-
Short Form
Return of Organization Exempt From Income Tax
OMB No 1545-1150
Under section 501(c) 527, or 4947(a)( 1) of the Internal Revenue Code
except black lung benefit rust or private foundation
Form 990-EZ
^ Sponsonng organizations of do or a iced funds, o ganizations that op ate one or more hose at facilities, and certain controlling
organizations as defined in section 512(bx13) must file Form 990 All other organizations with gross receipts less than $200,000 and total
_
_
assets less than $500,000 at the end of the year may use this form
Department of t6 Treasury
Internal Revenue Sernce
1 2011
Open to Public
Inspection
and
A For the 2011 calendar year , or tax year beginning
g Check e
C Name of or g anization
applicable
D Employer identification number
Address change
OName change
Initial return
=Terminated
NORTH DAKOTA CENTER FOR NURSING
%D-GvuJ100
Number and street (or P.O. box, if mail is not delivered to street address )
Room/suite E Telephone number
®n uabop din
BISMARCK
® Cash
ND
701-852-1810
504
919 SOUTH 7 STREET
=Amended return City or town, state or country, and ZIP + 4
F Group Exemption
Number
58504
0 Accrual
H Check ^ cif the organization is not
required to attach Schedule B
Website : ^ NDCENTERFORNURS ING. ORG
insert no . ) 0 4947 ( a )( 1 ) or 0 527 , ( Form 990 , 990-EZ, or 990-PF ).
Tax-exempt status ( check only one ) - ® 501 ( c )( 3 ) L 501 c
Check 00- 1 dthe organization is not a section 509(a)( 3) supporting organization or a section 527 organization and its gross receipts are normally not more than
$50,000. A Form 990-EZ or Form 990 return is not required though Form 990-N ( e-postcard) may be required ( see instructions ). But if the organization chooses to file
Accounting Method :
G
I
J
K
Other (specify) ^
a return , be sure to file a complete return.
L Add lines 5b, 6c, and 7b , to line 9 to determine gross receipts . If gross receipts are $200,000 or more , or if total assets (Part II,
line 25, column ( B ) below ) are $5 00 ,000 or more, file Form 990 instead of Form 990-EZ
Revenue, Expenses , and Changes in Net Assets or Fund Balances ( see the instructions for Part I.)
Part I
130 , 887.
Chw,k if the nrnant7atlnn Ilcerl Sr.. hedlde (1 to resnnnfi to any nllestlnn in this Part I
1
2
3
Contributions , gifts, grants , and similar amounts received
Program service revenue including government fees and contracts
Membership dues and assessments
4
Investment Income
n
1
2
3
Gross amount from sale of assets other than inventory
Less: cost or other basis and sales expenses
Gain or ( loss) from sale of assets other than inventory (Subtract line 5b from line 5a)
Gaming and fundraising events
Gross income from gaming ( attach Schedule G if greater than
$15,000)
b Gross income from fundraising events ( not including $
from fundraising events reported on line 1) (attach Schedule G if the sum of such
0
N
to
M
W
C3 W
5c
6a
of contributions
16
8z
z
17
y
Z
6b
6c
c Less: direct expenses from gaming and fundraising events
d Net income or (loss ) from gaming and fundraising events ( add lines 6a and 6b an d subtract line 6c)
7a
7a Gross sales of inventory, less returns and allowances
7b
b Less: cost of goods sold
c Gross profit or (loss ) from sales of inventory (Subtract line 7b from line 7a)
8 Other revenue (describe in Schedule 0)
9 Total revenue Add lines 1 2 3 4 5c 6d 7c and 8
10 Grants and similar amounts paid (list in Schedule 0)_.......
EID
I
11 Benefits paid to or for members
12 Salaries, other compensation , and e ployee- benefits
13 Professional fees and other payment^^ independent contractors
14
15
18
19
20
21
65.
5a
5b
gross income and contributions exceeds $15,000)
e'er
4
SEE SCHEDULE 0
5a
b
c
6
a
cc
130 , 822.
Occupancy, rent, utilities, and maintenan ce A^f^^J
Printing , publications , postage, and sippln g
_ _ . _...
