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
2016
Open to Public
Inspection
Name of the organization
INDEPENDENT MONTEFIORE SHELTER HOME
 
Employer identification number

34-0845389
Return Reference Explanation
Form 990, Part VI, Section A, Line 2 Eileen Blattner, Robert Blattner - family relationship; Sally Good, Sidney Good - family relationship; Patricia Mintz, Chuck Mintz- family relationship; Myrna Spira, James Spira-family relationship
Form 990, Part VI, Section B, Line 11b A copy of the Form 990 is reviewed by the Board Treasurer, CEO, and CFO before filing. The Treasurer communicates his or her review to various board committees and the board. The form 990 is available to all board members upon request.
Form 990, Part VI, Section B, Line 12c A copy of the written conflict of interest policy is sent to each officer, board member and key employee annually. Each person is required to review the policy and acknowledge in writing that he or she has done so. In addition, annually, each person completes a disclosure form identifying relationships, positions, or circumstances relating to actual or potential conflicts of interest as defined in the policy. Also, the Conflicts of Interest Policy is annually reviewed at a meeting of the Board of Directors.
Form 990, Part VI, Section B, Line 15 The compensation of the officers and key employees of the organization is determined and paid by Jewish Family Service Association. The Compensation Committee of Jewish Family Service Association's Board of Directors evaluates the performance of the organization's President and CEO and determines the compensation utilizing market comparability information. Other officers and key employees' compensation is determined by the results of performance evaluations, market comparability information, financial condition of the organization and reviewed and approved by the Compensation Committee
Form 990, Part VI, Section C, Line 19 The organization's financial statements are consolidated with the financial statements of the Jewish Family Service Association of Cleveland Ohio and made public as part of Jewish Family Service Association's annual report. The governing documents and conflict of interest policy are not made available to the public.
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


Additional Data


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