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
2014
Open to Public
Inspection
Name of the organization
MOUNTAIN LAKE CHILDREN'S RESIDENCE INC
 
Employer identification number

14-1810672
Return Reference Explanation
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS AND DIRECTORS ARE REQUIRED TO SIGN ON AN ANNUAL BASIS A STATEMENT WHICH ACKNOWLEDGES AND AFFIRMS THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND HAS AN UNDERSTANDING OF THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION OF ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL MUST BE APPROVED BY THE BOARD OF DIRECTORS
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C THE ORGANIZATION'S EXECUTIVE COMMITTEE SELECTS THE AUDITORS AND REVIEWS AND APPROVES THE AUDITED FINANCIAL STATEMENTS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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