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.") . | 33,275 | 116 | 33,391 | |||
| 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 | 223,431 | 244,127 | 240,441 | 245,709 | 256,988 | 1,210,696 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 54 | 51 | -27 | 197 | 238 | 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 | 223,485 | 244,178 | 240,414 | 279,181 | 257,342 | 1,244,600 |
| 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. | 58,431 | 104,127 | 95,441 | 110,906 | 368,905 | |
| c | Add lines 7a and 7b.. | 58,431 | 104,127 | 95,441 | 110,906 | 368,905 | |
| 8 | Public support. (Subtract line 7c from line 6.) | 875,695 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 223,485 | 244,178 | 240,414 | 279,181 | 257,342 | 1,244,600 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 26,624 | 17,961 | 17,832 | 445 | 2,580 | 65,442 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 26,624 | 17,961 | 17,832 | 445 | 2,580 | 65,442 |
| 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.).. | 250,109 | 262,139 | 258,246 | 279,626 | 259,922 | 1,310,042 |
| 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 VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE PRESIDENT, VICE PRESIDENT AND SECRETARY. THE EXECUTIVE COMMITTEE MEETS UPON CALL FOR THE PURPOSE OF PERFORMING BUSINESS THAT CANNOT WAIT FOR THE ACTION OF THE BOARD, AND TO CONSULT WITH OR ASSIST THE CEO AND/OR ADMINISTRATOR IN THE PERFORMANCE OF THEIR RESPECTIVE DUTIES. ANY ACTION OF THE EXECUTIVE COMMITTEE IS REPORTED FOR RATIFICATION AT THE NEXT MEETING OF TRUSTEES AND, IF INDICATED, MAY BE REPORTED SOONER BY MAIL. TWO MEMBERS OF THE COMMITTEE CONSTITUTE A QUORUM. |
| FORM 990, PART VI, SECTION A, LINE 3 | ALL MANAGEMENT FUNCTIONS ARE PERFORMED BY MARTHA AND MARY LUTHERAN SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | EBENEZER SERVICES IS A SUBSIDIARY OF MARTHA AND MARY LUTHERAN SERVICES (MMLS). WHILE MMLS IS NOT DEFINED AS A MEMBER OR STOCKHOLDER IN THE ORGANIZATIONAL DOCUMENTS, MMLS "HAS THE RIGHT TO PARTICIPATE" IN THE GOVERNANCE OF EBENEZER SERVICES AND AS A RESULT IS CONSIDERED A "MEMBER" FOR PURPOSES OF THIS QUESTION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MARTHA AND MARY LUTHERAN SERVICES, AS THE PARENT CORPORATION, ELECTS ALL TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | EBENEZER SERVICES IS A SUBSIDIARY OF MARTHA AND MARY LUTHERAN SERVICES. THERE ARE DEFINED "SUBSTANTIAL ISSUES" THAT MUST BE APPROVED BY THE PARENT CORPORATION. THESE "SUBSTANTIAL ISSUES" INCLUDE: A) ACQUISITION OR SALE OF REAL PROPERTY, B) CORPORATE BORROWING THAT IS OR WILL BE SECURED BY A MORTGAGE, DEED OF TRUST, OR OTHER ENCUMBRANCE ON CORPORATE REAL PROPERTY, C) DISSOLVING THE CORPORATION, OR D) SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT REVIEWED THE FORM 990 PRIOR TO THE COMPLETED FORM BEING SUBMITTED TO THE BOARD. A SUBCOMMITTEE OF THE BOARD UNDERTOOK A SPECIFIC REVIEW OF THE FORM 990 AND PROVIDED ITS RECOMMENDATION FOR APPROVAL TO THE ENTIRE BOARD. THE FORM 990 WAS APPROVED BY THE BOARD PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS NOT ESTABLISHED A CONFLICT OF INTEREST POLICY OF ITS OWN. HOWEVER, IT HAS ADOPTED THE CONFLICT OF INTEREST POLICY OF ITS PARENT ORGANIZATION, MARTHA AND MARY LUTHERAN SERVICES (MMLS). THE MMLS CONFLICT OF INTEREST POLICY IS AS FOLLOWS: EACH YEAR AND UPON SELECTION TO THE BOARD, ALL TRUSTEES AND EMPLOYEE OFFICERS ARE REQUIRED TO COMPLETE A FORM STATING THAT THEY UNDERSTAND THE POLICY AND THAT THERE HAS BEEN NO CONTRAVENTION OF THE POLICY BY THEMSELVES OR FAMILY DURING THE YEAR, OR IF THERE WAS A CONFLICT, IT WAS FULLY DISCLOSED AT THE TIME. IN THE CASE OF A CONFLICT, TRUSTEES WILL RECUSE THEMSELVES. TRUSTEES AND ALL EMPLOYEES, INCLUDING EMPLOYEE