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
Assisi Homes - Downer Place Inc
c/o Lutheran Social Services of Illinois
Employer identification number

36-4083919
Return Reference Explanation
Form 990, Part VI, Section B, line 11b An electronic copy of Form 990 is sent to both the organization's Board of Directors and to the Audit Committee of Lutheran Social Services of Illinois (LSSI), a related organization, for their review. Any changes or comments resulting from their review are then reflected in the Form 990 prior to its filing.
Form 990, Part VI, Section B, line 12c Members of the Board of Directors are required to disclose possible conflicts of interest annually by signing the conflict of interest policy. Additionally, the organization uses a group purchasing organization that monitors potential conflicts.
Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon request.
Form 990, Part XII, Line 2c: The Audit Committee of LSSI is responsible for the oversight of the audit as well as the selection and recommendation of the independent accountant to the Board for its approval on behalf of the Organization.
FORM 990, PART X, LINE 19: U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, CAPITAL ADVANCE NOT TO EXCEED $7,057,900, NO PRINCIPAL PAYMENTS REQUIRED, NON-INTEREST BEARING, DUE JULY 1, 2039, SECURED BY BUILDING. IF THE PROJECT IS USED FOR APPROVED PURPOSES OVER THE TERM, THE LOAN WILL BE DEEMED TO BE PAID AND DISCHARGED. THE AMOUNT DRAWN TO DATE IS $7,057,900. GRANT REVENUE FROM THE CAPITAL ADVANCE AGREEMENT IS BEING RECOGNIZED OVER THE TERM OF THE AGREEMENT ON A STRAIGHT-LINE BASIS. REVENUE REALIZED ON THIS AGREEMENT DURING THE YEAR ENDED JUNE 30, 2017 WAS $182,532. THE DEFERRED GRANT REVENUE RECORDED AT JUNE 30, 2017 TOTALED $4,015,699.
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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