^. Short Form OMB. 1545-1150 Form 990-EZ Return of Organization Exempt From Inome Tax 2@16 Under setion 501 (), 527, or 4947(a)(1) of the Internal Revenue Code (exept private foundations) 1v2 ^SZ Uv Do not enter soial seurity numers on this form as it may e made puli. Department of the Treasury Internal Revenue Servie Information aout Form 990-EZ and its instrutions is at www.irs.gov/forrn990. A For the 2016 alendar year, or tax year eginning, 2016, and ending, 20 B Chek if appliale: C Name of organization D Employer identifiation numer q Address hange Road Map Solutions In 45-3954108 q Name hange Numer and street (or P.O. ox, if mail is not delivered to street address) Room/sude E Telephone numer initial r 3051 W 144th Terr 785 272 5850 q Final retum/tertnmated City or town, state or provine, ountry, and ZIP or foreign postal ode El Amended return F Group Exemption q Appliation pending Leawood KS 66224 Numer G Aounting Method: q Cash q Arual Other (speify) H Chek q if the organization is not I Wesite: required to attah Shedule B J Tax-exempt status (hek only one) - q 501 ()(3) 501( 4 ) I (insert no.) q 4947(a ) (1) or 0527 (Form 990, 990-EZ, or 990-PF). K Form of organization 21 Corporation q Trust q Assoiation q Other L Add lines 5, 6, and 7 to line 9 to determine gross reeipts. If gross reeipts are $200,000 or more, or if total assets (Part 11, olumn (B) elow) are $500,000 or more, file Form 990 instead of Form 990-EZ.... $ Revenue, Expenses, and Changes in Net Assets or Fund Balanes (see the instrutions for Part I) Chek if the organization used Shedule 0 to respond to any Question in this Part I. (1 1 Contriutions, gifts, grants, and similar amounts reeived.. 1 115,500 2 Program servie revenue inluding government fees and ontrats......... 2 3 Memership dues and assessments.................... 3 4 Investment inome.................... 4 5a Gross amount from sale of assets other than inventory.... 5a Less: ost or other asis and sales expenses........ 5 Gain or (loss) from sale of assets other than inventory (Sutrat line 5 from line 5a).... 5 6 Gaming and fundraising events a Gross inome from gaming (attah Shedule G if greater than $15,000 ).................... 6a, Gross inome from fundraising events (not inluding $ of ontriutions from fundraising events reported on line 1) (attah Shedule G if the sum of suh gross inome and ontriutions exeeds $15,000).. 6 Less: diret expenses from gaming and fundraising events... 6 d Net inome or (loss) from gaming and fundraising events (add lines 6a and 6 and sutrat line 6)............................. 6d 7a Gross sales of inventory, less returns and allowanes..... 7a Less: ost of goods sold.............. 7 Gross profit or (loss) from sales of inventory (Sutrat line 7 from line 7a)....... 7 8 Other revenue (desrie in Shedule 0)...... 8 280 9 Total revenue. Add lines 1, 2, 3, 4, 5, 6d, 7, and 8 9 115,780 10 Grants and similar amounts paid (list in Shedule 0) 10 D 11 Benefits paid to or for memers........ ^P 11 1 2 Salaries, ot her, an d emp loyee ene fits. APR. 4 Z017... 12 60,186 II i 13 P i l f h t i d d,6 G rofess ona ees and ot er paymen s to n epen ent ontr t is -.^.T.^! 13 21,700 CIL 14 Oupany, rent, utilities, and maintenane. (. 0,!" UT 14 34,000 w 15 Printing, puliations, postage, and shipping.... 15 16 Other expenses (desrie in Shedule 0).................. 16 535 17 Total expenses. Add lines 10 through 16................ 10-17 116,421 18 Exess or (defiit) for the year (Sutrat line 17 from line 9)............ 18-641 19 Net assets or fund alanes at eginning of year (from line 27, olumn (A)) (must agree with end-of-year figure reported on prior year's return )............... 19 1,156 ' 20 Other hanges in net assets or fund alanes (explain in Shedule 0)......... 20 21 Net assets or fund alanes at end of year. Comine lines 18 throu g h 20. 21 515 For Paperwork Redution At tie, see the separate instrutions. Cat.. 106421 Form 99U- LZ (2016) 5
Form 990-EZ (2016) Page 2 Balane Sheets (see the instrutions for Part II) Chek if the organization used Shedule 0 to respond to any question in this Part II.. q (A) Beginning of year (B ) End of year 22 Cash, savings, and investments................. 1, 156 22 515 23 Land and uildings...................... 23 24 Other assets (desrie in Shedule 0 )............... 24 25 Total assets........................ 1,156 25 515 26 Total liailities (desrie in Shedule 0 )............. 26 27 Net assets or fund alanes (line 27 of olumn (B) must agree with line 21 ) 1,156 27 515 Statement of Program Servie Aomplishments (see the instrutions for Part 111) Chek if the organization used Shedule 0 to respond to any question in this Part III. q Expenses What is the organization's primary exempt purpose? Advane poliy goals for Road Map for Kansas (Required for setion 501()(3) and 501()(4) Desrie the organization's program servie aomplishments for eah of its three largest program servies, organaations, optional for as measured y expenses. In a lear and onise manner, desrie the servies provided, the numer of othe ) persons enefited, and other relevant information for eah program title. 