2024-07-18T09:36:30-05:00 2023-09-30 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2022-10-01 411804213 CENTENNIAL SQUARE C/O SUNRISE VILLAGE CENT 3202359532 1015 SE WILLMAR AVENUE WILLMAR MN 56201 TAMALA GJERDE FINANCE DIRECTOR 3202359532 2024-07-16 1 TAMALA GJERDE 999009999 0 JUSTIN HARTERT P02236744 5074467100 2024-07-16 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z MICHELLE HAEFNER 1015 SE WILLMAR AVENUE WILLMAR MN 56201 390676 0 X WWW.BETHESDAWILLMAR.COM X 1996 MN CENTENNIAL SQUARE PROVIDES ELDERLY AND HANDICAPPED HOUSING SERVICES. 12 12 0 0 0 0 0 0 198197 200109 94 -26575 0 189780 198291 363314 0 0 0 0 37034 36437 0 0 0 192849 216967 229883 253404 -31592 109910 1157260 1223947 61906 18683 1095354 1205264 SERVING OTHERS TOGETHER IN FAITH, COMMUNITY AND LIFE. 0 0 166097 0 200109 CENTENNIAL SQUARE OPERATES A 39-UNIT APARTMENT BUILDING FOR THE VERY LOW INCOME ELDERLY AND DISABLED PERSONS WHO MEET THE STANDARDS AS SET BY HUD. THE HOUSING IS LOCATED IN WILLMAR, MN. EACH APARTMENT INCLUDES ONE BEDROOM, BATHROOM, A KITCHEN, AND LIVING ROOM. THE BUILDING INCLUDES SPACIOUS COMMUNITY SPACES AND COIN-FREE LAUNDRY FACILITIES. CENTENNIAL SQUARE OFFERS MANY OPPORTUNITIES FOR SOCIALIZATION INCLUDING OUTINGS, SPECIAL MEAL EVENTS, AND GAMES. CENTENNIAL SQUARE HAS ENJOYED 98.6% OCCUPANCY, SERVING 40 PEOPLE, IN FISCAL YEAR ENDING SEPTEMBER 30,2023. 166097 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X TAMALA GJERDE 3202145604 901 SE WILLMAR MN WILLMAR MN 56201 MYRON BEHM VICE CHAIR 0.10 0.40 X X 0 0 0 SHERRI POOL SECRETARY 0.10 0.40 X X 0 0 0 ROGER AHRENHOLZ CHAIR 0.10 0.40 X X 0 0 0 LUTHER DYKEMA TREASURER 0.10 0.40 X X 0 0 0 JULIE KVEENE DIRECTOR 0.10 0.40 X 0 0 0 KAREN TUSHA MOHLIN DIRECTOR 0.10 0.40 X 0 0 0 PASTOR DEAN JOHNSON DIRECTOR 0.10 0.40 X 0 0 0 DAVID GEHANT DIRECTOR 0.10 0.40 X 0 0 0 MICHAEL GILSON DIRECTOR 0.10 0.40 X 0 0 0 JOAN BLONIGAN CHRISTIANSON DIRECTOR 0.10 0.40 X 0 0 0 CHERYL JOHNSON DIRECTOR 0.10 0.40 X 0 0 0 DR BETTY STREHLOW DIRECTOR 0.10 0.40 X 0 0 0 MICHELLE HAEFNER CEO 8.00 32.00 X 0 310782 39249 TAMALA GJERDE FINANCE DIRECTOR 8.00 32.00 X 0 86001 31962 ASHLEY BORMANN COO 8.00 32.00 X 0 161531 35934 TROY PEDERSON VP OF SENIOR HOUSING 8.00 32.00 X 0 66149 0 0 624463 107145 0 0 1 0 0 RESIDENT SERVICE REVEN 623000 200109 200109 200109 787 787 27362 -27362 -27362 -27362 INSURANCE PROCEEDS 900099 189780 189780 189780 363314 200109 0 163205 32448 32448 1465 1465 2524 2524 25870 25870 5725 5725 3621 3491 130 274 274 12805 12805 80245 77359 2886 36 35 1 75814 73087 2727 2062 1988 74 REPAIRS & MAINTENANCE 10515 10137 378 253404 166097 87307 0 75 75 123458 71124 1209 1549 4959 4537 3128809 2045520 992030 1083289 35529 63373 1157260 1223947 38447 4641 13446 14042 10013 0 61906 18683 X 1095354 1205264 1095354 1205264 1157260 1223947 109910 0 X X 0 1 X 1 0 X 324 324 194660 196089 199558 198197 200109 988613 194660 196089 199882 198197 200109 988937 0 4706 6093 4522 3303 5083 23707 4706 6093 4522 3303 5083 23707 965230 520 185 87 94 787 1673 520 185 87 94 787 1673 189780 189780 195180 196274 199969 198291 390676 1180390 0.81770 0.97520 0.00140 0.00130 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: INSURANCE PROCEEDS - 2022 AMOUNT: $ 189,780. 0 1 X 74215 74215 2833738 1837840 995898 171382 159608 11774 49474 48072 1402 1083289 RESIDENT TRUST 541 ENTRANCE DEPOSITS 16070 ESCROW FUND ACCOUNTS 14869 RELATED PARTY RECEIVABLE 31893 63373 X 363314 0 363314 0 363314 253404 0 253404 0 253404 PART IV, LINE 2B: TENANT SECURITY DEPOSITS REPRESENT AMOUNTS WHICH WILL BE REFUNDED TO TENANTS, SUBJECT TO TERMS OF THEIR LEASE AGREEMENTS. TENANT SECURITY DEPOSITS ARE PLACED IN A SEGREGATED SAVINGS ACCOUNT. RESIDENT TRUST FUNDS ARE RESIDENT'S FUNDS HELD BY CENTENNIAL SQUARE IN A SEGREGATED BANK ACCOUNT FOR THE USE BY RESIDENTS. PART X, LINE 2: CENTENNIAL SQUARE IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES; ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. CENTENNIAL SQUARE'S ANNUAL TAX FILINGS ARE SUBJECT TO REVIEW BY FEDERAL, STATE, AND LOCAL AUTHORITIES. CENTENNIAL SQUARE IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. CENTENNIAL SQUARE IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OTHER TAXES. 