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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 55,000 | 3,768 | 58,768 | |||
| 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 | 478,644 | 610,274 | 438,308 | 461,279 | 477,433 | 2,465,938 |
| 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 | 478,644 | 610,274 | 438,308 | 516,279 | 481,201 | 2,524,706 |
| 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. | 315,782 | 252,081 | 248,726 | 288,173 | 292,299 | 1,397,061 |
| c | Add lines 7a and 7b.. | 315,782 | 252,081 | 248,726 | 288,173 | 292,299 | 1,397,061 |
| 8 | Public support. (Subtract line 7c from line 6.) | 1,127,645 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 478,644 | 610,274 | 438,308 | 516,279 | 481,201 | 2,524,706 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 399 | 152 | 192 | 440 | 448 | 1,631 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 399 | 152 | 192 | 440 | 448 | 1,631 |
| 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.) .. | 2,820 | 3,490 | 41,313 | 23,928 | 50,069 | 121,620 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 481,863 | 613,916 | 479,813 | 540,647 | 531,718 | 2,647,957 |
| 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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | LAUNDRY INCOME - 2020 AMOUNT: $ 2,820. 2021 AMOUNT: $ 3,490. 2022 AMOUNT: $ 2,790. 2023 AMOUNT: $ 4,575. 2024 AMOUNT: $ 3,625. OTHER TENANT CHARGES - 2022 AMOUNT: $ 38,523. 2023 AMOUNT: $ 19,353. 2024 AMOUNT: $ 46,444. |
| Software ID: | |
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| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 5 AND PART V, LINE 2A: | THE FILING ORGANIZATION SERVES AS COMMON PAYMASTER TO TWO RELATED TAX-EXEMPT ORGANIZATIONS, CEDAR LANE SENIOR LIVING COMMUNITY I, INC. AND CEDAR LANE SENIOR LIVING COMMUNITY II, INC. THE NUMBER OF EMPLOYEES REPORTED REPRESENTS THE FILING ORGANIZATION'S ALLOCABLE SHARE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP CONSISTS OF ALL RESIDENTS AND STAFF OF CEDAR LANE SENIOR LIVING COMMUNITY III, INC., AND PERSONS INTERESTED IN THE CORPORATION'S PURPOSE PROVIDED THEY RESIDE IN ST. MARY'S, CHARLES OR CALVERT COUNTY, MARYLAND. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS ELECT THE ORGANIZATION'S GOVERNING BOARD AT THE ANNUAL MEETING. EACH MEMBER SHALL HAVE THE RIGHT TO CAST ONE VOTE FOR THE ELECTION OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | IN ADDITION TO THE ELECTION OF DIRECTORS, THE MEMBERS ALSO HAVE THE RIGHT TO CAST ONE VOTE EACH ON ALL MATTERS THAT MAY PROPERLY COME BEFORE THEM AT A MEMBERSHIP MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | EACH YEAR, PRIOR TO THE SUBMISSION OF THE ORGANIZATION'S FORM 990 TO THE INTERNAL REVENUE SERVICE, EACH VOTING MEMBER OF THE BOARD OF DIRECTORS SHALL BE PROVIDED WITH A COPY OF THE FINAL FORM 990 AS COMPLETED BY THE CERTIFIED PUBLIC ACCOUNTANTS. BOARD MEMBERS SHALL BE PROVIDED WITH AT LEAST FIVE BUSINESS DAYS TO REVIEW THE FORM AND SHOULD HAVE AN OPPORTUNITY TO RAISE QUESTIONS, MAKE SUGGESTIONS, AND ADDRESS ANY POTENTIAL PROBLEMS OR CONCERNS WITH THE CHAIR AND THE DIRECTOR OF FINANCE & ADMINISTRATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY APPLIES TO BOARD MEMBERS, STAFF, RESIDENTS AND CERTAIN VOLUNTEERS OF CEDAR LANE. AN INTERESTED PARTY IS UNDER A CONTINUING OBLIGATION TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST AS SOON AS IT IS KNOWN, OR REASONABLY SHOULD BE KNOWN. FOR BOARD MEMBERS, THE DISCLOSURE STATEMENTS SHALL BE PROVIDED TO THE CHAIR OF THE BOARD, OR IN THE CASE OF THE CHAIR OF THE BOARD'S DISCLOSURE STATEMENT SHALL BE PROVIDED TO THE SECRETARY OF THE BOARD. COPIES SHALL BE PROVIDED TO THE PRESIDENT. IN