BETA

VITALOGY FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
VITALOGY FOUNDATION (EIN 20-1030462)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-09-30
IRS object ID
201502739349300915
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-09-30T11:38:28-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911194016PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLARK NUBER PSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4TH STREET SUITE 1700AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN201030462EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VITALOGY FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVITABusinessNameControlTxt
Phone6153299902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FBMM INC PO BOX 340020AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP372030020ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMIE CHEEKPersonNm
Person TitleTREASURERPersonTitleTxt
Phone6153299902PhoneNum
Signature2015-09-24SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJANE M SEARINGPreparerPersonNm
PTINP00000565PTIN
Phone4254544919PhoneNum
Preparation2015-09-15PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTONE C GOSSARDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O FBMM INC PO BOX 340020AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP372030020ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$886,269GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateWALegalDomicileStateCd
Activity Or MissionTO RAISE FUNDS THROUGH DONATIONS FROM THE GENERAL PUBLIC IN ORDER TO SUPPORT OTHER NONPROFIT 501(C)3 ORGANIZATIONS AND GOVERNMENTAL INSTITUTIONS THROUGH CHARITABLE DONATIONS AND GRANTS WHICH ARE TO BE USED FOR EDUCATIONAL, CHARITABLE, RELIGIOUS, SCIENTIFIC, LITERARY AND/OR CONSERVATION PURPOSES.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,066,775PYContributionsGrantsAmt
CY Contributions Grants$881,984CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1,083PYInvestmentIncomeAmt
CY Investment Income$1,715CYInvestmentIncomeAmt
PY Other Revenue$34,878PYOtherRevenueAmt
CY Other Revenue$2,570CYOtherRevenueAmt
PY Total Revenue$1,102,736PYTotalRevenueAmt
CY Total Revenue$886,269CYTotalRevenueAmt
PY Grants And Similar Paid$616,761PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$882,272CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,975CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$3,020CYTotalFundraisingExpenseAmt
PY Other Expenses$42,776PYOtherExpensesAmt
CY Other Expenses$91,823CYOtherExpensesAmt
PY Total Expenses$659,537PYTotalExpensesAmt
CY Total Expenses$982,070CYTotalExpensesAmt
PY Revenues Less Expenses$443,199PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$95,801CYRevenuesLessExpensesAmt
Total Assets BOY$1,068,814TotalAssetsBOYAmt
Total Assets EOY$973,013TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,068,814NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$973,013NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO RAISE FUNDS THROUGH DONATION FROM THE GENERAL PUBLIC IN ORDER TO SUPPORT OTHER NONPROFIT 501(C)3 ORGANIZATIONS AND GOVERNMENTAL INSTITUTIONS THROUGH CHARITABLE DONATIONS AND GRANTS WHICH ARE TO BE USED FOR EDUCATIONAL, CHARITABLE, RELIGIOUS, SCIENTIFIC, LITERARY AND/OR CONSERVATION PURPOSES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$901,614ExpenseAmt
Grant$832,272GrantAmt
DescGRANTS AWARDED TO SPECIFIC CHARITABLE ORGANIZATIONS AND INDIVIDUALS CHOSEN BY THE OFFICERS OF THE FOUNDATION IN ACCORDANCE WITH THE PRIMARY PURPOSE OF VITALOGY FOUNDATION'S EXEMPT STATUS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$50,448ExpenseAmt
Grant$50,000GrantAmt
DescVITALOGY FOUNDATION SERVED AS THE FISCAL SPONSOR FOR HEAL EB, AN IRS APPROVED 501(C)(3) ORGANIZATION BETWEEN AUGUST 2013 THROUGH MAY 2014. HEAL EB IS AN ORGANIZATION DEDICATED TO TREATING AND FINDING A CURE FOR EPIDERMOLYSIS BULLOSA (EB). ONE GRANT FROM THE HEAL EB RESTRICTED FUNDS WAS MADE DURING 2013. ALL REMAINING RESTRICTED FUNDS WERE GRANTED TO 501(C)(3) ORGANIZATIONS THAT WERE APPROVED BY HEAL EB, AND SUPPORTED HEAL EB'S MISSION, IN 2014.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$952,062TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To OrgYes (1)MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FBMM INC CO JAMIE CHEEKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6153299902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 340020AddressLine1Txt
CityNASHVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP372030020ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JEFFREY A AMENT
PRESIDENT1.0020.00Yes (X)Yes (X)$0$0$0
MICHAEL D MCCREADY
VICE PRESIDENT1.0020.00Yes (X)Yes (X)$0$0$0
EDDIE J VEDDER
VICE PRESIDENT1.0020.00Yes (X)Yes (X)$0$0$0
KELLY CURTIS
SECRETARY1.0020.00Yes (X)Yes (X)$0$0$0
STONE C GOSSARD
TREASURER1.0020.00Yes (X)Yes (X)$0$0$0
MATTHEW D CAMERON
DIRECTOR1.000.00Yes (X)$0$0$0
JAMIE CHEEK
TREASURER1.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$881,984AllOtherContributionsAmt
