CLARK LEWIS FAMILY FOUNDATION: Form 990PF, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CLARK LEWIS FAMILY FOUNDATION (EIN 20-3839795)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-06
IRS object ID
201321269349100622
Schema version
2012v2.1
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)
Timestamp2013-05-06T12:52:32-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FELLNER & KUHNBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1900 SW FIFTH AVE SUITE 1815AddressLine1
CityPORTLANDCity
StateORState
ZIP Code972041227ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN203839795EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CLARKLEWIS FAMILY FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLARNameControl
Phone5032353685Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 SE SPOKANE STREETAddressLine1
Address Line2ROOM/SUITE 7AddressLine2
CityPORTLANDCity
StateORState
ZIP Code97202ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCANDACE C HOLZGRAFEName
TitlePRESIDENTTitle
Phone5032353685Phone
Date Signed2013-05-02DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameDEBORAH L PATTENName
Phone5032270443Phone
Date Prepared2013-05-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY97844FMVAssetsEOY
Method Of Accounting CashXMethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Received Rev And Expnss150000ContriReceivedRevAndExpnss
Total Revenue And Expenses150000TotalRevenueAndExpenses
Total Net Investment Income0TotalNetInvestmentIncome
Legal Fees Rev And Expnss565LegalFeesRevAndExpnss
Accounting Fees Rev And Expnss700AccountingFeesRevAndExpnss
Other Prof Fees Rev And Expnss10OtherProfFeesRevAndExpnss
Taxes Rev And Expnss130TaxesRevAndExpnss
Tot Opr Expenses Rev And Expnss1405TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm0TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps0TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss103975ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps103975ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss105380TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm0TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps103975TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses44620ExcessOfRevenueOverExpenses
Net Investment Income0NetInvestmentIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Cash BOY1CashBOY
Cash EOY1CashEOY
Savings And Temp Cash Invst BOY53224SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY97844SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV97844SavingsAndTempCashInvstEOYFMV
Total Assets BOY53225TotalAssetsBOY
Total Assets EOY97845TotalAssetsEOY
Total Assets EOYFMV97844TotalAssetsEOYFMV
Total Liabilities EOY0TotalLiabilitiesEOY
Org That Follow SFAS117XOrgThatFollowSFAS117
Unrestricted BOY53225UnrestrictedBOY
Unrestricted EOY97845UnrestrictedEOY
Total Net Assets BOY53225TotalNetAssetsBOY
Total Net Assets EOY97845TotalNetAssetsEOY
Total Liabilities Net Assets BOY53225TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY97845TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY53225TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses44620ExcessOfRevenueOverExpenses
Subtotal97845Subtotal
Total Net Assets Fund Balances EOY97845TotalNetAssetsFundBalancesEOY

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 TaxfalseLiableFor4942Tax
Qualifying Distributions Year198535QualifyingDistributionsYear1
Noncharitable Assets Year127744NoncharitableAssetsYear1
Distribution Ratio Year13.551579DistributionRatioYear1
Qualifying Distributions Year286825QualifyingDistributionsYear2
Qualifying Distributions Year3153795QualifyingDistributionsYear3
Qualifying Distributions Year4116890QualifyingDistributionsYear4
Qualifying Distributions Year585811QualifyingDistributionsYear5
Total Distribution Ratio3.551579TotalDistributionRatio
Average Distribution Ratio3.551579AverageDistributionRatio
Net Noncharitable Assets74401NetNoncharitableAssets
Adjusted Noncharitable Assets264241AdjustedNoncharitableAssets
Adj Nonchrtbl Assets And One264241AdjNonchrtblAssetsAndOnePct
Qualifying Distributions103975QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Investment Income Excise Tax0InvestmentIncomeExciseTax

Statements Regarding Activities StatementsRegardingActivities

FieldValueIRS element (for citing)
Legislative Political ActivitiesfalseLegislativePoliticalActivities
More Than100 SpentfalseMoreThan100Spent
Form1120 POL FiledfalseForm1120POLFiled
Activities Not Prev ReportedfalseActivitiesNotPrevReported
Changes To Articles Or BylawsfalseChangesToArticlesOrBylaws
Unrelated Bus Income Over1000falseUnrelatedBusIncomeOver1000
Termination EtcfalseTerminationEtc
Requirements Of Sect508etrueRequirementsOfSect508e
At Least5000 In AssetstrueAtLeast5000InAssets
States Filed WithORStatesFiledWith
Form990 PF Filed With AGtrueForm990PFFiledWithAG
Private Operating FoundationfalsePrivateOperatingFoundation
New Substantial ContributorsfalseNewSubstantialContributors
Interest In Controlled EntityfalseInterestInControlledEntity
Applicable Insurance ContractfalseApplicableInsuranceContract
Comply With Public Inspection RqrtrueComplyWithPublicInspectionRqr
Website AddressN/AWebsiteAddress
Books In Care Of Person NameCANDACE C HOLZGRAFEBooksInCareOfPersonName
Books In Care Of Phone Number5032353685BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line1300 SE SPOKANE 7AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97202ZIPCode
FieldValueIRS element (for citing)
Foreign BankfalseForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

