SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
ARBORSPRING RETREAT HOUSE
 
Employer identification number

26-0853927
Return Reference Explanation
FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE DESCRIPTION: INTEREST INCOME. AMOUNT: 58.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: . GRANTEE NAME: ALABASTER MOBLIE CLINIC. GRANTEE ADDRESS: 2832 MANSFIELD DRIVE BURBANK, CA 91504. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. METHOD USED TO DETERMINE BOOK VALUE: CASH. METHOD USED TO DETERMINE FMV: CASH. DATE OF GIFT: 06/08/15. AMOUNT GIVEN: 2,700.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID ACTIVITY CLASSIFICATION: . GRANTEE NAME: OMF INTERNATIONAL. GRANTEE ADDRESS: 10 W. DRY CREEK CIRCLE LITTLETON, CO 80120. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH. METHOD USED TO DETERMINE BOOK VALUE: CASH. METHOD USED TO DETERMINE FMV: CASH. DATE OF GIFT: 06/30/15. AMOUNT GIVEN: 5,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 7,700.
FORM 990-EZ, PART I, LINE 14 DESCRIPTION: DEPRECIATION. AMOUNT: 522.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: BANK CHARGES. AMOUNT: 257. DESCRIPTION: BOARD MEETINGS & RETREATS. AMOUNT: 2,156. DESCRIPTION: SUPPLIES. AMOUNT: 334. DESCRIPTION: PAYROLL TAXES. AMOUNT: 5,362. DESCRIPTION: WORKER'S COMPENSATION INSURANCE. AMOUNT: 1,161. DESCRIPTION: LIABILITY INSURANCE. AMOUNT: 2,740. DESCRIPTION: MEMBERSHIPS AND DUES. AMOUNT: 20. DESCRIPTION: PENALTIES. AMOUNT: 27. TOTAL TO FORM 990-EZ, LINE 16: 12,057.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 208. END OF YEAR AMOUNT: 713.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: PAYROLL TAXES. BEG. OF YEAR AMOUNT: 1,611. END OF YEAR AMOUNT: 1,634.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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