Total Contributions$881,984TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,715TotalRevenueColumnAmt
Exclusion$1,715ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCANADIAN TAX REFUNDDesc
Business711130BusinessCd
Total Revenue Column$2,570TotalRevenueColumnAmt
Exclusion$2,570ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,570OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$886,269TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,285ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$851,034TotalAmt
Program Services$851,034ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$31,238TotalAmt
Program Services$31,238ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,409TotalAmt
Management And General$7,409ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$566TotalAmt
Management And General$566ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,562TotalAmt
Program Services$2,423ProgramServicesAmt
Management And General$4,600ManagementAndGeneralAmt
Fundraising$2,539FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,890TotalAmt
Program Services$8,365ProgramServicesAmt
Management And General$2,525ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$59,264TotalAmt
Program Services$59,002ProgramServicesAmt
Fundraising$262FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,000TotalAmt
Management And General$6,000ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,081TotalAmt
Management And General$5,888ManagementAndGeneralAmt
Fundraising$193FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26TotalAmt
Fundraising$26FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$982,070TotalAmt
Program Services$952,062ProgramServicesAmt
Management And General$26,988ManagementAndGeneralAmt
Fundraising$3,020FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$209,297BOYAmt
EOY$36,787EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$859,517BOYAmt
EOY$936,226EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,068,814BOYAmt
EOY$973,013EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$885,286BOYAmt
EOY$973,013EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$183,528BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,068,814BOYAmt
EOY$973,013EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,068,814BOYAmt
EOY$973,013EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$95,801ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$344,950CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$707,154CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$245,320CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,066,775CurrentTaxYearMinus1YearAmt
Current Tax Year$881,984CurrentTaxYearAmt
Total$3,246,183TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$344,950CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$707,154CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$245,320CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,066,775CurrentTaxYearMinus1YearAmt
Current Tax Year$881,984CurrentTaxYearAmt
Total$3,246,183TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,246,183PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,710CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,489CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,011CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,083CurrentTaxYearMinus1YearAmt
Current Tax Year$1,715CurrentTaxYearAmt
Total$9,008TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$34,878CurrentTaxYearMinus1YearAmt
Current Tax Year$2,570CurrentTaxYearAmt
Total$37,448TotalAmt
FieldValueIRS element (for citing)
Total Support$3,292,639TotalSupportAmt
Public Support CY1700.98590PublicSupportCY170Pct
Public Support PY1700.98360PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationREFUND - 2013 AMOUNT: $ 33,236. 2014 AMOUNT: $ 2,570. EXPENSE REIMBURSEMENT - 2013 AMOUNT: $ 1,642.ExplanationTxt

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (3 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
EAST ASIA AND THE PACIFIC00GRANTMAKING$23,738
SUB-SAHARAN AFRICA00GRANTMAKING$7,500
EUROPE (INCLUDING ICELAND & GREENLAND)00FUNDRAISING
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$31,238SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$31,238TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp (2 entries)

RegionRegionTxtPurpose Of GrantPurposeOfGrantTxtCash GrantCashGrantAmtManner Of Cash DisbursementMannerOfCashDisbursementTxtNon Cash AssistanceNonCashAssistanceAmt
EAST ASIA AND THE PACIFICRELIEF FUND$23,738CASH PAYMENT$0
SUB-SAHARAN AFRICAEDUCATION$7,500CASH PAYMENT$0
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp Ownership0ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2:VITALOGY FOUNDATION REQUESTS LETTERS FROM THE OUTSIDE ORGANIZATIONS BEGINNING SIX (6) MONTHS AFTER THE GRANT WAS PAID. THESE LETTERS MUST DETAIL HOW THE GRANT IS BEING USED, AND IF ANY FUNDS REMAIN, HOW THE REMAINING FUNDS WILL BE USED. THESE LETTERS CONTINUE TO BE REQUESTED BY VITALOGY FOUNDATION UNTIL THE GRANT HAS BEEN USED IN FULL.