FieldValueIRS element (for citing)
Sale Or Exchange With Dsqfly PersonfalseSaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly PersonfalseBorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly PersonfalseFurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly PersonfalsePayCompensationToDsqflyPerson
Transfer Assets To Dsqfly PersonfalseTransferAssetsToDsqflyPerson
Payment To Government OfficalfalsePaymentToGovernmentOffical
Undistributed Income Prior YearsfalseUndistributedIncomePriorYears
Business HoldingsfalseBusinessHoldings
Jeopardy InvestmentsfalseJeopardyInvestments
Uncorrected Jeopardy InvestmentsfalseUncorrectedJeopardyInvestments
Influence LegislationfalseInfluenceLegislation
Influence ElectionfalseInfluenceElection
Grants To IndividualsfalseGrantsToIndividuals
Grants To OrganizationsfalseGrantsToOrganizations
Noncharitable PurposefalseNoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft ContractfalseRcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft ContractfalsePayPremiumsPrsnlBnftContract
Prohibited Tax Shelter TransactnfalseProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (5 entries)

Address Line1USAddress/AddressLine1Address Line2USAddress/AddressLine2CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
CANDACE C HOLZGRAFE
300 SE SPOKANESUITE 7PORTLANDOR97202PRESIDENT1.00000
JON R HOLZGRAFE
300 SE SPOKANESUITE 7PORTLANDOR97202SECRETARY1.00000
ANTHONY BEBER
17426 SW SARALA STBEAVERTONOR97007DIRECTOR1.00000
TRACEY BEBER
17426 SW SARALA STBEAVERTONOR97007DIRECTOR1.00000
BRETT BEBER
6206 SW VIEWPOINT LANEPORTLANDOR97239DIRECTOR1.00000
FieldValueIRS element (for citing)
Comp Of Highest Paid Empl NONENONECompOfHighestPaidEmplNONE
Comp Of Hghst Paid Cntrct NONENONECompOfHghstPaidCntrctNONE

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Description1N/ADescription1

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities0AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances75534AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets75534TotalFMVOfUnusedAssets
Adj Total FMV Of Unused Assets75534AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable1133CashDeemedCharitable
Net Noncharitable Assets74401NetNoncharitableAssets
Minimum Investment Return3720MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return3720MinimumInvestmentReturn
Distributable Amount Before Adj3720DistributableAmountBeforeAdj
Distributable Amount Before Ded3720DistributableAmountBeforeDed
Distributable Amount As Adjusted3720DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions103975ExpensesAndContributions
Qualifying Distributions103975QualifyingDistributions
Adj Qualifying Distributions103975AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted3720DistributableAmountAsAdjusted
Excess Distri Carryover Year568361ExcessDistriCarryoverYear5
Excess Distri Carryover Year4116890ExcessDistriCarryoverYear4
Excess Distri Carryover Year3153795ExcessDistriCarryoverYear3
Excess Distri Carryover Year286825ExcessDistriCarryoverYear2
Excess Distri Carryover Year197148ExcessDistriCarryoverYear1
Total Excess Distri Carryover523019TotalExcessDistriCarryover
Qualifying Distributions103975QualifyingDistributions
Applied To Current Year3720AppliedToCurrentYear
Remaining Distri From Corpus100255RemainingDistriFromCorpus
Total Corpus623274TotalCorpus
Undistributed Income CY0UndistributedIncomeCY
Excess Distri Cyov From Year568361ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year554913ExcessDistriCyovToNextYear
Excess From Year4116890ExcessFromYear4
Excess From Year3153795ExcessFromYear3
Excess From Year286825ExcessFromYear2
Excess From Year197148ExcessFromYear1
Excess From Current Year100255ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

FieldValueIRS element (for citing)
Contributing ManagerCANDACE C HOLZGRAFEContributingManager

