VITALOGY FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- VITALOGY FOUNDATION (EIN 20-1030462)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201243209349308214
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T16:07:47-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 271574632 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FBMM TAX PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 340020 | AddressLine1 |
| City | NASHVILLE | City |
| State | TN | State |
| ZIP Code | 372030020 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201030462 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VITALOGY FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | VITA | NameControl |
| Phone | 6153299902 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O FBMM INC PO BOX 340020 | AddressLine1 |
| City | NASHVILLE | City |
| State | TN | State |
| ZIP Code | 372030020 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STONE C GOSSARD | Name |
| Title | TREASURER | Title |
| Phone | 6153299902 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROGER W DUNAWAY III | Name |
| PTIN | P00815324 | PTIN |
| Phone | 6153299902 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STONE C GOSSARD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | C/O FBMM INC PO BOX 340020 | AddressLine1 |
| City | NASHVILLE | City |
| State | TN | State |
| ZIP Code | 372030020 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 708643 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2004 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | TO DISTRIBUTE FUNDS EXCLUSIVELY FOR EDUCATIONAL, CHARITABLE, RELIGIOUS, SCIENTIFIC AND/OR LITERARY PURPOSES, INCLUDING BUT NOT LIMITED TO THE MAKING OF GRANTS TO CHARITABLE ORGANIZATIONS FOR CHARITABLE PURPOSES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 6 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 344950 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 707154 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2710 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1489 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 347660 | TotalRevenuePriorYear |
| Total Revenue Current Year | 708643 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 295490 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 296138 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 5147 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 48804 | OtherExpensePriorYear |
| Other Expenses Current Year | 68036 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 344294 | TotalExpensesPriorYear |
| Total Expenses Current Year | 364174 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3366 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 344469 | RevenuesLessExpensesCY |
| Total Assets BOY | 468228 | TotalAssetsBOY |
| Total Assets EOY | 812697 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 468228 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 812697 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO DISTRIBUTE FUNDS EXCLUSIVELY FOR EDUCATIONAL, CHARITABLE, RELIGIOUS, SCIENTIFIC AND/OR LITERARY PURPOSES, INCLUDING BUT NOT LIMITED TO THE MAKING OF GRANTS TO CHARITABLE ORGANIZATIONS FOR CHARITABLE PURPOSES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 309892 | Expense |
| Grants | 296138 | Grants |
| Revenue | 0 | Revenue |
| Description | GRANTS 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. | Description |
| Total Program Service Expense | 309892 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 1 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 3 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 0 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FBMM INC CO JAMIE CHEEK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6153299902 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 340020 | AddressLine1 |
| City | NASHVILLE | City |
| State | TN | State |
| ZIP Code | 372030020 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (6 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JEFFREY A AMENT | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| MICHAEL D MCCREADY | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| EDDIE J VEDDER | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| KELLY CURTIS | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| STONE C GOSSARD | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| MATTHEW D CAMERON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 707154 | AllOtherContributions |
| Total Contributions | 707154 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1489 | TotalRevenueColumn |
| Exclusion | $1,489 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 708643 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,489 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295138 | Total |
| Program Services | 295138 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1000 | Total |
| Program Services | 1000 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2405 | Total |
| Management And General | 2405 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4425 | Total |
| Program Services | 885 | ProgramServices |
| Management And General | 3540 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25726 | Total |
| Program Services | 12863 | ProgramServices |
| Management And General | 7718 | ManagementAndGeneral |
| Fundraising | 5145 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12 | Total |
| Program Services | 6 | ProgramServices |
| Management And General | 4 | ManagementAndGeneral |
| Fundraising | 2 | Fundraising |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | FOREIGN TAXES PAID | Description |
| Total | 35468 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 35468 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 364174 | Total |
| Program Services | 309892 | ProgramServices |
| Management And General | 49135 | ManagementAndGeneral |
| Fundraising | 5147 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18258 | BOY |
| EOY | 431237 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 449970 | BOY |
| EOY | 381460 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 468228 | BOY |
| EOY | 812697 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 468228 | BOY |
| EOY | 812697 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 468228 | BOY |
| EOY | 812697 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 468228 | BOY |
| EOY | 812697 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 344469 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12402 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 422118 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 341986 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 344950 | CurrentTaxYearMinus1Year |
