subtract line 21 from line 20.....	660,697	689,737

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 20,402 including grants of $ ) (Revenue $ )
	Provide Retirement Benefits to Volunteer Firefighters

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses20,402

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	575

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	54,717

f	All other contributions, gifts, grants, and similar amounts not included above		1f	13,357

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		68,074

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....		0

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			-14,601			-14,601
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss).....			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		163
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			163			163
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	Charges for Services		900099	85	85
b	Other-Reimbursements		900099	2,317	2,317
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,402
12	Total revenue. See Instructions......			56,038	2,402		-14,438

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	575		575
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	3,150		3,150
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	4,014	4,014
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	0
23	Insurance ...	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Equipment Repairs & Maintenanc	7,771	7,771
b	Uniforms	3,093	3,093
c	Fund Raising	2,871			2,871
d	Misc	1,969	1,969
e	All other expenses	3,555	3,555
25	Total functional expenses. Add lines 1 through 24e	26,998	20,402	3,725	2,871
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		370	1	0
2	Savings and temporary cash investments .........		79,918	2	97,294
3	Pledges and grants receivable, net ......			3	0
4	Accounts receivable, net .............		3,000	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				6	0
7	Notes and loans receivable, net ....			7	0
8	Inventories for sale or use ........			8	0
9	Prepaid expenses and deferred charges ......			9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c	0
11	Investments—publicly traded securities .		561,900	11	586,043
12	Investments—other securities. See Part IV, line 11 .....		15,509	12	6,400
13	Investments—program-related. See Part IV, line 11 ..			13	0
14	Intangible assets ...............			14	0
15	Other assets. See Part IV, line 11 ...........			15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...		660,697	16	689,737

17	Accounts payable and accrued expenses .....		17
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	59,091	27	54,444
28	Temporarily restricted net assets ...........	601,606	28	635,293
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	660,697	33	689,737
34	Total liabilities and net assets/fund balances ........	660,697	34	689,737

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

1a	Land ...
b	Buildings
c	Leasehold improvements
d	Equipment ...
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII