BOYS & GIRLS CLUB OF SALEM MARION & POLK COUNTIES INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: BOYS & GIRLS CLUB OF SALEM MARION & POLK COUNTIES INC (EIN 93-0581470)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-09-26
IRS object ID: 202212699349301406
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-09-26T18:20:44-05:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	930623286	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ALDRICH CPAS AND ADVISORS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	680 HAWTHORNE AVE SE 140	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	930581470	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BOYS & GIRLS CLUB OF SALEM MARION	BusinessNameLine1Txt
Business Name Line2	& POLK COUNTIES	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	BOYS	BusinessNameControlTxt
Phone	5035817383	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1395 SUMMER ST NE	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	SUSAN BLOOM	PersonNm
Person Title	CHIEF EXECUTIVE OFFICER	PersonTitleTxt
Phone	5035817383	PhoneNum
Signature	2022-08-23	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	SUSAN	PersonFirstNm
Person Last	BLOOM	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	DEBRA D SMITH CPA	PreparerPersonNm
PTIN	P00646873	PTIN
Phone	5035857774	PhoneNum
Preparation	2022-08-23	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	SUSAN BLOOM	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1395 SUMMER ST NE	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$7,208,791	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BGC-SALEM.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1967	FormationYr
Legal Domicile State	OR	LegalDomicileStateCd
Activity Or Mission	TO INSPIRE AND ENABLE YOUTH IN GRADES 1-12 WITH A COMPREHENSIVE, ACTIVE LEARNING APPROACH.	ActivityOrMissionDesc
Voting Members Governing Body	36	VotingMembersGoverningBodyCnt
Voting Members Independent	36	VotingMembersIndependentCnt
Total Employee	116	TotalEmployeeCnt
Total Volunteers	269	TotalVolunteersCnt
Total Gross UBI	-$16,101	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$16,912,984	PYContributionsGrantsAmt
CY Contributions Grants	$4,964,069	CYContributionsGrantsAmt
PY Program Service Revenue	$132,062	PYProgramServiceRevenueAmt
CY Program Service Revenue	$200,298	CYProgramServiceRevenueAmt
PY Investment Income	-$13,060	PYInvestmentIncomeAmt
CY Investment Income	$10,840	CYInvestmentIncomeAmt
PY Other Revenue	$48,208	PYOtherRevenueAmt
CY Other Revenue	$378,109	CYOtherRevenueAmt
PY Total Revenue	$17,080,194	PYTotalRevenueAmt
CY Total Revenue	$5,553,316	CYTotalRevenueAmt
PY Grants And Similar Paid	$3,661,052	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,788,342	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,273,435	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$526,982	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,546,144	PYOtherExpensesAmt
CY Other Expenses	$1,268,778	CYOtherExpensesAmt
PY Total Expenses	$6,995,538	PYTotalExpensesAmt
CY Total Expenses	$3,542,213	CYTotalExpensesAmt
PY Revenues Less Expenses	$10,084,656	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,011,103	CYRevenuesLessExpensesAmt
Total Assets BOY	$14,317,503	TotalAssetsBOYAmt
Total Assets EOY	$16,301,542	TotalAssetsEOYAmt
Total Liabilities BOY	$665,040	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$597,204	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$13,652,463	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$15,704,338	NetAssetsOrFundBalancesEOYAmt
Mission	TO INSPIRE AND ENABLE ALL YOUTH GRADES 1-12, ESPECIALLY THOSE WHO NEED US MOST, TO REALIZE THEIR FULL POTENTIAL AS PRODUCTIVE, RESPONSIBLE AND CARING CITIZENS THROUGH THE DEVELOPMENT OF A POSITIVE SELF-IMAGE AND SELF-RELIANCE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$2,099,107	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$200,298	RevenueAmt
Desc	THE BOYS & GIRLS CLUB NURTURES YOUNG PEOPLE'S SELF-ESTEEM BY INSTILLING IN THEM A SENSE OF BELONGING, USEFULNESS, INFLUENCE AND COMPETENCE. THE CLUB SERVES OVER 307 YOUTH WITH A FOCUS ON A 360 DEGREE APPROACH, MEETING ESSENTIAL NEEDS AND IMPACTING YOUTH THROUGH THREE CORE AREAS: ACADEMIC SUCCESS; CHARACTER AND CITIZENSHIP; AND HEALTHY LIFESTYLES. THE IMPACT OF THE BOYS & GIRLS CLUB CAN BE SEEN IN THE DIVERSE PROGRAMS OFFERED: 1,115 DENTAL PROCEDURES WERE PERFORMED ON YOUTH; OVER 100,000 HEALTHY, LOCALLY SOURCED MEALS WERE SERVED; AND 137 YOUTH PARTICIPATED IN POWER HOUR, RECEIVING HOMEWORK HELP AND TUTORING.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$337,973	ExpenseAmt
Desc	T3: TRAINING TEENS FOR TOMORROW IS A TARGETED TEEN EDUCATION, PREVENTION AND EMPLOYMENT PROGRAM THROUGH THE BOYS & GIRLS CLUB THAT PREPARES HARD-TO-REACH YOUTH WITH 21ST CENTURY SKILL SET THAT SUPPORTS AND ALIGNS ACADEMICS WITH FUTURE CAREER PATHWAYS AND INDUSTRY TRENDS. OVER 130 YOUTHS RECEIVED JOB TRAINING, MENTORING AND EMPLOYMENT OPPORTUNITIES.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$2,437,080	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	Yes (1)	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	117	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	116	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	36	GoverningBodyVotingMembersCnt
Independent Voting Member	36	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BOYS & GIRLS CLUB OF SALEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5035817383	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1395 SUMMER ST NE	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
ERICE TEMPLETON
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
LUKE REESE
VICE-PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
PETE DEMINIZ
VICE-PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
ELLIOT GROENEVELD
TREASURER/SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
LETTIE PRICE
VICE-PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
DON STURGEON
VICE-PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
CHELSEA ARMSTRONG
VICE-PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRUCE ANDERSON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
LAURIE BARR
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
GEORGE BURKE
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
CLIFF CARPENTER
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ALEX CASEBEER
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
MIKE DELK
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0	1.00
JIM EYRE MD DMD
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
KATHY FIGLEY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
LUIS GARCIA
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
JIM GRIGGS
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0	1.00
JUSTIN MARTIN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ANDRES GUTIERREZ
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DAVE HILGEMANN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DAN JOHNSON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
KEN JUNDT
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
HEIDI LITCHFIELD
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
MATT LOKAN
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DON LULAY
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
RIC MCNALL
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
SHEA MORRISON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
NICOLE PALMATEER HAZELBAKER
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
EVANN REMINGTON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ELISA SCHOFIELD
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
TAD TRUAX
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
DEWEY WHITTON
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
ERIN WYLAM
BOARD MEMBER	1.00	Yes (X)		$0	$0	$0
SUSAN BLOOM
CEO	38.00		Yes (X)	$108,145	$0	$7,694	2.00
SHERI PATTERSON
COO/CFO	38.00		Yes (X)	$96,450	$0	$7,344	2.00

