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 (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)
LUTHERAN SOCIAL SERVICE OF MINNESOTA |
410872993 | 1 | Yes | 81,457 | 0 | |
| Total 1 | 81,457 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, 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 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
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 1 | THE BOARD OF TRUSTEES MAY ACT THROUGH AN EXECUTIVE COMMITTEE OR SUCH OTHER COMMITTEES AS MAY BE SPECIFIED IN RESOLUTIONS ADOPTED BY THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION AND SUCH OTHER MEMBERS AS APPOINTED BY THE CHAIR. THE EXECUTIVE COMMITTEE SHALL ALWAYS INCLUDE AT LEAST ONE TRUSTEE WHO IS ALSO A MEMBER OF THE BOARD OF DIRECTORS OF THE BENEFICIARY ORGANIZATION. THE EXECUTIVE COMMITTEE SHALL INCLUDE THE PRESIDENT OF LSSMN AS A VOTING MEMBER. EACH COMMITTEE SHALL HAVE THE DUTIES AND RESPONSIBILITIES IMPOSED ON IT FROM TIME TO TIME BY THE BOARD OF DIRECTORS, AND SHALL AT ALL TIMES BE SUBJECT TO THE DIRECTION OF THE BOARD OF TRUSTEES. THE COMMITTEES OF THE BOARD OF TRUSTEES SHALL INCLUDE INVESTMENT, NOMINATIONS, DONOR RELATIONS AND MARKETING, AND SUCH OTHER COMMITTEES AS ESTABLISHED BY THE BOARD OF TRUSTEES. THE CHAIRS AND MEMBERS OF EACH COMMITTEE SHALL BE APPOINTED BY THE CHAIR OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE FOUNDATION IS LUTHERAN SOCIAL SERVICE OF MINNESOTA. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE FOUNDATION'S BOARD OF TRUSTEES IS COMPOSED OF AT LEAST SEVEN AND NO MORE THAN TWENTY ONE INDIVIDUAL TRUSTEES, OF WHOM AT LEAST ONE-THIRD ARE MEMBERS OF A LUTHERAN CONGREGATION AND ONE OF WHOM IS THE CHIEF EXECUTIVE OFFICER OF LUTHERAN SOCIAL SERVICE WHO SERVES WITHOUT LIMITATION OF TERMS. AND AT LEAST TWO SHALL BE MEMBERS OF THE BOARD OF DIRECTORS OF THE BENEFICIARY ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOUNDATION'S BYLAWS MAY BE AMENDED BY THE BOARD OF TRUSTEES, AS PROVIDED BY LAW, SUBJECT TO THE POWER OF THE SOLE MEMBER AS PROVIDED BY LAW, TO ADOPT, AMEND, OR REPEAL BYLAWS ADOPTED, AMENDED, OR REPEALED BY THE BOARD OF TRUSTEES. NO AMENDMENT TO THESE BYLAWS THAT RELATES TO THE AFFILIATION REQUIREMENTS OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA SHALL BE EFFECTIVE UNTIL APPROVAL HAS BEEN RECEIVED FROM THE SOLE MEMBER. ANY AMENDMENT WHICH RELATES TO THE REQUIREMENTS FOR AFFILIATION WITH THE EVANGELICAL LUTHERAN CHURCH IN AMERICA MUST BE REPORTED TO THE MEMBERS OF THE FOUNDATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PUBLIC INSPECTION FORM 990 IS REVIEWED IN DETAIL BY THE FOUNDATION'S MANAGEMENT AND IS PROVIDED TO EACH BOARD TRUSTEE FOR THEIR REVIEW AND FEEDBACK PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | NO MEMBER OF THE BOARD OF TRUSTEES SHALL BE