JESSIE F RICHARDSON FOUNDATION: Form 990PF, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- JESSIE F RICHARDSON FOUNDATION (EIN 93-1316345)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-11
- IRS object ID
- 201742849349101054
- Schema version
- 2016v3.0
- 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-PF
- Schedule B
- Accounting Fees Schedule
- Other Assets Schedule
- Other Decreases Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Professional Fees Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-10-11T19:43:59-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 930928924 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PERKINS & COMPANY PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1211 SW FIFTH AVE SUITE 1000 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 972043710 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931316345 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JESSIE F RICHARDSON FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JESS | BusinessNameControlTxt |
| Phone | 5034084088 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15900 SE 82ND DRIVE | AddressLine1Txt |
| City | CLACKAMAS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97015 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEREN BROWN WILSON | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5034084088 | PhoneNum |
| Signature | 2017-10-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CYNTHIA P BARTHOLOMEW | PreparerPersonNm |
| PTIN | P01313965 | PTIN |
| Phone | 5032210336 | PhoneNum |
| Preparation | 2017-10-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 70.102.39.100 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-10-04 | IPDt |
| IP Tm | 14:57:27 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | FC2FD6F20AF929F1BDF8D36BCDF1CA8F3FB2C8BC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A5A6F1C0E07EDBEBF6E43D6E874CE1FF0144AD5F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $594,407 | FMVAssetsEOYAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $370,624 | ContriRcvdRevAndExpnssAmt |
| Interest On Sav Rev And Expnss | $1,269 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $1,269 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $1,269 | InterestOnSavingsAdjNetIncmAmt |
| Cap Gain Net Incm Net Invst Incm | $0 | CapGainNetIncmNetInvstIncmAmt |
| Net ST Capital Gain Adj Net Incm | $0 | NetSTCapitalGainAdjNetIncmAmt |
| Other Income Rev And Expnss | $10,139 | OtherIncomeRevAndExpnssAmt |
| Other Income Net Invst Incm | $0 | OtherIncomeNetInvstIncmAmt |
| Other Income Adj Net Incm | $10,139 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $382,032 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $1,269 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $11,408 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Comp Ofcr Dir Trst Net Invst Incm | $0 | CompOfcrDirTrstNetInvstIncmAmt |
| Comp Ofcr Dir Trst Adj Net Incm | $0 | CompOfcrDirTrstAdjNetIncmAmt |
| Comp Ofcr Dir Trst Dsbrs Chrtbl | $0 | CompOfcrDirTrstDsbrsChrtblAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $33,643 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Net Invst Incm | $0 | OthEmplSlrsWgsNetInvstIncmAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $1,000 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $32,643 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $12,145 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $2,429 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $1,269 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $9,716 | AccountingFeesChrtblPrpsAmt |
| Other Prof Fees Rev And Expnss | $87,122 | OtherProfFeesRevAndExpnssAmt |
| Other Prof Fees Net Invst Incm | $0 | OtherProfFeesNetInvstIncmAmt |
| Other Prof Fees Adj Net Incm | $0 | OtherProfFeesAdjNetIncmAmt |
| Other Prof Fees Dsbrs Chrtbl | $87,122 | OtherProfFeesDsbrsChrtblAmt |
| Occupancy Rev And Expnss | $4,102 | OccupancyRevAndExpnssAmt |
| Occupancy Net Invst Incm | $0 | OccupancyNetInvstIncmAmt |
| Occupancy Adj Net Incm | $0 | OccupancyAdjNetIncmAmt |
