FURP.ORG / PUBLIC DATA EXPLORER

JESSIE F RICHARDSON FOUNDATION: Form 990PF, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
JESSIE F RICHARDSON FOUNDATION (EIN 93-1316345)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-14
IRS object ID
201823189349103362
Schema version
2017v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-14T16:40:16-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930928924PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PERKINS & COMPANY PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11211 SW FIFTH AVE SUITE 1000AddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP972043710ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN931316345EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JESSIE F RICHARDSON FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJESSBusinessNameControlTxt
Phone5034084088PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line115900 SE 82ND DRIVEAddressLine1Txt
CityCLACKAMASCityNm
State AbbreviationORStateAbbreviationCd
ZIP97015ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEREN BROWN WILSONPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5034084088PhoneNum
Signature2018-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCYNTHIA P BARTHOLOMEWPreparerPersonNm
PTINP01313965PTIN
Phone5032210336PhoneNum
Preparation2018-11-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address70.102.39.100IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-12IPDt
IP Tm22:24:15IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdB01359FE453E4800DAEA04FA9F75AD3820A6EE36AtSubmissionCreationDeviceId
At Submission Filing Device Id8C1C78DD8FC880D0435241EC6ED772A926349A0DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$609,087FMVAssetsEOYAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$322,720ContriRcvdRevAndExpnssAmt
Interest On Sav Rev And Expnss$1,518InterestOnSavRevAndExpnssAmt
Interest On Sav Net Invst Incm$1,518InterestOnSavNetInvstIncmAmt
Interest On Savings Adj Net Incm$1,518InterestOnSavingsAdjNetIncmAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Net ST Capital Gain Adj Net Incm$0NetSTCapitalGainAdjNetIncmAmt
Other Income Rev And Expnss$26,603OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$0OtherIncomeNetInvstIncmAmt
Other Income Adj Net Incm$26,603OtherIncomeAdjNetIncmAmt
Total Rev And Expnss$350,841TotalRevAndExpnssAmt
Total Net Invst Incm$1,518TotalNetInvstIncmAmt
Total Adj Net Incm$28,121TotalAdjNetIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$0CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$0CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Adj Net Incm$0CompOfcrDirTrstAdjNetIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$0CompOfcrDirTrstDsbrsChrtblAmt
Oth Empl Slrs Wgs Rev And Expnss$121,074OthEmplSlrsWgsRevAndExpnssAmt
Oth Empl Slrs Wgs Net Invst Incm$0OthEmplSlrsWgsNetInvstIncmAmt
Oth Empl Slrs Wgs Adj Net Incm$0OthEmplSlrsWgsAdjNetIncmAmt
Oth Empl Slrs Wgs Dsbrs Chrtbl$121,074OthEmplSlrsWgsDsbrsChrtblAmt
Accounting Fees Rev And Expnss$9,615AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$1,925AccountingFeesNetInvstIncmAmt
Accounting Fees Adj Net Incm$1,683AccountingFeesAdjNetIncmAmt
Accounting Fees Chrtbl Prps$7,525AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$91,843OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$0OtherProfFeesNetInvstIncmAmt
Other Prof Fees Adj Net Incm$0OtherProfFeesAdjNetIncmAmt
Other Prof Fees Dsbrs Chrtbl$91,843OtherProfFeesDsbrsChrtblAmt
Occupancy Rev And Expnss$2,052OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$0OccupancyNetInvstIncmAmt
Occupancy Adj Net Incm$0OccupancyAdjNetIncmAmt
Occupancy Dsbrs Chrtbl$2,052OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$30,914TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$0TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Adj Net Incm$4,787TravConfMeetingAdjNetIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$26,127TravConfMeetingDsbrsChrtblAmt
Printing And Pub Rev And Expnss$1,052PrintingAndPubRevAndExpnssAmt
Printing And Pub Net Invst Incm$0PrintingAndPubNetInvstIncmAmt
Printing And Pub Adj Net Incm$0PrintingAndPubAdjNetIncmAmt
Printing And Pub Dsbrs Chrtbl$1,052PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$82,571OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$0OtherExpensesNetInvstIncmAmt
Other Expenses Adj Net Incm$664OtherExpensesAdjNetIncmAmt
