CLARK LEWIS FAMILY FOUNDATION: Form 990PF, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: CLARK LEWIS FAMILY FOUNDATION (EIN 20-3839795)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-09-27
IRS object ID: 201102709349100500
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990-PF
Schedule B
Accounting Fees Schedule
Compensation Explanation
Legal Fees Schedule
Taxes Schedule

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-09-27T11:27:15-05:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FELLNER & KUHN PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	900 SW 5TH AVE 1815	AddressLine1
City	PORTLAND	City
State	OR	State
ZIP Code	972041227	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990PF	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	203839795	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CLARKLEWIS FAMILY FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CLAR	NameControl
Phone	5032353685	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	300 SE SPOKANE STREET	AddressLine1
Address Line2	ROOM/SUITE 7	AddressLine2
City	PORTLAND	City
State	OR	State
ZIP Code	97202	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	CANDACE C HOLZGRAFE	Name
Title	PRESIDENT	Title
Phone	5032353685	Phone
Date Signed	2011-09-21	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	J D KUHN	Name
Phone	5032270443	Phone
Date Prepared	2011-09-21	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990-PF IRS990PF

Field	Value	IRS element (for citing)
Exempt PF	X	ExemptPF
FMV Assets EOY	3109	FMVAssetsEOY
Method Of Accounting Cash	X	MethodOfAccountingCash

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Field	Value	IRS element (for citing)
Contri Received Rev And Expnss	60000	ContriReceivedRevAndExpnss
Total Revenue And Expenses	60000	TotalRevenueAndExpenses
Total Net Investment Income	0	TotalNetInvestmentIncome
Legal Fees Rev And Expnss	289	LegalFeesRevAndExpnss
Accounting Fees Rev And Expnss	840	AccountingFeesRevAndExpnss
Taxes Rev And Expnss	45	TaxesRevAndExpnss
Tot Opr Expenses Rev And Expnss	1174	TotOprExpensesRevAndExpnss
Tot Opr Expenses Net Invst Incm	0	TotOprExpensesNetInvstIncm
Tot Opr Expenses Dsbrs Chrtbl Prps	0	TotOprExpensesDsbrsChrtblPrps
Contri Gifts Paid Rev And Expnss	86825	ContriGiftsPaidRevAndExpnss
Contri Gifts Paid Dsbrs Chrtbl Prps	86825	ContriGiftsPaidDsbrsChrtblPrps
Total Expenses Rev And Expnss	87999	TotalExpensesRevAndExpnss
Total Expenses Net Invst Incm	0	TotalExpensesNetInvstIncm
Total Expenses Dsbrs Chrtbl Prps	86825	TotalExpensesDsbrsChrtblPrps
Excess Of Revenue Over Expenses	-27999	ExcessOfRevenueOverExpenses
Net Investment Income	0	NetInvestmentIncome

Balance Sheets BalanceSheets

Field	Value	IRS element (for citing)
Savings And Temp Cash Invst BOY	31108	SavingsAndTempCashInvstBOY
Savings And Temp Cash Invst EOY	3109	SavingsAndTempCashInvstEOY
Savings And Temp Cash Invst EOYFMV	3109	SavingsAndTempCashInvstEOYFMV
Total Assets BOY	31108	TotalAssetsBOY
Total Assets EOY	3109	TotalAssetsEOY
Total Assets EOYFMV	3109	TotalAssetsEOYFMV
Total Liabilities EOY	0	TotalLiabilitiesEOY
Org That Follow SFAS117	X	OrgThatFollowSFAS117
Unrestricted BOY	31108	UnrestrictedBOY
Unrestricted EOY	3109	UnrestrictedEOY
Total Net Assets BOY	31108	TotalNetAssetsBOY
Total Net Assets EOY	3109	TotalNetAssetsEOY
Total Liabilities Net Assets BOY	31108	TotalLiabilitiesNetAssetsBOY
Total Liabilities Net Assets EOY	3109	TotalLiabilitiesNetAssetsEOY

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Field	Value	IRS element (for citing)
Total Net Assets Fund Balances BOY	31108	TotalNetAssetsFundBalancesBOY
Excess Of Revenue Over Expenses	-27999	ExcessOfRevenueOverExpenses
Subtotal	3109	Subtotal
Total Net Assets Fund Balances EOY	3109	TotalNetAssetsFundBalancesEOY

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Field	Value	IRS element (for citing)
Liable For4942 Tax	false	LiableFor4942Tax
Qualifying Distributions Year1	153795	QualifyingDistributionsYear1
Qualifying Distributions Year2	116890	QualifyingDistributionsYear2
Qualifying Distributions Year3	85811	QualifyingDistributionsYear3
Qualifying Distributions Year4	32550	QualifyingDistributionsYear4
Net Noncharitable Assets	0	NetNoncharitableAssets
Adj Nonchrtbl Assets And One	0	AdjNonchrtblAssetsAndOnePct
Qualifying Distributions	86825	QualifyingDistributions

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Field	Value	IRS element (for citing)
Domestic Org Meeting Sect4940e	X	DomesticOrgMeetingSect4940e
Investment Income Excise Tax	0	InvestmentIncomeExciseTax
Amount Credited To Next Year	0	AmountCreditedToNextYear