Other expenses ( describe in Schedule 0)
OGDEN f UT
j
Total exp enses . Add lines 10 throw hi
Excess or ( deficit) for the year (Subtract line 17 from line 9)
Net assets or fund balances at beginning of year (from line 27, column (A))
(must agree with end -of-year figure reported on prior year' s return)
Other changes in net assets or fund balances ( explain in Schedule 0)
Net assets or fund balances at end of year. Combine lines 18 throw h 20
6d
^
_1
LHA For Paperwork Reduction Act Notice, see the separate instructions.
SEE
SCHEDULE O
7c
8
9
10
11
12
13
14
15
16
17
18
Op,
19
20
21
130 , 887.
996 .
3 401 .
1 462 .
90
23 , 611.
119
11
0 .
0 .
11 , 417 .
Form 990-EZ (2011)
G%
132171
02-06-12
470 .
417 .
10
99O-EZ0011)
Paft II
NORTH DAKOTA CENTER FOR NURSING
45-
Balance Sheets . (see the instructions for Part II.)
Check if the organization used Schedule 0 to res pond to an y q uestion in this Part II
(A) Beginning of year
22
0 . 22
Cash, savings, and investments
Land and buildings
Other assets (describe in Schedule 0)
23
24
12 , 546.
23
0. 24
SEE SCHEDULE 0
25 Total assets
Total liabilities (describe in Schedule 0)
SEE SCHEDULE 0
Net assets or fund balances ( line 27 of column B must ag ree with line 21 )
26
27
(B) End of year
0. 25
1 , 626.
14 , 172.
0. 26
0 . 27
11
2 , 755.
417.
Part III Statement of Program Service Accomplishments (see the instructions for Part III.)
Expenses
Check if the org anization used Schedule 0 to respond to an y q uestion in this Part I I I ® (Required for section
501(c)(3) and 501(c)(4)
organizations and section
4947(a)(1) trusts; optional
for others.)
What is the organization 's primary exempt purpose?SEE SCHEDULE 0
Describe the orga nization ' s program service accomplishments for each of its three largest program services, as measured by expenses In a clear and concise
manner, desabe the services provided, the number of persons benefited , and other relevant information for each program title
28 SEE SCHEDULE 0
(Grants $
If this amount includes forei g n g rants , check here
00, 0 28a
(Grants $
If this amount includes foreig n rants check here
01, 0 29a
If this amount includes foreig n g rants , check here
(Grants $
Other program services (describe in Schedule 0)
If this amount includes foreig n g rants , check here
(Grants
32 Total Progr am service ex enses (add lines 28a throug h 31 a)
30a
111 , 838.
29
30
31
31a
1111P, 32
111
838.
Part IV List of Officers , Directors , Trustees, and Key Employees . List each one even if not compensated (see the instructions for Part IV)
Check if the organization used Schedule 0 to respond to any question in this Part IV
(
a ) Name and address
MARGARET REED
919 S 7TH ST
BISMARCK , ND 58504
BISMARCK , ND 58504
919 S 7TH ST , BISMARCK , ND 58504
SUSAN PEDERSON
919 S 7TH ST , BISMARCK , ND 58504
919 S 7TH ST , BISMARCK , ND 58504
BISMARCK ,
ND 58504
BISMARCK , ND 58504
BISMARCK , ND 58504
0.
0.
0.
0.
38 , 958.
2 , 278.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
0.
2.00
EXECUTIVE DIR ECTOR
40.00
DIRECTOR
1.00
1.00
1.00
1.00
1.00
1.00
DIRECTOR
BISMARCK , ND 58504
ADELE SIGL
919 S 7TH ST
0.
DIRECTOR
ROBERT YOUNG
132172
0.
2.00
DIRECTOR
TRACY EVANSON
02-08-12
0.
DIRECTOR
JAMIE SPERLE
919 S 7TH ST
0.
2.00
DIRECTOR
JOSH ASKVIG
919 S 7TH ST
0.
emP
DIRECTOR
CHERYL RISING
919 S 7TH ST
(d not paid, enter -0-)
(e) Estimated
amount of other
compensation
W-2/1089- MISC)
(d) Health benefits,
TREASURER
PATRICIA MOULTON
919 S 7TH ST , BISMARCK , ND 58504
JULIE HANSON
919 S 7TH ST
position
oyobee benefit
plans, anddeferred
(C) Reportable
ICE PRESIDE
CONSTANCE KALANEK
919 S 7TH ST
compensation (Forms
RESIDENT
BISMARCK , ND 58504
KAREN LATHAM
919 S 7TH ST
(b) Title and average hours
per week devoted to
1.00
DIRECTOR
BISMARCK , ND 58504
1.00
0.
