2024-01-31T14:24:52-06:00 2023-03-31 910189318 MOSS ADAMS LLP 805 SW BROADWAY STE 1400 PORTLAND OR 97205 990 2022-04-01 461684147 SERENITY LANE HEALTH SERVICES FOUNDATION SERE 5414842156 PO BOX 8549 COBURG OR 97408 BRIAN CARLIN CFO 5414842156 2024-01-29 1 BRIAN CARLIN 999009999 0 WENDY CAMPOS P00448102 5032421447 2024-01-29 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PETE KERNS PO BOX 8549 COBURG OR 97408 17710 0 X WWW.SERENITYLANE.ORG X 2012 OR TO RAISE AND ADMINISTER FUNDS FOR THE BENEFIT OF SERENITY LANE HEALTH SERVICES. 6 6 0 9 0 0 0 17710 0 0 0 0 0 0 0 17710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17710 0 12881 4829 0 -4829 12881 TO RAISE AND ADMINISTER FUNDS FOR THE BENEFIT OF SERENITY LANE HEALTH SERVICES, AN AFFILIATED ORGANIZATION TRANSFORMING LIVES THROUGH THE TREATMENT OF ADDICTION. 0 0 THE ORGANIZATION IS NOT CURRENTLY ACTIVE; NO PROGRAM ACTIVITIES IN CURRENT YEAR. 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 OR X BRIAN CARLIN CFO 5412848617 PO BOX 8549 COBURG OR 97408 DEAN HANSEN CHAIRMAN 1.00 1.00 X X 0 0 0 PATRICIA STRAUBE SECRETARY & TREASURER 0.50 0.00 X X 0 0 0 PAUL WINHOLD TRUSTEE 0.50 0.00 X 0 0 0 JAMES KOONS TRUSTEE 0.50 0.00 X 0 0 0 JUDITH BALDWIN TRUSTEE 0.50 0.00 X 0 0 0 MARY ANNE MCMURREN TRUSTEE 0.50 0.00 X 0 0 0 PETE KERNS PRESIDENT & CEO 1.00 41.00 X 0 170000 19161 0 170000 19161 0 0 1 0 0 17710 17710 17710 0 0 0 0 0 0 0 0 12881 0 12881 4829 0 4829 0 X -4829 12881 -4829 12881 0 12881 17710 0 X 0 1 X 1 0 X X X 1 SERENITY LANE HEALTH SERVICES 943113708 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: SERENITY LANE HEALTH SERVICES, SERENITY LANE, AND SERENITY LANE HEALTH SERVICES FOUNDATION ARE NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES. SERENITY LANE HEALTH SERVICES, SERENITY LANE, AND SERENITY LANE HEALTH SERVICES FOUNDATION HAVE ALSO BEEN CLASSIFIED AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS WITHIN THE MEANING OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES IN THE CONSOLIDATED FINANCIAL STATEMENTS PURSUANT TO ASC 740, INCOME TAXES. THE ORGANIZATION GENERALLY EVALUATES ANY UNCERTAIN TAX POSITIONS CONSISTENT WITH ACCOUNTING AND DISCLOSURE REQUIREMENTS OF ASC 450, CONTINGENCIES. THE ORGANIZATION DID NOT HAVE ANY UNCERTAIN TAX POSITIONS IN CONNECTION WITH THESE CONSOLIDATED FINANCIAL STATEMENTS. 0 0 0 0 0 0 0 0 0 PETE KERNS PRESIDENT & CEO 0 170000 0 0 0 0 0 0 0 19161 0 189161 0 0 FORM 990, PART VI, SECTION A, LINE 7A SERENITY LANE HEALTH SERVICES FOUNDATION IS A SUPPORTING ORGANIZATION OF SERENITY LANE HEALTH SERVICES. THE BOARD OF SERENITY LANE HEALTH SERVICES HAS THE POWER TO REMOVE AND REPLACE TRUSTEES OF THE FOUNDATION AT ANY TIME, WITH OR WITHOUT CAUSE. THE TRUSTEES OF THE FOUNDATION SERVE AS THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE PRESIDENT/CEO, CHIEF FINANCIAL OFFICER AND THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY CALLS FOR BOARD NOTIFICATION OF ANY TRANSACTIONS WITH A PARTY IN INTEREST. FORM 990, PART VI, SECTION B, LINE 15 N/A - THE ORGANIZATION DID NOT PROVIDE COMPENSATION TO ANY PARTIES. 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. SERENITY LANE PO BOX 8549 COBURG OR 97408 930606316 TREATMENT OF THE DISEASE OF CHEMICAL DEPENDENCY OR 501(C)(3) LINE 3 N/A 0 SERENITY LANE HEALTH SERVICES PO BOX 8549 COBURG OR 97408 943113708 ADMINISTRATIVE SUPPORT FOR SERENITY LANE OR 501(C)(3) LINE 12B, II SERENITY LANE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0