Other Expenses Dsbrs Chrtbl$81,907OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$339,121TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$1,925TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Adj Net Incm$7,134TotOprExpensesAdjNetIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$331,580TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$0ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$0ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$339,121TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$1,925TotalExpensesNetInvstIncmAmt
Total Expenses Adj Net Incm$7,134TotalExpensesAdjNetIncmAmt
Total Expenses Dsbrs Chrtbl$331,580TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses$11,720ExcessRevenueOverExpensesAmt
Net Investment Income$0NetInvestmentIncomeAmt
Adjusted Net Income$20,987AdjustedNetIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$202,793CashBOYAmt
Cash EOY$212,968CashEOYAmt
Cash EOYFMV$212,968CashEOYFMVAmt
Sav And Temp Cash Invst BOY$390,368SavAndTempCashInvstBOYAmt
Sav And Temp Cash Invst EOY$392,028SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$392,028SavAndTempCashInvstEOYFMVAmt
Prepaid Expenses BOY$1,246PrepaidExpensesBOYAmt
Prepaid Expenses EOY$4,091PrepaidExpensesEOYAmt
Prepaid Expenses EOYFMV$4,091PrepaidExpensesEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$5,149LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,149LandBldgEquipAccumDeprecAmt
Other Assets BOY$0OtherAssetsBOYAmt
Other Assets EOY$0OtherAssetsEOYAmt
Other Assets EOYFMV$0OtherAssetsEOYFMVAmt
Total Assets BOY$594,407TotalAssetsBOYAmt
Total Assets EOY$609,087TotalAssetsEOYAmt
Total Assets EOYFMV$609,087TotalAssetsEOYFMVAmt
Loans From Officers BOY$1,246LoansFromOfficersBOYAmt
Loans From Officers EOY$4,206LoansFromOfficersEOYAmt
Total Liabilities BOY$1,246TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,206TotalLiabilitiesEOYAmt
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind
Capital Stock BOY$0CapitalStockBOYAmt
Capital Stock EOY$0CapitalStockEOYAmt
Additional Paid In Capital BOY$0AdditionalPaidInCapitalBOYAmt
Additional Paid In Capital EOY$0AdditionalPaidInCapitalEOYAmt
Retained Earning BOY$593,161RetainedEarningBOYAmt
Retained Earning EOY$604,881RetainedEarningEOYAmt
Tot Net Ast Or Fund Balances BOY$593,161TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$604,881TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$594,407TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$609,087TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$593,161TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses$11,720ExcessRevenueOverExpensesAmt
Other Increases$0OtherIncreasesAmt
Subtotal$604,881SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$604,881TotNetAstOrFundBalancesEOYAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$238,743AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$516,027NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.462656DistributionYr1Rt
Adjusted Qlfy Distri Yr2$205,078AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$426,546NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.480788DistributionYr2Rt
Adjusted Qlfy Distri Yr3$240,315AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$420,596NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.571368DistributionYr3Rt
Adjusted Qlfy Distri Yr4$201,161AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$416,602NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.482861DistributionYr4Rt
Adjusted Qlfy Distri Yr5$251,729AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$433,558NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.580612DistributionYr5Rt
Total Distribution2.578285TotalDistributionRt
Average Distribution0.515657AverageDistributionRt
Net Vl Noncharitable Assets$617,994NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$318,673AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$0NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$318,673AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$331,580QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eYes (X)DomesticOrgMeetingSect4940eInd
Investment Income Excise Tax$0InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$0SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$0TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$0EstimatedPlusOvpmtIncmTxAmt
Extsn Request Income Tax Paid$0ExtsnRequestIncomeTaxPaidAmt
Backup Withholding Withheld$0BackupWithholdingWithheldAmt
Total Payments And Credits$0TotalPaymentsAndCreditsAmt
Es Penalty$0EsPenaltyAmt
Tax Due$0TaxDueAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateOROrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating FoundationYes (1)PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressJFRFOUNDATION.ORGWebsiteAddressTxt

