EMPIRE HEALTH FOUNDATION: Form 990PF, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
EMPIRE HEALTH FOUNDATION (EIN 26-3375286)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-10-25
IRS object ID
201242999349100404
Schema version
2011v1.2
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)
Timestamp2012-10-25T12:02:16-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1601 WEST RIVERSIDE SUITE 700AddressLine1
CitySPOKANECity
StateWAState
ZIP Code992010622ZIPCode
FieldValueIRS element (for citing)
Return Type990PFReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN263375286EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EMPIRE HEALTH FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEMPINameControl
Phone5093151323Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 244AddressLine1
CitySPOKANECity
StateWAState
ZIP Code99210ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANTONY CHIANGName
TitlePRESIDENTTitle
Phone5093151323Phone
Date Signed2012-10-18DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBARBARA L EARNHEARTName
PTINP00240388PTIN
Phone5093636300Phone
Date Prepared2012-10-05DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Exempt PFXExemptPF
FMV Assets EOY66287270FMVAssetsEOY
Method Of Accounting AccrualXMethodOfAccountingAccrual

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Received Rev And Expnss4171325ContriReceivedRevAndExpnss
Dividends Rev And Expnss1427818DividendsRevAndExpnss
Dividends Net Invst Incm1427818DividendsNetInvstIncm
Net Gain Sale Assets Rev And Expnss-601322NetGainSaleAssetsRevAndExpnss
Gross Sales Price111120646GrossSalesPrice
Capital Gain Net Incm Net Invst Incm0CapitalGainNetIncmNetInvstIncm
Other Income Rev And Expnss2622143OtherIncomeRevAndExpnss
Other Income Net Invst Incm0OtherIncomeNetInvstIncm
Other Income Adj Net Incm2622143OtherIncomeAdjNetIncm
Total Revenue And Expenses7619964TotalRevenueAndExpenses
Total Net Investment Income1427818TotalNetInvestmentIncome
Total Adjusted Net Income2622143TotalAdjustedNetIncome
Comp Ofcr Dir Trst Rev And Expnss189780CompOfcrDirTrstRevAndExpnss
Comp Ofcr Dir Trst Net Invst Incm18976CompOfcrDirTrstNetInvstIncm
Comp Ofcr Dir Trst Adj Net Incm0CompOfcrDirTrstAdjNetIncm
Comp Ofcr Dir Trst Dsbrs Chrtbl Prps170804CompOfcrDirTrstDsbrsChrtblPrps
Oth Empl Slrs Wgs Rev And Expnss329814OthEmplSlrsWgsRevAndExpnss
Oth Empl Slrs Wgs Net Invst Incm4589OthEmplSlrsWgsNetInvstIncm
Oth Empl Slrs Wgs Adj Net Incm0OthEmplSlrsWgsAdjNetIncm
Oth Empl Slrs Wgs Dsbrs Chrtbl Prps314205OthEmplSlrsWgsDsbrsChrtblPrps
Pension Empl Bnft Rev And Expnss141622PensionEmplBnftRevAndExpnss
Pension Empl Bnft Net Invst Incm4580PensionEmplBnftNetInvstIncm
Pension Empl Bnft Adj Net Incm0PensionEmplBnftAdjNetIncm
Pension Empl Bnft Dsbrs Chrtbl Prps140719PensionEmplBnftDsbrsChrtblPrps
Legal Fees Rev And Expnss308314LegalFeesRevAndExpnss
Legal Fees Net Invst Incm5083LegalFeesNetInvstIncm
Legal Fees Adj Net Incm0LegalFeesAdjNetIncm
Legal Fees Dsbrs Chrtbl Prps445841LegalFeesDsbrsChrtblPrps
Accounting Fees Rev And Expnss52495AccountingFeesRevAndExpnss
Accounting Fees Net Invst Incm10490AccountingFeesNetInvstIncm
Accounting Fees Adj Net Incm0AccountingFeesAdjNetIncm
Accounting Fees Dsbrs Chrtbl Prps42005AccountingFeesDsbrsChrtblPrps
Other Prof Fees Rev And Expnss1264875OtherProfFeesRevAndExpnss
Other Prof Fees Net Invst Incm143361OtherProfFeesNetInvstIncm
Other Prof Fees Adj Net Incm0OtherProfFeesAdjNetIncm
Other Prof Fees Dsbrs Chrtbl Prps1343579OtherProfFeesDsbrsChrtblPrps
Taxes Rev And Expnss35031TaxesRevAndExpnss
Taxes Net Invst Incm0TaxesNetInvstIncm
Taxes Adj Net Incm0TaxesAdjNetIncm
Taxes Dsbrs Chrtbl Prps0TaxesDsbrsChrtblPrps
Deprec And Depletion Rev And Expnss15679DeprecAndDepletionRevAndExpnss
Deprec And Depletion Net Invst Incm0DeprecAndDepletionNetInvstIncm
Deprec And Depletion Adj Net Incm0DeprecAndDepletionAdjNetIncm
Occupancy Rev And Expnss54509OccupancyRevAndExpnss
Occupancy Net Invst Incm0OccupancyNetInvstIncm
Occupancy Adj Net Incm0OccupancyAdjNetIncm
Occupancy Dsbrs Chrtbl Prps54302OccupancyDsbrsChrtblPrps
Trav Conf Meeting Rev And Expnss146330TravConfMeetingRevAndExpnss
Trav Conf Meeting Net Invst Incm0TravConfMeetingNetInvstIncm
Trav Conf Meeting Adj Net Incm0TravConfMeetingAdjNetIncm
Trav Conf Meeting Dsbrs Chrtbl Prps136709TravConfMeetingDsbrsChrtblPrps
Other Expenses Rev And Expnss3638682OtherExpensesRevAndExpnss
Other Expenses Net Invst Incm0OtherExpensesNetInvstIncm
Other Expenses Adj Net Incm0OtherExpensesAdjNetIncm
Other Expenses Dsbrs Chrtbl Prps10740801OtherExpensesDsbrsChrtblPrps
Tot Opr Expenses Rev And Expnss6177131TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm187079TotOprExpensesNetInvstIncm
Tot Opr Expenses Adj Net Incm0TotOprExpensesAdjNetIncm
Tot Opr Expenses Dsbrs Chrtbl Prps13388965TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss1007303ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps1138325ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss7184434TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm187079TotalExpensesNetInvstIncm
Total Expenses Adj Net Incm0TotalExpensesAdjNetIncm
Total Expenses Dsbrs Chrtbl Prps14527290TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses435530ExcessOfRevenueOverExpenses
Net Investment Income1240739NetInvestmentIncome
Adjusted Net Income2622143AdjustedNetIncome

