2018-11-13T16:57:59-06:00 2017-12-31 910189318 MOSS ADAMS LLP 999 THIRD AVENUE SUITE 2800 SEATTLE WA 98104 990 2017-01-01 472335650 GLASSYBABY WHITE LIGHT FUND GLAS 2065189060 3406 E UNION STREET SEATTLE WA 98122 DAVID ROBINSON EXECUTIVE DIRECTOR 2065189060 2018-11-02 1 EMINA O CRESSWELL CPA P01217304 2063026500 2018-11-02 12.129.7.100 2018-11-02 19:15:37 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C07EA3D2EFE7589B691C7C6F5A7C1991A329BAB3 2017 2019-02-21 02:37:17Z DAVID ROBINSON 3406 E UNION STREET SEATTLE WA 98122 1630347 0 X WWW.GLASSYBABYWHITELIGHTFUND.ORG X 2014 WA PROVIDE FINANCIAL AND EMOTIONAL ASSISTANCE TO THOSE IN NEED IN ORDER TO PROMOTE HOPE AND HEALING. 3 3 0 4 0 0 1471762 1630347 0 0 0 0 -120627 0 1351135 1630347 1321480 1910285 0 0 3333 0 0 0 0 16706 13731 1341519 1924016 9616 -293669 443572 149903 0 0 443572 149903 GLASSYBABY'S MISSION IS TO PROVIDE FINANCIAL AND EMOTIONAL ASSISTANCE TO THOSE IN NEED, IN ORDER TO PROMOTE HOPE AND HEALING. 0 0 1910285 1910285 THE ORGANIZATION PROMOTES HEALING, WELLNESS, AND HOPE THROUGH THE SUPPORT OF ORGANIZATIONS AND PROGRAMS THAT ASSIST THOSE IN NEED. AS OF DECEMBER 31, 2017, GLASSYBABY WHITE LIGHT FUND IN CONJUNCTION WITH GLASSYBABY HAS PROVIDED COMMUNITY SUPPORT OF OVER $7,000,000. 1910285 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 1 1 0 1 0 0 0 1 1 1 1 0 0 0 0 0 CA OR WA X DAVID ROBINSON 2065189060 3406 E UNION STREET SEATTLE WA 98122 X LEE RHODES PRESIDENT 0.40 40.00 X X 0 0 0 ELIZA CUMMINGS VICE PRESIDENT 0.40 0.00 X X 0 0 0 PEGGY VANCE DIRECTOR 0.40 0.00 X 0 0 0 DAVID ROBINSON EXECUTIVE DIRECTOR 5.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 1630347 1630347 1630347 0 0 0 1910285 1910285 3990 3990 6238 6238 2205 2205 1298 1298 1924016 1910285 13731 0 443572 149903 443572 149903 0 0 X 0 0 0 0 443572 149903 443572 149903 443572 149903 -293669 0 X 0 0 0 X 819136 1471762 1630347 3921245 819136 1471762 1630347 3921245 3783165 138080 417 417 3921662 130312 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: VENDOR REFUNDS - 2016 AMOUNT: $ 417. 1 CONSERVATION INTERNATIONAL 2011 CRYSTAL DRIVE SUITE 500 ARLINGTON VA 22202 521497470 501(C)(3) 96220 GENERAL PROGRAM SERVICE CONTRIBUTION VA PUGET SOUND 1660 S COLUMBIAN WAY SEATTLE WA 98108 911714936 GOVERNMENT 75482 GENERAL PROGRAM SERVICE CONTRIBUTION EVERGREENHEALTH FOUNDATION 12040 NE 128TH STREET KIRKLAND WA 98034 911519430 501(C)(3) 56101 GENERAL PROGRAM SERVICE CONTRIBUTION SAN FRANCISCO PUBLIC MONTESSORI PTA 2340 JACKSON STREET SAN FRANCISCO CA 94115 900633862 501(C)(3) 55666 GENERAL PROGRAM SERVICE CONTRIBUTION SEATTLE SEAHAWKS WOMEN'S ASSOCIATION 12 SEAHAWKS WAY RENTON WA 98056 900775964 501(C)(3) 54684 GENERAL PROGRAM SERVICE CONTRIBUTION UCSF FOUNDATION PO BOX 45339 SAN FRANCISCO CA 94145 942829914 501(C)(3) 53971 GENERAL PROGRAM SERVICE CONTRIBUTION ISSAQUAH FOOD AND CLOTHING BANK 179 1ST AVE SE ISSAQUAH WA 98027 911245499 501(C)(3) 47328 GENERAL PROGRAM SERVICE CONTRIBUTION NORTHWEST HARVEST PO BOX 12272 SEATTLE WA 98102 910826037 501(C)(3) 42234 GENERAL PROGRAM SERVICE 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GENERAL PROGRAM SERVICE CONTRIBUTION HARLEM MOTHERS SAVE PO BOX 2110 NEW YORK NY 10027 260847222 501(C)(3) 15808 GENERAL PROGRAM SERVICE CONTRIBUTION 826 VALENCIA 826 VALENCIA ST SAN FRANCISCO CA 94110 043694151 501(C)(3) 15000 GENERAL PROGRAM SERVICE CONTRIBUTION FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FAIRVIEW AVENUE N J5-200 SEATTLE WA 98109 237156071 501(C)(3) 14945 GENERAL PROGRAM SERVICE CONTRIBUTION SAN FRANCISCO VA MEDICAL CENTER 4150 CLEMENT STREET SAN FRANCISCO CA 94121 311575142 GOVERNMENT 13962 GENERAL PROGRAM SERVICE CONTRIBUTION CHILDREN'S CANCER ASSOCIATION 1200 NW NAITO PARKWAY PORTLAND OR 97209 931181662 501(C)(3) 13752 GENERAL PROGRAM SERVICE CONTRIBUTION RAVE FOUNDATION 159 S JACKSON STREET SUITE 200 SEATTLE WA 98104 463932075 501(C)(3) 13365 GENERAL PROGRAM SERVICE CONTRIBUTION LADYBUG HOUSE 1215 4TH AVE SEATTLE WA 98161 901020508 501(C)(3) 13015 GENERAL PROGRAM SERVICE CONTRIBUTION OREGON FOOD BANK 7900 NE 33RD DRIVE PORTLAND OR 97211 930785786 501(C)(3) 12955 GENERAL PROGRAM SERVICE CONTRIBUTION CANCER SUPPORT COMMUNITY PASADENA 76 EAST DEL MAR BLVD PASADENA CA 91105 954201985 501(C)(3) 12246 GENERAL PROGRAM SERVICE CONTRIBUTION RAINIER VALLEY FOOD BANK 4205 RAINIER AVENUE S SEATTLE WA 98188 911500768 501(C)(3) 12216 GENERAL PROGRAM SERVICE CONTRIBUTION SKAGIT VALLEY HOSPITAL FOUNDATION PO BOX 1376 MOUNT VERNON WA 98273 943078550 501(C)(3) 11549 GENERAL PROGRAM SERVICE CONTRIBUTION MARSHA RIVKIN CENTER FOR OVARIAN CANCER 801 BROADWAY SEATTLE WA 98122 912054035 501(C)(3) 11389 GENERAL PROGRAM SERVICE CONTRIBUTION CANCER CAREPOINT 2505 SAMARITAN DRIVE SAN JOSE CA 95124 273029691 501(C)(3) 11141 GENERAL PROGRAM SERVICE CONTRIBUTION UW FOUNDATION BOX 358045 SEATTLE WA 98195 943079432 501(C)(3) 11140 GENERAL PROGRAM SERVICE CONTRIBUTION SEATTLE ARTS AND LECTURES 340 15TH AVENUE EAST SEATTLE WA 98112 911384964 501(C)(3) 11057 GENERAL PROGRAM SERVICE CONTRIBUTION AMERICAN RED CROSS PO BOX 3097 SEATTLE WA 98144 530196605 501(C)(3) 10984 GENERAL 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SERVICE CONTRIBUTION PANCREATIC CANCER ACTION NETWORK 1500 ROSECRANS AVE SUITE 200 MANHATTAN BEACH CA 90266 330841281 501(C)(3) 6891 GENERAL PROGRAM SERVICE CONTRIBUTION WINDERMERE FOUNDATION 5424 SAND POINT WAY NE SEATTLE WA 98105 911440894 501(C)(3) 6560 GENERAL PROGRAM SERVICE CONTRIBUTION PEDIATRIC CORTICAL VISUAL IMPAIRMENT SOCIETY 4257 N 140TH ST OMAHA NE 68164 471752181 