| FORM 990, PART VI, SECTION A, LINE 1 |
THE ORGANIZATION'S EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, VICE-CHAIRS, AND THE CHAIRS OF OTHER BOARD COMMITTEES. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT FOR AND ON BEHALF OF THE BOARD WHEN THE BOARD IS NOT IN SESSION, BUT IS ACCOUNTABLE TO THE BOARD FOR ALL ACTIONS TAKEN. ALL FORMAL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE REPORTED TO THE BOARD FOR RATIFICATION DURING THE NEXT MEETING. |
| FORM 990, PART VI, SECTION A, LINE 3 |
EFFECTIVE JULY 1, 2012, THE ORGANIZATION ENTERED INTO A MANAGEMENT AGREEMENT WITH LUTHERAN SOCIAL SERVICE OF MINNESOTA, EFFECTIVE THROUGH JUNE 30, 2018. |
| FORM 990, PART VI, SECTION A, LINE 4 |
DURING THE TAX YEAR THE ORGANIZATION AMENDED ITS GOVERNING DOCUMENTS TO REFLECT AN AFFILIATION AGREEMENT WITH LUTHERAN SOCIAL SERVICE OF MINNESOTA. |
| FORM 990, PART VI, SECTION A, LINE 7A |
THE ORGANIZATION'S BOARD OF DIRECTORS IS APPOINTED BY LUTHERAN SOCIAL SERVICE OF MINNESOTA ("LSS") AND CHILDREN'S HOME SOCIETY FOUNDATION ("CHS FOUNDATION"). LSS SHALL APPOINT THE HIGHEST NUMBER OF DIRECTORS THAT DOES NOT EXCEED 70% OF THE TOTAL NUMBER OF DIRECTORS, WHILE CHS FOUNDATION SHALL APPOINT THE REMAINING NUMBER OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B |
CERTAIN AMENDMENTS TO THE ORGANIZATION'S BYLAWS REQUIRE APPROVAL BY CHS FOUNDATION OR BY ALL OF THE CHS FOUNDATION DIRECTORS THEN IN OFFICE. |
| FORM 990, PART VI, SECTION B, LINE 11 |
THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND REVIEWED IN DETAIL BY THE AUDIT COMMITTEE. THE APPROVED FORM 990 WILL BE PROVIDED TO EACH MEMBER OF THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C |
ANNUAL DISCLOSURE FORMS ARE REQUIRED TO BE COMPLETED BY ALL BOARD MEMBERS. IF A POTENTIAL CONFLICT ARISES, THE CONFLICTED INDIVIDUAL SHALL NOT PARTICIPATE IN THE DISCUSSION (EXCEPT TO DISCLOSE MATERIAL FACTS), VOTE, OR HAVE INVOLVEMENT IN ANY OTHER ACTION RELATED TO THE CONFLICTED TRANSACTION. CONFLICTS ARE DETERMINED BY UNCONFLICTED BOARD MEMBERS. ANY CONFLICT OF INTEREST PROCEEDINGS ARE DOCUMENTED IN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A |
UNDER THE MANAGEMENT AGREEMENT WITH LSSMN, JODI HARPSTEAD IS THE CEO OF CHSMN. HER COMPENSATION AND ANNUAL APPRAISAL IS PERFORMED BY THE EXECUTIVE COMMITTEE OF THE LSSMN BOARD OF DIRECTORS. THE CFO KEN BORLE ALSO SERVES UNDER THE MANAGEMENT AGREEMENT AND HIS COMPENSATION IS REVIEWED AND DETERMINED UNDER THE POLICIES OF LSSMN. THE COMPENSATION REPORTED INCLUDES SERVICES FOR LSS AND ALL OF ITS AFFILIATES. PERFORMANCE APPRAISALS AND SALARY ADJUSTMENTS FOR THE SENIOR DIRECTOR ARE MADE BY THE CEO. THIS PROCESS WAS LAST UNDERTAKEN FOR THE SENIOR DIRECTOR OF ADOPTION, ALEXIS OBERDORFER, IN 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 |
THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: |
CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -1,911. CHANGE IN VALUE OF BENEFICIAL INTEREST COMMUNITY FOUNDATION HOLDING -77,614. CHANGE IN VALUE OF TRUST 10,803. |
Attach to Form 990 or 990-EZ.