Balance Sheets BalanceSheets

FieldValueIRS element (for citing)
Cash BOY2563941CashBOY
Cash EOY1833559CashEOY
Cash EOYFMV1833559CashEOYFMV
Accounts Receivable705000AccountsReceivable
Accounts Receivable BOY1369710AccountsReceivableBOY
Accounts Receivable EOY705000AccountsReceivableEOY
Accounts Receivable EOYFMV705000AccountsReceivableEOYFMV
Grants Receivable EOY3903552GrantsReceivableEOY
Grants Receivable EOYFMV3903552GrantsReceivableEOYFMV
Other Notes And Loans Receivable125074OtherNotesAndLoansReceivable
Allwnc For Dbtfl Acct Other Rcvbl0AllwncForDbtflAcctOtherRcvbl
Other Notes And Loans Rcvbl BOY956406OtherNotesAndLoansRcvblBOY
Other Notes And Loans Rcvbl EOY125074OtherNotesAndLoansRcvblEOY
Other Notes And Loans Rcvbl EOYFMV125074OtherNotesAndLoansRcvblEOYFMV
Prepaid Expenses EOY31181PrepaidExpensesEOY
Prepaid Expenses EOYFMV31181PrepaidExpensesEOYFMV
Investments Govt Oblig BOY15995595InvestmentsGovtObligBOY
Investments Govt Oblig EOY15804074InvestmentsGovtObligEOY
Investments Govt Oblig EOYFMV15804074InvestmentsGovtObligEOYFMV
Investments Corp Stock BOY9800222InvestmentsCorpStockBOY
Investments Corp Stock EOY3693781InvestmentsCorpStockEOY
Investments Corp Stock EOYFMV3693781InvestmentsCorpStockEOYFMV
Investments Other BOY46916927InvestmentsOtherBOY
Investments Other EOY39670120InvestmentsOtherEOY
Investments Other EOYFMV39670120InvestmentsOtherEOYFMV
Land Building And Equipment Basis114310LandBuildingAndEquipmentBasis
Accum Deprec Land Bldg And Equip19638AccumDeprecLandBldgAndEquip
Land Building And Equipment BOY108858LandBuildingAndEquipmentBOY
Land Building And Equipment EOY94672LandBuildingAndEquipmentEOY
Land Building And Equipment EOYFMV94672LandBuildingAndEquipmentEOYFMV
Other Assets BOY173877OtherAssetsBOY
Other Assets EOY426257OtherAssetsEOY
Other Assets EOYFMV426257OtherAssetsEOYFMV
Total Assets BOY77885536TotalAssetsBOY
Total Assets EOY66287270TotalAssetsEOY
Total Assets EOYFMV66287270TotalAssetsEOYFMV
Accounts Payable BOY9131390AccountsPayableBOY
Accounts Payable EOY8400209AccountsPayableEOY
Other Liabilities BOY19315299OtherLiabilitiesBOY
Other Liabilities EOY12442839OtherLiabilitiesEOY
Total Liabilities BOY28446689TotalLiabilitiesBOY
Total Liabilities EOY20843048TotalLiabilitiesEOY
Org That Follow SFAS117XOrgThatFollowSFAS117
Unrestricted BOY48607866UnrestrictedBOY
Unrestricted EOY40600263UnrestrictedEOY
Temporarily Restricted BOY830981TemporarilyRestrictedBOY
Temporarily Restricted EOY4596147TemporarilyRestrictedEOY
Permanently Restricted EOY247812PermanentlyRestrictedEOY
Total Net Assets BOY49438847TotalNetAssetsBOY
Total Net Assets EOY45444222TotalNetAssetsEOY
Total Liabilities Net Assets BOY77885536TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY66287270TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