PART I, LINE 3:VITALOGY FOUNDATION USES THE CASH METHOD OF ACCOUNTING TO REPORT EXPENDITURES WITHIN THE ORGANIZATIONS FINANCIAL STATEMENTS.
PART I, LINE 3(3):VITALOGY FOUNDATION DOES FUNDRAISING IN EUROPE THROUGH PEARL JAM CONCERTS. EXPENSES FOR THESE FUNDRAISING EVENTS ARE DONATED BY PEARL JAM TOURING, INC.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (30 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxtAddress Line2USAddress/AddressLine2Txt
ARTS CORPS
4408 DELRIDGE WAY SW 110SEATTLEWA98106912044679501(C)(3)$5,750HELPS BRING ARTS EDUCATION TO A REGION WHERE RACE LARGELY DETERMINES ARTS EDUCATION ACCESS AND TABLE SPONSORSHIP
ATC RENAMING & REBRANDING CAMPAIGN
1475 15TH STSAN FRANCISCOCA98108721600331501(C)(3)$20,000FUNDS WILL BE USED FOR ATC'S REBRANDING AND RENAMING CAMPAIGN
CASCADE VALLEY HOSPITAL
330 S STILLAGUAMISH AVEARLINGTONWA98223911912269501(C)(3)$10,000SUPPORT FUNERAL COSTS, FIRST RESPONDERS, AND FAMILIES AFFECTED BY THE LANDSLIDE
CCFA
9 LAKE BELLEVUE DR STE 203BELLEVUEWA98005136193105501(C)(3)$15,000SUPPORTS CCFA'S MISSION TO CURE CROHN'S DISEASE AND ULCERATIVE COLITIS AND TO INCREASE QUALITY OF LIFE OF THOSE AFFECTED
CCFA
9 LAKE BELLEVUE DR STE 203BELLEVUEWA98005136193105501(C)(3)$25,000SUPPORTS CCFA'S CAMP OASIS SCHOLARSHIP FUND
CONCERNED UNITED BIRTHPARENTS INC
PO BOX 5538SHERMAN OAKSCA91413042605741501(C)(3)$25,000PROVIDE SCHOLARSHIP DOLLARS TO ATTEND FUTURE CUB RETREATS; DEFRAY COSTS TO BRING IN EDUCATION SPEAKERS FOR RETREATS; HIRE OF TECHNOLOGY AD CONSULTANT TO ADVISE CUB
DESC
515 THIRD AVESEATTLEWA98104911275815501(C)(3)$10,000TO PROVIDE SHELTER AND TREATMENT TO COMMUNITY'S MOST VULNERABLE PEOPLE
EB RESEARCH PARTNERSHIP
1725 YORK AVE STE 29GNEW YORKNY10128272417202501(C)(3)$10,000TO FUND RESEARCH AIMED AT TREATING AND ULTIMATELY CURING EB
FRIENDS OF KEXP
113 DEXTER AVE NSEATTLEWA98109912061474501(C)(3)$10,000TO SUPPORT THE CAMPAIGN FOR KEXP'S NEW HOME
HEAL EB
5404 ALTON PKWY STE 5-A 794IRVINECA92604455334708501(C)(3)$151,217PAID OUT FUNDS TO HEAL EB THAT WERE COLLECTED WHILE ACTING AS ITS FISCAL SPONSOR (EB RESEARCH)
HEDGEBROOK
216 1ST AVE S STE 251SEATTLEWA98104800012629501(C)(3)$6,000SUPPORTS THE HEDGEBROOK SONGWRITERS RESIDENCY PROGRAM
LUCILLE PACKARD FOUNDATION FOR CHILDREN'S HEALTH
400 HAMILTON AVE STE 340PALO ALTOCA94301770440090501(C)(3)$50,000TO FURTHER THEIR GENE TRANSFER TRIALS WITH THE FDA
MUSICARES
3030 OLYMPIC BLVDSANTA MONICACA90404954470909501(C)(3)$12,000PROVIDES A SAFETY NET OF CRITICAL ASSISTANCE FOR MUSIC PEOPLE IN TIMES OF NEED
NORTH COUNTIES FAMILY SERVICES
PO BOX 1103DARRINGTONWA98241800594827501(C)(3)$15,000TO RAISE FUNDS TO CONSTRUCT A SKATE PARK IN OLD SCHOOL PARK
PROCLAIM JUSTICE
2303 RR 620 S 135-462LAKEWAYTX78734461395681501(C)(3)$20,000TO EFFECTIVELY ADVOCATE FOR INDIVIDUALS WHO HAVE BEEN WRONGFULLY CONVICTED
REVOLUTION PER MINUTE
