2019-08-14T20:35:33-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2017-10-01 472352652 PACIFIC RETIREMENT SERVICES FOUNDATION INC PACI 8887246424 1 WEST MAIN STREET NO 303 MEDFORD OR 97501 BRIAN MCLEMORE BOARD CHAIR 8887246424 2019-08-14 1 KURT BENNION P01469618 4252506100 2019-08-14 67.137.57.251 2019-08-14 14:14:08 PD P 33F877C3ABFBB78B8EF2964D67A95BC3B590144C D393EE94A1B818777A7285D28D1C1E92A392F7EC 2017 2019-02-21 02:37:17Z BRIAN MCLEMORE 1 WEST MAIN STREET NO 303 MEDFORD OR 97501 1060124 0 X WWW.RETIREMENT.ORG X 2014 OR TO SUPPORT ACTIVITIES OF PACIFIC RETIREMENT SERVICES, INC. 3 3 0 40 0 0 130771 253862 0 0 39187 118366 6083 -49641 176041 322587 0 2500 0 0 0 0 0 0 0 124959 202000 124959 204500 51082 118087 1016656 1057358 92245 87008 924411 970350 TO SUPPORT ACTIVITIES OF PACIFIC RETIREMENT SERVICES, INC. 0 0 200834 2500 0 TO SUPPORT ACTIVITIES OF PACIFIC RETIREMENT SERVICES, INC. 200834 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 X 3 3 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X JOSH BLACKSON 5418577205 1 WEST MAIN STREET SUITE 303 MEDFORD OR 97501 BRIAN MCLEMORE CHAIR 1.00 50.00 X X 0 673575 54543 WILLIAM D THORNDIKE VICE CHAIR 1.00 0.00 X X 0 0 0 CAROLYN LYN HENNION SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 0 673575 54543 0 0 1 0 0 175241 78621 253862 20820 20820 785442 687896 97546 97546 97546 0 175241 49641 -49641 -49641 322587 0 0 68725 2500 2500 607 607 1500 1500 1217 1217 94 94 PROGRAM FUND EXPENSES 198240 198240 DUES AND SUBSCRIPTIONS 342 342 204500 200834 3666 0 172747 190470 22864 170 300 820875 866588 1016656 1057358 48824 30517 43421 56491 92245 87008 X 668961 637328 240809 318381 14641 14641 924411 970350 1016656 1057358 118087 -72148 0 X 0 1 X 1 0 X 799399 130771 253862 1184032 799399 130771 253862 1184032 1184032 60549 30654 20820 112023 60394 60394 1356449 0.87290 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: FUNDRAISING EVENT REVENUES 14641 772 772 14641 14641 1390 1390 14641 14641 14641 0.00000 1.00000 0.00000 0 0 0 DUE TO AFFILIATES 56491 56491 X PART V, LINE 4: EARNINGS FROM THE ENDOWMENT FUNDS ARE USED TO FURTHER THE FOSTER GRANDPARENT PROGRAM. PART X, LINE 2: THE FOUNDATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE FOUNDATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT SEPTEMBER 30, 2018, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. GOLF TOURNAMENT 161084 161084 45884 VALENVINO 14157 14157 3757 175241 175241 49641 49641 -49641 0 0 0 0 0 0 0 1 0 BRIAN MCLEMORE CHAIR 0 611022 0 62553 0 0 0 31225 0 23318 0 728118 0 0 PART I, LINE 3 COMPENSATION WAS DETERMINED BY PACIFIC RETIREMENT SERVICES, INC., A RELATED ORGANIZATION, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH COMPENSATION. PART I, LINE 7 THE ORGANIZATION PAID BONUSES THIS YEAR. THE PROCESS FOR DETERMINING EXECUTIVE BONUSES IS DISCRETIONARY. IT IS DETERMINED BY THE VP OF OPERATIONS FOR PRS AND IT IS BASED ON THE PERFORMANCE OF THE COMMUNITY FOR THE YEAR. FORM 990, PART VI, SECTION A, LINE 3 PACIFIC RETIREMENT SERVICES FOUNDATION, INC.'S BOARD OF DIRECTORS DELEGATES DAY TO DAY MANAGEMENT TO PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 6 PACIFIC RETIREMENT SERVICES FOUNDATION, INC. HAS ONE MEMBER, WHICH IS PACIFIC RETIREMENT SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A PACIFIC RETIREMENT SERVICES, INC. HAS THE AUTHORITY TO ELECT DIRECTORS TO THE PACIFIC RETIREMENT SERVICES FOUNDATION, INC. BOARD OF DIRECTORS FROM A LIST OF NOMINEES SELECTED BY THE PACIFIC RETIREMENT SERVICES FOUNDATION, INC. BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS ARE RESERVED TO PACIFIC RETIREMENT SERVICES, INC., THE SOLE MEMBER: (A) ADOPT, AMEND OR RESTATE THE BYLAWS OF THE ORGANIZATION; (B) ADOPT, AMEND OR RESTATE THE ORGANIZATION'S LONG-RANGE PLAN, STRATEGIC PLAN OR MISSION STATEMENT; (C) APPROVE ANY MERGER OR CONSOLIDATION OF THE ORGANIZATION WITH ANOTHER ENTITY, OR ANY PARTIAL OR TOTAL LIQUIDATION OF THE ORGANIZATION'S ASSETS; (D) APPROVE ANY DEBT OR ENTER INTO ANY CONTRACT NOT CONTEMPLATED BY THE ANNUAL BUDGET, IF THE DOLLAR AMOUNT EXCEEDS THE SUM OF $100,000; (E) MAKE ANY GIFTS OR GRATUITOUS TRANSFERS IN EXCESS OF $5,000 IN ANY CALENDAR YEAR; (T) CREATE A TAXABLE OR TAX-EXEMPT SUBSIDIARY OR AFFILIATED ORGANIZATION; (G) ACQUIRE A CONTROLLING INTEREST IN ANOTHER ENTITY; (H) APPOINT OUTSIDE AUDITORS; (I) ELECT OR APPOINT THE ORGANIZATION'S DIRECTORS INCLUDING THE FILLING OF VACANCIES CAUSED BY THE DEATH, REMOVAL OR RESIGNATION OF A DIRECTOR; AND (J) REMOVE ANY OF THE ORGANIZATION'S DIRECTORS AND OFFICERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CFO, CONTROLLER AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE ARE SENT TO ALL BOARD MEMBERS AND KEY EMPLOYEES ANNUALLY. THERE ARE TWO POLICIES RELATED TO CONFLICTS OF INTEREST: 1) BOARD OF DIRECTORS; 2) KEY EMPLOYEES, WHICH IDENTIFY THE PURPOSE, DEFINITIONS, AND PROCEDURES. IF A CONFLICT IS SELF-IDENTIFIED BY A BOARD MEMBER OR KEY EMPLOYEE IN THE QUESTIONNAIRE AND/OR MEETING, PROCEDURES ARE FOLLOWED AND DOCUMENTED ACCORDING TO THE POLICY. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUESTS GO THROUGH THE CORPORATE COUNSEL. PACIFIC RETIREMENT SERVICES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931067253 SUPPORTING ORGANIZATION OR 501(C)(3) LINE 12C, III-FI N/A 0 ROGUE VALLEY MANOR 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930453216 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 THE CUMBERLAND REST INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 750891470 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CASCADE MANOR INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930557803 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931179254 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 HOLLADAY PARK PLAZA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930513697 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 CAPITOL LAKES INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 391412320 SENIOR HOUSING WI 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 ROGUE VALLEY MANOR FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930712867 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 ROGUE VALLEY MANOR 0 UNIVERSITY RETIREMENT COMMUNITY FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931301816 PUBLIC FOUNDATION CA 501(C)(3) LINE 7 UNIVERSITY RETIREMENT COMMUNITY AT DAVIS INC 0 TRINITY TERRACE FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 912162130 PUBLIC FOUNDATION TX 501(C)(3) LINE 7 THE CUMBERLAND REST INC 0 HOLLADAY PARK PLAZA FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 264529118 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 HOLLADAY PARK PLAZA 0 MIRABELLA WASHINGTON FOUNDATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 450574348 PUBLIC FOUNDATION WA 501(C)(3) LINE 7 MIRABELLA 0 CASCADE MANOR FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 931330100 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CASCADE MANOR INC 0 CAPITOL LAKES FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 383781089 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 CAPITOL LAKES INC 0 MIRABELLA 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 342030255 SENIOR HOUSING WA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 MIRABELLA PORTLAND FOUNDATION INC 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 452508860 PUBLIC FOUNDATION OR 501(C)(3) LINE 7 MIRABELLA AT SOUTH WATERFRONT 0 MIRABELLA AT SOUTH WATERFRONT 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 711016384 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 COMMUNITY VOLUNTEER NETWORK 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930892261 COMMUNITY SERVICES OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930864466 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ASHLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 930942933 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS HOUSING CORPORATION 1 WEST MAIN ST 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501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM LIVELY OAKS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943194409 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM REEDSPORT HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212538 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM YREKA HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943212540 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM EUGENE HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943247154 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM FORT WORTH I HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311520436 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM BEND II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 943260016 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM FORT WORTH II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587415 SENIOR HOUSING TX 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MEDFORD III HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587418 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM ROSEBURG II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311587420 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM GRANTS PASS II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662259 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM DAVIS HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311662208 SENIOR HOUSING CA 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM MYRTLE CREEK II HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 MEDFORD OR 97501 311715321 SENIOR HOUSING OR 501(C)(3) LINE 10 PACIFIC RETIREMENT SERVICES INC 0 RVM PORTLAND HOUSING CORPORATION 1 WEST MAIN ST SUITE 303 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