Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for 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 | |||||
| (A)
CHRISTIAN CARE MESA II |
900067112 | 10 | No | 0 | 560,737 | |
|
Total 1
|
0 | 560,737 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION A, LINE 1 | IN ORDER TO QUALIFY AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER INTERNAL REVENUE CODE SECTION 509(A), AN ORGANIZATION "MUST BE ORGANIZED, AND AT ALL TIMES THEREAFTER OPERATED, EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ONE OR MORE SPECIFIED ORGANIZATIONS DESCRIBED IN SECTION 509(A)(1 OR (2)". AS PROVIDED FOR UNDER TREASURY REGULATION 1.509(A)-4(D)(2)(IV), THE ORGANIZATION MEETS THIS REQUIREMENT BECAUSE THERE HAS BEEN AN HISTORIC AND CONTINUING RELATIONSHIP BETWEEN THE ORGANIZATION AND THE ORGANIZATION IT SUPPORTS, CHRISTIAN CARE MESA II, INC. ("CC MESA II"). THE OASIS AT HISTORIC MESA IS A 40-UNIT ASSISTED LIVING FACILITY WITH A 20-BED MEMORY CARE CENTER FOR LOW- AND MIDDLE-INCOME SENIORS. ALTHOUGH CC MESA II PROVIDES ALL OF THE PROGRAMING AND RESIDENT SERVICES, IN ORDER TO OBTAIN FINANCING THROUGH THE US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ("HUD") TO BUILD THE BUILDING, HUD REQUIRED THE PROPERTY TO BE HELD IN A SEPARATE LEGAL ENTITY. AS A RESULT, CC MESA III WAS FORMED TO HOLD THE BUILDING, AND SERVICE THE MORTGAGE AND RELATED INSURANCE REQUIREMENT, IN SUPPORT OF CC MESA II'S EXEMPT FUNCTION, WHICH IS TO PROVIDE ELDERLY PERSONS AND HANDICAPPED PERSONS WITH HOUSING FACILITIES AND SERVICES TO PROMOTE THEIR HEALTH, SECURITY, HAPPINESS AND USEFULNESS IN LONGER LIVING. THIS HISTORIC RELATIONSHIP HAS CONTINUED UNINTERRUPTED FROM 2007 TO TODAY. BECAUSE THE ORGANIZATION COULD NOT FULFILL ITS EXEMPT PURPOSE WITHOUT CC MESA II, AND CC MESA II, COULD NOT EXPAND ITS PROGRAMS BEYOND THE CAPACITY OF THE BUILDING IT ALREADY OWNED WITHOUT THE ORGANIZATION, IT IS CLEAR THERE ALSO IS A SUBSTANTIAL IDENTITY OF INTERESTS BETWEEN THE ORGANIZATIONS, A SECOND, AND FINAL, REQUIREMENT UNDER TREASURY REGULATION 1.509(A)-4(D)(2)(IV). |
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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, CONSISTING OF THE OFFICERS OF THE CORPORATION AND THE PAST CHAIRMAN OR PRESIDENT, ARE AUTHORIZED TO REPRESENT THE BOARD OF DIRECTORS IN NEGOTIATIONS WITH ANY AND ALL AGENTS REPRESENTING INTERESTED OR RELATED PARTIES. HOWEVER, THE COMMITTEE MAY NOT ENCUMBER OR OBLIGATE THE CORPORATION WITHOUT SPECIFIC CONFIRMATION FROM THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE CEO, CFO, SR. VP AND EXECUTIVE DIRECTOR ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR PROVIDING OVERSIGHT OF THE DAILY MANAGEMENT OF THE ORGANIZATION. THE CORPORATION AND MANAGEMENT ENTERED INTO A MANAGEMENT AGREEMENT ON A MONTH-TO-MONTH BASIS UNDER WHICH THE CORPORATION IS TO PAY MANAGEMENT AND BOOKKEEPING FEES IN AN AMOUNT SPECIFIED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP OF THE CORPORATION IS COMPOSED OF AND LIMITED TO THE INDEPENDENT CHRISTIAN CHURCHES OF ARIZONA. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION MAY NOT SELL OR OTHERWISE DISPOSE OF MORE THAN $200,000 OF REAL PROPERTY OVER THE OBJECTION OF 51% OR MORE OF THE MEMBERS EXCEPT IN THE ORDINARY COURSE OF BUSINESS AND ON SUCH TERMS AND CONDITIONS AS ARE CONSISTENT WITH THE BEST INTEREST AND PURPOSES OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO WILL REVIEW COMPLETED FORM 990 AND PROVIDE A FINAL DRAFT TO THE GOVERNING BOARD ALLOWING FOR A COMMENT PERIOD BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND ANY OTHER PERSON WITH SUBSTANTIAL INFLUENCE ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. PART OF THIS STATEMENT REQUIRES THEM TO SIGN AND CONFIRM THAT THEY HAVE READ AND UNDERSTOOD