Appication Submission Info AppicationSubmissionInfo

FieldValueIRS element (for citing)
Recipient NameCANDACE HOLZGRAFERecipientName

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1300 SE SPOKANE APT 7AddressLine1
CityPORTLANDCity
StateORState
ZIP Code97202ZIPCode
FieldValueIRS element (for citing)
Recipient Phone Number5032353685RecipientPhoneNumber
Form And Info And MaterialsNO PRESCRIBED FORMFormAndInfoAndMaterials
Submission DeadlinesNONESubmissionDeadlines
Restrictions On AwardsNONERestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (23 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient RelationshipRecipientRelationshipPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmountBusiness Name Line2RecipientBusinessName/BusinessNameLine2
BIG BROTHERSSISTERS
42-600 COOK STREET 110PALM DESERTCA92211NONEPROGRAM SUPPORT$500
OREGON ZOO FOUNDATION
4001 SW CANYON ROADPORTLANDOR97221NONEPROGRAM SPONSORSHIP$43,000
THE LIVING DESERT
47-900 PORTSIDE AVEPALM DESERTCA92263NONEPROGRAM SUPPORT$100
COASTER THEATRE FOUND
9770 SW SUNSHINE CTBEAVERTONOR97005NONEPROGRAM SPONSOR$5,000
PORTLAND WOMEN'S FOUND
PO BOX 1032PORTLANDOR97207NONEPROGRAM SUPPORT$20,125
ST MARY'S ACADEMY
1615 SW 5TH AVENUEPORTLANDOR97201NONETUITION ASSISTANCE FUND$5,000
VARIETY
74-040 HWY 111PALM DESERTCA92260NONEPROVIDING BIKES/HELMETS TO CHILDREN$5,000
GOOD SAMARITAN HOME
2130 HARRISONQUINCYIL62301NONEPROGRAM SUPPORT$5,500
PORTLAND GARDEN CLUB
1132 SW VISTA AVENUEPORTLANDOR97205NONEPROGRAM SUPPORT$1,000
AFRICAN SPORTS OUTREACH
2859 SW CEDAR HILLS BLVDBEAVERTONOR97005NONESUPPORT CHILDRENS SOCCER TEAMS$1,500
GROWING GARDENTS
2203 NE OREGON STREETPORTLANDOR97232NONEPROGRAM SUPPORT$500
STEVE MARTIN SCHOLARSHIP FUND
PO BOX 219CANNON BEACHOR97110NONEPROGRAM SUPPORT$500
DESERT COMMUNITY FOUNDATION
75-105 MERLE DRIVE SUITEPALM DESERTCA92211NONEPROGRAM SUPPORT$1,000TED ROBINSON SCHOLARSHIP FUND
CITY OF HOPE
1500 E DUARTE RDDUARTECA91010NONEPROGRAM SUPPORT$1,650
ESTACADA COMMUNITY FOUNDATION
PO BOX 1498ESTACADAOR97023NONEMEMORIAL - BRAD DAY$500SKATE PARK
PALMS TO PINES ROTARY FOUNDATION
1111 DESERT FALLS PKWYPALM DESERTCA92211NONEPROGRAM SUPPORT$100
JOHN TRACY CLINIC
806 W ADAMS BLVDLOS ANGELESCA90007NONEPROGRAM SUPPORT$5,500
MACDONALD CENTER
605 NW COUCH STPORTLANDOR97209NONEPROGRAM SUPPORT$5,000
LOCKWOOD UNITED METHODIST CHURCH
PO BOX 241LOCKWOODMO65682NONEMEMORIAL - JOHN JONES$200
PROSTATE CANCER FOUNDATION
1250 FOURTH STREETSANTA MONICACA90401NONEMEMORIAL - JIM LEHR$200
CANNON BEACH FIRE & RESCUE
PO BOX 24CANNON BEACHOR97110NONEPROGAM SUPPORT$100
PALM DESERT HS VOCAL BOOSTERS
74910 AZTEC ROADPALM DESERTCA92260NONEPROGRAM SUPPORT$1,000
CANNON BEACH HISTORY CENTER
PO BOX 1005CANNON BEACHOR97110NONECANNON RESTORATION PROJECT$1,000
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year103975TotGrantOrContriPaidDuringYear

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

FieldValueIRS element (for citing)
Trnsfr Of Cash To Noncharitable EOfalseTrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EOfalseTrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of AssetsfalseSalesOrExchangesOfAssets
Purchase Assets Noncharitable EOfalsePurchaseAssetsNoncharitableEO
Rental Of Facilities EtcfalseRentalOfFacilitiesEtc
Reimbursement ArrangementsfalseReimbursementArrangements
Loans Or Loan GuaranteesfalseLoansOrLoanGuarantees
Performance Of Services EtcfalsePerformanceOfServicesEtc
Sharing Of Facilities EtcfalseSharingOfFacilitiesEtc
Relationships Noncharitable E OsfalseRelationshipsNoncharitableEOs

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFXOrganization501c3ExemptPF
General RuleXGeneralRule

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor Number1ContributorNumber
Contributor Name IndividualCANDACE HOLZGRAFEContributorNameIndividual

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1300 SE SPOKANE STREETAddressLine1
CityPORTLANDCity
StateORState
ZIP Code97202ZIPCode
FieldValueIRS element (for citing)
Aggregate Contributions150000AggregateContributions
Person Contribution TypeXPersonContributionType

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryINDIRECT ACCOUNTING FEESCategory
Amount$700Amount

Compensation Explanation CompensationExplanation

Compensation Compensation (5 entries)

CANDACE C HOLZGRAFE
JON R HOLZGRAFE
ANTHONY BEBER
TRACEY BEBER
BRETT BEBER

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFees

FieldValueIRS element (for citing)
CategoryINDIRECT LEGAL FEESCategory
Amount$565Amount

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees OtherProfessionalFees

FieldValueIRS element (for citing)
CategoryINDIRECT OTHER PROFESSIONAL FEESCategory
Amount$10Amount

Taxes Schedule TaxesSchedule

Taxes Taxes

FieldValueIRS element (for citing)
CategoryINDIRECT TAXES/LICENSESCategory
Amount$130Amount

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