Persons With Books Name PersonsWithBooksName

FieldValueIRS element (for citing)
Business Name Line1KEREN BROWN WILSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5034084088PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line115900 SE 82ND DRIVEAddressLine1Txt
CityCLACKAMASCityNm
State AbbreviationORStateAbbreviationCd
ZIP97015ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified PrsnYes (1)SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified PrsnYes (1)BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified PrsnYes (1)FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified PrsnYes (1)PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Acts Fail To Qlfy As Exceptions0ActsFailToQlfyAsExceptionsInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
KEREN BROWN WILSON
15900 SE 82ND DRIVECLACKAMASOR97015CHAIR, PRESIDENT & DIRECTOR40.00$0$0$0
GARY WITHERS
15900 SE 82ND DRIVECLACKAMASOR97015VICE CHAIR & DIRECTOR2.00$0$0$0
KEN BURGESS
15900 SE 82ND DRIVECLACKAMASOR97015SECRETARY & DIRECTOR2.00$0$0$0
TONY LEINWEBER
15900 SE 82ND DRIVECLACKAMASOR97015TREASURER & DIRECTOR2.00$0$0$0
JOANNE HANDY
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
MARVIN KAISER
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
SEAN KUNI
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
CARMEN LARGAESPADA
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
CARRON SUDDRETH
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
DAVE CARBONEAU
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
KRISTEN CONNER
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
JAY STOWERS
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
DAVE TUPPER
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
MARY JAEGER
15900 SE 82ND DRIVECLACKAMASOR97015DIRECTOR2.00$0$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt

Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CONCEPTS IN COMMUNITY LIVING INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line115900 SE 82ND DRIVEAddressLine1Txt
CityCLACKAMASCityNm
State AbbreviationORStateAbbreviationCd
ZIP97015ZIPCd
FieldValueIRS element (for citing)
Service TypePROGRAM MANAGEMENT SERVICESServiceTypeTxt
Compensation$123,642CompensationAmt
FieldValueIRS element (for citing)
Contractor Paid Over50k0ContractorPaidOver50kCnt

Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp

FieldValueIRS element (for citing)
Description1GLOBAL PROGRAM SUPPORT FOR INDIGENT OLDER ADULTS IN NICARAGUA:1. DEVELOPED AND CONDUCTED ELDER CARE HOME ADMINISTRATOR TRAINING AT NATIONAL ELDER TRAINING CENTER IN JINOTEPE, NICARAGUA.2. FILMED AND PRODUCED 8 ADDITIONAL CAREGIVER TRAINING VIDEOS FOR SPANISH LANGUAGE NONLITERATE ADULT LEARNERS.3. COORDINATED VOLUNTEER SERVICE VISITS TO IMPROVE CONDITIONS AT THE ELDER CARE HOME IN JINOTEGA. 4. CONTINUED PROVIDING SCHOLARSHIPS FUNDING FOR STUDENTS PERFORMING SERVICE LEARNING FROM AMERICAN AND NICARAGUAN UNIVERSITIES IN ALLIED HEALTH (INCLUDING NURSING, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, PHYSICIAN ASSISTANTS, PHARMACY, PSYCHOLOGY, COMMUNITY HEALTH, GERONTOLOGY).5. CONTINUED SUPPORT OF NICARAGUAN AGING ADVISORY COUNCIL IN DEVELOPMENT OF NATIONAL STRATEGIC PLAN AND ADVOCACY FOR DEVELOPMENT OF CARE STANDARDS.CONTINUED ON NEXT STATEMENT.Description1Txt
Expenses1$0Expenses1Amt
Description2CHARITABLE ACTIVITY #1, GLOBAL PROGRAM SUPPORT, CONT'D:6. SIGNED AGREEMENT WITH AMERICAN NICARAGUA FOUNDATION TO IMPROVE ACCESS TO MEDICINE AND SUPPLIES FOR ELDER CARE HOMES IN NICARAGUA.7. RECRUITED AND TRAINED 4 COMMUNITY LIASONS THROUGHOUT NICARAGUA TO INCREASE VISABILITY OF AND BRING RESOURCES TO ELDER CARE HOMES THROUGHOUT NICARAGUA.Description2Txt
Expenses2$171,150Expenses2Amt
Description3EDUCATION/TRAINING/RESEARCH/POLICY:1. ORGANIZED SERVICE LEARNING TRIPS AND CLINICAL FIELDWORK FOR 29 STUDENTS, 4 FACULTY.2. CONTINUED EXPANSION OF PHYSICAL THERAPY FIELDWORK PILOT3. FUNDED 7 SCHOLARSHIPS AND 5 COMMUNITY AWARDS TOTALING $12,213.4. CONTINUED DISCUSSIONS WITH WASHINGTON STATE UNIVERSITY REGARDING DEVELOPMENT OF SERVICE LEARNING, FIELD WORK AND INDEPENDENT STUDY PROGRAM.5. CONTINUED PRODUCTION OF LEAP (LIFE ENRICHMENT ACTIVITY PROGRAM) FOR ASSISTED LIVING RESIDENTS INCLUDING MONTHLY NEWSLETTERS.6. CONDUCTED SURVEY OF ALL ELDER CARE HOMES IN NICARAGUA TO DETERMINE STRENGTHS AND AREAS OF NEED.7. CONDUCTED COMMUNITY ASSET MAPPING EXERCISE OF AVAILABLE RESOURCES FOR GRANDPARENTS RAISING GRANDCHILDREN.8. BEGAN WORKING WITH THE PUBLIC AND PRIVATE UNIVERSITY SYSTEMS IN NICARAGUA TO INTRODUCE PRINCIPLES OF CARE FOR OLDER ADULTS IN HEALTH CARE FIELD CURRICULUM.Description3Txt
Expenses3$22,477Expenses3Amt
Description4INCREASE AWARENESS AND SUPPORT FOR VERY LOW INCOME ADULTS IN US:1. WORKED WITH WEST VIRGINIA UNIVERSITY MEDICAL SCHOOL TO IDENTIFY STRATEGIES FOR RURAL HEALTH COMMUNITY ENGAGEMENT.2. IDENTIFIED PROGRAMMATIC STRATEGIES AND IMPLEMENTATION PLAN FOR TIES THAT BIND PROGRAM BENEFITING OREGON GRANDPARENTS RAISING GRANDCHILDREN.3. SUPPORTED ACTIVITIES OF OREGON AGING PROGRAMS, SPECIFICALLY, MEALS ON WHEELS AND ELDERS IN ACTION.4. SUPPORTED JFRF AFFORDABLE HOUSING AND SERVICES WORK GROUP TO FOSTER INNOVATION IN THE AREA OF PROVIDING HOUSING THAT LOW INCOME RESIDENTS CAN AFFORD, COMBINED WITH SUPPORTIVE SERVICES. 5. FOUNDATION REPRESENTATIVES SERVED ON: A) AMAZON ADVISORY BOARD ON COST EFFECTIVE PRODUCT DEVELOPMENT FOR OLDER ADULTS AND CAREGIVERS; B) PURPLE RIBBON COMMISSION TO IMPROVE QUALITY SERVICE TO OLDER ADULTS WITH DEMENTIA AND IMPROVE SUPPORT FOR CAREGIVERS; C) LIVEWELL ADVISORY BOARD; AND D) ASSOCIATION OF OCCUPATIONAL THERAPY.Description4Txt
Expenses4$65,780Expenses4Amt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$0AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$627,405AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$0FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$627,405TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$627,405AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$9,411CashDeemedCharitableAmt
Net Vl Noncharitable Assets$617,994NetVlNoncharitableAssetsAmt
Minimum Investment Return$30,900MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Sect4942j3j5 Fndtn And Frgn OrgYes (X)Sect4942j3j5FndtnAndFrgnOrgInd

