2024-10-29T12:38:48-05:00 2023-12-31 390758449 WIPFLI LLP 170 N RADNOR-CHESTER RD SUITE 200 RADNOR PA 19087 990 2023-01-01 391388991 EVERGREEN FOUNDATION INC EVER 9202332340 1130 N WESTFIELD ST OSHKOSH WI 54902 BILLIE JO HIGGINS TREASURER 9202332340 2024-10-21 1 0 SOLOMON MARDAKHAEV P01806552 6105653930 2024-10-02 2023 2024-10-15 13:58:12Z KENNETH A ARNESON 1130 N WESTFIELD ST OSHKOSH WI 54902 8161656 0 X WWW.EVERGREENOSHKOSH.COM X 1981 WI TO USE AND SECURE RESOURCES IN SUPPORT OF THE EVERGREEN RETIREMENT COMMUNITY VISION. 9 9 0 9 0 0 754808 885412 0 0 985483 223407 0 0 1740291 1108819 742255 1184170 0 0 0 0 0 0 125756 287704 237342 1029959 1421512 710332 -312693 19987827 22030908 121329 578362 19866498 21452546 EVERGREEN FOUNDATION, INC. RECEIVES GIFTS AND BEQUESTS, RAISES FUNDS FOR SPECIFIC PROJECTS OR NEEDS, ADMINISTERS AND INVESTS FUNDS, AND DISBURSES PAYMENTS TO AND ON BEHALF OF EVERGREEN RETIREMENT COMMUNITY, INC. 0 0 1197439 1184170 0 THE EVERGREEN FOUNDATION SUPPORTS THE EVERGREEN VISION TO BE A "VIBRANT COMMUNITY THAT OFFERS RICH LIFE EXPERIENCES AND CHOICES IN PROGRAMS, SERVICES, AND ENVIRONMENTS FOR THOSE WE SERVE" THROUGH CHARITABLE CONTRIBUTIONS, LEAVE A LEGACY DESIGNATIONS AND VOLUNTEER INVOLVEMENT. THE EVERGREEN FOUNDATION HELPS PROVIDE DIGNITY, COMFORT AND SECURITY FOR THOSE WHO CALL EVERGREEN HOME; ENHANCES THE LIVING ENVIRONMENTS AND EXPERIENCES OFFERED TO THE RESIDENTS; AND SUPPORTS THE ACTIVITIES THE RESIDENTS ENJOY. 1197439 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 0 0 0 WI X BILLIE JO HIGGINS 9202332340 1130 N WESTFIELD ST OSHKOSH WI 54902 MARY HANSEN CHAIR 1.00 X X 0 0 0 BARB KNUTZEN VICE CHAIR 1.00 X X 0 0 0 ANNA FILIPOVA DIRECTOR 1.00 X 0 0 0 DARRICK MUNSCH DIRECTOR 1.00 X 0 0 0 WAYNE OEHLER DIRECTOR 1.00 X 0 0 0 KATHY PROPP DIRECTOR 1.00 X 0 0 0 JOHN SCHORSE DIRECTOR 1.00 X 0 0 0 TOM WINTHEISER DIRECTOR 1.00 X 0 0 0 ALYSON ZIERDT DIRECTOR 1.00 X 0 0 0 KEN ARNESON PRESIDENT/CEO 1.00 40.00 X 0 284401 22186 BILLIE JO HIGGINS VP FINANCE & IS/TREASURER 1.00 40.00 X 0 159608 10458 VICKI TESSMER SECRETARY 1.00 X 0 33075 19092 STEPHANIE KINTOPF SECRETARY 1.00 X 0 8424 0 0 485508 51736 0 0 1 0 EVERGREEN RETIREMENT COMMUNITY 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 MANAGEMENT SERVICES 138934 1 885412 885412 262417 262417 7013827 7052837 -39010 -39010 -39010 1108819 0 0 223407 1184170 1184170 138934 13178 125756 13310 13310 70412 70412 13246 13246 577 577 ASSOCIATION DUES 475 475 FOOD & DIETARY SUPPLIES 115 115 273 23 250 1421512 1197439 98317 125756 5418 10300 15109 0 18411674 20346491 1555626 1674117 19987827 22030908 701 755 120628 577607 121329 578362 X 13863283 15623785 6003215 5828761 19866498 21452546 19987827 22030908 X -312693 2114685 -215944 X 0 1 X 1 0 X 596834 794864 1917943 754808 885412 4949861 596834 794864 1917943 754808 885412 4949861 834874 4114987 335863 293976 228215 379398 262417 1499869 6449730 0.63800 0.42620 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8123849 5105 952998 109308 8972644 9359493 1285 -1175308 61621 8123849 9606849 636799 1267606 2104418 47343 9359493 8677264 22450 1006818 59932 39751 9606849 7448232 448 1327688 60892 37163 8677264 0.45260 0.00000 0.54740 1 0 0 INTEREST IN COMMUNITY FOUNDATION 53118 BENEFICIAL INTEREST IN TRUST 1620999 1674117 DUE TO AFFILIATE 577607 577607 3153092 2114685 2114685 1038407 70412 70412 1108819 166930 0 166930 70412 1184170 1254582 1421512 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUNDS BENEVOLENT NEEDS FOR RESIDENTS OF EVERGREEN RETIREMENT COMMUNITY WHO HAVE EXHAUSTED THEIR PERSONAL RESOURCES, WOODLANDS PRESERVATION, LIFECARE LEARNING, PASTORAL CARE, CREATIVE ARTS, GROUNDS BEAUTIFICATION AND UNRESTRICTED USES. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS TO AFFILIATE 1,184,170. 1 EVERGREEN RETIREMENT COMMUNITY INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 391081800 501(C)(3) 1184170 0 BENEVOLENT NEED, SPECIAL PROJECTS (RESTRICTED FUNDS), GROUNDS BEAUTIFICATION, AND SPECIAL PROJECTS APPROVED BY THE BOARD (UNRESTRICTED FUNDS). 1 0 PART I, LINE 2: THE FOUNDATION ONLY DISTRIBUTES FUNDS TO EVERGREEN RETIREMENT COMMUNITY, INC. FUNDS FOR THE BENEVOLENT NEED ARE BUDGETED AT A SPECIFIC LEVEL EACH YEAR AND DISBURSED MONTHLY. RESTRICTED FUNDS FOR SPECIAL PROJECTS ARE DISBURSED WHEN EVIDENCE OF THE PROJECT'S COMPLETION IS PROVIDED. UNRESTRICTED FUNDS ALLOCATED FOR DISTRIBUTION BY THE BOARD FOR A SPECIFIC USE ARE DISBURSED WHEN EVIDENCE OF THE PROJECT'S COMPLETION IS PROVIDED. GRANTS FOR EDUCATION ASSISTANCE ARE ONLY DISBURSED AFTER DOCUMENTATION OF AMOUNTS PAID IS PROVIDED BY RECIPIENT. 0 0 0 0 0 0 1 0 0 KEN ARNESON PRESIDENT/CEO 0 273151 0 11250 0 0 0 17053 0 5133 0 306587 0 0 BILLIE JO HIGGINS VP FINANCE & IS/TREASURER 0 156027 0 3581 0 0 0 9573 0 885 0 170066 0 0 PART I, LINE 3 THE FOUNDATION RELIES ON A RELATED ORGANIZATION, EVERGREEN RETIREMENT COMMUNITY, INC. TO DETERMINE THE COMPENSATION FOR THE CEO/PRESIDENT. THE RELATED ORGANIZATION USED THE FOLLOWING PRACTICES TO DETERMINE THE COMPENSATION FOR THE CEO/PRESIDENT: COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 6 PRESIDENT/CEO (KEN ARNESON), CFO/TREASURER (BILLIE JO HIGGINS), EXECUTIVE ASSISTANT/SECRETARY (VICKI TESSMER) OF EVERGREEN RETIREMENT COMMUNITY, AS MEMBERS OF THE MANAGEMENT TEAM, RECEIVE AN ANNUAL BONUS, PART OF WHICH RELATES TO THE NET INCOME OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 GENERAL MANAGEMENT SERVICES AND ACCOUNTING FUNCTIONS ARE PROVIDED BY EVERGREEN RETIREMENT COMMUNITY, INC, A RELATED ENTITY. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENT OF THE BYLAWS RELATED TO AMENDING THE BYLAWS AND DISSOLVING THE ORGANIZATION REQUIRES APPROVAL OF THE BOARD OF DIRECTORS OF EVERGREEN RETIREMENT COMMUNITY,INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE ORGANIZATION'S TREASURER. AN ELECTRONIC VERSION OF THE FORM 990 WAS POSTED ON THE BOARD OF DIRECTOR'S WEB PAGE WITH MEMBERS GIVEN THE OPPORTUNITY TO REVIEW IT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL EMPLOYEES AND IT HAS A CODE OF CONDUCT POLICY THAT APPLIES TO ALL BOARD MEMBERS. BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST AND TO CONDUCT BUSINESS WITH EVERGREEN IN A MANNER THAT SUPPORTS THE INTERESTS OF EVERGREEN AND AVOIDS UNFAIR PERSONAL ADVANTAGE. NONCOMPLIANCE WITH THE CODE OF CONDUCT MAY RESULT IN REMOVAL FROM THE BOARD FOLLOWING AN OPPORTUNITY FOR EXPLANATION TO THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 EVERGREEN FOUNDATION, INC. MAKES AVAILABLE UPON REQUEST ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY TO THE GENERAL PUBLIC. THESE DOCUMENTS ARE PROVIDED WITHIN A REASONABLE PERIOD OF TIME. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN COMMUNITY FOUNDATION -6,196. CHANGE IN BENEFICIAL INTEREST IN TRUST -209,748. EVERGREEN RETIREMENT COMMUNITY INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 391081800 NURSING CARE WI 501(C)(3) LINE 10 0 EVERGREEN COMMUNITIES INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 874810560 SENIOR LIVING WI 501(C)(3) LINE 12D, III-O 0 EVERGREEN VILLAGE INC 1130 NORTH WESTFIELD STREET OSHKOSH WI 54902 391505337 CO-OPERATIVE WI N/A C 0 0 1 0 1 1 0 0 0 0 0 1 0 0 1 1 0 1 0 0