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$204,595	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$15,038	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Membership Dues	$5,448	MembershipDuesAmt
Fundraising	$180,049	FundraisingAmt
Government Grants	$941,433	GovernmentGrantsAmt
All Other Contributions	$3,837,139	AllOtherContributionsAmt
Noncash Contributions	$1,105,846	NoncashContributionsAmt
Total Contributions	$4,964,069	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EARLY RISER CAMP FEES	900099	$143,027	$143,027
PROGRAM FEES	900099	$55,600	$55,600
FIELD TRIPS & BUS FEES	900099	$1,671	$1,671

Field	Value	IRS element (for citing)
Total Program Service Revenue	$200,298	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,840	TotalRevenueColumnAmt
Exclusion	$10,840	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$112,011	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$112,011	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$112,011	TotalRevenueColumnAmt
Exclusion	$112,011	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$307,680	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$180,049	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$93,636	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$214,044	TotalRevenueColumnAmt
Exclusion	$214,044	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$1,519,122	GamingGrossIncomeAmt
Gaming Direct Expenses	$1,481,593	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$37,529	TotalRevenueColumnAmt
Unrelated Business Revenue	-$16,101	UnrelatedBusinessRevenueAmt
Exclusion	$53,630	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$50,894	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$80,246	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$29,352	TotalRevenueColumnAmt
Exclusion	-$29,352	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
INSURANCE REIMBURSEMENT	900099	$32,462	$32,462
OTHER/CREDIT CARD REWARDS	900099	$11,415	$11,415