Form 990-EZ (90111
Pa e 3
Form 990-EZ ( 2011 )
45-2605788
NORTH DAKOTA CENTER FOR NURSING
Part V Other Information (Note the Schedule A and personal benefit contract statement requirements in the
instructions for Part V.) Check if the organization used Sch. 0 to respond to any question in this Part V
Did the organization engage in any significant activity not previously reported to the IRS? If 'Yes; provide a detailed description of each
activity in Schedule 0
34 Were any sign ifi cant changes made to the organizing or governing documents? If 'Yes; attach a conformed copy of the amended
documents it they reflect a change to the organization ' s name . Otherwise, explain the change on Schedule 0 (see instructions)
35a Did the organ ization have unrelated business gross income of $1 ,000 or more during the year from business activities ( such as those reported
on lines 2, 6a, and 7a, among others)?
b If Yes ; to line 35a, has the organization filed a Form 990-T for the year? If 'No,* provide an explanation in Schedule 0
c Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax
33
36
37 a
b
38a
b
requirements during the year? If 'Yes; complete Schedule C, Part III
Did the organization undergo a liquidation, dissolution, termination, or significant disposition of net assets during the year? If 'Yes;
complete applicable parts of Schedule N
^ ^ 37a ^
Enter amount of political expenditures, direct or indirect, as described in the instructions.
Did the organization file Form 1120-POL for this year?
Did the organization borrow from, or make any loans to, any officer, director, trustee, or key employee or were any such loans made
in a prior year and still outstanding at the end of the tax year covered by this return?
38b
If Yes,' complete Schedule L, Part II and enter the total amount involved
N/A
0
Section 501(c)(7) organizations. Enter:
39a
N /A
a Initiation fees and capital contributions included on line 9
39b
b Gross receipts, included on line 9, for public use of club facilities
N/A
40a Section 501(c)(3) organizations. Enter amount of tax imposed on the organization during the year under:
section 4911 Bo.
0.
0 . ; section 4912 ^
0 . ;section 4955 ^
b Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in any section 4958 excess benefit transaction during the
year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ?
If Yes, complete Schedule L, Part I
c Section 501(c)(3) and 501(c)(4) org anizations. Enter amount of tax imposed on organization managers
or disqualified persons during the year under sections 4912, 4955, and 4958
^
0.
d Section 501(c)(3) and 501(c)(4) organizations. Enter amount of tax on line 40c reimbursed by the
39
organization
e All organizations. At any time during the tax year, was the organization a party to a prohibited tax shelter
41
transaction? If 'Yes; complete Form 8886-T
List the states with which a copy of this return is filed. ^
0.
NONE
42a The organization's books are in care of ^ PATR I C IA MOULTON
Located at ^ 919 SOUTH 7TH STREET SOUTH, STE
43
^
X
504,
Telephone no. ^ 701-852-1810
ZIP+4 ^ 58504
BISMARCK, N
At any time during the calendar year, did the organization have an interest in or a signature or other authority
over a financial account in a foreign country (such as a bank account, securities account, or other financial
account)?
If 'Yes; enter the name of the foreign country. ^
See the instructions for exceptions and filing requirements for Form TD F 90-22 . 1, Report of Foreign Bank and Financial Accounts.
At any time during the calendar year, did the organization maintain an office outside of the U.S.?
If 'Yes; enter the name of the foreign country: ^
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 - Check here
and enter the amount of tax-exempt interest received or accrued during the tax year
^ 143 I
Yes No
42b
X
42c
X
N/A
44a Did the organization maintain any donor advised funds during the year? If 'Yes; Form 990 must be completed instead of
Form 990-EZ
b Did the organization operate one or more hospital facilities during the year? If 'Yes; Form 990 must be completed instead
of Form 990-EZ
c Did the organization receive any payments for indoor tanning services during the year?
d If Yes' to line 44c, has the organization filed a Form 720 to report these payments? If 'No,' provide an explanation
in Schedule 0
45a Did the organization have a controlled entity within the meaning of section 512(b)(13)?
