2024-09-13T15:47:09-05:00 2023-10-31 450250958 EIDE BAILLY LLP 401 N 31ST ST STE 1120 BILLINGS MT 591011281 990PF 2022-11-01 596138602 SAMPLE FOUNDATION INC SAMP 4062450550 PO BOX 279 BILLINGS MT 59103 BARBARA M SAMPLE EXECUTIVE DIRECTOR/PRESIDENT 4062450550 2024-09-10 1 1 RONALD J YATES JR CPA P00543293 4068962400 2024-09-10 2022 2024-08-08 14:25:15Z X 9832982 X 2334168 116924 116924 141605 141605 786738 5981043 786738 12003 11731 3391438 1056998 0 0 0 16150 8075 8075 5972 5972 0 1547 1547 0 3803 0 776 232 0 28248 15826 8075 2089508 2089508 2117756 15826 2097583 1273682 1041172 44216 24062 24062 190 190 190 2471638 3083794 6228579 0 3302932 3135406 3025255 400056 437488 44060 36803 3500 7257 7257 5544609 6818291 9832982 0 0 X 5544609 6818291 0 0 0 0 5544609 6818291 5544609 6818291 5544609 1273682 0 6818291 0 6818291 MELLON - PUBLICLY TRADED SECURITIES P 2022-10-07 2023-10-31 4726220 4766057 -39837 -39837 MELLON - PUBLICLY TRADED SECURITIES P 2019-08-16 2023-10-31 1244571 428248 816323 816323 CAPITAL GAINS DIVIDENDS P 10252 10252 10252 786738 14472 0 14472 0 14472 1228 0 20000 0 21228 X 26 6730 6730 0 0 0 0 0 0 0 0 0 0 0 1 1 MT 1 0 0 0 0 1 SAMPLEFOUNDATION.ORG BARBARA SAMPLE 4062450550 PO BOX 279 BILLINGS MT 59103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 BRIDGET SAMPLE JOYNER 1298 TAMMANY LN HAMILTON MT 59840 DIRECTOR 0.10 0 0 0 BARBARA SAMPLE 2517 IRVING PLACE BILLINGS MT 59102 EXEC. DIRECTOR/PRESIDENT 1.00 0 0 0 DAVID F SAMPLE 34174 CAMDEN LANE POLSON MT 59860 DIRECTOR 0.10 0 0 0 PATRICK G SAMPLE PO BOX 410 INDEX WA 98256 DIRECTOR 0.10 0 0 0 RONALD J YATES JR CPA PO BOX 7112 BILLINGS MT 591037112 TREASURER 0.10 0 0 0 JAMES SAMPLE 275 WEST 96TH STREET APT 8B NEW YORK NY 10025 DIRECTOR 0.10 0 0 0 JOHN SAMPLE 120 HITCHING POST RD BOZEMAN MT 59715 DIRECTOR 0.10 0 0 0 JOSEPH F SAMPLE 833 PARKVIEW WAY MISSOULA MT 59803 DIRECTOR 0.10 0 0 0 KATE SAMPLE 632 KNICKERBOCKER ST MADISON WI 53711 DIRECTOR 0.10 0 0 0 RYAN SAMPLE 1394 HARVARD ROAD NE ATLANTA GA 30306 DIRECTOR 0.10 0 0 0 NONE 0 NONE 0 0 6863979 3581253 0 10445232 0 0 10445232 156678 10288554 514428 514428 14472 14472 499956 0 499956 0 499956 2097583 0 2097583 499956 6652 0 0 2097583 6652 0 0 499956 1590975 0 0 1590975 0 0 0 0 0 0 0 1590975 1590975 BARBARA SAMPLE DAVID F SAMPLE PATRICK G SAMPLE BARBARA SAMPLE PO BOX 279 BILLINGS MT 591030279 4062565567 LETTER GIVING ORGANIZATIONAL BACKGROUND AND PURPOSES, SPECIFIC NEED & AMOUNT REQUESTED. ATTACH 501(C)(3) IRS