28 PliYDevelopment -Paid staff to analyze PoliY options onerning thepoliy goals set forth in The Road Map for -Kansas. ----------------------------------------------------- (Grants $ 0) If this amount inludes forei g n grants, hek here. q 28a 30,000 29 poliyadyoax_paid_staff to ommuniate with the legislature and exeutive ranh leaders on issues and ---- - -------------------------------- ------------------------------------------------------------ poliy_goals set forth - in - The -Road- Map for-kansas ------------------------------------------------ (Grants $ o) If this amount inludes forei gn g rants, hek here. q 29a 25,000 30 Voter Researh _Conduterdpolling to asertain voter 's opinions and understanding of theissues and - - - - - - - - - - - - - - - - -------------------- --------- possile polix options set forth in The Road Map for Kansas ---------------------------------------------------------------- (Grants $ o) If this amount inludes foreign grants, hek here. q 30a 16,700 31 Other program servies (desrie in Shedule 0).................. Grants $ If this amount inludes forei g n rants, hek here. q 31a 32 Total program servie expenses (add lines 28a through 31 a) 32 71, 700 FEMMM List of Offiers. Diretors. Trustees, and Kev Emolovees (list eah one even if not ompensated-see the instrutions for Part IVI Chek if the organization used Shedule O to respond to an question in this Part IV. q (a) Name and title () Average hours per week devoted to position () Reportale (d) Health enefits, ontnutions to employee (e) Estimated amount of (Forms W-2/1099-MISC) (d not paid, enter -0-) enefit plans, and deferred other Clyde Kensinger ----------------------------------------------------- Diretor, Offier 1 0 0 0 Tre-lla- Anderson -------- Diretor, Offier 1 0 0 0 T.C. Anderson Diretor, Offier 3 0 0 0 David Kensinger President 20 90,000 0 0 Form 990-EZ (2016)
Form 990- EZ (2016) Page 3 JIM Other Information (te the Shedule A and personal enefit ontrat statement requirements in the instrutions for Part V) Chek if the organization used Shedule 0 to respond to any question in this Part V.. q 33 34 36 37a 38a 39 a 40a d e 41 42a 43 44a d 45a Did the organization engage in any signifiant ativity not previously reported to the IRS? If "," provide a detailed desription of eah ativity in Shedule 0................... 33 Were any signifiant hanges made to the organizing or governing douments? If "," attah a onformed opy of the amended douments if they reflet a hange to the organization's name. Otherwise, explain the hange on Shedule 0 (see instrutions)...................... 34 Did the organization have unrelated usiness gross inome of $1,000 or more during the year from usiness ativities (suh as those reported on lines 2, 6a, and 7a, among others)?............ 3 If "," to line 35a, has the organization filed a Form 990-T for the year? If "," provide an explanation in Shedule 0 35 3 Was the organization a setion 501 ()(4), 501 ()(5), or 501 ()(6) organization sujet to setion 6033(e) notie, reporting, and proxy tax requirements during the year? If "," omplete Shedule C, Part III..... 35 3 Did the organization undergo a liquidation, dissolution, termination, or signifiant disposition of net assets during the year? If "," omplete appliale parts of Shedule N............. 36 Enter amount of politial expenditures, diret or indiret, as desried in the instrutions 37a 0 Did the organization file Form 1120-POL for this year?.................. 37 3 Did the organization orrow from, or make any loans to, any offier, diretor, trustee, or key employee or were any suh loans made in a prior year and still outstanding at the end of the tax year overed y this return?. 38a 3 If "," omplete Shedule L, Part Il and enter the total amount involved.... 38 Setion 501 ()(7) organizations. Enter: Initiation fees and apital ontriutions inluded on line 9.......... 39a Gross reeipts, inluded on line 9, for puli use of lu failities....... 39 Setion 501()(3) organizations. Enter amount of tax imposed on the organization during the year under: setion 4911 ; setion 4912 ; setion 4955 Setion 501()(3), 501()(4), and 501()(29) organizations. Did the organization engage in any setion 4958 exess enefit transation during the year, or did it engage in an exess enefit transation in a prior year that has not een reported on any of its prior Forms 990 or 990-EZ? If "," omplete Shedule L, Part I 40 3 Setion 501()(3), 501()(4), and 501()(29) organizations. Enter amount of tax imposed on organization managers or disqualified persons during the year under setions 4912, 4955, and 4958....................... 0 Setion 501()(3), 501()(4), and 501()(29) organizations. Enter amount of tax on line 40 reimursed y the organization................ 0 All organizations. At any time during the tax year, was the organization a party to a prohiited tax shelter transation? If "," omplete Form 8886-T................... 40e 3 List the states with whih a opy of this return is filed Kansas The organization's ooks are in are of T_C._Anderson Telephone no. 785 272 5850 - - - - - ------ ---------------------- - - Loated at 2334 SW Mayfair Plae, Topeka, AS ZIP + 4 66611-2054 ---------------- ---------------- At any time during the alendar year, did the organization have an interest in or a signature or other authority over a finanial aount in a foreign ountry (suh as a ank aount, seurities aount, or other finanial aount)? 