45 b Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section
Form 990-EZ(2011)
132173
02-06-12
Form 990-EZ (2011)
46
NORTH DAKOTA CENTER FOR NURSING
45-2605788
Page 4
Yes No
Did the organization engage , directly or indirectly, in political campaign activities on behalf of or in opposition to candidates for public office
If'Y 'com p lete Schedule C . Part I
46
X
Section 501 (c)(3) organizations and section 4947(a)(1) nonexempt charitable trusts only. All section 501(c)(3)
PartVI
organizations and section 4947(a)(1) nonexempt chartable trusts must answer questions 47-49b and 52, and complete the tables
for lines 50 and 51. Check if the organization used Schedule 0 to respond to any auestion in this Part VI
47
48
49a
b
50
Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If Yes; complete Sch. C , Part II
Is the organization a school as described in section 170 (b)(1)(A)(n)7 If 'Yes, complete Schedule E
Did the organ ization make any transfers to an exempt non-charitable related organization?
If Yes; was the related organization a section 527 organization?
f
X
X
X
49b
Complete this table for the organization ' s five highest compensated employees ( other than officers , directors, trustees and key employees) who each received more
than $100,000 of comp ensation from the organization. If there is none , enter "N one.'
(e) Estimated
(a) Name and address of each employee
(b) Title and average hours
(C) Reportable
( d) Health benefits,
contributions to
compensation (Forms
paid more than $100,000
per week devoted to
amount of other
vloes-rnisc)
`"
p^ans,oand deferred
position
p
compensation
NONE
51
47
48
49a
compensation
Total number of other employees paid over $100,000
Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the
d Total number of other independent contractors each receiving over $100,000
52 Did the organization complete Schedule A? Note : All section 501( c)(3) organs
SCHEDULE A
OMB No 1545-0047
Public Charity Status and Public Support
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Severe
2011
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
^ Attach to Form 990 or Form 990-EZ. ^ See separate instructions.
Open to Public
Inspection
Employer identification number
Name of the organization
AS_7iZ nS700
Part I
Reason for Public Charity Status (All organizations must complete this part.) See Instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1 0 A church, convention of churches, or association of churches described in section 170(bXl)(A)(i).
2 0 A school described in section 170( b)(1)(A)(ii). (Attach Schedule E.)
3 0 A hosprtal or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name,
4
city, and state*
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
section 170(b)(1)(A)(iv). (Complete Part II.)
5
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
6
7 ® An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
section 170(b)(1)(A)(vi ). (Complete Part II.)
A community trust described in section 170(b)(1)(A)(vi ). (Complete Part II.)
8
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees , and gross receipts from
9
activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.
See section 509(a)(2). (Complete Part III.)
10 0 An organization organized and operated exclusively to test for public safety . See section 509(a)(4).
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
11
more publicly supported organizations described in section 509(a)(1) or section 509(a)(2) See section 509(a)(3). Check the box that
describes the type of supporting organization and complete lines 11 a through 11 h.
d = Type III -Other
b 0 Type II
c 0 Type III - Functionally integrated
a 0 Type I
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than
e
foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III
f
0
supporting organization , check this box
g
Since August 17, 2006 , has the organization accepted any gift or contribution from any of the following persons?
Yes No
(i) A person who directly or indirectly controls , either alone or together with persons described in (I) and (I) below,
h
the governing body of the supported organization?
(ii) A family member of a person described in () above?
(iii) A35% controlled entity of a person described in () or () above?
Provide the following information about the supported organization(s)
(i) Name of supported
organization
(ii) EIN
(iii) Type of
organization
(described on lines 1-9
above or IRC section
(see instructions ))
-
-
(vi) Is the
v Did Yyou notify
(iv)) Is the organization (1
fY the
organization col.
in col. (i) listed in your organization in col. (i) organized inin the
U.S.?
governing document? (i) of your support?
Total
LHA For Paperwork Reduction Act Notice , see the Instructions for
Form 990 or 990-EZ
132021
01-24-12
-
Yes
No
Yes
No
Yes
-
11 i
11 ii
11 iii
(vii) Amount of
support
No
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990
2011 NORTH DAKOTA CENTER FOR NURSING
45-2605788 Pa e 2
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) ^
1 Gr ts, grants, contributions, and
membership fees received. (Do not
(a) 2007
(b) 2008
include any 'unusual grants.')
c 2009
2010
(e ) 2011
Total
13 0 8 2 2.