DETERMINATION LETTER. AUGUST 1 GENERALLY LIMITED TO ORGANIZATIONS IN THE STATE OF MONTANA & COLLIER COUNTY FLORIDA (HISTORICALLY). NO GRANTS WILL BE PROVIDED TO RELIGIOUS OR POLITICAL ORGANIZATIONS OR TAX SUPPORTED INSTITUTIONS. ACLU 125 BROAD STREET NEW YORK NY 10004 PC DESIGNATED 3000 ADULT RESOURCES ALLIANCE 1505 AVE D BILLINGS MT 59102 PC BLIZZARD BOXES 5250 ALBERTA BAIR THEATER 2801 3RS AVE N BILLINGS MT 59101 PC FIREPROOF CURTAINS 3000 ALBERTA BAIR THEATER 2801 3RS AVE N BILLINGS MT 59101 PC DESIGNATED 1000 AMERICAN JOBS FOR AMERICAN YOUTH PO BOX 923 HELENA MT 59624 PC WEBSITE RENOVATION 5000 AMNESTY INTERNATIONAL 311 WEST 43RD ST 7TH FLOOR NEW YORK NY 10036 PC DESIGNATED 3000 BEAUTY OF BRONZE 201 S CHELAN AVE WENATCHEE WA 98801 PC DESIGNATED 3000 BEFRIENDERS 807 NORTH TRACY BOZEMAN MT 59715 PC OFFICE FURNITURE/LAPTOPS 3355 BIG FORK FOOD BANK 7535 MONTANA HWY 35 BIGFORK MT 59911 PC REFRIGERATED FOOD DELIVERY VAN 10000 BILLINGS PUBLIC LIBRARY FOUNDATION 510 N BROADWAY 2 BILLINGS MT 59101 PC DESIGNATED 4000 BILLLINGS PUBLIC SCHOOLS 101 10TH STREET WEST BILLINGS MT 59102 GOV DESIGNATED 3250 BILLINGS SYMPHONY SOCIETY 2820 2ND AVE N BILLINGS MT 59101 PC EQUIPMENT TO ENHANCE SERVICES 3500 BILLINGS PUBLIC SCHOOLSORCHARD SCHOOL 101 10TH STREET WEST BILLINGS MT 59102 GOV ORCHARD ELEMENTARY SCHOOL PLAYGROUND AND MAINTENANCE PROJECT 2023 15000 BLUE MOUNTAIN CLINIC 610 N CALIFORNIA ST MISSOULA MT 59801 PC NEW ROOF 19500 BOYCE L ANSLEY SCHOOL 120 RALPH MCGILL BLVD NE BLDG 3 SUITE B1 ATLANTA GA 30308 PC DESIGNATED 1000 BOYS & GIRLS CLUB OF RICHLAND COUNTY 201 3RD AVE SE SIDNEY MT 59270 PC OUTDOOR ACTIVITIES SPACE 15000 BOYS & GIRLS OF RONAN PO BOX 334 RONAN MT 59864 PC DESIGNATED 2000 BRIDGER CARE 1288 N 14TH AVE 201 BOZEMAN MT 59715 PC MEDICAL TABLE, ANALYSIS MACHINE AND ULTRASOUND MACHINE 9391 BULLETIN OF THE ATOMIC SCIENTISTS 77 W WASHINGTON ST CHICAGO IL 60602 PC DESIGNATED 2000 BUTTE CARES 305 W MERCURY BUTTE MT 59701 PC EQUIPMENT FOR SUBSTANCE ABUSE 4120 BUTTERFLY HOUSE PO BOX 8885 MISSOULA MT 59807 PC DESIGNATED 1000 CASA OF LAKE CTY 410 1ST STREET E POLSON MT 59860 PC DESIGNATED 3000 CHILD BRIDGE PO BOX 310 BIG FORK MT 59911 PC PHOTO VIDEO EQUIPMENT 4610 CHILDCARE CONNECTIONS 2415 W 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STREET MISSOULA MT 59802 PC DESIGNATED 3000 FAMILY OUTREACH 1236 HELENA AVE HELENA MT 59601 PC MANNEQUINS; CPR TRAINING MATERIALS 2000 FAMILY PROMISE OF GALLATIN VALLEY 1603 TSCHACHE LANE BOZEMAN