| Current Tax Year | 707154 | CurrentTaxYear |
| Total | 1828610 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12402 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 422118 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 341986 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 344950 | CurrentTaxYearMinus1Year |
| Current Tax Year | 707154 | CurrentTaxYear |
| Total | 1828610 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 1828610 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10233 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8761 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2969 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2710 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1489 | CurrentTaxYear |
| Total | 26162 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1854772 | TotalSupport |
| Public Support Pertcentage170 | 0.98590 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98380 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 1 | GrantRecordsMaintained |
Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|
| CANADA | 0 | 1 | FUNDRAISING | 46358 |
| HAITI | 0 | 0 | GRANTMAKING | 20000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 1 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 1 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 66358 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 66358 | TotalAmountSpent |
Grants To Orgs Outside US GrantsToOrgsOutsideUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | HAITI | Region |
| Purpose Of Grant | HAITI GENERAL FUND | PurposeOfGrant |
| Amount Of Cash Grant | 20000 | AmountOfCashGrant |
| Manner Of Cash Disbursement | CASH PAYMENT | MannerOfCashDisbursement |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Method Of Valuation | CASH | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of501c3 Orgs | 1 | TotalNumberOf501c3Orgs |
| Total Number Of Other Orgs | 0 | TotalNumberOfOtherOrgs |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 0 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | Address Line2AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVOCACY FOR PATIENTS WITH CHRONIC ILLNESS INC | |||||||||||
| 18 TIMBERLINE DRIVE | FARMINGTON | CT | 06032 | 830415607 | 501(C)(3) | 20000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| AIR TRAFFIC CONTROL EDUCATION FUND INC | |||||||||||
| 1475 15TH STREET | SAN FRANCISCO | CA | 94103 | 721600331 | 501(C)(3) | 10000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| ARKANSAS TAKE ACTION | |||||||||||
| 125 ENGLEWOOD ROAD | LITTLE ROCK | AR | 72207 | 261807968 | 501(C)(3) | 50000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| ARTS CORPS | |||||||||||
| 4408 DELRIDGE WAY SW 110 | SEATTLE | WA | 98106 | 912044679 | 501(C)(3) | 5000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| BLESSINGS IN A BACKPACK | |||||||||||
| 1839 BROWNSBORO ROAD | LOUISVILLE | KY | 40206 | 261964620 | 501(C)(3) | 49280 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| DOWNTOWN EMERGENCY SERVICE CENTER | |||||||||||
| 515 THIRD AVENUE | SEATTLE | WA | 98104 | 911275815 | 501(C)(3) | 20000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| GULF RESTORATION NETWORK | |||||||||||
| 338 BARONNE STREET SUITE 200 | NEW ORLEANS | LA | 70112 | 721447742 | 501(C)(3) | 20000 | 0 | N/A | N/A | GULF OF MEXICO OIL SPILL RESPONSE PROGRAM | |
| MILWAUKEE RIVERKEEPER | |||||||||||
| 1845 NORTH FARWELL AVENUE SUITE 100 | MILWAUKEE | WI | 53202 | 391846305 | 501(C)(3) | 24640 | 0 | N/A | N/A | TO PROTECT MILWAUKEE RIVERS & SAFEGUARD WATER QUALITY | 100 |
| PARTNERS IN HEALTH | |||||||||||
| 888 COMMONWEALTH AVE 3RD FLOOR | BOSTON | MA | 02215 | 043567502 | 501(C)(3) | 20000 | 0 | N/A | N/A | HAITI EMERGENCY RESPONSE PROGRAM GENERAL FUND | |
| STRONGHOLD SOCIETY | |||||||||||
| 2022 EAST 134TH WAY | THORNTON | CO | 80241 | 273621140 | 501(C)(3) | 23578 | 0 | N/A | N/A | TO BUILD WK4-DIRECTIONS SKATE PARK ON THE PINE RIDGE INDIAN RESERVATION | |
| TREEHOUSE | |||||||||||
| 2100 24TH AVE SOUTH SUITE 200 | SEATTLE | WA | 981444632 | 911425676 | 501(C)(3) | 15000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| WILD SALMON CENTER | |||||||||||
| 721 NW NINTH AVENUE SUITE 300 | PORTLAND | OR | 97209 | 943166095 | 501(C)(3) | 10000 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| WISCONSIN VOICES INC | |||||||||||
| 252 EAST HIGHLAND AVENUE SUITE 208 | MILWAUKEE | WI | 53202 | 273183754 | 501(C)(3) | 24640 | 0 | N/A | N/A | GENERAL SUPPORT FUND | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 13 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: VITALOGY 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 BEQUEATHS TO DATE BY YEAR THAT INCLUDES TRACKING ON UPDATES RECEIVED BY GRANTEES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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 VI, SECTION A, LINE 2 | EXPLANATION OF BUSINESS RELATIONSHIP WITH OTHER OFFICERS OR DIRECTORS: ALL MEMBERS OF THE BOARD HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WAS REVEIWED BY AN OUTSIDE CPA FIRM AND THE BOARD MEMBERS PRIOR TO FILING THE TAX RETURN. |
| FORM 990, PART VI, SECTION C, LINE 19 | VITALOGY FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FORM 990 AVAILABLE TO INTERESTED PARTIES UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VITALOGY HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 340020 | AddressLine1 |
| City | NASHVILLE | City |
| State | TN | State |
| ZIP Code | 372030020 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 912013250 | EIN |
| Primary Activities | GRANT MAKING | PrimaryActivities |
| Legal Domicile State | WA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | PF | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| PEARL JAM LLC | |||||||||
| PO BOX 340020 | NASHVILLE | TN | 372030020 | 911695049 | MUSICAL ENTERTAINMENT | WA | N/A | 0 | 0 |
| DEKERIVER LLC | |||||||||
| 1900 SOUTH CORGIAT DRIVE | SEATTLE | WA | 98108 | 203277547 | BUILDING RENTAL | WA | N/A | 0 | 0 |
| TEN CLUB LLC | |||||||||
| 1900 SOUTH CORGIAT DRIVE | SEATTLE | WA | 98108 | 912094535 | FAN CLUB MERCHANDISE | WA | N/A | 0 | 0 |
| MONKEYWRENCH FILMS LLC | |||||||||
| PO BOX 340020 | NASHVILLE | TN | 372030020 | 264471983 | FILM PRODUCTION | CA | N/A | 0 | 0 |
| PERMASEAL FILM PRODUCTION COMPANY LLC | |||||||||
| PO BOX 340020 | NASHVILLE | TN | 372030020 | 264508356 | FILM PRODUCTION | WA | N/A | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| MONKEYWRENCH INC | ||||||||
| PO BOX 340020 | NASHVILLE | TN | 372030020 | 331062443 | MUSICAL RECORDINGS | WA | N/A | S |
| PEARL JAM TOURING INC | ||||||||
| PO BOX 340020 | NASHVILLE | TN | 372030020 | 911531093 | MUSICAL ENTERTAINMENT | NV | N/A | S |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Comments