Field	Value	IRS element (for citing)
Other Revenue Total	$43,877	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,553,316	TotalRevenueColumnAmt
Related Or Exempt Func Income	$200,298	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$16,101	UnrelatedBusinessRevenueAmt
Exclusion	$405,050	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$219,633	TotalAmt
Management And General	$219,633	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,762,746	TotalAmt
Program Services	$1,356,375	ProgramServicesAmt
Management And General	$85,292	ManagementAndGeneralAmt
Fundraising	$321,079	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$54,968	TotalAmt
Program Services	$37,610	ProgramServicesAmt
Management And General	$8,455	ManagementAndGeneralAmt
Fundraising	$8,903	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$85,778	TotalAmt
Program Services	$58,691	ProgramServicesAmt
Management And General	$13,194	ManagementAndGeneralAmt
Fundraising	$13,893	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$150,310	TotalAmt
Program Services	$102,845	ProgramServicesAmt
Management And General	$23,120	ManagementAndGeneralAmt
Fundraising	$24,345	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$47,250	TotalAmt
Management And General	$47,250	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$141,925	TotalAmt
Program Services	$36,522	ProgramServicesAmt
Management And General	$23,808	ManagementAndGeneralAmt
Fundraising	$81,595	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$38,179	TotalAmt
Program Services	$28,238	ProgramServicesAmt
Management And General	$7,760	ManagementAndGeneralAmt
Fundraising	$2,181	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$251,227	TotalAmt
Program Services	$232,028	ProgramServicesAmt
Management And General	$14,565	ManagementAndGeneralAmt
Fundraising	$4,634	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$16,974	TotalAmt
Program Services	$10,576	ProgramServicesAmt
Management And General	$3,942	ManagementAndGeneralAmt
Fundraising	$2,456	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$163,316	TotalAmt
Program Services	$161,244	ProgramServicesAmt
Management And General	$2,072	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$93,165	TotalAmt
Program Services	$52,593	ProgramServicesAmt
Management And General	$38,638	ManagementAndGeneralAmt
Fundraising	$1,934	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
CNP FOOD & SUPPLIES	$237,582	$237,582	$0	$0
SUPPLIES	$199,032	$98,861	$36,152	$64,019
MISCELLANEOUS EXPENSE	$33,366	$10,121	$23,245
DUES AND FEES	$32,851	$7,131	$25,720	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$13,911	TotalAmt
Program Services	$6,663	ProgramServicesAmt
Management And General	$5,305	ManagementAndGeneralAmt
Fundraising	$1,943	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,542,213	TotalAmt
Program Services	$2,437,080	ProgramServicesAmt
Management And General	$578,151	ManagementAndGeneralAmt
Fundraising	$526,982	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,689,741	BOYAmt
EOY	$7,095,685	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$899,326	BOYAmt
EOY	$899,385	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,657,401	BOYAmt
EOY	$2,854,556	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$157,260	BOYAmt
EOY	$16,283	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$11,620	BOYAmt
EOY	$11,872	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$39,397	BOYAmt
EOY	$65,250	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$6,593,352	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$3,794,627	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,822,758	BOYAmt
EOY	$2,798,725	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$40,000	BOYAmt
EOY	$2,559,786	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$14,317,503	BOYAmt
EOY	$16,301,542	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$161,680	BOYAmt
EOY	$552,096	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$17,060	BOYAmt
EOY	$45,108	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$486,300	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$665,040	BOYAmt
EOY	$597,204	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,032,667	BOYAmt
EOY	$6,832,412	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,619,796	BOYAmt
EOY	$8,871,926	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$13,652,463	BOYAmt
EOY	$15,704,338	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,317,503	BOYAmt
EOY	$16,301,542	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$2,011,103	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$40,772	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Public Organization170	Yes (X)	PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,206,236	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,432,784	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,978,257	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$16,912,984	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,964,069	CurrentTaxYearAmt
Total	$29,494,330	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,206,236	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,432,784	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,978,257	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$16,912,984	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,964,069	CurrentTaxYearAmt
Total	$29,494,330	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$239,351	SubstantialContributorsTotAmt
Public Support Total170	$29,254,979	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$108,157	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$126,558	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$147,939	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$136,509	CurrentTaxYearMinus1YearAmt
Current Tax Year	$122,851	CurrentTaxYearAmt
Total	$642,014	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$91,935	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$308,095	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$289,177	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$0	CurrentTaxYearMinus1YearAmt
Current Tax Year	$222,221	CurrentTaxYearAmt
Total	$911,428	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,663	CurrentTaxYearMinus4YearsAmt
Current Tax Year	$43,877	CurrentTaxYearAmt
Total	$47,540	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$31,095,312	TotalSupportAmt
Gross Receipts Rltd Activities	$961,956	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.94080	PublicSupportCY170Pct
Public Support PY170	0.93330	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,455,576	OtherCostOrOtherBasisAmt
Book Value	$1,455,576	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,078,931	OtherCostOrOtherBasisAmt
Depreciation	$2,918,417	DepreciationAmt
Book Value	$1,160,514	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$302,634	OtherCostOrOtherBasisAmt
Depreciation	$257,829	DepreciationAmt
Book Value	$44,805	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$573,798	OtherCostOrOtherBasisAmt
Depreciation	$441,601	DepreciationAmt
Book Value	$132,197	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$182,413	OtherCostOrOtherBasisAmt
Depreciation	$176,780	DepreciationAmt
Book Value	$5,633	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,798,725	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	CONSTRUCTION IN PROCESS	Desc
Book Value	$2,559,786	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$2,559,786	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$5,712,146	TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts	$158,830	DonatedServicesAndUseFcltsAmt
Revenue Not Reported	$158,830	RevenueNotReportedAmt
Revenue Subtotal	$5,553,316	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$5,553,316	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$3,660,271	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$158,830	DonatedServicesUseFcltsAmt
Other Expenses Included	-$40,772	OtherExpensesIncludedAmt
Expenses Not Reported	$118,058	ExpensesNotReportedAmt
Expenses Subtotal	$3,542,213	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$3,542,213	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART X, LINE 2:

THE CLUB FOLLOWS US GAAP RELATED TO THE RECOGNITION OF UNCERTAIN TAX POSITIONS. THESE STANDARDS PROVIDE DETAILED GUIDANCE FOR FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, AND DISCLOSURE OF UNCERTAIN TAX POSITIONS. IT REQUIRES AN ENTITY TO RECOGNIZE THE FINANCIAL STATEMENT IMPACT OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WOULD NOT BE SUSTAINED IF EXAMINED BY A TAXING AUTHORITY. MANAGEMENT HAS DETERMINED THAT THE CLUB HAS NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 AND 2020.

PART XII, LINE 2D - OTHER ADJUSTMENTS:

BAD DEBT EXPENSE -40,772.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	CIVIL WAR DINNER & AUCTION	Event1Nm
Gross Receipts Event1	$380,092	GrossReceiptsEvent1Amt
Charitable Contri Event1	$140,449	CharitableContriEvent1Amt
Gross Revenue Event1	$239,643	GrossRevenueEvent1Amt
Food And Beverage Event1	$6,450	FoodAndBeverageEvent1Amt
Entertainment Event1	$3,200	EntertainmentEvent1Amt
Other Direct Expenses Event1	$42,000	OtherDirectExpensesEvent1Amt
Event2	GOLF EVENT	Event2Nm
Gross Receipts Event2	$107,637	GrossReceiptsEvent2Amt
Charitable Contri Event2	$39,600	CharitableContriEvent2Amt
Gross Revenue Event2	$68,037	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$11,800	RentFacilityCostsEvent2Amt
Other Direct Expenses Event2	$30,186	OtherDirectExpensesEvent2Amt
Gross Receipts Total	$487,729	GrossReceiptsTotalAmt
Charitable Contributions Tot	$180,049	CharitableContributionsTotAmt
Gross Revenue Total Events	$307,680	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$11,800	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$6,450	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$3,200	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$72,186	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$93,636	DirectExpenseSummaryEventsAmt
Net Income Summary	$214,044	NetIncomeSummaryAmt

Gaming Information GamingInformationGrp

Field	Value	IRS element (for citing)
Gross Revenue Bingo	$1,390,194	GrossRevenueBingoAmt
Cash Prizes Bingo	$793,028	CashPrizesBingoAmt
Non Cash Prizes Bingo	$15,572	NonCashPrizesBingoAmt
Rent Facility Costs Bingo	$287,657	RentFacilityCostsBingoAmt
Other Direct Expenses Bingo	$240,307	OtherDirectExpensesBingoAmt
Volunteer Labor Bingo	0	VolunteerLaborBingoInd
Gross Revenue Other Gaming	$128,928	GrossRevenueOtherGamingAmt
Cash Prizes Other Gaming	$69,885	CashPrizesOtherGamingAmt
Rent Fclty Costs Other Gaming	$19,647	RentFcltyCostsOtherGamingAmt
Oth Direct Expnss Other Gaming	$55,497	OthDirectExpnssOtherGamingAmt
Volunteer Labor Other Gaming	0	VolunteerLaborOtherGamingInd
Gross Revenue Total Gaming	$1,519,122	GrossRevenueTotalGamingAmt
Cash Prizes Total Gaming	$862,913	CashPrizesTotalGamingAmt
Non Cash Prizes Total Gaming	$15,572	NonCashPrizesTotalGamingAmt
Rent Fclty Costs Total Gaming	$307,304	RentFcltyCostsTotalGamingAmt
Oth Direct Expnss Total Gaming	$295,804	OthDirectExpnssTotalGamingAmt
Direct Expense Summary Gaming	$1,481,593	DirectExpenseSummaryGamingAmt
Net Gaming Income Summary	$37,529	NetGamingIncomeSummaryAmt

