2018-01-23T09:50:56-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 5001 SPRING VALLEY ROAD SUITE 600W DALLAS TX 75244 990 2016-01-01 200930296 ST JAMES HOUSE FOUNDATION STJA 2814251200 5800 BAKER ROAD BAYTOWN TX 77520 PAMELA NOLTING TRUSTEE 2814251200 2018-01-18 1 MICHAEL SIEGEL P01587323 9723835700 67.137.57.251 2018-01-18 11:41:29 CS 802784201731903d7e02 2017-11-15 P 620CE377AB574A82531DB92133EAAE39445EB33D DCF0373DDA6742FC5BF358053C4714DA36D31C0A 2016 2021-01-29 14:40:06Z X PAMELA NOLTING 5800 BAKER ROAD BAYTOWN TX 77520 55261 0 X N/A X 2003 TX THE FOUNDATION WAS FORMED EXCLUSIVELY FOR RELIGIOUS AND CHARITABLE PURPOSES. 6 6 0 0 0 0 0 0 0 0 53901 55261 0 0 53901 55261 68954 100407 0 0 0 0 0 0 0 0 0 68954 100407 -15053 -45146 1248146 2725850 0 0 1248146 2725850 THE FOUNDATION WAS FORMED EXCLUSIVELY FOR RELIGIOUS AND CHARITABLE PURPOSES. 0 0 100407 100407 THE FOUNDATION IS OPERATED EXCLUSIVELY FOR RELIGIOUS AND CHARITABLE PURPOSES. 100407 1 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 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 6 6 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X WES BARD 2035214055 1 CRESTA CIRCLE 1 SAN RAFAEL CA 94903 X KATHY TELLEPSEN PRESIDENT 1.00 X X 0 0 0 SUSAN JOSEY VICE-PRESIDENT 1.00 X X 0 0 0 NORMAN KITTRELL TREASURER 1.00 X X 0 0 0 SHIRLEY SHOCKLEY SECRETARY 1.00 X X 0 0 0 SUSAN MORRISON TRUSTEE 0.50 X 0 0 0 PAMELA S NOLTING TRUSTEE 0.50 5.00 X 0 0 0 0 0 0 0 0 0 0 0 17374 17374 37887 0 37887 37887 37887 55261 0 0 55261 100407 100407 100407 100407 0 0 44696 44696 0 0 1248146 2725850 1248146 2725850 0 0 X 1248146 2725850 1248146 2725850 1248146 2725850 X -45146 45771 1477079 X 0 0 0 X X 2 ST JAMES HOUSE OF BAYTOWN 741355219 10 1 100407 0 EPISCOPAL DIOCESE OF TEXAS 741143081 1 1 0 0 2 100407 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 44696 44696 0 0 1 ST JAMES HOUSE OF BAYTOWN INC 5800 W BAKER ROAD BAYTOWN TX 77520 741355219 501(C)(3) 100407 TO PROVIDE FINANCIAL ASSISTANCE TO RESIDENTS UNABLE TO PAY THE FULL COST OF CARE. 1 PART I, LINE 2: THE FOUNDATION PAYS GRANTS TO A RELATED SENIOR LIVING ENTITY (ST. JAMES HOUSE OF BAYTOWN) WHICH USES THE FUNDS EXCLUSIVELY FOR ITS RESIDENTS. FORM 990, PART VI, SECTION B, LINE 11B IT IS MADE AVAILABLE TO THE BOARD MEMBERS BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION C, LINE 19 THESE ITEMS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER 1,477,079. FORM 990, PAGE 1, SECTION B: IT WAS BROUGHT TO OUR ATTENTION THAT THE INFORMATION INCLUDED IN THE PREVIOUSLY FILED 990 WAS INCORRECT BECAUSE WE WERE PROVIDED WITH THE WRONG INVESTMENT STATEMENT. LISTED BELOW ARE THE CHANGES MADE IN THE AMENDED 990 TO REFLECT THE CORRECT INVESTMENT ACTIVITY FOR THE YEAR-ENDED 12/31/16: PAGE 1, PART I, LINE 10 WAS $119 IN THE PREVIOUSLY FILED 990, NOW IT IS $55,261 IN THE AMENDED 990. PAGE 1, PART I, LINE 12 AND PAGE 9, PART VIII, LINE 12 WAS $119 IN THE PREVIOUSLY FILED 990, NOW IT IS $55,261 IN THE AMENDED 990. PAGE 1, PART I, LINE 13 AND PAGE 10, PART IX, LINE 1 WAS $298,079 IN THE PREVIOUSLY FILED 990, NOW IT IS $100,407 IN THE AMENDED 990. PAGE 1, PART I, LINE 18 AND PAGE 10, PART IX, LINE 25 WAS $298,079 IN THE PREVIOUSLY FILED 990, NOW IT IS $100,407 IN THE AMENDED 990. PAGE 1, PART I, LINE 20 AND LINE 22 AND PAGE 11, PART X, LINE 16 AND LINE 34 WAS $0 IN THE PREVIOUSLY FILED 990, NOW IT IS $2,725,850 IN THE AMENDED 990. PAGE 2, PART III, LINE 4A AND LINE 4E FOR EXPENSES WAS $298,079 IN THE PREVIOUSLY FILED 990, NOW IT IS $100,407 IN THE AMENDED 990. PAGE 2, PART III, LINE 4A FOR THE GRANT EXPENSE WAS $298,079 IN THE PREVIOUSLY FILED 990, NOW IT IS $100,407 IN THE AMENDED 990. PAGE 3, PART IV, LINE 3 WAS CHECKED NO IN THE PREVIOUSLY FILED 990, NOW IT IS CHECKED YES. PAGE 9, PART VIII, LINE 3 WAS $2,333 IN THE PREVIOUSLY FILED 990, NOW IT IS $17,374 IN THE AMENDED 990. PAGE 9, PART VIII, LINE 7D WAS -$2,214 IN THE PREVIOUSLY FILED 990, NOW IT IS $37,877 IN THE AMENDED 990. PAGE 11, PART X, LINE 11 AND LINE 27 WAS $0 IN THE PREVIOUSLY FILED 990, NOW IT IS $2,725,850 IN THE AMENDED 990. PAGE 12, PART XI, LINE 5 WAS $12,506 IN THE PREVIOUSLY FILED 990, NOW IT IS $45,771 IN THE AMENDED 990. PAGE 12, PART XI, LINE 9 WAS -$962,692 IN THE PREVIOUSLY FILED 990, NOW IT IS $1,477,079 IN THE AMENDED 990. ST JAMES HOUSE OF BAYTOWN 5800 W BAKER ROAD BAYTOWN TX 77520 741355219 SENIOR LIVING TX 501(C)(3) LINE 10 EPISCOPAL DIOCESE OF TEXAS 0 EPISCOPAL DIOCESE OF TEXAS 1225 TEXAS AVENUE HOUSTON TX 77002 741143081 TO ADMINISTER ALL CHURCHES AND MINISTRIES WITHIN THE DIOCESE TX 501(C)(3) LINE 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0