| Occupancy Dsbrs Chrtbl | $4,102 | OccupancyDsbrsChrtblAmt |
| Trav Conf Meeting Rev And Expnss | $44,871 | TravConfMeetingRevAndExpnssAmt |
| Trav Conf Meeting Net Invst Incm | $0 | TravConfMeetingNetInvstIncmAmt |
| Trav Conf Meeting Adj Net Incm | $8,826 | TravConfMeetingAdjNetIncmAmt |
| Trav Conf Meeting Dsbrs Chrtbl | $36,045 | TravConfMeetingDsbrsChrtblAmt |
| Printing And Pub Rev And Expnss | $296 | PrintingAndPubRevAndExpnssAmt |
| Printing And Pub Net Invst Incm | $0 | PrintingAndPubNetInvstIncmAmt |
| Printing And Pub Adj Net Incm | $0 | PrintingAndPubAdjNetIncmAmt |
| Printing And Pub Dsbrs Chrtbl | $296 | PrintingAndPubDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $68,819 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Net Invst Incm | $0 | OtherExpensesNetInvstIncmAmt |
| Other Expenses Adj Net Incm | $0 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $68,819 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $250,998 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $2,429 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $11,095 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $238,743 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $250,998 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $2,429 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $11,095 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $238,743 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | $131,034 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $313 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $82,036 | CashBOYAmt |
| Cash EOY | $202,793 | CashEOYAmt |
| Cash EOYFMV | $202,793 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $384,495 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $390,368 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $390,368 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl BOY | $35 | AcctRcvblBOYAmt |
| Prepaid Expenses BOY | $125 | PrepaidExpensesBOYAmt |
| Prepaid Expenses EOY | $1,246 | PrepaidExpensesEOYAmt |
| Prepaid Expenses EOYFMV | $1,246 | PrepaidExpensesEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $5,149 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,149 | LandBldgEquipAccumDeprecAmt |
| Other Assets BOY | $0 | OtherAssetsBOYAmt |
| Other Assets EOY | $0 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $0 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $466,691 | TotalAssetsBOYAmt |
| Total Assets EOY | $594,407 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $594,407 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $3,362 | AccountsPayableBOYAmt |
| Loans From Officers EOY | $1,246 | LoansFromOfficersEOYAmt |
| Total Liabilities BOY | $3,362 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,246 | TotalLiabilitiesEOYAmt |
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
| Capital Stock BOY | $0 | CapitalStockBOYAmt |
| Capital Stock EOY | $0 | CapitalStockEOYAmt |
| Additional Paid In Capital BOY | $0 | AdditionalPaidInCapitalBOYAmt |
| Additional Paid In Capital EOY | $0 | AdditionalPaidInCapitalEOYAmt |
| Retained Earning BOY | $463,329 | RetainedEarningBOYAmt |
| Retained Earning EOY | $593,161 | RetainedEarningEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $463,329 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $593,161 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $466,691 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $594,407 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $463,329 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | $131,034 | ExcessRevenueOverExpensesAmt |
| Other Increases | $0 | OtherIncreasesAmt |
| Subtotal | $594,363 | SubtotalAmt |
| Other Decreases | $1,202 | OtherDecreasesAmt |
| Tot Net Ast Or Fund Balances EOY | $593,161 | TotNetAstOrFundBalancesEOYAmt |
Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liable Section4942 Tax | 0 | LiableSection4942TaxInd |
| Adjusted Qlfy Distri Yr1 | $205,078 | AdjustedQlfyDistriYr1Amt |
| Net Vl Noncharitable Assets Yr1 | $426,546 | NetVlNoncharitableAssetsYr1Amt |