1475 15TH STSAN FRANCISCOCA94103721600331501(C)(3)$10,000PROVIDES ARTISTS WITH STRATEGY AND SUPPORT FOR THEIR ACTIVISM AND PHILANTHROPY
ROCK & ROLL HALL OF FAME FOUNDATION
162 WEST 56TH ST STE 405NEW YORKNY10019133171867501(C)(3)$12,000ROCK AND ROLL HALL OF FAME INDUCTION DINNER
ROCK SCHOOL
10903 NE 53RD STKIRKLANDWA98033460494902501(C)(3)$8,000TO COVER TEACHING ARTIST COSTS FOR CLASSES AND TO HELP COVER THE COSTS OF SUMMER CAMPS
SEATTLE CHILDREN'S HOSPITAL FOUNDATION
PO BOX 5371 M/S S-200SEATTLEWA98145911156519501(C)(3)$35,723TO SUPPORT THE GREATEST NEEDS FUND
SEATTLE CHILDREN'S HOSPITAL FOUNDATION
PO BOX 5371 M/S S-200SEATTLEWA98145911156519501(C)(3)$5,000TO SUPPORT THE UNCOMPENSATED CARE PROGRAM
SILVERLAKE CONSERVATORY OF MUSIC
3920 W SUNSET BLVDLOS ANGELESCA90029270030546501(C)(3)$25,000TO PURCHASE/RENOVATE A BUILDING TO SERVE AS THEIR LONG TERM HOME
SPRUCE STREET SCHOOL
914 VIRGINIA STSEATTLEWA98101910963223501(C)(3)$10,000DONATION TO THE GENERAL FUND
SPRUCE STREET SCHOOL
914 VIRGINIA STSEATTLEWA98101910963223501(C)(3)$10,000DONATION TO THE ANNUAL FUND THAT SUPPORTS ART, MUSIC, PE, ELECTIVES, AND FINANCIAL AID
STRONGHOLD SOCIETY
2022 E 134TH WAYTHORNTONCO80241273621140501(C)(3)$200,000TO BUILD A CONCRETE SKATEPARK ON THE BLACKFEET RESERVATION IN BROWNING, MT
THE ACTOR'S GANG
9070 VENICE BLVDCULVER CITYCA90232954226223501(C)(3)$20,000TO SUPPORT THE GENERAL OPERATIONS OF THE ACTORS' GANG WHICH PRODUCES AND DEVELOPS ARTISTIC AND COMMUNITY OUTREACH PROGRAMS
THE ARMENIAN DRAMATIC ARTS ALLIANCE
3325 N GLENOAKS BLVDBURBANKCA91504830436115501(C)(3)$10,000FOR PRODUCTION OF THE TIME OF OUR LIES (PLAY ON LIFE OF HOWARD ZINN)
TREEHOUSE
2100 24TH AVE S STE 200SEATTLEWA98122911425676501(C)(3)$20,120USED AS MATCHING TO MOTIVATE OTHERS TO GIVE GENEROUSLY AT THE ANNUAL HOLIDAY MAGIC RADIO EVENT
TREEHOUSE
2100 24TH AVE S STE 200SEATTLEWA98122911425676501(C)(3)$2,500TO HELP ACHIEVE GOAL OF HELPING YOUTH IN FOSTER CARE GRADUATE FROM HIGH SCHOOL AT SAME RATE AS PEERS
WAR CHILD US
AVANT BUILDING STE 900 200 DELAWAREBUFFALONY14202200994157501(C)(3)$35,723PROVIDES ACCESS TO EDUCATION, OPPORTUNITY AND JUSTICE FOR CHILDREN AND COMMUNITIES IN WAR-AFFECTED REGIONS OF THE WORLDAVE
WILD LOVE PRESERVE
12239 10TH AVE SBURIENWA98168273729450501(C)(3)$10,000USED TOWARDS EXPENSES TO CARE FOR WLP'S 130 ADOPTED IDAHO WILD HORSES
FieldValueIRS element (for citing)
Total501c3 Org26Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationVITALOGY FOUNDATION SELECTS GRANTEES THROUGH AN INTERNAL PROCESS WITH THE FOUNDATION'S BOARD OF DIRECTORS. EACH POTENTIAL GRANTEE'S REQUEST IS REVIEWED BY EACH BOARD MEMBER TO ENSURE IT MEETS THE VITALOGY FOUNDATION'S MISSION GUIDELINES AND THE CHARITY WILL USE THE GRANT EXCLUSIVELY TO CARRY OUT THE "AS DETAILED" CHARITABLE PROJECT, OR FOR GENERAL OPERATIONS, EXCLUSIVELY FOR EXEMPT PURPOSES. ONCE THE GRANTEE HAS BEEN APPROVED, VITALOGY FOUNDATION PROVIDES THE CHARITY WITH A GRANTEE