Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 | |||||
|
Total |
||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,079,724 | 2,114,427 | 1,237,030 | 3,878,415 | 781,898 | 11,091,494 |
| 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 | 3,376,564 | 4,384,911 | 4,503,107 | 4,149,968 | 4,417,571 | 20,832,121 |
| 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 | 6,456,288 | 6,499,338 | 5,740,137 | 8,028,383 | 5,199,469 | 31,923,615 |
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 31,923,615 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 6,456,288 | 6,499,338 | 5,740,137 | 8,028,383 | 5,199,469 | 31,923,615 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 77,597 | 86,160 | 139,150 | 126,989 | 161,580 | 591,476 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 77,597 | 86,160 | 139,150 | 126,989 | 161,580 | 591,476 |
| 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.).. | 6,533,885 | 6,585,498 | 5,879,287 | 8,155,372 | 5,361,049 | 32,515,091 |
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part V, Line 2a & Part IX Lines 5-10 | Compensation: The compensation reported in Part IX, Lines 5-10 represents the amount of compensation paid by Lutheran Social Services of ND, a related organization, that was reimbursed by Lutheran Social Services Housing, Inc. for services provided to Lutheran Social Services Housing, Inc. Since all payroll documents including the W-3 and W-2s are issued by Lutheran Social Services ND, a related organization, Lutheran Social Services Housing, Inc. does not issue a W-3 and reported 0 in Part V, Line 2a. |
| Form 990, Part VI, Section A, line 1 | The Board may establish an Executive Committee consisting of the officers of the Corporation and such Board Members as may be appointed by the Board. The Executive Committee will have authority to meet and take action on items between board meetings provided such actions are consistent with directions and authorizations by the Board to the Executive Committee. During the fiscal year the Board did not utilize an Executive Committee although it was authorized to do so. |
| Form 990, Part VI, Section A, line 2 | Jessica Thomasson, Paulette Paulson, John Phillips, Sarah Elliott, and Kara Winkelman have a business relationship with each other and with Kris Fehr, Ryan Taylor, and Bishop Mark Narum. Jessica, Paulette, John, Sarah and Kara are all employees of Lutheran Social Services of North Dakota in which Kris, Ryan and Mark each serve as board members or officers. |
| Form 990, Part VI, Section A, line 3 | The relationship between Lutheran Social Services Housing, Inc (LSS Housing) and Lutheran Social Services of North Dakota (LSS ND) is detailed in a memorandum of agreement (MOA) reviewed and approved by each organization's board of directors. In brief, LSS Housing contracts with LSS ND for several administrative support services (Ex. Payroll, Information Technology, Office Space). Both the President/CEO, Vice President/Secretary and CFO/Controller functions of LSS Housing are contracted to LSS ND employees (covered under the aforementioned MOA). See part VII for compensation paid to the President/CEO, Jessica Thomasson, President, Paulette Paulson, Vice President/Secretary, John Phillips, Director of Finance, Kara Winkelman and Controller, Sarah Elliott by LSS ND. The President/CEO, Jessica Thomasson, President, Paulette Paulson, Vice President/Secretary, John Phillips, Director of Finance, Kara Winkelman, and Controller, Sarah Elliott are paid by LSS ND, however the compensation is reimbursed by LSS Housing Inc. for services provided to LSS Housing Inc. See part VII for amounts of compensation received by the President/CEO, President, Vice President/Secretary, Director of Finance and Controller for services provided to LSS Housing Inc. |
| Form 990, Part VI, Section A, line 6 | The sole member is Lutheran Social Services of North Dakota. |
| Form 990, Part VI, Section A, line 7a | Lutheran Social Services of North Dakota shall select no more than forty-nine percent of the voting members of the Board and the terms of those board members will be three-year terms. |
| Form 990, Part VI, Section A, line 7b | The member (Lutheran Social Services of North Dakota) must approve a resolution to dissolve the corporation. |
| Form 990, Part VI, Section A, line 8b | The bylaws allow for an Executive Committee but there was no such committee during the year or other committee with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The organizational staff will review and assist in preparation of the Form 990. Prior to being filed, the Form 990 will also be given to the board of directors for their approval. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy covers members of the board of directors, staff, volunteers and consultants of the organization. Board members having a conflict of interest may not participate or act with respect to the contract or transaction unless the contract or transaction is shown to be fair and reasonable; the material facts and the board member interest are fully disclosed; and, the transaction is approved in good faith by two-thirds of the board members entitled to vote, not counting any vote of the interested board member. Determinations of whether a conflict exists are made at the program director level. If the conflict of interest involved the program director, it would be determined by the CEO. Actual conflicts are reviewed by the program director, CEO and if necessary, the board of directors. |
| Form 990, Part VI, Section B, line 15 | Compensation is determined by the related organization, Lutheran Social Services of North Dakota. The President of the Board works with the Chief Talent Officer on a format for electronic review of compensation. This review could also include some employees and/or outside interests such as peers and pastors. The President of the Board receives the overall organization compensation increases. A committee meets to discuss review results, percentage increase and any other potential increase such as bonus or merit pay. Comparability data is also examined. The CEO's compensation is discussed with the full board of directors. The compensation package goes into effect on the CEO's anniversary date. The Organization does a similar review using comparability data for all officers at least every 5 years. Form 990, Part VI, Line 16: Joint Venture Policies All joint ventures in which the Organization participates are governed by operating agreements or limited partnership agreements that restrict those entities to purposes that conform to those of an organization operated exclusively for charitable purposes within the meaning of Section 501(c)(3) of the Internal Revenue Service Code as amended from time to time. |
| Form 990, Part VI, Section C, line 19 | The organization does not make its governing documents, conflict of interest policy or financial statements available to the public. |
| Software ID: | |
| Software Version: |