501(C)(3) 6302 GENERAL PROGRAM SERVICE CONTRIBUTION UCSF MEDICAL CENTER AUXILIARY 505 PARNASSUS AVE M167A BOX 0208 SAN FRANCISCO CA 94143 941550853 501(C)(3) 6000 GENERAL PROGRAM SERVICE CONTRIBUTION COLLEGE SUCCESS FOUNDATION 1605 NW SAMMAMISH ROAD ISSAQUAH WA 98027 912036088 501(C)(3) 5849 GENERAL PROGRAM SERVICE CONTRIBUTION SEATTLE AQUARIUM SOCIETY 1483 ALASKAN WAY PIER 59 SEATTLE WA 98101 911189249 501(C)(3) 5818 GENERAL PROGRAM SERVICE CONTRIBUTION CHILDRENS HEALTH GUILD PO BOX 1152 LAFAYETTE CA 94549 453767735 501(C)(3) 5615 GENERAL PROGRAM SERVICE CONTRIBUTION WHATCOM HOSPICE FOUNDATION 2901 SQUALICUM PARKWAY BELLINGHAM WA 98225 943146369 501(C)(3) 5544 GENERAL PROGRAM SERVICE CONTRIBUTION SBP 2645 TOULOUSE ST NEW ORLEANS LA 70119 262189665 501(C)(3) 5520 GENERAL PROGRAM SERVICE CONTRIBUTION FANCONI ANEMIA RESEARCH FUND INC 1801 WILLAMETTE ST STE 200 EUGENE OR 97401 930995453 501(C)(3) 5447 GENERAL PROGRAM SERVICE CONTRIBUTION CHILDREN'S HEALTH COUNCIL 650 CLARK WAY PALO ALTO CA 94304 941312311 501(C)(3) 5352 GENERAL PROGRAM SERVICE CONTRIBUTION RONALD MCDONALD HOUSE AT STANFORD 520 SAND HILL ROAD PALO ALTO CA 94304 942538615 501(C)(3) 5308 GENERAL PROGRAM SERVICE CONTRIBUTION PRIDE FOUNDATION 2014 E MADISON ST SEATTLE WA 98122 911325007 501(C)(3) 5247 GENERAL PROGRAM SERVICE CONTRIBUTION CHILDRENS CANCER ASSOCIATION 1200 NW NAITO PKWY STE 140 PORTLAND OR 97209 931181662 501(C)(3) 5209 GENERAL PROGRAM SERVICE CONTRIBUTION COMMUNITY FOUNDATION OF THE NAPA VALLEY 3299 CLAREMONT WAY STE 2 NAPA CA 94558 680349777 501(C)(3) 5160 GENERAL PROGRAM SERVICE CONTRIBUTION AUSTIN COMMUNITY FOUNDATION FOR THE CAPITAL AREA 4315 GUADALUPE AUSTIN TX 78751 741934031 501(C)(3) 5121 GENERAL PROGRAM SERVICE CONTRIBUTION GRAY AREA FOUNDATION FOR THE ARTS 2665 MISSION ST SAN FRANCISCO CA 94110 263383316 501(C)(3) 5075 GENERAL PROGRAM SERVICE CONTRIBUTION SEASON OF MIRACLES FOUNDATION 4478 162ND CT SE BELLEVUE WA 98006 813010044 501(C)(3) 5072 GENERAL PROGRAM SERVICE CONTRIBUTION 89 0 PART I, LINE 2: EACH OF THE WHITE LIGHT FUND'S GRANTS GENERALLY WILL BE GOVERNED BY AN AWARD LETTER OR GRANT AGREEMENT THAT ESTABLISHES ITS TERMS AND CONDITIONS AND RESTRICTING THE USE OF GRANT FUNDS FOR CHARITABLE PURPOSES. AS OF YET, THE FUND HAS NOT DEVELOPED A FORM OF GRANT AGREEMENT OR AWARD LETTER THAT IT MAY USE FOR ITS GRANTS. THE FUND MAY REQUIRE GRANTEES TO PREPARE AND SUBMIT REPORTS TO THE FUND CONCERNING EXPENDITURE OF THE GRANT FUNDS AND PROGRESS TOWARD ACHIEVEMENT OF OUTCOMES, DEPENDING ON THE SIZE AND NATURE OF THE GRANT AND THE SCOPE OF ANY PROJECT FUNDED BY THE GRANT. FORM 990, PART VI, SECTION A, LINE 6 GLASSYBABY IS THE SOLE CORPORATE MEMBER OF THE FUND. FORM 990, PART VI, SECTION A, LINE 7A UNDER THE FUND'S BYLAWS, GLASSYBABY, LLC AS A CORPORATE MEMBER, HAS THE RIGHT TO APPOINT AND REMOVE THE DIRECTORS OF THE GLASSYBABY WHITE LIGHT FUND. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990, INCLUDING SCHEDULE B, IS REVIEWED BY THE BOARD AND EXECUTIVE DIRECTOR BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THIS CONFLICT OF INTEREST POLICY (THE "POLICY") IS TO PROTECT THE INTERESTS OF GLASSYBABY WHITE LIGHT FUND (THE "FUND") IN CONNECTION WITH ANY TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF ANY COVERED PERSON, AS DEFINED BELOW. THIS POLICY PROVIDES (I) A SYSTEMATIC MECHANISM FOR DISCLOSING AND EVALUATING POTENTIAL AND ACTUAL CONFLICTS; AND (II) PROCEDURES FOR THE BOARD OF DIRECTORS OR A COMMITTEE WITH BOARD-DELEGATED AUTHORITY IN CONSIDERING ANY TRANSACTION OR ARRANGEMENT WHERE A CONFLICT MAY EXIST. THIS POLICY IS INTENDED TO SUPPLEMENT, BUT NOT REPLACE, ANY APPLICABLE STATE AND FEDERAL LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT CORPORATIONS. THIS POLICY ADDRESSES TRANSACTIONS AND ARRANGEMENTS INVOLVING THE FUND'S DIRECTORS, OFFICERS, MEMBERS OF ANY COMMITTEE OF THE FUND'S BOARD OF DIRECTORS WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS, AND THE FUND'S EXECUTIVE EMPLOYEES (E.G., EXECUTIVE DIRECTOR, CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER) AND ANY OTHER MANAGER OR SUPERVISOR IDENTIFIED BY THE BOARD OF DIRECTORS OR THE PRESIDENT AS EXERCISING SUBSTANTIAL INFLUENCE OVER THE OPERATIONS OF THE FUND ("COVERED PERSONS"). EVERY COVERED PERSON SHALL SIGN A STATEMENT THAT AFFIRMS THAT HE OR SHE HAS RECEIVED A COPY OF THIS POLICY, HAS READ AND UNDERSTANDS IT, AND HAS AGREED TO COMPLY WITH IT, DISCLOSING HIS OR HER ACTUAL AND POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS. EACH COVERED PERSON SHALL PROMPTLY AND FULLY DISCLOSE ALL MATERIAL FACTS OF EVERY ACTUAL OR POTENTIAL CONFLICT OF INTEREST: (I) EXISTING AT THE TIME WHEN HE/SHE BECOMES A COVERED PERSON; (II) THAT ARISES WHILE HE/SHE IS A COVERED PERSON, AT THE TIME SUCH ACTUAL OR POTENTIAL CONFLICT ARISES; AND (III) ANNUALLY THROUGH THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. ALL DISCLOSURES INVOLVING A TRANSACTION OR ARRANGEMENT BEING CONSIDERED AT A MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE SHALL BE MADE TO ALL MEMBERS PRESENT AT SUCH MEETING. ALL OTHER DISCLOSURES SHALL BE MADE TO THE PRESIDENT (WHO SHALL DISCLOSE HIS OR HER CONFLICTS TO THE BOARD OF DIRECTORS). A COVERED PERSON WHO IS IN DOUBT AS TO THE EXISTENCE OF A CONFLICT OF INTEREST IS ENCOURAGED TO DISCLOSE ALL FACTS PERTAINING TO THE TRANSACTION OR ARRANGEMENT BEFORE UNDERTAKING THE TRANSACTION OR ARRANGEMENT OR MAKING ANY DECISION IN THE MATTER. (I) THE PRESIDENT SHALL DISCLOSE TO THE BOARD OF DIRECTORS ALL CONFLICTS OF INTEREST REPORTED TO HIM OR HER UNDER THIS