THE CASE OF STAFF OR VOLUNTEERS WITH SIGNIFICANT DECISION-MAKING AUTHORITY, THE DISCLOSURE STATEMENTS SHALL BE PROVIDED TO THE PRESIDENT OF THE ORGANIZATION, OR IN THE CASE OF THE PRESIDENT'S DISCLOSURE STATEMENT SHALL BE PROVIDED TO THE CHAIR OF THE BOARD. THE SECRETARY OF THE BOARD OF DIRECTORS SHALL FILE COPIES OF ALL DISCLOSURE STATEMENTS WITH THE OFFICIAL CORPORATE RECORDS OF THE ORGANIZATION. WHENEVER THERE IS REASON TO BELIEVE THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS BETWEEN CEDAR LANE AND AN INTERESTED PARTY, THE BOARD OF DIRECTORS SHALL DETERMINE THE APPROPRIATE ORGANIZATIONAL RESPONSE. THIS SHALL INCLUDE, BUT NOT NECESSARILY BE LIMITED TO, INVOKING THE PROCEDURES DESCRIBED BELOW, WITH RESPECT TO A SPECIFIC PROPOSED ACTION OR TRANSACTION. WHERE THE ACTUAL OR POTENTIAL CONFLICT INVOLVES AN EMPLOYEE OF THE ORGANIZATION OTHER THAN THE PRESIDENT, THE PRESIDENT SHALL, IN THE FIRST INSTANCE, BE RESPONSIBLE FOR REVIEWING THE MATTER AND MAY TAKE APPROPRIATE ACTION AS NECESSARY TO PROTECT THE INTERESTS OF THE ORGANIZATION. THE PRESIDENT SHALL REPORT TO THE CHAIR OF THE BOARD THE RESULTS OF ANY REVIEW AND THE ACTION TAKEN. THE CHAIR OF THE BOARD, IN CONSULTATION WITH THE EXECUTIVE COMMITTEE, SHALL DETERMINE IF ANY FURTHER BOARD REVIEW OR ACTION IS REQUIRED. WHERE AN ACTUAL OR POTENTIAL CONFLICT EXISTS BETWEEN THE INTERESTS OF CEDAR LANE AND AN INTERESTED PARTY WITH RESPECT TO A SPECIFIC PROPOSED ACTION OR TRANSACTION, CEDAR LANE SHALL REFRAIN FROM THE PROPOSED ACTION OR TRANSACTION UNTIL SUCH TIME AS THE PROPOSED ACTION OR TRANSACTION HAS BEEN APPROVED BY THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. THE FOLLOWING PROCEDURES SHALL APPLY: AN INTERESTED PARTY WHO HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A PROPOSED ACTION OR TRANSACTION OF THE CORPORATION SHALL NOT PARTICIPATE IN ANYWAY IN, OR BE PRESENT DURING, THE DELIBERATIONS AND DECISION MAKING OF THE ORGANIZATION WITH RESPECT TO SUCH ACTION OR TRANSACTION. THE INTERESTED PARTY MAY, UPON REQUEST, BE AVAILABLE TO ANSWER QUESTIONS OR PROVIDE MATERIAL FACTUAL INFORMATION ABOUT THE PROPOSED ACTION OR TRANSACTION. THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS MAY APPROVE THE PROPOSED ACTION OR TRANSACTION UPON FINDING THAT IT IS IN THE BEST INTERESTS OF THE CORPORATION. THE BOARD SHALL CONSIDER WHETHER THE TERMS OF THE PROPOSED TRANSACTION ARE FAIR AND REASONABLE TO THE ORGANIZATION AND WHETHER IT WOULD BE POSSIBLE, WITH REASONABLE EFFORT, TO FIND A MORE ADVANTAGEOUS ARRANGEMENT WITH A PARTY OR ENTITY THAT IS NOT AN INTERESTED PARTY. APPROVAL BY THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS SHALL BE BY VOTE OF A MAJORITY OF DIRECTORS IN ATTENDANCE AT A MEETING AT WHICH A QUORUM IS PRESENT. AN INTERESTED PARTY SHALL NOT BE COUNTED FOR PURPOSES OF DETERMINING WHETHER A QUORUM IS PRESENT, OR FOR PURPOSES OF DETERMINING WHAT CONSTITUTES A MAJORITY VOTE OF DIRECTORS IN ATTENDANCE. THE MINUTES OF THE MEETING SHALL REFLECT THAT THE CONFLICT DISCLOSURE WAS MADE, THE VOTE TAKEN AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION BY THE INTERESTED PARTY. AND PARTICIPATION BY THE INTERESTED PARTY. |
| FORM 990, PART VI, SECTION B, LINE 15 | TO DETERMINE THE COMPENSATION OF THE PRESIDENT & CEO AND THE DIRECTOR OF FINANCE & ADMINISTRATION, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS COMPENSATION DATA FOR COMPARABLE POSITIONS/ORGANIZATIONS FROM SALARY SURVEYS AND OTHER SOURCES, AND MAKES A COMPENSATION RECOMMENDATION TO THE FULL BOARD FOR APPROVAL. THE PROCESS WAS LAST CONDUCTED IN 2021 AND WAS DOCUMENTED IN THE MINUTES OF THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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