FieldValueIRS element (for citing)
Total Net Assets Fund Balances BOY49438847TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses435530ExcessOfRevenueOverExpenses
Other Increases0OtherIncreases
Subtotal49874377Subtotal
Other Decreases4430155OtherDecreases
Total Net Assets Fund Balances EOY45444222TotalNetAssetsFundBalancesEOY

Capital Gains And Losses CapitalGainsAndLosses

Capital Gains And Losses Info CapitalGainsAndLossesInfo

FieldValueIRS element (for citing)
Description Of AssetSECURITIESDescriptionOfAsset
How AcquiredPHowAcquired
Date Acquired2010-01-01DateAcquired
Date Sold2011-06-30DateSold
Gross Sales Price111120646GrossSalesPrice
Cost Or Other Basis111721968CostOrOtherBasis
Gain Or Loss-601322GainOrLoss
Gains Minus Excess Or Losses-601322GainsMinusExcessOrLosses
FieldValueIRS element (for citing)
Capital Gain Net Income-601322CapitalGainNetIncome

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

FieldValueIRS element (for citing)
Liable For4942 Tax0LiableFor4942Tax
Qualifying Distributions Year121267749QualifyingDistributionsYear1
Noncharitable Assets Year181066770NoncharitableAssetsYear1
Distribution Ratio Year10.262349DistributionRatioYear1
Qualifying Distributions Year27939819QualifyingDistributionsYear2
Noncharitable Assets Year281116441NoncharitableAssetsYear2
Distribution Ratio Year20.097882DistributionRatioYear2
Total Distribution Ratio0.360231TotalDistributionRatio
Average Distribution Ratio0.180116AverageDistributionRatio
Net Noncharitable Assets70251955NetNoncharitableAssets
Adjusted Noncharitable Assets12653501AdjustedNoncharitableAssets
One Percent Net Investment Income12407OnePercentNetInvestmentIncome
Adj Nonchrtbl Assets And One12665908AdjNonchrtblAssetsAndOnePct
Qualifying Distributions14527290QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

FieldValueIRS element (for citing)
Domestic Org Meeting Sect4940eXDomesticOrgMeetingSect4940e
Investment Income Excise Tax12407InvestmentIncomeExciseTax
Tax Under Section5110TaxUnderSection511
Subtotal12407Subtotal
Subtitle A Tax0SubtitleATax
Tax Based On Investment Income12407TaxBasedOnInvestmentIncome
Est Tax Payments And Overpayment26080EstTaxPaymentsAndOverpayment
Total Credits And Payments26080TotalCreditsAndPayments
Overpayment13673Overpayment
Amount Credited To Next Year13673AmountCreditedToNextYear
Amount To Be Refunded0AmountToBeRefunded

Statements Regarding Activities StatementsRegardingActivities

FieldValueIRS element (for citing)
Legislative Political Activities0LegislativePoliticalActivities
More Than100 Spent0MoreThan100Spent
Form1120 POL Filed0Form1120POLFiled
Sect4955 Tax On Organization0Sect4955TaxOnOrganization
Sect4955 Tax On Managers0Sect4955TaxOnManagers
Reimbursement Of Tax0ReimbursementOfTax
Activities Not Prev Reported0ActivitiesNotPrevReported
Changes To Articles Or Bylaws0ChangesToArticlesOrBylaws
Unrelated Bus Income Over10000UnrelatedBusIncomeOver1000
Termination Etc0TerminationEtc
Requirements Of Sect508e1RequirementsOfSect508e
At Least5000 In Assets1AtLeast5000InAssets
States Filed WithWAStatesFiledWith
Form990 PF Filed With AG1Form990PFFiledWithAG
Private Operating Foundation0PrivateOperatingFoundation
New Substantial Contributors0NewSubstantialContributors
Interest In Controlled Entity0InterestInControlledEntity
Applicable Insurance Contract0ApplicableInsuranceContract
Comply With Public Inspection Rqr1ComplyWithPublicInspectionRqr
Website AddressEMPIREHEALTHFOUNDATION.ORGWebsiteAddress
Books In Care Of Person NameTHE ORGANIZATIONBooksInCareOfPersonName
Books In Care Of Phone Number5093151323BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

FieldValueIRS element (for citing)
Address Line1111 N POST ST SUITE 301AddressLine1
CitySPOKANECity
StateWAState
ZIP Code99201ZIPCode
FieldValueIRS element (for citing)
Foreign Bank0ForeignBank

Statements Regarding Acty4720 StatementsRegardingActy4720

FieldValueIRS element (for citing)
Sale Or Exchange With Dsqfly Person0SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person0BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person0FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person0PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person0TransferAssetsToDsqflyPerson
Payment To Government Offical0PaymentToGovernmentOffical
Uncorrected Prior Acts0UncorrectedPriorActs
Undistributed Income Prior Years0UndistributedIncomePriorYears
Business Holdings0BusinessHoldings
Jeopardy Investments0JeopardyInvestments
Uncorrected Jeopardy Investments0UncorrectedJeopardyInvestments
Influence Legislation0InfluenceLegislation
Influence Election0InfluenceElection
Grants To Individuals0GrantsToIndividuals
Grants To Organizations0GrantsToOrganizations
Noncharitable Purpose0NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract0RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract0PayPremiumsPrsnlBnftContract
Prohibited Tax Shelter Transactn0ProhibitedTaxShelterTransactn