13 0 8 22.
13 0 8 2 2.
130 , 822.
2 Tax revenues levied for the organization's benefit and either paid to
or expended on its behalf
3 The value of services or facilities
furnished by a governmental unit to
the organization without charge
4 Total. Add lines 1 through 3
5 The portion of total contributions
by each person (other than a
governmental unit or publicly
supported organization) included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f)
6
1 130 , 822.
Public su pp ort. Subtract line 5 from line 4
Section B. Total Support
Calendar year (or fiscal year beginning in) ^
(a) 2007
(c) 2009
(b) 2008
(e) 2011
( d) 2010
7 Amounts from line 4
130 822.
8 Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources
65.
9 Net income from unrelated business
activities, whether or not the
business is regularly camed on
10 Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part IV) 11 Total support. Add lines 7 through 10
12 Gross receipts from related activities, etc (see instructions)
12
13 First five years . If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
organization, check this box and stop here
Section C. Computation of Public Support Percentage
Total
130 822.
65.
130 887.
^
14 Public support percentage for 2011 (line 6, column (f) divided by line 11, column (l)
14
99 . 95
%
15 Public support percentage from 2010 Schedule A, Part II, line 14
15
%
16a 33 1/3% support test - 2011 . If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
stop here. The organization qualifies as a publicly supported organization
oilb 33 1/3% support test - 2010 . If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and stop here . The organization qualifies as a publicly supported organization
^Q
17a 10% -facts - and-circumstances test - 2011. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,
and if the organization meets the 'facts-and-circumstances' test, check this box and stop here . Explain in Part IV how the organization
meets the 'facts-and-circumstances' test. The organization qualifies as a publicly supported organization
o. 0
b 10% -facts - and-circumstances test - 2010. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 109'0 or
more, and if the organization meets the 'facts-and-circumstances' test, check this box and stop here . Explain in Part IV how the
organization meets the "facts-and-circumstances" test The organization qualifies as a publicly supported organization
No. Q
18 Private foundation . If the organization did not check a box on line 13. 16a. 16b. 17a, or 17b. check this box and see instructions
or. F-1
Schedule A (Form 990 or 990-EZ) 2011
132022
01-24-12
Pag e 3
Schedule A (Form 990 or 990-EZ) 2011
Part III Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fads to
qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) ^
1 Gifts, grants , contributions, and
membership fees received (Do not
include any 'unusual grants.')
(a) 2007
b 2008
c 2009
d 2010
a 2011
Total
( a) 2007
(b) 2008
c 2009
(d) 2010
(e) 2011
Total
2 Gross receipts from admissions,
merchandise sold or services performed, or facilities furnished in
any activity that is related to the
organization's tax-exempt purpose
3 Gross receipts from activities that
are not an unrelated trade or business under section 513
4 Tax revenues levied for the organization's benefit and either paid to
or expended on its behalf
5 The value of services or facilities
furnished by a governmental unit to
the organization without charge
6 Total. Add lines 1 through 5
7a Amounts included on lines 1, 2, and
3 received from disqualified persons
b Amounts included on lines 2 and 3 received
from other than disqualified persons that
exceed the greater of $5,000 or 1% of the
amount on Ime 13 for the year
c Add Imes 7a and 7b
8
Public su
ort Subtract line 7c from line 6 )
Section B. Total Support
Calendar year (or fiscal year beginning in) ^
9 Amounts from line 6
10a Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources
b Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975
c Add lines 1 Oa and 1 Ob
Net income from unrelated business
activities not included in line 10b,
whether or not the business is
regularly camed on
12 Other income Do not include gain
or loss from the sale of capital
assets (Explain in Part IV)
13 Total support (Add Imes e, loc,11, and 12
14 First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
11
check this box and stow here
Section C. Computation of Public Su pp ort Percenta g e
15 Public support percentage for 2011 pine 8, column (f) divided by line 13, column (f))
16 Public support percentage from 2010 Schedule A. Part III line 15
Section D. Com putation of Investment Income Percenta g e
^
15
16
Investment income percentage for 2011 (line 10c, column (f) divided by line 13, column (f))
17
18
18 Investment income percentage from 2010 Schedule A, Part ill, line 17
19a 33 1/3% support tests - 2011 . If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not
more than 33 1/3%, check this box and stop here . The organization qualifies as a publicly supported organization
b 33 1/3% support tests - 2010 . If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and
line 18 is not more than 33 1/3%, check this box and stop here . The organization qualifies as a publicly supported organization
20 Private foundation . If the organization did not check a box on line 14, 19a, or 19b, check this box an d see instructions
%
%
%
%
17
132023 01-24-12
^0
^Q
^
Schedule A (Form 990 or 990-EZ) 2011
Supplemental Information to Form 990 or 990-EZ
'SCHEDUL'E 0
(Form 990 or 990-EZ)
Complete to provide information for responses to specific questions on
Open to Public
110- Attach to Form 990 or 990-EZ
ernal Revenue Service
Inspection
Name of the organization
Employer identification number
NORTH DAKOTA CENTER FOR NURSING
FORM 990-EZ,
2011
Form 990 or 990-EZ or to provide any additional information.