EMPLOYED BY THE ORGANIZATION NOR SHALL THEY HOLD ANY DIRECT OR INDIRECT FINANCIAL INTEREST IN THE ASSETS, LEASES, BUSINESS TRANSACTIONS OR PROFESSIONAL SERVICES OF THE ORGANIZATION. EXCEPTIONS TO THIS POLICY MAY BE MADE BY THE BOARD OF TRUSTEES PURSUANT TO THE FOLLOWING REQUIREMENTS: (1) SHOULD ANY MEMBER OF THE BOARD OF TRUSTEES OR ANY INDIVIDUAL WHO SERVES ON A COMMITTEE OF THE BOARD BE INVOLVED IN ANY WAY, DIRECTLY OR INDIRECTLY, IN A BUSINESS OR FINANCIAL TRANSACTION PERTAINING TO THE ORGANIZATION, THAT PERSON SHALL MAKE KNOWN SUCH INVOLVEMENT TO THE BOARD BY PROVIDING FULL DISCLOSURE OF ALL INFORMATION RELEVANT TO THAT INVOLVEMENT; (2) UPON NOTICE BY THE INDIVIDUAL OF A BUSINESS OR FINANCIAL TRANSACTION PERTAINING TO THE ORGANIZATION, THE EXECUTIVE COMMITTEE SHALL CONSIDER SUCH INVOLVEMENT AND MAKE AN APPROPRIATE DECISION PERTAINING THERETO; AND (3) THE BOARD OR COMMITTEE MEMBER SHALL NOT PARTICIPATE IN ANY WAY WITH RESPECT TO THE DECISION AS TO SUCH MATTERS NOR SHALL THAT PERSON PARTICIPATE IN ANY VOTE TAKEN WITH RESPECT TO SUCH TRANSACTION. LUTHERAN SOCIAL SERVICE FOUNDATION HOLDS THE REASONABLE EXPECTATION THAT TRUSTEES, OFFICERS AND THE ORGANIZATION WILL, AT ALL TIMES, BE GUIDED BY HONESTY, GOOD SENSE AND HIGH ETHICAL STANDARDS. THE ORGANIZATION EXPECTS TRUSTEES AND OFFICERS TO HAVE A DUTY OF LOYALTY TO THE ORGANIZATION AND TO AVOID ANY CONFLICT OF INTEREST, AS OUTLINED BELOW, BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION: (1) TRUSTEES AND OFFICERS MAY NOT USE THEIR POSITION TO MAKE A PERSONAL PROFIT OR GAIN OTHER PERSONAL ADVANTAGES; (2) SHOULD ANY DIRECTOR OF OFFICER BE INVOLVED IN ANY WAY, DIRECTLY OR INDIRECTLY, IN A BUSINESS OR FINANCIAL TRANSACTION PERTAINING TO THE ORGANIZATION, THAT PERSON SHALL MAKE KNOWN SUCH INVOLVEMENT TO MANAGEMENT BY PROVIDING FULL DISCLOSURE OF ALL INFORMATION RELEVANT TO THAT INVOLVEMENT; (3) OFFICERS ARE REQUIRED BY THE BOARD OF TRUSTEES TO ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT WHICH WILL BE MAINTAINED IN THE PERSONNEL FILES; (4) IF A MEMBER OF THE SENIOR MANAGEMENT TEAM HAS OR POTENTIALLY HAS SOME INVOLVEMENT IN A MATTER/ACTION THAT MAY BE A CONFLICT OF INTEREST, THAT INDIVIDUAL WILL EXCLUDE THEMSELVES FROM THE REVIEW AND DETERMINATION PROCESS OF THE MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION DOES NOT SET THE COMPENSATION OF THE CEO OR OTHER OFFICERS. THE COMPENSATION IS SET BY THE COMPENSATION COMMITTEE OF THE LUTHERAN SOCIAL SERVICE OF MINNESOTA BOARD OF DIRECTORS, WHICH DOCUMENTS THEIR DELIBERATIONS AND DECISION PROCESS. IN THEIR DELIBERATIONS, THE COMMITTEE USES COMPARABILITY DATA PROVIDED BY A THIRD PARTY ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | DEFERRED GIFTS -55,938. PRIOR YEAR ADJUSTMENT TO CORPUS -42,597. |
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