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (14 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeTitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
BARB CHAMBERLAIN
938 16TH AVENUESPOKANEWA99203TRUSTEE1.00000
ANNE C COWLES
1727 EAST 20TH AVENUESPOKANEWA99203TRUSTEE1.00000
DEB HARPER
1629 E 46TH AVENUESPOKANEWA99223TRUSTEE1.00000
TERESSA MARTINEZ
PO BOX 248WELLPINITWA99040TRUSTEE1.00000
GARMAN LUTZ
8620 E BOARDWALK LANESPOKANEWA99212TREASURER1.00000
SUE LANI MADSEN
PO BOX 107EDWALLWA99008TRUSTEE1.00000
THERESA SANDERS
1812 EAST SUNBURST LANESPOKANEWA99224VICE CHAIR1.00000
SAM SELINGER MD
5441 S QUAIL RIDGE CIRCLESPOKANEWA99223TRUSTEE1.00000
MICHAEL A SENSKE
8120 W SUNSET HIGHWAYSPOKANEWA99224CHAIRMAN1.00000
ALMA MCNAMEE
10310 E BRIDGES ROADELKWA99009TRUSTEE1.0000268
BARRY BACON
1200 E COLUMBIA AVECOLVILLEWA99114TRUSTEE1.00000
MATTHEW LAYTON
17204 W DENO ROADMEDICAL LAKEWA99022TRUSTEE1.00000
ANNE HIRSCH
2917 W FORT WORTH DRIVESPOKANEWA99224SECRETARY1.00000
ANTONY CHIANG
617 W SHOSHONESPOKANEWA99203PRESIDENT40.00189780228271347

Compensation Of Highest Paid Empl CompensationOfHighestPaidEmpl

FieldValueIRS element (for citing)
NameDAVE LUHNName

US Address USAddress

FieldValueIRS element (for citing)
Address Line16202 N VISTA RIDGE LANEAddressLine1
CitySPOKANECity
StateWAState
ZIP Code99217ZIPCode
FieldValueIRS element (for citing)
TitleCHIEF FINANCIAL OFFITitle
Average Hours Per Week40.00AverageHoursPerWeek
Compensation63580Compensation
Employee Benefits2700EmployeeBenefits
Expense Account1807ExpenseAccount
FieldValueIRS element (for citing)
Tot Number Of Oth Empl Paid Over50k0TotNumberOfOthEmplPaidOver50k

Compensation Of Hghst Paid Cntrct CompensationOfHghstPaidCntrct (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeType Of ServiceTypeOfServiceCompensationCompensation
DRINKER BIDDLE & REATH LLP
ONE LOGAN SQUARE STE 2000PHILADELPHIAPA191036996LEGAL SERVICES400671
MERCER INC
601 WEST MAIN AVESPOKANEWA99201ACTUARIAL SERVICES307377
BESSEMER TRUST
100 WOODBRIDGE CENTER DRIVEWOODBRIDGENJ07095INVESTMENT MANAGEMENT247814
WITHERSPOON KELLEY ET AL
422 W RIVERSIDESPOKANEWA99201LEGAL SERVICES219523
QUALITY REIMBURSEMENT SERVICES INCL
150 NORTH SANTA ANITA AVE STE 570AARCADIACA91006MEDICARE RECOVERY SERVICES128450
FieldValueIRS element (for citing)
Tot Number Of Cntrct Paid Over50k4TotNumberOfCntrctPaidOver50k

Summary Of Direct Charitable Acty SummaryOfDirectCharitableActy

FieldValueIRS element (for citing)
Description1ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES TO PROMOTE GOOD HEALTH IN THE GREATER SPOKANE REGION THROUGH PROMOTION, FACILITATION, AND/OR FUNDING OF HEALTHCARE SERVICES, EDUCATION AND RESEARCH.Description1
Expenses114527290Expenses1

Sum Of Program Related Investments SumOfProgramRelatedInvestments

FieldValueIRS element (for citing)
Total0Total

Minimum Investment Return MinimumInvestmentReturn

FieldValueIRS element (for citing)
Avg Monthly FMV Of Securities69053540AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances2268242AvgMonthlyCashBalances
FMV All Other Noncharitable Assets0FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets71321782TotalFMVOfUnusedAssets
Reduction Claimed0ReductionClaimed
Acquisition Indebtedness0AcquisitionIndebtedness
Adj Total FMV Of Unused Assets71321782AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable1069827CashDeemedCharitable
Net Noncharitable Assets70251955NetNoncharitableAssets
Minimum Investment Return3512598MinimumInvestmentReturn