DoftheTreasury
Inttemal
OMB No 1545-0047
PART I,
LINE 4,
45-2605788
OTHER INVESTMENT INCOME:
DESCRIPTION OF PROPERTY:
AMOUNT:
INTEREST INCOME
FORM 990-EZ,
PART I,
65.
LINE 16,
OTHER EXPENSES:
DESCRIPTION OF OTHER EXPENSES:
AMOUNT:
SUPPLIES
2,708.
TRAVEL
7,483.
BANK FEES/MISCELLANEOUS
33.
CONFERENCE FEES
1,225.
BOARD EXPENSES
1,376.
FILING FEES
1,360.
ND CONSENSUS COUNCIL
2,500.
PAYROLL TAXES
6,926.
TOTAL TO FORM 990-EZ,
LINE 16
FORM 990-EZ,
LINE 24,
PART II,
23,611.
OTHER ASSETS:
DESCRIPTION
BEG.
OTHER DEPRECIABLE ASSETS
FORM 990-EZ,
PART II,
LINE 26,
BEG.
ACCRUED LIABILITIES
PART III,
END OF YEAR
0.
1,626.
OF YEAR
END OF YEAR
0.
2,755.
OTHER LIABILITIES:
DESCRIPTION
FORM 990-EZ,
OF YEAR
PRIMARY EXEMPT PURPOSE - TO GUIDE THE ONGOING
DEVELOPMENT OF A WELL-PREPARED AND DIVERSE NURSING WORKFORCE TO MEET
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990- EL
132211
01-23-12
Schedule 0 (Form 990 or 990- EZ) (2011)
(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.
^ Attach to Form 990 or 990- EZ
Department of the Treasury
Internal Revenue Service
Name of the organization
2011
Open to Public
Inspection
Employer identification number
45-2605788
NORTH DAKOTA CENTER FOR NURSING
THE NEEDS OF THE CITIZENS OF NORTH DAKOTA THROUGH RESEARCH,
RECRUITMENT AND RETENTION ,
FORM 990-EZ,
OMB No 1545-0047
Supplemental Information to Form 990 or 990-EZ
SCHEDULE 0
PART III,
EDUCATION,
ADVOCACY AND PUBLIC POLICY.
LINE 28,
PROGRAM SERVICE ACCOMPLISHMENTS:
TO GUIDE THE ONGOING DEVELOPMENT OF A WELL-PREPARED AND
DIVERSE NURSING WORKFORCE TO MEET THE NEEDS OF THE
CITIZENS OF NORTH DAKOTA THROUGH RESEARCH,
RECRUITMENT AND RETENTION,
FORM 990-EZ,
PART V,
DURING THE YEAR,
RECEIVE ANY FUNDS,
DID NOT,
DURING THE YEAR,
PAY ANY PREMIUMS,
DIRECTLY,
ON A PERSONAL BENEFIT CONTRACT.
LHA For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ
132211
01-23-12
DIRECTLY,
TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.
THE ORGANIZATION,
OR INDIRECTLY,
ADVOCACY AND PUBLIC POLICY.
INFORMATION REGARDING PERSONAL BENEFIT CONTRACTS:
THE ORGANIZATION DID NOT,
OR INDIRECTLY,
EDUCATION,
Schedule 0 (Form 990 or 990-EZ) (2011)