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$331,580ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$331,580QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$331,580AdjustedQualifyingDistriAmt

Private Operating Foundations PrivateOperatingFoundationsGrp

FieldValueIRS element (for citing)
Private Operating Fndtn Ruling2002-02-12PrivateOperatingFndtnRulingDt
Section4942j3Yes (X)Section4942j3Ind

Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp

FieldValueIRS element (for citing)
Current Year$20,987CurrentYearAmt
Year1$313Year1Amt
Year2$1,039Year2Amt
Year3$1,027Year3Amt
Total$23,366TotalAmt

Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp

FieldValueIRS element (for citing)
Current Year$17,839CurrentYearAmt
Year1$266Year1Amt
Year2$883Year2Amt
Year3$873Year3Amt
Total$19,861TotalAmt

Qualifying Distributions QualifyingDistributionsGrp

FieldValueIRS element (for citing)
Current Year$331,580CurrentYearAmt
Year1$238,743Year1Amt
Year2$205,078Year2Amt
Year3$240,315Year3Amt
Total$1,015,716TotalAmt

Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp

FieldValueIRS element (for citing)
Current Year$0CurrentYearAmt
Year1$0Year1Amt
Year2$0Year2Amt
Year3$0Year3Amt
Total$0TotalAmt

Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp

FieldValueIRS element (for citing)
Current Year$331,580CurrentYearAmt
Year1$238,743Year1Amt
Year2$205,078Year2Amt
Year3$240,315Year3Amt
Total$1,015,716TotalAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp

FieldValueIRS element (for citing)
Current Year$20,600CurrentYearAmt
Year1$17,201Year1Amt
Year2$14,218Year2Amt
Year3$14,020Year3Amt
Total$66,039TotalAmt

Total Support TotalSupportGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Public Support Type PublicSupportType

FieldValueIRS element (for citing)
Total$0TotalAmt

Largest Support From EO LargestSupportFromEOGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Investment Income GrossInvestmentIncomeGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Supplementary Information SupplementaryInformationGrp

FieldValueIRS element (for citing)
Contributing ManagerKEREN BROWN WILSONContributingManagerNm
Contributing ManagerKEN BURGESSContributingManagerNm
Contributing ManagerSEAN KUNIContributingManagerNm
Contributing ManagerCARRON SUDDRETHContributingManagerNm

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonKEREN BROWN WILSONRecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line115900 SE 82ND DRIVEAddressLine1Txt
CityCLACKAMASCityNm
State AbbreviationORStateAbbreviationCd
ZIP97015ZIPCd
FieldValueIRS element (for citing)
Recipient Phone5034084088RecipientPhoneNum
Form And Info And MaterialsNONE SPECIFIED AT THIS TIMEFormAndInfoAndMaterialsTxt
Submission DeadlinesNONE SPECIFIED AT THIS TIMESubmissionDeadlinesTxt
Restrictions On AwardsNONE SPECIFIED AT THIS TIMERestrictionsOnAwardsTxt
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$0TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$1,518ExclusionAmt

Other Revenue Described OtherRevenueDescribedGrp

FieldValueIRS element (for citing)
DescTRIPS, TRAINING, SPEAKER FEESDesc
Related Or Exempt Function Incm$26,603RelatedOrExemptFunctionIncmAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$1,518ExclusionAmt
Related Or Exempt Function Incm$26,603RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$28,121TotalIncomeProducingActyAmt

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp

FieldValueIRS element (for citing)
Line Number11ALineNumberTxt
Relationship StatementPROVIDED SPEAKER FOR EDUCATIONAL PROGRAM, COORDINATED SERVICE LEARNING TRIPS AND SITE VISITS FOR ADULTS AND YOUTH TO EDUCATE PARTICIPANTS ON ELDER CARE AND ADMINISTRATION OF ELDER CARE HOMES, AND TO PROVIDE SUPPORT TO THE AGING.RelationshipStatementTxt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp (15 entries)