| Distribution Yr1 | 0.480788 | DistributionYr1Rt |
| Adjusted Qlfy Distri Yr2 | $240,315 | AdjustedQlfyDistriYr2Amt |
| Net Vl Noncharitable Assets Yr2 | $420,596 | NetVlNoncharitableAssetsYr2Amt |
| Distribution Yr2 | 0.571368 | DistributionYr2Rt |
| Adjusted Qlfy Distri Yr3 | $201,161 | AdjustedQlfyDistriYr3Amt |
| Net Vl Noncharitable Assets Yr3 | $416,602 | NetVlNoncharitableAssetsYr3Amt |
| Distribution Yr3 | 0.482861 | DistributionYr3Rt |
| Adjusted Qlfy Distri Yr4 | $251,729 | AdjustedQlfyDistriYr4Amt |
| Net Vl Noncharitable Assets Yr4 | $433,558 | NetVlNoncharitableAssetsYr4Amt |
| Distribution Yr4 | 0.580612 | DistributionYr4Rt |
| Adjusted Qlfy Distri Yr5 | $158,355 | AdjustedQlfyDistriYr5Amt |
| Net Vl Noncharitable Assets Yr5 | $413,597 | NetVlNoncharitableAssetsYr5Amt |
| Distribution Yr5 | 0.382873 | DistributionYr5Rt |
| Total Distribution | 2.498502 | TotalDistributionRt |
| Average Distribution | 0.499700 | AverageDistributionRt |
| Net Vl Noncharitable Assets | $516,027 | NetVlNoncharitableAssetsAmt |
| Adj Net Vl Noncharitable Assets | $257,859 | AdjNetVlNoncharitableAssetsAmt |
| Net Investment Income Pct | $0 | NetInvestmentIncomePctAmt |
| Adj Nonchrtbl Net Invst Incm Pct | $257,859 | AdjNonchrtblNetInvstIncmPctAmt |
| Qualifying Distributions | $238,743 | QualifyingDistributionsAmt |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $0 | InvestmentIncomeExciseTaxAmt |
| Tax Under Section511 | $0 | TaxUnderSection511Amt |
| Subtotal | $0 | SubtotalAmt |
| Subtitle A Tax | $0 | SubtitleATaxAmt |
| Tax Based On Investment Income | $0 | TaxBasedOnInvestmentIncomeAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Tax Due | $0 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | 0 | LegislativePoliticalActyInd |
| More Than100 Spent | 0 | MoreThan100SpentInd |
| Form1120 POL Filed | 0 | Form1120POLFiledInd |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Tax Reimbursed | $0 | TaxReimbursedAmt |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | 0 | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (1) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (1) | AtLeast5000InAssetsInd |
| Org Report Or Register State | OR | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (1) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (1) | PrivateOperatingFoundationInd |
| New Substantial Contributors | 0 | NewSubstantialContributorsInd |
| Own Controlled Entity | 0 | OwnControlledEntityInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (1) | ComplyWithPublicInspRqrInd |
| Website Address | JFRFOUNDATION.ORG | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEREN BROWN WILSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5034084088 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15900 SE 82ND DRIVE | AddressLine1Txt |
| City | CLACKAMAS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | 0 | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | Yes (1) | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | Yes (1) | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | Yes (1) | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | 0 | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | 0 | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | 0 | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | 0 | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | 0 | UncorrectedPriorActsInd |
| Undistributed Income PY | 0 | UndistributedIncomePYInd |
| Business Holdings | 0 | BusinessHoldingsInd |
| Jeopardy Investments | 0 | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | 0 | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | 0 | InfluenceLegislationInd |
| Influence Election | 0 | InfluenceElectionInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Noncharitable Purpose | 0 | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| KEREN BROWN WILSON | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | CHAIR & PRESIDENT | 40.00 | $0 | $0 | $0 |
| GARY WITHERS | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | VICE CHAIR & DIRECTOR | 2.00 | $0 | $0 | $0 |