THE COMPANY'S CONFLICT OF INTEREST POLICY. THEY ALSO AGREE TO NOTIFY THE CHAIR OF THE BOARD OR PRESIDENT AND/OR THE CEO IMMEDIATELY IF THEY BECOME AWARE OF ANY POTENTIAL CONFLICTS. IF AN INDIVIDUAL HAS A CONFLICT, THEY ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION OF THE ISSUE AND THE VOTING PROCESS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND SR. VP ARE NOT COMPENSATED BY CHRISTIAN CARE MESA III, INC. THE CEO AND SR. VP ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR THEIR SERVICES PROVIDED TO ALL CHRISTIAN CARE COMPANIES. THEIR COMPENSATION IS DETERMINED BY LOOKING AT COMPARABILITY DATA THROUGH REVIEW OF FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION SURVEYS AND STUDIES. THE CEO'S COMPENSATION IS REVIEWED BY THE PERSONNEL COMMITTEE AND RATIFIED BY THE INDEPENDENT GOVERNING BOARD. THE CEO AND SR. VP'S COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN WRITTEN EMPLOYMENT CONTRACTS. THIS DOCUMENTATION IS PREPARED IN JUNE OF EACH YEAR. THE CFO AND THE EXECUTIVE DIRECTOR ARE NOT COMPENSATED BY CHRISTIAN CARE MESA III, INC. THE CFO AND THE EXECUTIVE DIRECTOR ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR THEIR SERVICES PROVIDED TO MULTIPLE CHRISTIAN CARE RELATED ENTITIES. THEIR COMPENSATION IS DETERMINED BY LOOKING AT COMPARABILITY DATA THROUGH REVIEW OF FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION SURVEYS AND STUDIES. THEY DO NOT HAVE WRITTEN EMPLOYMENT CONTRACTS. THEIR COMPENSATION IS ALSO REVIEWED ANNUALLY ON THEIR ANNIVERSARY DATE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990 | CHRISTIAN CARE MESA III, INC. ("CC MESA III") WAS AMENDED BECAUSE ACTIVITY RELATED TO THE PROVISION OF PROGRAMS AND RESIDENT SERVICES SHOULD HAVE BEEN REPORTED ON CHRISTIAN CARE MESA II, INC.'S ("CC MESA II") RETURN. CC MESA II IS A 501(C)(3) ORGANIZATION SUPPORTED BY CC MESA III. CC MESA III ONLY OWNS THE BUILDING AND SERVICES THE MORTGAGE AND THE RELATED INSURANCE REQUIREMENTS. THE FOLLOWING PARTS WERE AFFECTED: PAGE 1- BOXES B, LINE C, LINE G, LINE J PART I - LINE 6 PART I- PRIOR YEAR- LINE 8-12, 15, 17-22 PART I- CURRENT YEAR- LINE 8-12, 15, 17-22 PART III- LINES 4A & 4E PART V - CHECKBOX IN HEADER IS NO LONGER CHECKED AND RELATED DISCLOSURE HAS BEEN REMOVED PART IV- LINE 9, 12A PART VI- SECTION A, LINE 3 DISCLOSURE REMOVED REFERENCE TO CHIEF HUMAN RESOURCE OFFICER PART VI- SECTION B, LINE 15 DISCLOSURE REMOVED REFERENCES TO CHIEF HUMAN RESOURCE OFFICER PART VII SECTION A- REMOVED EDWARD JOHNSON PART VII SECTION A - LINES 1B AND 1D PART VII SECTION B- LINES 1 AND 2, REMOVED CONTRACTOR PART VIII- LINE 1F, 1H, 2A, 2G, 3, 6A, 6C, 6D, 9A, 9B, 9C, 10B, 10C, 12 PART IX- LINE 7-10, 11A, 11B, 11C, 11G, 12-14, 16, 17, 19, 22, 23, 24A-24E, 25 PART X- LINE 10A, 10B PART X, BEGINNING OF YEAR-LINE 1, 2, 4, 8, 9, 10C, 15, 16, 17, 19, 21, 25, 26, 27, 33, 34 PART X, END OF YEAR-LINE 1, 2, 4, 8, 9, 10C, 15, 16, 17, 19, 21, 25, 26, 27, 33, 34 PART XI- LINE 1-4, 10 PART XII- LINE 2B SCHEDULE A PART I- LINE 10, 12, 12B, 12F, 12G PART III - DELETED PART IV SECTION A - COMPLETED PART IV SECTION C - COMPLETED PART VI - ADDED DISCLOSURE FOR PART IV SECTION A, LINE 1 SCHEDULE D PART IV- THIS PART IS NO LONGER APPLICABLE PART VI- LINE 1B, 1D, 1E, TOTAL PART IX- LINE 1 & 2, COLUMN B PART IX- LINE 3, COLUMN A & B PART IX - TOTAL LINE PART X- LINE 3, COLUMN B, TOTAL LINE PART XI- LINE 1, 3, 5 PART XII- LINE 1, 3, 5 PART XIII- PART IV LINE 2B DISCLOSURE REMOVED SCHEDULE J PART II, EDWARD JOHNSON REMOVED SCHEDULE O FORM 990, PART III, LINE 4A DISCLOSURE FORM 990 PART V, LINE 2A DISCLOSURE REMOVED FORM 990, PART VI, SECTION B, LINE 12C - ADDED "ANNUALLY" TO THE END OF FIRST SENTENCE. SCHEDULE R PART V- LINE 1J, 1L, 1O, 1R |
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