Distributable DistributableAmount

FieldValueIRS element (for citing)
Minimum Investment Return3512598MinimumInvestmentReturn
Tax Based On Investment Income12407TaxBasedOnInvestmentIncome
Total Tax12407TotalTax
Distributable Amount Before Adj3500191DistributableAmountBeforeAdj
Recoveries Qlfy Distributions14391RecoveriesQlfyDistributions
Distributable Amount Before Ded3514582DistributableAmountBeforeDed
Deduction Fr Distributable$0DeductionFrDistributableAmount
Distributable Amount As Adjusted3514582DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

FieldValueIRS element (for citing)
Expenses And Contributions14527290ExpensesAndContributions
Program Related Investments Total0ProgramRelatedInvestmentsTotal
Qualifying Distributions14527290QualifyingDistributions
One Pct Sect4940e Org Net Invst Incm12407OnePctSect4940eOrgNetInvstIncm
Adj Qualifying Distributions14514883AdjQualifyingDistributions

Undistributed Income UndistributedIncome

FieldValueIRS element (for citing)
Distributable Amount As Adjusted3514582DistributableAmountAsAdjusted
Undistributed Income Prior Year0UndistributedIncomePriorYear
Total For Prior Years0TotalForPriorYears
Excess Distri Carryover Year37298554ExcessDistriCarryoverYear3
Excess Distri Carryover Year23887174ExcessDistriCarryoverYear2
Excess Distri Carryover Year117266560ExcessDistriCarryoverYear1
Total Excess Distri Carryover28452288TotalExcessDistriCarryover
Qualifying Distributions14527290QualifyingDistributions
Applied To Year10AppliedToYear1
Applied To Prior Years0AppliedToPriorYears
Treated As Distri From Corpus0TreatedAsDistriFromCorpus
Applied To Current Year3514582AppliedToCurrentYear
Remaining Distri From Corpus11012708RemainingDistriFromCorpus
Excess Distri Cyov App CY Corpus0ExcessDistriCyovAppCYCorpus
Excess Distri Cyov Applied CY0ExcessDistriCyovAppliedCY
Total Corpus39464996TotalCorpus
Prior Year Undistributed Income0PriorYearUndistributedIncome
Prior Year Deficiency Or Tax0PriorYearDeficiencyOrTax
Taxable Amount10TaxableAmount1
Taxable Amount20TaxableAmount2
Undistributed Income CY0UndistributedIncomeCY
Distri From Corpus170b1 E Or4942g30DistriFromCorpus170b1EOr4942g3
Excess Distri Cyov From Year50ExcessDistriCyovFromYear5
Excess Distri Cyov To Next Year39464996ExcessDistriCyovToNextYear
Excess From Year37298554ExcessFromYear3
Excess From Year23887174ExcessFromYear2
Excess From Year117266560ExcessFromYear1
Excess From Current Year11012708ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

Appication Submission Info AppicationSubmissionInfo

FieldValueIRS element (for citing)
Recipient NameEMPIRE HEALTH FOUNDATIONRecipientName

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 244AddressLine1
CitySPOKANECity
StateWAState
ZIP Code99210ZIPCode
FieldValueIRS element (for citing)
Recipient Phone Number5093151323RecipientPhoneNumber
Form And Info And MaterialsAPPLICATIONS CAN BE MADE ON-LINE AT HTTP://EMPIREHEALTHFOUNDATION.ORG OR IN WRITING THROUGH THE BOARD OF DIRECTORS OF EMPIRE HEALTH FOUNDATION.FormAndInfoAndMaterials
Submission DeadlinesSEE WEBSITE HTTP://EMPIREHEALTHFOUNDATION.ORG/ FOR AVAILABLE CYCLES.SubmissionDeadlines
Restrictions On AwardsREQUESTS MUST BE IN THE CONSISTENT WITHIN THE SCOPE OF THE ARTICLES OF INCORPORATION AND BYLAWS.RestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (78 entries)