POLICY. THE BOARD OF DIRECTORS WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION OR ARRANGEMENT GIVING RISE TO THE POTENTIAL CONFLICT OF INTEREST TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION OR ARRANGEMENT. THE BOARD OF DIRECTORS MAY, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (II) A COVERED PERSON WHO HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH THE BOARD OF DIRECTORS OR A COMMITTEE IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE A PRESENTATION TO THE BOARD OR COMMITTEE, TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. (III) IN ANY CASE IN WHICH A COVERED PERSON HAS A POSITION AS A DIRECTOR, TRUSTEE OR OFFICER OF A GRANT APPLICANT, THE BOARD OF DIRECTORS SHALL NOT BE REQUIRED TO EVALUATE WHETHER THERE IS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. THE COVERED PERSON WHO SERVES IN SUCH POSITION SHALL NOT BE PRESENT FOR AND SHALL NOT PARTICIPATE (OTHER THAN TO ANSWER QUESTIONS RAISED BY THE DISINTERESTED DIRECTORS OR COMMITTEE MEMBERS) IN ANY PORTION OF A MEETING OF THE BOARD OF DIRECTORS OR A COMMITTEE APPOINTED BY THE BOARD AT WHICH A GRANT TO, OR ANY OTHER ACTION CONCERNING THE GRANT APPLICANT, IS CONSIDERED. THIS PROVISION IS INTENDED TO AVOID CONFLICTS IN FIDUCIARY OBLIGATIONS OF THE COVERED PERSON OWED TO THE GRANT APPLICANT AND TO AVOID ANY APPEARANCE OF IMPROPRIETY. THE FUND MAY ENTER INTO A TRANSACTION OR ARRANGEMENT IN WHICH A COVERED PERSON HAS A CONFLICT OF INTEREST IF: (I) THE COVERED PERSON HAS DISCLOSED THE CONFLICT OF INTEREST IN ACCORDANCE WITH THIS POLICY; (II) A MAJORITY OF DIRECTORS WHO HAVE NO INTEREST IN THE TRANSACTION OR ARRANGEMENT APPROVE THE TRANSACTION OR ARRANGEMENT AT A BOARD OR COMMITTEE MEETING AFTER DETERMINING, IN GOOD FAITH AND AFTER REASONABLE INVESTIGATION, THAT THE TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO THE FUND AND IS IN THE FUND'S BEST INTEREST; (III) ANY COVERED PERSON WHO HAS AN ACTUAL OR POTENTIAL CONFLICT WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING ANY SUCH TRANSACTION OR ARRANGEMENT (PROVIDED, HOWEVER, THAT ANY SUCH COVERED PERSON MAY APPEAR AT A MEETING TO ANSWER QUESTIONS CONCERNING THE TRANSACTION OR ARRANGEMENT); AND (IV) IN ANY ARRANGEMENT OR TRANSACTION INVOLVING COMPENSATION, REMUNERATION OR OTHER ECONOMIC OR FINANCIAL BENEFIT TO THE COVERED PERSON, THE BOARD OF DIRECTORS RELIES UPON APPROPRIATE COMPARABILITY DATA, SUCH AS AN INDEPENDENT APPRAISAL OR AN INDEPENDENT COMPENSATION STUDY, IN REACHING ITS DETERMINATION AS TO THE FAIRNESS AND REASONABLENESS OF THE TRANSACTION OR ARRANGEMENT TO THE FUND. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. GLASSYBABY LLC 624 S LANDER STREET SEATTLE WA 98134 900187688 GLASS PRODUCTS WA N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0