Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Part VI, Line 2- Officer has family or business relationship: | The organization has 2 members that are brothers and 2 members that are cousins. |
| Part VI, Line 6- Organization has members or stockholders: | The organization is a fraternal benefit society with its members being the owners of a life insurance policy. Members are active by maintaining an insurance or annuity policy. |
| Part VI, Line 7a- Persons and groups who can elect any members of governing body: | Members are active by maintaining an insurance or annuity policy. Members can be elected to be a convention delegate through their respective lodges. Members can be nominated for the Board or for officer positions at the convention. The convention is held every four years. |
| Part VI, Line 7b- Governing body decisions are subject to approval by: | Delegates to the convention vote on changes to the bylaws. The governing body then executes policies as defined by the bylaws. |
| Part VI, Line 11b- Process used by the organization to review this 990 return: | Certified Public Accountant prepare the form and review it with the President and the Treasurer. Form reviewed for amounts reconciled to certified statutory audit and for any changes in policy or procedures from the prior year. |
| Part VI, Line 12c- Monitoring and enforcement of conflict of interest policy: | Each September the Directors complete a disclosure form. The President, and secretary review these forms for any potential conflicts and propose any resolutions. The audit chairman reviews the officer disclosure forms. The potential for conflicts is monitored through the year at each Board meeting. |
| Part VI, Line 15a and 15b- Compensation review process: | A Compensation Committee of Directors reviews performance and recommends any salary increases every June for full time officer. Increases cannot exceed the maximums. The convention sets limits every four years. The Compensation Committee adjusts wages for the full time. |
| Part VI, Line 19- How Org makes documentation, policies & statements public: | A copy of the organization bylaws are provided to each new member. The bylaws are reviewed at each convention and published in the association monthly newspaper when the convention adopts changes. Any governing document is available to a member upon request at the home office. The annual statement that is filed with the Ohio Department of Insurance is available upon request at the home office. A condensed summary of it is published in the association newspaper on an annual basis. |
| Part XI, Line 9- Reconciliation changes in net assets or fund balances: | Increase in Asset Valuation Reserve- $3,311; Change in Non-Admitted Assets- ($79,363), Change in Reserve due to Change in Valuation Basis- ($52,445); Total Other Changes in Surplus- ($76,504) |
| Software ID: | |
| Software Version: |