Address Line1RecipientUSAddress/AddressLine1CityRecipientUSAddress/CityStateRecipientUSAddress/StateZIP CodeRecipientUSAddress/ZIPCodeRecipient RelationshipRecipientRelationshipRecipient Foundation StatusRecipientFoundationStatusPurpose Of Grant Or ContributionPurposeOfGrantOrContributionAmountAmount
WOMEN'S HEARTH
920 W 2ND AVESPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$244
DENVER'S GREAT KIDS HEAD START
1155 DECATUR STREETDENVERCO80204NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$300
VANESSA BEHAN CRISIS NURSERY
1004 E 8TH AVESPOKANEWA99203NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$470
FAMILY RESOURCE CENTER
PO BOX 1130DAVENPORTWA99122NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$1,000
AMERICAN HEART ASSOCIATION
140 S ARCHER ST 610SPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$1,500
ADAMS COUNTY PUBLIC HEALTH DEPARTMENT
425 E MAINOTHELLOWA99344NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,000
DEPT OF PUBLIC HEALTH AND EMERGENCY MGT
N 301 MAINCOLFAXWA99111NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,000
NE TRI-COUNTY HEALTH DISTRICT
240 E DOMINIONCOLVILLEWA99114NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,000
ADAMS COUNTY COMMUNITY PUBLIC HEALTH
315 N 14TH AVEOTHELLOWA99344NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,500
CURLEW CIVICS CLUB
PO BOX 111CURLEWWA99118NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,540
POTLATCH FUND
801 2ND AVE STE 304SEATTLEWA98104NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,850
EWU INSTITUTE FOR PUBLIC POLICY
668 RIVERPOINT BLVD SUITE 238SPOKANEWA99004NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$2,948
ADAMS COUNTY COMMUNITY NETWORK
315 N 14TH AVEOTHELLOWA99344NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$3,000
PALOUSE HIV CONSORTIUM
PO BOX 1013PULLMANWA99163NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$3,000
ST ALOYSIUS SCHOOL
611 E MISSIONSPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$3,000
SPOKANE TRIBAL HEALTH ED DEPT
6203 AGENCY LOOP ROADWILLPINITWA99040NONERECOGNIZED TRIBETO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$4,000
TRI-COUNTY COMMUNITY HEALTH FUND
1200 E COLUMBIA AVECOLVILLEWA99114NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$4,500
CANCER PATIENT CARE
1507 E SPRAGUE AVESPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$5,000
LAKE ROOSEVELT COMMUNITY HEALTH CENTERS
39 SHORTCUT ROADINCHELIUMWA99138NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$5,000
SOCIAL VENTURES PARTNERS SEATTLE
1601 2ND AVESEATTLEWA98101NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$5,000
STEVENS COUNTY FIRE DISTRICT #1
4532 RAILROAD AVECLAYTONWA99110NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$5,000
THIN AIR RADIO
35 WEST MAIN SUITE 340SPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$5,000
HOSPICE OF SPOKANE
PO BOX 2215SPOKANEWA99210NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$6,000
YMCA OF THE INLAND NORTHWEST
1126 N MONROESPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$6,750
NEWPORT HOSPITAL & HEALTH SERVICES
714 W PINENEWPORTWA99156NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$6,776
PARTNERS WITH CHILDREN & FAMILIES SPOKANE
613 S WASHINGTONSPOKANEWA99204NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$7,500
THE NATIVE PROJECT
1803 W MAXWELLSPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$7,500
WHITMAN COUNTY HEALTH DEPARTMENT
310 N MAIN SUITE 108COLFAXWA99111NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$7,500
NE YOUTH CENTER
3004 E QUEEN AVESPOKANEWA99207NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$9,000
ODYSSEY YOUTH CENTER
1121 S PERRY STREETSPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$9,000
COMMUNITIES IN SCHOOLS OF SPOKANE COUNTY
905 W RIVERSIDE STE 314SPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
LUTHERAN COMMUNITY SERVICES NORTHWEST
210 W SPRAGUESPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
SPOKANE AIDS NETWORK
905 S MONROESPOKANEWA99204NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
EAST CENTRAL COMMUNITY CENTER
500 S STONESPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
INLAND NORTHWEST HEALTH SERVICES
PO BOX 469SPOKANEWA99210NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
KETTLE FALLS SCHOOL DISTRICT
PO BOX 458KETTLE FALLSWA99141NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
THE URBAN INSTITUTE
2100 M STREETWASHINGTONDC20037NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
WALLA WALLA COMMUNITY COLLEGE
500 TAUSICK WAYWALLA WALLAWA99362NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,000
PHILANTHROPY NW
2101 4TH AVESEATTLEWA98121NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$10,400
YOUTH EMERGENCY SERVICES
PO BOX 944NEWPORTWA99156NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$11,000
SPOKANE REGIONAL HEALTH DISTRICT
1101 W COLLEGE AVESPOKANEWA99201NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$11,300
LINCOLN COUNTY HEALTH DEPARTMENT ON BEHALF OF THE LINCOLN COUNTY PUBLIC HEA
90 NICHOLSDAVENPORTWA99122NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,000
BLUEPRINTS FOR LEARNING
35 WEST MAIN SUITE 280SPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,500
CCS FOUNDATION
N 501 RIVERPOINT BLVDSPOKANEWA99217NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,500
LINCOLN COUNTY PUBLIC HOSPITAL
10 NICHOLS STREETDAVENPORTWA99122NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,500
PROVIDENCE HEALTH & SERVICES WASHINGTON
104 W 5THSPOKANEWA99204NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,500
RURAL RESOURCES COMMUNITY ACTION
956 S MAIN STREETCOLVILLEWA99114NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$12,500
SPOKANE PRESCRIPTION ASSISTANCE
1111 HARVARD AVESEATTLEWA98122NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$13,500
NE WASHINGTON HEALTH PROGRAMS
509 E MAINCHEWELAHWA99109NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$15,000
WHITWORTH UNIVERSITY
300 W HAWTHORNE ROADSPOKANEWA99251NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$15,000
SPOKANE COUNTY MEDICAL SOCIETY
104 S FREYA SUITE 114SPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY.$16,500
UNION GOSPEL MISSION ASSOCIATION OF SPOKANE
1224 E TRENT AVE PO BOX 4066SPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$17,000
DAYBREAK YOUTH SERVICES
11711 E SPRAGUE ST STE D4SPOKANE VALLEYWA99206NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$17,500
MEALS ON WHEELS SPOKANE
1222 W 2ND STREETSPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$18,000
SPOKANE DISTRICT DENTAL SOCIETY FOUNDATION
PO BOX 4432SPOKANEWA99220NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$18,500
WASHINGTON STATE DEPARTMENT OF HEALTH
PO BOX 47890OLYMPIAWA98504NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$19,105
NW AUTISM CENTER
25 W 5TH AVESPOKANEWA99204NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$20,000
SPOKANE COUNTY MEDICAL SOCIETY FOUNDATION
104 S FREYA SUITE 114SPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$20,000
YAKIMA VALLEY FARM WORKER'S CLINIC
518 W FIRST AVETOPPENISHWA98948NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$20,000
ST JOSEPH FAMILY CENTER
1016 N SUPERIORSPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$20,500
CHENEY PUBLIC SCHOOLS
520 FOURTH STREETCHENEYWA99004NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$22,400
CITY OF CHENEY PARKS AND REC DEPT
2640 1ST STREET SUITE BCHENEYWA99004NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$22,400
REPUBLIC SCHOOL DISTRICT
30306 E HWY 20SPOKANEWA99166NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$23,000
TRANSITIONAL PROGRAMS FOR WOMEN DBA TRANSITIONS
3104 W FORT GEORGE WRITE DRSPOKANEWA99224NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
YOUTH SUICIDE PREVENTION PROGRAM
444 NE RAVENNA BLVD STE 401SEATTLEWA98115NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
ADAMS COUNTY JUVENILE SERVICES
425 E MAINOTHELLOWA99344NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
CHRIST CLINIC
914 CARLISLE AVESPOKANEWA99205NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
SPOKANE COUNTY
312 W 8TH AVESPOKANEWA99201NONEGOVERNMENT AGENCYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
CUSICK SCHOOL DISTRICT
305 MONUMENTAL WAYCUSICKWA99119NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,000
SPOKANE TRIBE OF INDIANS
PO BOX 100WILLPINITWA99040NONERECOGNIZED TRIBETO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$25,500
YFA CONNECTIONS
22 S THOR STREETSPOKANE WAWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$27,500
SPOKANE COUNTY UNITED WAY
920 N WASHINGTON STREETSPOKANEWA99201NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$30,000
CHOICE REGIONAL HEALTH NETWORK
2409 PACIFIC AVE SEOLYMPIAWA98501NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THE$31,672
FRONTIER BEHAVIORAL HEALTH
107 S DIVISIONSPOKANEWA99202NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$32,500
EASTERN WASHINGTON UNIVERSITY
202 SUTTON HALLCHENEYWA99004NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$37,850
WASHINGTON STATE UNIVERSITY
PO BOX 643140PULLMANWA99164NONESCHOOLTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$47,500
KALISPEL TRIBE OF INDIANS
PO BOX 96USKWA99180NONERECOGNIZED TRIBETO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$57,500
EXPERIENCE FOOD PROJECT
PO BOX 723LANGELYWA98260NONEOTHER PUBLIC CHARITYTO ASSIST ORGANIZATION TO PROMOTE GOOD HEALTH IN THEIR COMMUNITY$89,820
FieldValueIRS element (for citing)
Tot Grant Or Contri Paid During Year1138325TotGrantOrContriPaidDuringYear
Tot Grant Or Contri Approved Future0TotGrantOrContriApprovedFuture