| KEN BURGESS | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | SECRETARY & DIRECTOR | 2.00 | $0 | $0 | $0 |
| TONY LEINWEBER | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | TREASURER & DIRECTOR | 2.00 | $0 | $0 | $0 |
| JOANNE HANDY | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| MARVIN KAISER | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| SEAN KUNI | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| CARMEN LARGAESPADA | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| CARRON SUDDRETH | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| NICOLE MAHER | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| DAVE CARBONEAU | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| KRISTEN CONNER | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| JAY STOWERS | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| DAVE TUPPER | ||||||||
| 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | DIRECTOR | 2.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Comp Of Hghst Pd Empl Or NONE | NONE | CompOfHghstPdEmplOrNONETxt |
| Other Employee Paid Over50k | 0 | OtherEmployeePaidOver50kCnt |
| Comp Of Hghst Pd Cntrct Or NONE | NONE | CompOfHghstPdCntrctOrNONETxt |
| Contractor Paid Over50k | 0 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | GLOBAL 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 30 CAREGIVER TRAINING VIDEOS FOR SPANISH LANGUAGE NONLITERATE ADULT LEARNERS.3. CONTINUED SUPPORT OF ELDER HOMES IN NICARAGUAN CITIES OF JUIGALPA, SOMOTO, ESTELI, OCOTOL, JINOTEGA, JINOTEPE, MANAGUA, DIRIAMBA AND SAN MARCOS.4. HELD COMMUNITY AND UNIVERSITY TRAININGS ON DIABETES, DEMENTIA, INCONTINENCE, AND NUTRITION.6. IMPLEMENTED PILOT FIELDWORK PROJECT FOR PHYSICAL THERAPY. | Description1Txt |
| Expenses1 | $0 | Expenses1Amt |
| Description2 | CHARITABLE ACTIVITY #1, GLOBAL PROGRAM SUPPORT, CONT'D:7. CONTINUED PROVIDING SCHOLARSHIP 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).9. CONTINUED SUPPORT OF NICARAGUAN AGING ADVISORY COUNCIL IN DEVELOPMENT OF NATIONAL STRATEGIC PLAN AND ADVOCACY FOR DEVELOPMENT OF CARE STANDARDS.10. SIGNED AGREEMENT WITH ROTARACT FOR INTERGENERATIONAL PROGRAM TO BRING OLD AND YOUNG ADULTS TOGETHER.11. WORKED IN COLLABORATION WITH NICARAGUA MINISTRY OF HEALTH AND PRIVATE NGOS TO HAVE CLINICS IN DIRIAMBA, SAN MARCOS, JUIGALPA, ESTELI AND JINOTENGA.12. FACILITATED THE WORK OF AMIGOS VOLUNTEER GROUP TO PROVIDE EYE EXAMINATIONS AND PROVISION OF GLASSES IN JINOTEGA AND MASATEPE. | Description2Txt |
| Expenses2 | $153,107 | Expenses2Amt |
| Description3 | EDUCATION/TRAINING/RESEARCH/POLICY:1. ORGANIZED SERVICE LEARNING TRIPS AND CLINICAL FIELDWORK FOR STUDENTS OF UNIV. OF NEW HAMPSHIRE, NORTHLAND COLLEGE, PACIFIC UNIV., PORTLAND STATE UNIV., AND OREGON HEALTH AND SCIENCE UNIV. FOR 27 STUDENTS, 5 FACULTY.2. FUNDED 13 SCHOLARSHIPS, 4 COMMUNITY AWARDS.3. CONTINUED DISCUSSIONS WITH WASHINGTON STATE UNIV. REGARDING DEVELOPMENT OF SERVICE LEARNING, FIELD WORK AND INDEPENDENT STUDY PROGRAM.4. CONTINUED WORK ON AGING MATTERS PROJECTS AT PORTLAND STATE UNIV. AND SCHOOL OF ENGINEERING.5. WROTE SECTION OF GERONTOLOGY TEXTBOOK AND 1 PEER REVIEWED ARTICLE RELATING TO AGING.6. CONTINUED PRODUCTION OF LEAP (LIFE ENRICHMENT ACTIVITY PROGRAM) FOR ASSISTED LIVING RESIDENTS INCLUDING MONTHLY NEWSLETTERS.7. CONDUCTED SURVEY OF ALL ELDER CARE HOMES IN NICARAGUA TO DETERMINE STRENGTHS AND AREAS OF NEED.8. CONDUCTED FOCUS GROUPS AMONG GRANDPARENTS RAISING GRANDCHILDREN TO DETERMINE BEST AREAS AND STRATEGIES TO PROVIDE SUPPORT. | Description3Txt |
| Expenses3 | $8,439 | Expenses3Amt |
| Description4 | INCREASE AWARENESS AND SUPPORT FOR VERY LOW INCOME ADULTS IN U.S.:1. WORKED WITH WEST VIRGINIA UNIV MEDICAL SCHOOL TO IDENTIFY STRATEGIES FOR RURAL HEALTH COMMUNITY ENGAGEMENT.2. CONTINUED DEVELOPMENT OF PROGRAM BENEFITING OREGON GRANDPARENTS RAISING GRANDCHILDREN.3. SUPPORTED ACTIVITIES OF OREGON AGING PROGRAMS, SPECIFICALLY MEALS ON WHEELS & ELDERS IN ACTION.4. INITIATED JFRF AFFORDABLE HOUSING WITH SERVICES WORK GROUP TO FOSTER INNOVATION IN THE AREA OF PROVIDING HOUSING 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)TWO BOARDS WHOSE MISSIONS ARE TO PROVIDE SERVICES TO OLDER ADULTS, PRIMARILY MEDICAID RECIPIENTS; AND D)BOARD DESIGNED TO IMPROVE QUALITY OF CARE FOR OLDER ADULTS IN NH AND AL. | Description4Txt |