0 0 0 0 0 0 0 0 0 MICHELLE HAEFNER CEO 0 310782 0 0 0 0 0 9054 0 30195 0 350031 0 0 ASHLEY BORMANN COO 0 161531 0 0 0 0 0 5489 0 30445 0 197465 0 0 PART I, LINE 3 THE CEO IS COMPENSATED BY BETHESDA, A MINNESOTA NON-PROFIT RELATED ORGANIZATION. BETHESDA USES THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: 1. INDEPENDENT COMPENSATION SONSULTANT 2. CONDENSATION SURVEY 3. APPROVAL BY THE BOARD OF DIRECTORS OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE WHICH CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS AND ONE ADDITIONAL BOARD MEMBER. THIS COMMITTEE ONLY ACTS IN THE INTERCAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND AT ALL TIMES IS SUBJECT TO THE CONTROL AND DIRECTION OF THE FULL BOARD OF DIRECTORS. TO THE EXTENT DETERMINED BY THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE CLASS OF MEMBERSHIP. MEMBERSHIP CONSISTS OF CONGREGATIONS OF CHRISTIAN CHURCHES WHICH HAVE APPLIED FOR MEMBERSHIP AND ARE APPROVED BY THE BOARD OF DIRECTORS. IT ALSO CONSISTS OF INDIVIDUAL MEMBERS WHO ARE IN GOOD STANDING AT THE TIME OF THE ADOPTION OF THE BYLAWS, AND ADDITIONAL INDIVIDUAL MEMBERS WHO ARE MEMBERS AND ARE IN GOOD STANDING OF ANY CHRISTIAN CHURCH CONGREGATION. THEIR MEMBERSHIP MUST BE APPROVED BY THE BOARD OF DIRECTORS. EACH CONGREGATION SHALL BE ENTITLED TO THREE VOTING DELEGATES. CONGREGATIONS WITH MORE THAN 500 CONFIRMED MEMBERS WILL BE ENTITLED TO FOUR VOTING DELEGATES. EACH DELEGATE IS ENTITLED TO ONE VOTE AT ALL ANNUAL MEETINGS. FORM 990, PART VI, SECTION A, LINE 7A EACH DELEGATE IS ENTITLED TO ONE VOTE AT ALL ANNUAL MEETING ON THE ELECTION OF BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B ANY AMENDMENT TO THE BYLAWS TO INCREASE OR DECREASE THE VOTE REQUIRED FOR A MEMBER ACTION MUST BE APPROVED BY THE MEMBERS. THE POWER TO AMEND THE ARTICLES OF INCORPORATION SHALL BE VESTED SOLELY IN THE VOTING MEMBERS AFTER BEING PROPOSED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND FINANCE DIRECTOR HAVE REVIEWED THE FORM 990. THE FINAL FORM 990 WAS EMAILED TO THE BOARD MEMBERS PRIOR TO A BOARD MEETING WHERE AT THAT TIME THE BOARD GAVE THE FINAL APPROVAL OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE KEY EMPLOYEES AND THE BOARD OF DIRECTORS. THE CEO REVIEWS THE ANNUAL DISCLOSURES FOR CONFLICTS AND DETERMINES IF ONE EXISTS. IF A CONFLICT OF INTEREST EXISTS, THAT INDIVIDUAL MUST ABSTAIN FROM VOTING ON THE ITEM IN CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE CEO IS COMPENSATED BY BETHESDA, A MINNESOTA NON-PROFIT RELATED ORGANIZATION. BETHESDA USES THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION. 1. INDEPENDENT COMPENSATION CONSULTANT, 2. COMPENSATION SURVEY, 3. APPROVAL BY THE BOARD OF DIRECTORS OR COMPENSATION COMMITTEE. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. BETHESDA 901 SE WILLMAR AVENUE WILLMAR MN 56201 410693843 NURSING HOME MN 501(C)(3) LINE 10 SEE PART VII 1 SUNRISE VILLAGE 901 SE WILLMAR AVENUE WILLMAR MN 56201 411670808 INDEPENDENT & ASSISTED LIVING MN 501(C)(3) LINE 10 SEE PART VII 1 BETHESDA FOUNDATION OF WILLMAR 901 SE WILLMAR AVENUE WILLMAR MN 56201 411457903 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12B, II SEE PART VII 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 SCHEDULE R PART II COLUMN F CENTENNIAL SQUARE AND ITS RELATED ENTITIES LISTED IN SCHEDULE R, PART II ALL SHARE A COMMON BOARD OF DIRECTORS WHICH RESULTS IN COMMON CONTROL OF EACH OF THE ENTITIES.