Analysis Income Producing Acty AnalysisIncomeProducingActy

Dividends And Int From Sec Part VII DividendsAndIntFromSecPartVII

FieldValueIRS element (for citing)
Exclusion Code14ExclusionCode
Exclusion$1,427,818ExclusionAmount

Gain Sales Assets Oth Than Invntry GainSalesAssetsOthThanInvntry

FieldValueIRS element (for citing)
Exclusion Code18ExclusionCode
Exclusion-$601,322ExclusionAmount

Other Revenue Described OtherRevenueDescribed (4 entries)

DescriptionDescriptionExclusion CodeExclusionCodeExclusionExclusionAmount
COST REPORT INCOME01$178,040
OTHER REFUND INCOME01$10,772
MISCELLANEOUS01$2,418,940
REFUND OF EXPENSES01$14,391

Subtotals Part XVIA SubtotalsPartXVIA

FieldValueIRS element (for citing)
Unrelated Business Income$0UnrelatedBusinessIncomeAmount
Exclusion$3,448,639ExclusionAmount
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Part XVIA3448639TotalPartXVIA

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

FieldValueIRS element (for citing)
Trnsfr Of Cash To Noncharitable EO0TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO0TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO0PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc0RentalOfFacilitiesEtc
Reimbursement Arrangements0ReimbursementArrangements
Loans Or Loan Guarantees0LoansOrLoanGuarantees
Performance Of Services Etc0PerformanceOfServicesEtc
Sharing Of Facilities Etc0SharingOfFacilitiesEtc
Relationships Noncharitable E Os0RelationshipsNoncharitableEOs

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFXOrganization501c3ExemptPF
General RuleXGeneralRule

Contributor Info ContributorInfo (3 entries)