| Expenses4 | $25,366 | Expenses4Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $523,885 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $523,885 | TotalFMVOfUnusedAssetsAmt |
| Reduction Claimed | $0 | ReductionClaimedAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $523,885 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $7,858 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $516,027 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $25,801 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
Qualifying Distri Part XII QualifyingDistriPartXIIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $238,743 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Qualifying Distributions | $238,743 | QualifyingDistributionsAmt |
| Pct Sect4940e Org Net Invst Incm | $0 | PctSect4940eOrgNetInvstIncmAmt |
| Adjusted Qualifying Distri | $238,743 | AdjustedQualifyingDistriAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Fndtn Ruling | 2002-02-12 | PrivateOperatingFndtnRulingDt |
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $313 | CurrentYearAmt |
| Year1 | $1,039 | Year1Amt |
| Year2 | $1,027 | Year2Amt |
| Year3 | $1,166 | Year3Amt |
| Total | $3,545 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $266 | CurrentYearAmt |
| Year1 | $883 | Year1Amt |
| Year2 | $873 | Year2Amt |
| Year3 | $991 | Year3Amt |
| Total | $3,013 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $238,743 | CurrentYearAmt |
| Year1 | $205,078 | Year1Amt |
| Year2 | $240,315 | Year2Amt |
| Year3 | $201,161 | Year3Amt |
| Total | $885,297 | TotalAmt |
Qualifying Distri Not Used Drt QualifyingDistriNotUsedDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Year3 | $0 | Year3Amt |
| Total | $0 | TotalAmt |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $238,743 | CurrentYearAmt |
| Year1 | $205,078 | Year1Amt |
| Year2 | $240,315 | Year2Amt |
| Year3 | $201,161 | Year3Amt |
| Total | $885,297 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $17,201 | CurrentYearAmt |
| Year1 | $14,218 | Year1Amt |
| Year2 | $14,020 | Year2Amt |
| Year3 | $13,887 | Year3Amt |
| Total | $59,326 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributing Manager | KEREN BROWN WILSON | ContributingManagerNm |
Application Submission Info ApplicationSubmissionInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Person | KEREN BROWN WILSON | RecipientPersonNm |
Recipient US Address RecipientUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15900 SE 82ND DRIVE | AddressLine1Txt |
| City | CLACKAMAS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient Phone | 5034084088 | RecipientPhoneNum |
| Form And Info And Materials | NONE SPECIFIED AT THIS TIME | FormAndInfoAndMaterialsTxt |
| Submission Deadlines | NONE SPECIFIED AT THIS TIME | SubmissionDeadlinesTxt |
| Restrictions On Awards | NONE SPECIFIED AT THIS TIME | RestrictionsOnAwardsTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grant Or Contri Pd Dur Yr | $0 | TotalGrantOrContriPdDurYrAmt |
| Total Grant Or Contri Apprv Fut | $0 | TotalGrantOrContriApprvFutAmt |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $1,269 | ExclusionAmt |
Other Revenue Described OtherRevenueDescribedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NICARAGUA TRIP FEES | Desc |
| Related Or Exempt Function Incm | $10,139 | RelatedOrExemptFunctionIncmAmt |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Unrelated Business Taxbl Incm | $0 | UnrelatedBusinessTaxblIncmAmt |
| Exclusion | $1,269 | ExclusionAmt |
| Related Or Exempt Function Incm | $10,139 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $11,408 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Line Number | 11A | LineNumberTxt |