Field	Value	IRS element (for citing)
States Where Gaming Conducted	OR	StatesWhereGamingConductedCd
Licensed	Yes (1)	LicensedInd
License Suspended Etc	0	LicenseSuspendedEtcInd
Gaming With Nonmembers	Yes (1)	GamingWithNonmembersInd
Member Of Other Entity	0	MemberOfOtherEntityInd
Gaming Other Facility	1.00000	GamingOtherFacilityPct
Individual With Books	TARYNA ORTEGA	IndividualWithBooksNm

Persons With Books US Address PersonsWithBooksUSAddress

Field	Value	IRS element (for citing)
Address Line1	1395 SUMMER ST NE	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Field	Value	IRS element (for citing)
Cntrct With3rd Prty For Game Rev	0	CntrctWith3rdPrtyForGameRevInd
Gaming Manager Person	TARYNA ORTEGA	GamingManagerPersonNm
Gaming Manager Compensation	$50,455	GamingManagerCompensationAmt
Gaming Manager Services Prov	THE MANAGER HIRES, TRAINS AND SUPERVISES EMPLOYEES, PREPARES REPORTS, MAKES DEPOSITS, KEEPS GENERAL LEDGERS, ADVERTISES, AND OTHER DUTIES AS ASSIGNED.	GamingManagerServicesProvTxt
Gaming Manager Is Employee	Yes (X)	GamingManagerIsEmployeeInd
Charitable Distribution Rqr	0	CharitableDistributionRqrInd

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercialGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$1,105,846	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	LUKE REESE, MATT LOKAN, JIM GRIGGS, DAVID HILGEMANN, CATHERINE YAO, LUIS GARCIA AND DON LULAY HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11B	THE TAX RETURN IS REVIEWED BY THE CEO AND COO ALONG WITH THE EXECUTIVE/FINANCE COMMITTEE BOARD MEMBERS FOR THEM TO REVIEW AND PROVIDE ANY COMMENTS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD IS ASKED TO REVIEW CONFLICT OF INTEREST POLICY AND MAKE ANY DISCLOSURES AT BOARD MEETINGS ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15	EXECUTIVE COMMITTEE COMPARED COMPENSATION FOR DIRECTORS IN CLUBS ACROSS THE NATION, AND LOOKED AT SALARIES AND COST OF LIVING IN THE SALEM AREA TO DETERMINE COMPENSATION. KEY EMPLOYEE SALARIES ARE SET BY THE EXECUTIVE DIRECTOR WITH THE USE OF A RANGE SET BY THE BOARD APPROVED BGC-SALEM COMPENSATION PLAN.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	BAD DEBT EXPENSE 40,772.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	BOYS & GIRLS CLUB OF SALEM MARION & POLK COUNTIES FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1395 SUMMER ST NE	AddressLine1Txt
City	SALEM	CityNm
State Abbreviation	OR	StateAbbreviationCd
ZIP	97301	ZIPCd

Field	Value	IRS element (for citing)
EIN	931038306	EIN
Primary Activities	PROMOTE HEALTH, SOCIAL, EDUC & CHARACTER DEVELOPMENT OF YOUTH THROUGH PROGRA	PrimaryActivitiesTxt
Legal Domicile State	OR	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	LINE 12A, I	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	BOYS & GIRLS CLUB OF SALEM MARION & POLK	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (1)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
BOYS & GIRLS CLUB OF SALEM MARION & POLK COUNTIES FOUNDATION
J	$98,751	FMV
BOYS & GIRLS CLUB OF SALEM MARION & POLK COUNTIES FOUNDATION
L	$53,808	FMV