FORM THAT REQUESTS DETAILED INFORMATION ON THE ORGANIZATION INCLUDING ITS TAX ID NUMBER, IRS TAX DETERMINATION LETTER, AS WELL AS THE FUNDS REQUESTED AND HOW THEY WILL BE USED, A DISCLAIMER THAT NO GOODS OR SERVICES WERE EXCHANGED FOR THE GRANT, AND A REQUEST FOR UPDATES AND REPORTS. AFTER THE GRANTEE FORM IS IN HAND, THE CHARITY IS SENT THE FUNDS ALONG WITH THE FOUNDATION'S DONATION ACKNOWLEDGEMENT LETTER WHICH REQUESTS A SIGNATORY BACK CONFIRMING RECEIPT OF THE FUNDS. VITALOGY FOUNDATION FOLLOWS-UP WITH THE GRANTEES TO ENSURE THEY ARE ADHERING TO OUR GUIDELINES THROUGH REGULAR PHONE CALLS AS WELL AS REQUESTING WRITTEN UPDATES EVERY SIX MONTHS. THE VITALOGY FOUNDATION TEAM ALSO MAKES SITE VISITS TO SELECT LARGER SCALE GRANTEES TO GET FIRST HAND KNOWLEDGE OF HOW THE FUNDS ARE BEING APPLIED/DISPERSED IN THE FIELD. FROM THESE REPORTS AND CORRESPONDENCE WITH THE GRANTEE, THE VITALOGY FOUNDATION TEAM PROVIDES UPDATES TO THE BOARD OF DIRECTORS TWO WAYS; THROUGH WEEKLY PROJECT UPDATES AND THROUGH A MORE DETAILED ANNUAL PROJECT UPDATE AS WARRANTED BASED UPON THE SIZE OF THE GRANT. TO TRACK THESE PROJECTS, THE GRANTEES' WRITTEN REPORTS, TEAM CORRESPONDENCE, AND BOARD UPDATES ARE FILED ALONG WITH THE CORRESPONDING GRANTEE FORM AND IRS LETTER ACKNOWLEDGEMENT. INTERNALLY, VITALOGY FOUNDATION KEEPS A RUNNING CONTRIBUTION SUMMARY OF ALL GRANTS MADE TO DATE BY YEAR THAT INCLUDES TRACKING ON UPDATES RECEIVED BY GRANTEES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 6, TOTAL NUMBER OF VOLUNTEERS:THE TOTAL NUMBER OF VOLUNTEERS CONSISTS OF THE SIX NON-COMPENSATED BOARD MEMBERS.
FORM 990, PART III, LINE 3VITALOGY FOUNDATION SERVED AS THE FISCAL SPONSOR FOR A SEPARATE 501(C)(3) ORGANIZATION NAMED HEAL EB THRU MAY 2014.
FORM 990, PART VI, SECTION A, LINE 2ALL MEMBERS OF THE BOARD HAVE BUSINESS RELATIONSHIP WITH EACH OTHER.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY AN OUTSIDE CPA FIRM, REVIEWED BY OUTSIDE CONSULTANTS KNOWLEDGABLE ABOUT THE ORGANIZATION, AND PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION C, LINE 19VITALOGY FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FORM 990 AVAILABLE TO INTERESTED PARTIES UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
PEARL JAM LLC
PO BOX 340020NASHVILLETN372030020911695049MUSICAL ENTERTAINMENTWAN/A
DEKERIVER LLC
1900 SOUTH CORGIAT DRIVESEATTLEWA98108203277547BUILDING RENTALWAN/A
TEN CLUB LLC
1900 SOUTH CORGIAT DRIVESEATTLEWA98108912094535FAN CLUB MERCHANDISEWAN/A
MONKEYWRENCH FILMS LLC
PO BOX 340020NASHVILLETN372030020264471983FILM PRODUCTIONCAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
MONKEYWRENCH INC
PO BOX 340020NASHVILLETN372030020331062443MUSICAL RECORDINGSWAN/AS0
PEARL JAM TOURING INC
PO BOX 340020NASHVILLETN372030020911531093MUSICAL ENTERTAINMENTNVN/AS0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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