MT 59718 PC MATTRESSES 10000 FAMILY PROMISE OF GREAT FALLS 102 12TH ST NORTH GREAT FALLS MT 59403 PC COMUTER, MONITOR AND PILLOWS 3800 FAMILY PROMISE OF YELLOWSTONE 40 10TH STREET QWAR BILLINGS MT 59102 PC PLAY EQUIPMENT 25000 FARM TO SCHOOL OF PARK CO 215 E LEWIS ST STE 206 LIVINGSTON MT 59047 PC INVESTING IN INSULATION FOR FARM TO SCHOOLS FOOD DELIVERY FLEET 11500 FINLEYPOINT VOLUNTEER FIRE DEPT 35408 MT HIGHWAY 35 POLSON MT 59860 GOV DESIGNATED 1000 FLORENCE CRITTENTON HOME & SERVICES 901 N HARRIS ST HELENA MT 59601 PC FURNISHINGS 10000 FRIENDS OF THE CHILDREN 735 MICHIGAN AVE MISSOULA MT 59802 PC FURNISHINGS 7500 FRIENDS OF THE CHILDREN OF EASTERN MT 2613 VIRGINIA LANE BILLINGS MT 59102 PC PROMOTING POSITIVE CHILDHOOD DEVELOPMENT THROUGH RELATIONSHIP BASED PROGRAMMING 7000 FRIENDSHIP 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4000 MONTANA LEGAL SERVICES 616 HELENA AVE STE 100 HELENA MT 59601 PC PLEXIGLASS GUARDS, CUBICLE WALLS AND DIVDERS 9897 MONTANA PUBLIC BROADCASTING MONTANA STATE UNIVERSITY BOZEMAN MT 59715 PC DESIGNATED 3000 MONTANA WILDERNESS SCHOOL 26 SHAWNEE WAY BOZEMAN MT 59715 PC TRUCK TOPPER FOR PICKUP FOR RESUPPLIES AND OVERNIGHTS AND A THIRD CANOE TRAILER 10000 MT NON PROFIT ASSN 7 WEST 6TH AVENUE STE 504 HELENA MT 59624 PC VEHICLE FOR MEETING AGENCIES ACROSS THE STATE 5000 MUSIC FOR NEWMAN SCHOOL 605 SOUTH BILLINGS BLVE BILLINGS MT 59101 PC DESIGNATED 5500 NORTHERN CHEYENNE FOOD PANTRY PO BOX 159 LAME DEER MT 59043 PC USED PICK UP TRUCK FOR DELIVERY 10000 OUTDOORS FOR ALL FDN 6344 NE 74TH ST 102 SEATTLE WA 98115 PC DESIGNATED 3000 PARTNERSHIP IN HOPE FOUNDATION 700 SOUTH AVE WEST STE C MISSOULA MT 59801 PC VIDEOS 15000 POVERELLO CENTER PO BOX 7644 MISSOULA MT 59802 PC FOOD SERVICE EQUIPMENT 10016 REACH INC 322 GALLATIN PARK DRIVE BOZEMAN MT 59715 PC REPAIRS TO NORTH TRACY APARTMENT 6244 RONALD MCDONALD HOUSE OF CHARITIES 3003 FORT MISSOULA RD MISSOULA MT 59804 PC DESIGNATED 3000 SAFE HARBOR PO BOX 497 RONAN MT 59864 PC KITCHEN RENOVATION 2500 SAFE SPACE INC PO BOX 594 THOMPSON FALLS MT 59873 PC COMPUTER UPGRADE 3500 SIMULATION IN MOTION 2021 11TH AVE STE 1 HELENA MT 59601 PC HIGH FIDELITY MANNEQUINS 1000 SKY VALLEY ARTS COUNCIL PO BOX 18 SULTAN WA 98294 PC DESIGNATED 5000 SMALL WONDER CHILDCARE 512 BROADWAY LEWISTOWN MT 59457 PC SECURE ENTRANCE 11603 ST JOSEPH HOSPITAL PROVIDENCE 6 THIRTEENTH AVE EAST POLSON MT 59860 PC DESIGNATED 3500 ST VINCENT DEPAUL 3005 FIRST AVE SOUTH BILLINGS MT 59101 PC