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08-08-' 17 15:25 FROM- South Bend Heritage 574-289-4560 T-320 P0002/0003 F-306
<br />form 990
<br />hm
<br />A Far th0 Zr115 CO
<br />LBTSNUED- TO NOMMER 25., 2016
<br />Return of Organization ExeMPt From inCOme T8x
<br />section 501(o), W, or 90(a,X1) at the IntenW FteMenue Code (&Xaept IIrIato touadal
<br />► I)O no enter social secuft nurnbers an thi9 iOM sus It MWbe rna& puubllc.
<br />a O Norm of otgaw n
<br />ww+�
<br />C�a tse SO ITIJ BEND HSRZTAGE FOUNDATION, INC .
<br />�] Dofn b0sinesss9
<br />��, Number anrf sheet (or PA. inuc it ttrai! is not deiver8d to strottaddrese)
<br />D anggoyer identification number
<br />23-7394320
<br />E Telephone number
<br />574--289-1066
<br />803 LINCOLNWAY WEST
<br />ass s 036,3 7.
<br />City ort nwn, state or province, countrY, and 21P or fore P11W 000
<br />N(0)16 tnta s group return
<br />�am, ,des SOUTH BEND, ZIT 46616
<br />CO MAR ANT
<br />for r.ttbardinetes? ...., C Yeot { No
<br />a1 oHlcer
<br />[] F Name and 9ddress Of pttnclp XN 4a 1
<br />y(p) Arc d1 sibma a4s fndoded'tF i Na
<br />803 LINCOLNWAY W, SOUTH BMW,
<br />)� {inser#na, 49A7 a (1 Ar
<br />52i 1t'N0," attachaLt (seainstruotions)
<br />I ax�ace d010 3 501 a
<br />.! webmt 9BSERZTAGE . OR'C3
<br />Otf<eri lL Year
<br />IH c Gr g�c nn numt7sr
<br />of fonrratlon: 1 7 M Stale of le a1 damicitec Z
<br />K Form of or nation rporatian rust Association
<br />1 Brfefiydeecdhathaorar�ization'snussinnarmastsni�icantscilvnas. rl'Q
<br />M"ITY, Until
<br />CE OpG L ORATION,
<br />O.F' URBAN NEIGrHBORHOODS AND MWOWER R SZU
<br />I
<br />1pthe o t?ation dlscartttnued its aperadons or disposed Of THOTetirerr 2W of ha not assa%^
<br />2 Checktlftb;X ► �'" 23
<br />a Number of voMg members of the goveming body (Part Vl, line 10} ... ............. . .
<br />3
<br />. . ................ a
<br />a
<br />in d art VI, time 1b)..................................
<br />4 dumber of lndependeM voting membere of the 5O' f1 Ohl
<br />t3
<br />at
<br />5 Total number of inoMduats employed h calendar Year 2p15 (Part V, ene 2sj,,,,,,,,,,,,,,•...,,.............,.__... 0
<br />aTotal number of vohutteem (estimate if necessary}..................................................................................
<br />Ta '
<br />7 a Total unfelated business tavenue from Part Vlli, column (C), line 12...............................................................
<br />0
<br />7b `
<br />b Net unrelated businesstaxable income ftm Forst► 88a% Gna 34
<br />......
<br />PriarYea► ntYetiar
<br />1. , 0 ' ` , --
<br />8 C.9ntr Vd0M 2innd grants (t'an Vlll, Ins 1h)-....... _........................................ .........,.,
<br />, ,46 •
<br />9 Program service revenue (Past V1111 line 29) ............fum„ ....................
<br />r 1 (} $
<br />10 Investmentincome "A 'All, oorr (A), rmea 3,4, and 7'd) .......................................
<br />� 4 4 a � , 7 •
<br />'t1 Other revenue OW All, column (A), lino& v, Bd, f3o, 9c,10c, and 118) ........... .......... __
<br />1
<br />r .
<br />w . , •
<br />+ 0
<br />12 Tate( ravanua • add lines 8 through 11 must a ual part VI fumn ring _..
<br />{iw 0 •
<br />10 Grants ww simllaremounts paid (Poet K column (A), Ilnas 13) .............................. .
<br />14 Benefits Maid to or for members (Part IX, column (A), line 4)......................................
<br />5 •
<br />an, empfoYee btrteirts lPa►t lX, a0lumn (A), fines FYI 0) .........
<br />15 Salarias other compa"40n,
<br />r
<br />0. U.
<br />lea pmfepsionalfun _ ngf0mzTar Kd0lumn(A),VwI10) �.
<br />fundraising expenses (Part DC, Oolurm (Aj, Gne 2bj to.+711,
<br />za.,�:`'� � �3� "�&'• ,,' 1; •,;� : �
<br />' 4 '% (i,4 (i 7
<br />b Total
<br />iy Other elcpen9ea (f' t �, C0lumn (A), fines 11 a i 1d, '11-240) ... ......... —.,_............ ....
<br />,,
<br />1
<br />18 7Otel expenses. Add tines I&V (must equal Pert D(, column (A), One 26) ...,.............. ...
<br />• . 1 � •
<br />20 Tout aesats (PEA Ifne if,)................................................................................I...
<br />21 Total 11ablitles (Part X, One 20) .-.,—..— ...........................
<br />Under pentues of Perjury.
<br />Of
<br />this return,
<br />based on atl fnformatlon
<br />91gn � ran ter o cer
<br />Here X CO )Va4j Z, EXECUTM D212ECTOR
<br />tyP8 ar n a an
<br />Preparefs stgnalure
<br />Prlm/iypeprepaxer` HA AME9 8. CHAMPER 1 /p2 � � � m 00956$3�.
<br />Paid YAMS S. CHAMPSR Hrm'sFIN 01
<br />'O&CO Propater finnsnne
<br />unOniY Fimr'saddress�,. ]3L�TF MMKLIN ;EN 4I5�.r T, Phone na.574--264-2247
<br />err own e7 ee i alto .............. ............ Yes Na
<br />May the Ins df ems this return � to fttw;ctiotts. Farm M (2015
<br />s3m , ,z-Is-ta LRA For p""Ork Aedttc00 Aot Notice, a tfe®sGpara
<br />SEE SCSEDULE 0 FOR ORGANI%ATXON HISS101q STATEMENT CONTINUATION
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