Contributor NumberContributorNumberContributor Name IndividualContributorNameIndividualAddress Line1ContributorAddressUS/AddressLine1CityContributorAddressUS/CityStateContributorAddressUS/StateZIP CodeContributorAddressUS/ZIPCodeAggregate ContributionsAggregateContributionsPerson Contribution TypePersonContributionTypeNoncash Contribution TypeNoncashContributionType
1BOONE FOUNDATION428 RIVERSIDE SUITE 700SPOKANEWA99201214509XX
2WOODROW FOUNDATION428 RIVERSIDE SUITE 700SPOKANEWA9920138264XX
3GRANT MAKERS IN HEALTH1100 CONNECTICUT AVE NW SUITE 1200WASHINGTONDC2003615000X

Noncash Property NoncashProperty (2 entries)

Contributor Number From Part IContributorNumberFromPartINoncash Property DescriptionNoncashPropertyDescriptionFair Market ValueFairMarketValueDate ReceivedDateReceived
1SECURITIES2071622011-01-01
2SECURITIES375092011-01-01

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

FieldValueIRS element (for citing)
CategoryACCOUNTINGCategory
Amount$52,495Amount
Net Investment Income10490NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps42005DisbursementsCharitablePrps

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corp Stock InvestmentsCorpStock

FieldValueIRS element (for citing)
EOY Book Value3693781EOYBookValue
EOYFMV3693781EOYFMV

Investments Govt Obligations Sch InvestmentsGovtObligationsSch

FieldValueIRS element (for citing)
US Govt Securities EOY Book Value15804074USGovtSecuritiesEOYBookValue
US Govt Securities EOYFMV15804074USGovtSecuritiesEOYFMV
State Local Securities EOY Book Val0StateLocalSecuritiesEOYBookVal
State Local Securities EOYFMV0StateLocalSecuritiesEOYFMV

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOther

FieldValueIRS element (for citing)
Listed At Cost Or FMVFMVListedAtCostOrFMV
Book Value39670120BookValue
EOYFMV39670120EOYFMV

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFees

FieldValueIRS element (for citing)
CategoryLEGAL EXPENSESCategory
Amount$308,314Amount
Net Investment Income5083NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps445841DisbursementsCharitablePrps

Other Assets Schedule OtherAssetsSchedule

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBOY Book ValueBOYBookValueEOY Book ValueEOYBookValueEOYFMVEOYFMV
DEPOSITS2000000
ACCRUED INVESTMENT INCOME153877178445178445
BENEFICIAL INTERESTS IN TRUSTS0247812247812

Other Decreases Schedule OtherDecreasesSchedule

Other Decreases OtherDecreases

FieldValueIRS element (for citing)
DescriptionNET UNREALIZED LOSSDescription
Amount$4,430,155Amount

Other Expenses Schedule OtherExpensesSchedule

Other Expenses OtherExpenses (13 entries)

DescriptionDescriptionRevenue And Expenses Per BooksRevenueAndExpensesPerBooksNet Investment IncomeNetInvestmentIncomeAdjusted Net IncomeAdjustedNetIncomeDisbursements Charitable PrpsDisbursementsCharitablePrps
OFFICE EXPENSES & POSTAGE297670025271
DUES, LICENSES, MEMBERSHIPS4064004039
GENERAL INSURANCE174210048602
PBGC INSURANCE746900074690
EXECUTIVE RECRUITING222820022282
TRAILING: PENSION PLAN CONTRIBUTIONS8566631008566631
TRAILING: PLAN LIABILITY-5166460000
TRAILING: 403(B) CONTRIBUTIONS-75428001146572
TRAILING: OTHER TRAILING MATTERS27588007588
TRAILING: UNEMPLOYMENT & WORKPERS COMP7636500345459
CHARITABLE GIFT ANNUITY PAYMENTS478060026762
PY SETTLEMENT1395600498956
UNEMPLOYMENT RESERVE000-26051

Other Income Schedule2 OtherIncomeSchedule2

Other Income OtherIncome (4 entries)

DescriptionDescriptionRevenue And Expenses Per BooksRevenueAndExpensesPerBooksAdjusted Net IncomeAdjustedNetIncome
COST REPORT INCOME178040178040
OTHER REFUND INCOME1077210772
MISCELLANEOUS24189402418940
REFUND OF EXPENSES1439114391

Other Liabilities Schedule OtherLiabilitiesSchedule

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionBOY Book ValueBOYBookValueEOY Book ValueEOYBookValue
PPD FUNDING1610829910941839
INSURANCE RESERVE882000594000
PROFESSIONAL LIABILITY650000454000
403(B) LIABILITY1552000330000
COBRA LIABILITY123000123000

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees OtherProfessionalFees

FieldValueIRS element (for citing)
CategoryOTHER PROFESSIONAL FEESCategory
Amount$1,264,875Amount
Net Investment Income143361NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps1343579DisbursementsCharitablePrps

Taxes Schedule TaxesSchedule

Taxes Taxes

FieldValueIRS element (for citing)
CategoryTAX AND LICENSECategory
Amount$35,031Amount
Net Investment Income0NetInvestmentIncome
Adjusted Net Income0AdjustedNetIncome
Disbursements Charitable Prps0DisbursementsCharitablePrps

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