| Relationship Statement | COORDINATED TRIP TO NICARAGUA TO EDUCATE VOLUNTEERS ON ELDER CARE AND TO PROVIDE SUPPORT TO INDIGENT OLDER NICARAGUAN ADULTS. | RelationshipStatementTxt |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | 0 | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | 0 | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | 0 | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | 0 | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | 0 | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | 0 | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | 0 | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | 0 | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | 0 | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | 0 | RelationshipsNonchrtblEOInd |
Schedule B IRS990ScheduleB
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| General Rule | Yes (X) | GeneralRuleInd |
Contributor Information ContributorInformationGrp (13 entries)
| ContributorContributorNum | Address Line1ContributorUSAddress/AddressLine1Txt | CityContributorUSAddress/CityNm | State AbbreviationContributorUSAddress/StateAbbreviationCd | ZIPContributorUSAddress/ZIPCd | Total ContributionsTotalContributionsAmt | Person ContributionPersonContributionInd |
|---|---|---|---|---|---|---|
| KEREN BROWN WILSON | ||||||
| 1 | 15900 SE 82ND DRIVE | CLACKAMAS | OR | 97015 | $67,000 | Yes (X) |
| SEAN KUNI | ||||||
| 2 | 1401 NW 48TH STREET | VANCOUVER | WA | 98663 | $5,000 | Yes (X) |
| VITAL LIFE A MARQUIS AND CONSONUS FOUNDATION | ||||||
| 3 | 4650 SE INTERNATIONAL WAY SUITE 100 | MILWAUKIE | OR | 97222 | $10,000 | Yes (X) |
| KEN BURGESS | ||||||
| 4 | 3580 LONESOME PINE RD | WHITAKERS | NC | 27891 | $5,000 | Yes (X) |
| CARE CONCEPTS LLC | ||||||
| 5 | PO BOX 19509 | PORTLAND | OR | 97280 | $5,000 | Yes (X) |
| CLAPPS CONVALESCENT NURSING HOME | ||||||
| 6 | 500 MOUNTAIN TOP DR | ASHEBORO | NC | 27203 | $5,000 | Yes (X) |
| COMMUNITY FOUNDATION OF GREENVILLE | ||||||
| 7 | 630 E WASHINGTON ST | GREENVILLE | SC | 29601 | $5,000 | Yes (X) |
| SOCIAL VENTURE PARTNERS PORTLAND | ||||||
| 8 | 221 NW 2ND AVE | PORTLAND | OR | 97209 | $15,000 | Yes (X) |
| VILLAGES OF WILKES | ||||||
| 9 | 206 OLD BRICKYARD RD | NORTH WILKESBORO | NC | 28659 | $5,000 | Yes (X) |
| VIBRA SPECIALTY HOSPITAL OF PORTLAND | ||||||
| 10 | 10300 NE HANCOCK ST | PORTLAND | OR | 97220 | $5,000 | Yes (X) |
| GARY WITHERS | ||||||
| 11 | 7186 SW ARRANMORE WY | PORTLAND | OR | 97223 | $6,000 | Yes (X) |
| ARDENT HEALTH & REHABILITATION CO | ||||||
| 12 | 229 AIRPORT RD 7 | ARDEN | NC | 28704 | $5,000 | Yes (X) |
| CLAPPS NURSING CENTER INC | ||||||
| 13 | PO BOX 249 | PLEASANT GARDEN | NC | 27313 | $5,500 | Yes (X) |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING & BOOKKEEPING | CategoryTxt |
| Amt | $12,145 | Amt |
| Net Investment Income | $2,429 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $1,269 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $9,716 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| ORGANIZATIONAL COST | $16,679 | $16,679 | $16,679 |
| LESS: ACCUMULATED AMORTIZATION | -$16,679 | -$16,679 | -$16,679 |
Other Decreases Schedule OtherDecreasesSchedule
Other Decreases Detail OtherDecreasesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUAL TO CASH ADJUSTMENT - PRIOR YEAR | Desc |
| Amt | $1,202 | Amt |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (5 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| SCHOLARSHIPS | $12,864 | $0 | $0 | $12,864 |
| POSTAGE, SHIPPING, DELIVERY | $216 | $0 | $0 | $216 |
| PROGRAM SUPPLIES | $14,413 | $0 | $0 | $14,413 |
| IN-KIND PROGRAM SUPPLIES EXPENSE | $6,915 | $0 | $0 | $6,915 |
| OTHER | $34,411 | $0 | $0 | $34,411 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NICARAGUA TRIP FEES | Desc |
| Revenue And Expenses Per Books | $10,139 | RevenueAndExpensesPerBooksAmt |
| Adjusted Net Income | $10,139 | AdjustedNetIncomeAmt |
Other Professional Fees Schedule OtherProfessionalFeesSchedule
Other Professional Fees Detail OtherProfessionalFeesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Net Investment IncomeNetInvestmentIncomeAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|---|
| INFORMATION TECHNOLOGY | $2,119 | $0 | $0 | $2,119 |
| OTHER | $85,003 | $0 | $0 | $85,003 |