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 |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 32,039 | 95,113 | 116,605 | 616,743 | 1,336,631 | 2,197,131 |
| 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 | 12,050,525 | 12,705,380 | 13,785,377 | 12,517,689 | 13,358,022 | 64,416,993 |
| 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 | 12,082,564 | 12,800,493 | 13,901,982 | 13,134,432 | 14,694,653 | 66,614,124 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 461 | 461 | 450 | 225 | 1,597 | |
| 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.. | 461 | 461 | 450 | 225 | 1,597 | |
| 8 | Public support. (Subtract line 7c from line 6.) | 66,612,527 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 12,082,564 | 12,800,493 | 13,901,982 | 13,134,432 | 14,694,653 | 66,614,124 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,809 | 2,161 | 2,696 | 2,135 | 3,029 | 11,830 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,809 | 2,161 | 2,696 | 2,135 | 3,029 | 11,830 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 28,623 | 79,027 | 42,929 | 27,159 | 31,788 | 209,526 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 12,112,996 | 12,881,681 | 13,947,607 | 13,163,726 | 14,729,470 | 66,835,480 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | BEAUTY AND BARBER - 2017 AMOUNT: $ 36,416. 2018 AMOUNT: $ 29,074. 2019 AMOUNT: $ 22,927. VENDING/MEAL - 2017 AMOUNT: $ 6,259. 2019 AMOUNT: $ 4,974. 2020 AMOUNT: $ 1,180. 2021 AMOUNT: $ 55. MISCELLANEOUS - 2017 AMOUNT: $ -30,187. 2018 AMOUNT: $ 14,308. 2019 AMOUNT: $ 3,104. 2020 AMOUNT: $ 663. 2021 AMOUNT: $ 1,411. DISCOUNTS - 2017 AMOUNT: $ 16,135. 2018 AMOUNT: $ 11,463. 2019 AMOUNT: $ 11,924. 2020 AMOUNT: $ 20,566. 2021 AMOUNT: $ 20,322. INSURANCE GAIN - 2018 AMOUNT: $ 24,182. DEBT EXTINGUISHMENT - SECURITY DEPOSIT - 2020 AMOUNT: $ 4,750. 2021 AMOUNT: $ 9,100. GARAGE RENTAL - 2021 AMOUNT: $ 900. |
| 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 3 | THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO MIDWEST CHRISTIAN VILLAGES, A MANAGEMENT COMPANY AND RELATED EXEMPT ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO AND THE CEO HAVE REVIEWED THE 990 PRIOR TO FILING. A DRAFT COPY OF THE 990 IS MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW BEFORE FILING |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENT IS INCLUDED IN THE EMPLOYEE HANDBOOK WHICH EVERY EMPLOYEE IS GIVEN A COPY OF AND SIGNS AN ACKNOWLEDGEMENT FOR ON THEIR FIRST DAY OF EMPLOYMENT. IF A VIOLATION OCCURS, EMPLOYEES CAN REPORT DIRECTLY TO THEIR SUPERVISOR OR USE THE 800 NUMBERS WHICH ARE POSTED AT EACH LOCATION. VIOLATIONS ARE INVESTIGATED BY INDIVIDUALS AT THE VICE PRESIDENT LEVEL, AND AT LEAST TWO INDIVIDUALS WOULD MAKE THE FINAL DETERMINATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. THE BOARD OF DIRECTORS HAS ADOPTED A CONFLICT OF INTEREST POLICY. ANNUALLY EVERY BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM AND IDENTIFIES ANY POTENTIAL CONFLICTS. THEY ALSO CERTIFY THAT THEY HAVE REVIEWED AND AGREE TO ABIDE BY THE CURRENT POLICY IN PLACE. IF A POTENTIAL CONFLICT ARISES IT IS REVIEWED BY THE BOARD OF DIRECTORS AND DISCUSSED AND VOTED ON. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, OFFICERS AND KEY EMPLOYEES IS DETERMINED BY A RELATED ORGANIZATION, MIDWEST CHRISTIAN VILLAGES. THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS AND SUPPORTED BY THE ORGANIZATION'S VPHR. THE EXECUTIVE COMPENSATION COMMITTEE OPERATES UNDER A BOARD APPROVED CHARTER, COMPENSATION PHILOSOPHY AND RETAINS AN INDEPENDENT CONSULTANT TO COMPLETE A COMPREHENSIVE EXECUTIVE COMPENSATION EVALUATION UTILIZING CONSULTANT'S LIBRARY OF PUBLIC AND PRIVATE DATA SOURCES, SUPPLEMENTED BY THEIR EXPERIENCES IN THE INDUSTRY CULMINATING IN A WRITTEN REPORT SUBMITTED TO THE EXECUTIVE COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE FINDINGS OF THE INDEPENDENT CONSULTANT, HAS THE OPPORTUNITY TO DISCUSS THE FINDINGS AMONG THE COMMITTEE MEMBERS AND WITH THE CONSULTANT. AS SPECIFIED BY THE BY-LAWS THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES A RECOMMENDATION FOR THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF OTHER EXECUTIVE POSITIONS. THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES THE COMMITTEE-APPROVED COMPENSATION PHILOSOPHY AND APPROVED COMPENSATION FOR THE CEO, COO AND CFO TO A THIRD PARTY TO OBTAIN A WRITTEN ASSESSMENT OF REASONABLENESS WITH THE CONTEXT OF THE STANDARDS SET FORTH UNDER THE INTERNAL REVENUE CODE SECTION 4958 AND RELATED DEPARTMENT OF TREASURY REGULATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALTHOUGH NOT A REQUIREMENT, THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST THESE ITEMS. THIS IS IN ADDITION TO INFORMATION POSTED ON ITS WEBSITE. |
| FORM 990, PART IX, LINE 11G | CONTRACTED THERAPY: PROGRAM SERVICE EXPENSES 9,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,650. PROFESSIONAL & CONSULTING FEES: PROGRAM SERVICE EXPENSES 333,810. MANAGEMENT AND GENERAL EXPENSES 15,651. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,461. CONTRACTED SALARIES: PROGRAM SERVICE EXPENSES 570,352. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 570,352. CONTRACTED THERAPY: PROGRAM SERVICE EXPENSES 632,628. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 632,628. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. |
| FORM 990, PART XII, LINE 3B: | THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT BEEN COMPLETED YET FOR THE YEAR-END 06/30/22, BUT PLANS TO BE COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN THE RELEVANT OMB GUIDANCE. |
| Software ID: | |
| Software Version: |