ContributorContributorNumAddress Line1ContributorUSAddress/AddressLine1TxtCityContributorUSAddress/CityNmState AbbreviationContributorUSAddress/StateAbbreviationCdZIPContributorUSAddress/ZIPCdTotal ContributionsTotalContributionsAmtPerson ContributionPersonContributionInd
KEN BURGESS
13580 LONESOME PINE RDWHITAKERSNC27891$11,835Yes (X)
CLAPPS CONVALESCENT NURSING HOME INCMOUNTAIN TOP LIVING
2500 MOUNTAIN TOP DRASHEBORONC27203$5,000Yes (X)
CLAPP'S NURSING CENTER INC
3PO BOX 249PLEASANT GARDENNC273130249$5,000Yes (X)
VITAL LIFE FOUNDATION
44560 SE INTERNATIONAL WAY SUITE 100MILWAUKIEOR97222$10,000Yes (X)
SEAN KUNI
58612 NW 21ST AVEVANCOUVERWA98665$6,572Yes (X)
LARRY & DEBORAH LOLLIS FAMLY FUND COMMUNITY FOUNDATION OF GREENVILLE
6630 E WASHINGTON SUITE AGREEENVILLESC29601$10,000Yes (X)
DAVID CARBONEAU
71229 SE 55TH AVEPORTLANDOR97215$5,000Yes (X)
KEREN BROWN WILSON
812523 SE 131ST CTCLACKAMASOR97015$25,000Yes (X)
SOCIAL VENTURE PARTNERS
9308 SW 1ST AVE 158PORTLANDOR97204$12,500Yes (X)
OREGON HEALTH CARE ASSOCIATION
1011740 SW 68TH PARKWAY SUITE 250PORTLANDOR97223$5,000Yes (X)
CARE CONCEPTS INCVILLAGES OF WILKES
11204 OLD BRICKYARD RDNORTH WILKESBORONC28659$5,000Yes (X)
VILLAGES OF WILKES TRADITIONAL LIVING
12204 OLD BRICKYARD RDNORTH WILKESBORONC28659$5,000Yes (X)
HAROLD & ARLENE SCHNITZER CARE FOUNDATION
13PO BOX 2708PORTLANDOR97208$20,000Yes (X)
CARRON SUDDRETH
141414 NC HWY 268LENOIRNC28645$5,000Yes (X)
HILLTOP FOUNDATION
151000 SW VISTA AVE SUITE 1105PORTLANDOR97205$5,000Yes (X)

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING & BOOKKEEPINGCategoryTxt
Amt$9,615Amt
Net Investment Income$1,925NetInvestmentIncomeAmt
Adjusted Net Income$1,683AdjustedNetIncomeAmt
Disbursements Charitable Prps$7,525DisbursementsCharitablePrpsAmt

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (2 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
ORGANIZATIONAL COST$16,679$16,679$16,679
LESS: ACCUMULATED AMORTIZATION-$16,679-$16,679-$16,679

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp (10 entries)

DescDescRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
SCHOLARSHIP FUNDS$18,222$0$0$18,222
PROGRAM SUPPLIES$18,916$0$664$18,252
IN-KIND PROGRAM SUPPLIES$13,940$0$0$13,940
INSURANCE$3,200$0$0$3,200
MEETINGS AND EVENTS$22,475$0$0$22,475
BANK FEES$3,372$0$0$3,372
REPAIRS$2,117$0$0$2,117
OREGON CHARITABLE FEE$259$0$0$259
OREGON CORPORATE FEE$50$0$0$50
OTHER$20$0$0$20

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescTRIPS, TRAINING, SPEAKER FEESDesc
Revenue And Expenses Per Books$26,603RevenueAndExpensesPerBooksAmt
Adjusted Net Income$26,603AdjustedNetIncomeAmt

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtAdjusted Net IncomeAdjustedNetIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
INFORMATION TECHNOLOGY$913$0$0$913
CONTRACTED SERVICES$89,676$0$0$89,676
OTHER$1,254$0$0$1,254