OFFICERS, ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS OF INTEREST WHENEVER THEY ARISE. THE GOVERNANCE COMMITTEE DETERMINES WHETHER CONFLICTS EXIST AND REVIEWS ACTUAL CONFLICTS OF INTEREST TO DETERMINE APPROPRIATE ACTIONS. ALSO, EACH YEAR PRIOR TO THE PREPARATION OF THE FORM 990, ALL TRUSTEES AND EMPLOYEE OFFICERS WHO SERVED DURING THE YEAR ARE PROVIDED WITH A QUESTIONNAIRE SPECIFICALLY TAILORED TO THE REQUIREMENTS OF FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION DOES NOT PROVIDE A SALARY TO THE CEO. INSTEAD, THE CEO RECEIVES COMPENSATION FROM THE PARENT ORGANIZATION, MARTHA AND MARY LUTHERAN SERVICES (MMLS). THE BOARD PERSONNEL COMMITTEE SETS THE COMPENSATION PACKAGE FOR THE CEO UTILIZING COMPENSATION BENCHMARKS AND ADDITIONAL PARAMETERS RELATED TO THE CONSTRAINTS OF BOARD-APPROVED BUDGET GUIDELINES. MMLS SETS AND PAYS THE COMPENSATION FOR THE CHIEF FINANCIAL OFFICER AND CHIEF OPERATIONS/STRATEGY OFFICER. THE CEO AND HR DIRECTOR USE BENCHMARKS FROM LEADINGAGE WASHINGTON TO ESTABLISH A STARTING WAGE AND DETERMINE A FAIR AND EQUITABLE WAGE RANGE FOR OUR CHIEF FINANCIAL OFFICER AND CHIEF OPERATIONS/STRATEGY OFFICER POSITIONS WITHIN MARTHA AND MARY. THE BOARD PRESIDENT REVIEWS AND SIGNS OFF ON ANY ADDITIONAL WAGE INCREASES FOR THE CHIEF FINANCIAL OFFICER AND CHIEF OPERATIONS/STRATEGY OFFICER POSITIONS BEYOND THE STARTING WAGE. THIS PAST YEAR THE ENTIRE BOARD ALSO REVIEWED THE WAGES OF COMPENSATION AND A ROUGH DRAFT OF PERFORMANCE MANAGEMENT METHODOLOGY FOR ALL KEY POSITIONS INCLUDING THE CHIEF FINANCIAL OFFICER AND CHIEF OPERATIONS/STRATEGY OFFICER. |
| FORM 990, PART VI, SECTION C, LINE 19 | OUR FINANCIAL INFORMATION IS PUBLISHED IN OUR ANNUAL REPORT AND IS DISTRIBUTED TO OUR SUPPORTERS AND THE GREATER COMMUNITY. AUDITED FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT GENERALLY AVAILABLE TO THE PUBLIC. |
| Software ID: | |
| Software Version: |
|
Affiliated Group Business Name:
MARTHA AND MARY LUTHERAN SERVICES
Address. Either US or Foreign Type:
PO BOX 127
POULSBO, WA983700127 EIN:
91-0567265
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
2,288,290
Total Exempt Purpose Expenditures:
2,288,290
Lobbying Nontaxable Amount:
264,415
Grassroots Nontaxable Amount:
66,104
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
MARTHA AND MARY HEALTH SERVICES
Address. Either US or Foreign Type:
PO BOX 127
POULSBO, WA983700127 EIN:
94-3229627
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
18,121,731
Total Exempt Purpose Expenditures:
18,121,731
Lobbying Nontaxable Amount:
1,000,000
Grassroots Nontaxable Amount:
250,000
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
MARTHA AND MARY HOME AND COMMUNITY SERVICES
Address. Either US or Foreign Type:
PO BOX 127
POULSBO, WA983700127 EIN:
91-1293400
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
1,157,806
Total Exempt Purpose Expenditures:
1,157,806
Lobbying Nontaxable Amount:
190,781
Grassroots Nontaxable Amount:
47,695
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
MARTHA AND MARY CHILDREN'S SERVICES
Address. Either US or Foreign Type:
PO BOX 127
POULSBO, WA983700127 EIN:
91-1916806
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
3,795,666
Total Exempt Purpose Expenditures:
3,795,666
Lobbying Nontaxable Amount:
339,783
Grassroots Nontaxable Amount:
84,946
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|
|
Affiliated Group Business Name:
MARTHA AND MARY LUTHERAN SERVICES (DBA EBENEZER SERVICES)
Address. Either US or Foreign Type:
PO BOX 127
POULSBO, WA983700127 EIN:
91-1249343
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
140,295
Total Exempt Purpose Expenditures:
140,295
Lobbying Nontaxable Amount:
28,059
Grassroots Nontaxable Amount:
7,015
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
|