ROOFTOP HVAC SYSTEM 14899 THOREAU ELEMENTARY PTO 3870 NAKOMA RD MADISON WI 53711 PC DESIGNATED 1000 THRIVE 407 FERGUSON AVE BOZEMAN MT 59718 PC DEFILBRILLATOR 1755 UNITED WAY OF MISSOULA 412 W ALDER MISSOULA MT 59802 PC REFURBISH FACILITY 8045 UNIVERSITY OF MONTANA EXCELLENCE FUND 950 ARTHUR AVE MISSOULA MT 59807 GOV DESIGNATED 1500 WATSON CHILDREN'S CENTER 4978 BUCKHOUSE LANE 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16150 8075 8075 SOFTWARE 2013-06-20 8500 8500 SL 3.000000000000 0 0 SOFTWARE 2015-05-12 7000 7000 SL 3.000000000000 0 0 SOFTWARE 2017-05-20 7000 7000 SL 3.000000000000 0 0 SOFTWARE 2019-07-02 7000 7000 SL 3.000000000000 0 0 SOFTWARE 2021-05-11 7000 3500 SL 3.000000000000 2333 0 SOFTWARE 2023-04-13 7560 SL 3.000000000000 1470 0 AMERICAN EXPRESS CO 296898 274128 APPLE INC FXD RT 242993 239243 BOEING CO SR NT 249777 242210 CVS HEALTH CORP COM 249355 239455 HUBBELL INC FXD RD 242483 236833 KRAFT HEINZ FOODS CO 283590 265551 LOWES COS INC NT 247500 228812 MCCORMICK & CO INC 247273 225810 NORTHROP GRUMMAN CORP SR NT 249745 228215 PHILLIPS 66 CO SR NT 252500 233505 THERMO FISHER SCIENTIFIC INC 249333 247507 VERIZON COMMUNICATIONS INC. FXD RT 241573 232890 MCDONALDS CORP MEDIUM TERM NTS 249912 241247 ABBOT LABS 35390 236375 BRISTOL MYERS SQUIBB 35931 206120 EMERSON ELECTRIC 12797 400365 JOHNSON & JOHNSON 38851 222510 CANADIAN NATIONAL RAILWAY 22025 423120 PFIZER INC COM 104972 91680 CONOCOPHILLIPS 90469 415800 HONEYWELL INTERNATIONAL INC. 73887 238238 PROCTOR & GAMBLE COMPANY 126593 300060 CHEVRON CORPORATION 153457 218595 PHILLIPS 66 24387 171105 VERIZON COMMUNICATIONS INC. 168020 112416 WEYERHAEUSER COMPANY 121800 183616 ALPHABET INC. 177094 372240 CVS HEALTH CORP COM 180576 207030 INVESCO EXCHANGE TRADED FD TR S&P 500 259845 399900 JP MORGAN CHASE & CO 161297 208590 QUANTA SVCS INC 106407 534784 QUALCOMM, INC 149592 217980 ZOETIS INC COM 164138 157000 VISA INC COM CL A 220466 235100 BLACKSTONE INC COM 170169 184700 T-MOBILE US INC COM 224950 230176 SALESFORCE INC COM 260681 261079 BNY MELLON/U.S. TREASURY OBLIGATIONS AT COST 272991 281248 ENTERPRISE PRODUCTS PARTNERS LP AT COST 127065 156240 SOFTWARE 8500 8500 0 SOFTWARE 7000 7000 0 SOFTWARE 7000 7000 0 SOFTWARE 7000 7000 0 SOFTWARE 7000 5833 1167 SOFTWARE 7560 1470 6090 MISCELLANEOUS ADMINISTRATION 776 232 0 ENTERPRISE PRODS PARTNERS 11730 11730 11730 OTHER INCOME 1 1 1 NONDIVIDEND DISTRIBUTIONS 272 272 INVESTMENT/BANK FEES 5972 5972 0 TAXES 1547 1547 0