TY 2016 Form 990 Schedule O

efile Public Visual Render ObjectId: 201721229349301172 - Submission: 2017-05-02 TIN: 31-0978515

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.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2016

Open to Public
Inspection

Name of the organization

Plain City Senior Center Inc

Employer identification number

31-0978515

Return Reference	Explanation
Form 990, Part VI, Section A, line 2	Harley & Judy Bodenbender have a family relationship. Paul & Donna Gibson have a family relationship. Ben & Kathy Cosgray have a family relationship.
Form 990, Part VI, Section A, line 3	Plain City Senior Center, Inc. has delegated the management duties to Wallick Properties, LLC.
Form 990, Part VI, Section A, line 8b	No committee meetings were held.
Form 990, Part VI, Section B, line 11b	The board members receive a copy of Form 990 and then the treasurer will review it with the person who signs the 990.
Form 990, Part VI, Section B, line 12c	All contractual relationships are reviewed for conflicts of interests. Previous year's conflict of interest list is reviewed and updated annually.
Form 990, Part VI, Section C, line 19	All governing documents are made available to the public upon request.
Form 990, Part IX, line 24e	Supplies: Program service expenses 11,141. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,141. Health insurance: Program service expenses 8,095. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,095. Payroll taxes (project's share): Program service expenses 6,807. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,807. Mortgage insurance: Program service expenses 5,684. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,684. Workmen's compensation: Program service expenses 3,934. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,934. Miscellaneous financial expenses: Program service expenses 3,385. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,385. Other Administrative: Program service expenses 2,986. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,986. Trash & Snow Removal: Program service expenses 2,278. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,278. Other renting expenses: Program service expenses 1,680. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,680. Bad debts: Program service expenses 484. Management and general expenses 0. Fundraising expenses 0. Total expenses 484. Vehicle Repairs: Program service expenses 294. Management and general expenses 0. Fundraising expenses 0. Total expenses 294.
Form 990, Part XII, Line 2c	The process has not changed from the prior year.

Return Reference

Explanation

Form 990, Part VI, Section A, line 2

Harley & Judy Bodenbender have a family relationship. Paul & Donna Gibson have a family relationship. Ben & Kathy Cosgray have a family relationship.

Form 990, Part VI, Section A, line 3

Plain City Senior Center, Inc. has delegated the management duties to Wallick Properties, LLC.

Form 990, Part VI, Section A, line 8b

No committee meetings were held.

Form 990, Part VI, Section B, line 11b

The board members receive a copy of Form 990 and then the treasurer will review it with the person who signs the 990.

Form 990, Part VI, Section B, line 12c

All contractual relationships are reviewed for conflicts of interests. Previous year's conflict of interest list is reviewed and updated annually.

Form 990, Part VI, Section C, line 19

All governing documents are made available to the public upon request.

Form 990, Part IX, line 24e

Supplies: Program service expenses 11,141. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,141. Health insurance: Program service expenses 8,095. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,095. Payroll taxes (project's share): Program service expenses 6,807. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,807. Mortgage insurance: Program service expenses 5,684. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,684. Workmen's compensation: Program service expenses 3,934. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,934. Miscellaneous financial expenses: Program service expenses 3,385. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,385. Other Administrative: Program service expenses 2,986. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,986. Trash & Snow Removal: Program service expenses 2,278. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,278. Other renting expenses: Program service expenses 1,680. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,680. Bad debts: Program service expenses 484. Management and general expenses 0. Fundraising expenses 0. Total expenses 484. Vehicle Repairs: Program service expenses 294. Management and general expenses 0. Fundraising expenses 0. Total expenses 294.

Form 990, Part XII, Line 2c

The process has not changed from the prior year.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2016

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