42 3 If "," enter the name of the foreign ountry: See the instrutions for exeptions and filing requirements for FinCEN Form 114, Report of Foreign Bank and Finanial Aounts (FBAR). At any time during the alendar year, did the organization maintain an offie outside the United States? 42 3 If "," enter the name of the foreign ountry: Setion 4947(a)(1) nonexempt haritale trusts filing Form 990-EZ in lieu of Form 1041-Chek here... q and enter the amount of tax-exempt interest reeived or arued during the tax year..... 43 Did the organization maintain any donor advised funds during the year? If "," Form 990 must e ompleted instead of Form 990-EZ........................ Did the organization operate one or more hospital failities during the year? If "," Form 990 must e ompleted instead of Form 990-EZ........................ Did the organization reeive any payments for indoor tanning servies during the year?....... If "" to line 44, has the organization filed a Form 720 to report these payments? If ",' provide an explanation in Shedule 0........................... Did the organization have a ontrolled entity within the meaning of setion 512()(13)?....... Did the organization reeive any payment from or engage in any transation with a ontrolled entity within the meaning of setion 512()(13)? If "," Form 990 and Shedule R may need to e ompleted instead of Form 990-EZ (see instrutions).......................... 145 i I 3 Form 990-EZ (2016) 44a 3 44 3 44 3 44d 3
Form 990 -EZ (2016) Page 4 46 Did the organization engage, diretly or indiretly, in politial ampaign ativities on ehalf of or in opposition to andidates for puli offie? If "," omplete Shedule C, Part I........... 1 46 Vf Setion 501()(3) organizations only All setion 501()(3) organizations must answer questions 47-49 and 52, and omplete the tales for lines 50 and 51. Chek if the organization used Shedule 0 to respond to any question in this Part VI. q 47 Did the organization engage in loying ativities or have a setion 501(h) eletion in effet during the tax year? If "," omplete Shedule C, Part 11..................... 47 48 Is the organization a shool as desried in setion 170()(1)(A)(li)? If "," omplete Shedule E.... 48 49a Did the organization make any transfers to an exempt non -haritale related organization?...... 49a If "," was the related organization a setion 527 organization?.............. 49 50 Complete this tale for the organization's five highest ompensated employees (other than offiers, diretors, trustees, and key employees ) who eah reeived more than $100,000 of from the organization. If there is none, enter "ne." (a) Name and title of eah employee () Average hours per week devoted to position () Reportale (Forms W-2/1099-MISC) (d) Health enefits, ontriutions to employee enefit plans, and deferred (e) Estimated amount of other f Total numer of other employees paid over $100,000.... 51 Complete this tale for the organization's five highest ompensated independent ontrators who eah reeived more than $100,000 of from the organization. If there is none, enter "ne." (a) Name and usiness address of eah independent ontrator () Type of servie () Compensation d Total numer of other independent ontrators eah reeivi 52 Did the organization omplete Shedule A? te: All ompleted Shedule A............ Under penalties of perjury, I delare that I have examined this return, inluding aom true, orret, and omplete. Delaration of preparer (other than offier) is ased on all Sign T-1 k I - I" 4A 2A4 Signature of offier Here ' T.C. Anderson, Treasurer Type or print name and title Paid Preparer Use Only Print/Type preparer ' s name Preparer ' s signature Firm's name Firm's address May the IRS disuss this return with the preparer shown aove? Si
SCHEDULE O Supplemental Information to Form 990 or 990-EZ OMB. 1545-0047 (Form 990 or 990-EZ) Complete to provide information for responses to speifi questions on O Form 990 or 990-EZ or to provide any additional information. 2 16 Department of the Treasury Attah to Form 990 or 990-EZ. - Internal Revenue Servie Information aout Shedule 0 (Form 990 or 990-EZ) and its instrutions is at www.irs.gov/form990. - Name of the organaation Employer identifiation numer Road Map Solutions In. 45 3954108 Line 16. Other Expenses:_Unemploy_ment Tax $336.00_ Annual Report Fee $60.00_ Bank Fee $10.00_ and Travel $128.76. Line -8: Other-Inome-Legal Fee_Refund-5280.00---------------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------- ---------------------- --------------------------------------- --------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --------------------------------------- --------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- --------------------------------------- For Paperwork Redution At tie, see the Instrutions for Form 990 or 990-E2. Cat. 51056K Shedule 0 (Form 990 or 990-El) (2016)