Statements Regarding Activities StatementsRegardingActivities

Field	Value	IRS element (for citing)
Legislative Political Activities	false	LegislativePoliticalActivities
More Than100 Spent	false	MoreThan100Spent
Form1120 POL Filed	false	Form1120POLFiled
Activities Not Prev Reported	false	ActivitiesNotPrevReported
Changes To Articles Or Bylaws	false	ChangesToArticlesOrBylaws
Unrelated Bus Income Over1000	false	UnrelatedBusIncomeOver1000
Termination Etc	false	TerminationEtc
Requirements Of Sect508e	true	RequirementsOfSect508e
At Least5000 In Assets	true	AtLeast5000InAssets
States Filed With	OR	StatesFiledWith
Form990 PF Filed With AG	true	Form990PFFiledWithAG
Private Operating Foundation	false	PrivateOperatingFoundation
New Substantial Contributors	false	NewSubstantialContributors
Interest In Controlled Entity	false	InterestInControlledEntity
Applicable Insurance Contract	false	ApplicableInsuranceContract
Comply With Public Inspection Rqr	true	ComplyWithPublicInspectionRqr
Website Address	N/A	WebsiteAddress
Books In Care Of Person Name	CANDACE C HOLZGRAFE	BooksInCareOfPersonName
Books In Care Of Phone Number	5032353685	BooksInCareOfPhoneNumber

Books In Care Of US Address BooksInCareOfUSAddress

Field	Value	IRS element (for citing)
Address Line1	300 SE SPOKANE 7	AddressLine1
City	PORTLAND	City
State	OR	State
ZIP Code	97202	ZIPCode

Statements Regarding Acty4720 StatementsRegardingActy4720

Field	Value	IRS element (for citing)
Sale Or Exchange With Dsqfly Person	false	SaleOrExchangeWithDsqflyPerson
Borrow Or Lend With Dsqfly Person	false	BorrowOrLendWithDsqflyPerson
Furnished Goods With Dsqfly Person	false	FurnishedGoodsWithDsqflyPerson
Pay Compensation To Dsqfly Person	false	PayCompensationToDsqflyPerson
Transfer Assets To Dsqfly Person	false	TransferAssetsToDsqflyPerson
Payment To Government Offical	false	PaymentToGovernmentOffical
Undistributed Income Prior Years	false	UndistributedIncomePriorYears
Business Holdings	false	BusinessHoldings
Jeopardy Investments	false	JeopardyInvestments
Uncorrected Jeopardy Investments	false	UncorrectedJeopardyInvestments
Influence Legislation	false	InfluenceLegislation
Influence Election	false	InfluenceElection
Grants To Individuals	false	GrantsToIndividuals
Grants To Organizations	false	GrantsToOrganizations
Noncharitable Purpose	false	NoncharitablePurpose
Rcv Funds To Pay Prsnl Bnft Contract	false	RcvFundsToPayPrsnlBnftContract
Pay Premiums Prsnl Bnft Contract	false	PayPremiumsPrsnlBnftContract

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (5 entries)

Address Line1USAddress/AddressLine1	Address Line2USAddress/AddressLine2	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	TitleTitle	Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition	CompensationCompensation	Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc	Expense Account Other AllowancesExpenseAccountOtherAllowances
CANDACE C HOLZGRAFE
300 SE SPOKANE	SUITE 7	PORTLAND	OR	97202	PRESIDENT	0.00	0	0	0
JON R HOLZGRAFE
300 SE SPOKANE	SUITE 7	PORTLAND	OR	97202	SECRETARY	0.00	0	0	0
ANTHONY BEBER
17426 SW SARALA ST		BEAVERTON	OR	97007	DIRECTOR	0.00	0	0	0
TRACEY BEBER
17426 SW SARALA ST		BEAVERTON	OR	97007	DIRECTOR	0.00	0	0	0
BRETT BEBER
6206 SW VIEWPOINT LANE		PORTLAND	OR	97239	DIRECTOR	0.00	0	0	0

Field	Value	IRS element (for citing)
Comp Of Highest Paid Empl NONE	NONE	CompOfHighestPaidEmplNONE
Comp Of Hghst Paid Cntrct NONE	NONE	CompOfHghstPaidCntrctNONE

Sum Of Program Related Investments SumOfProgramRelatedInvestments

Field	Value	IRS element (for citing)
Description1	N/A	Description1

Minimum Investment Return MinimumInvestmentReturn

Field	Value	IRS element (for citing)
Avg Monthly FMV Of Securities	0	AvgMonthlyFMVOfSecurities
Avg Monthly Cash Balances	0	AvgMonthlyCashBalances
FMV All Other Noncharitable Assets	0	FMVAllOtherNoncharitableAssets
Total FMV Of Unused Assets	0	TotalFMVOfUnusedAssets
Adj Total FMV Of Unused Assets	0	AdjTotalFMVOfUnusedAssets
Cash Deemed Charitable	0	CashDeemedCharitable
Net Noncharitable Assets	0	NetNoncharitableAssets
Minimum Investment Return	0	MinimumInvestmentReturn

Distributable DistributableAmount

Field	Value	IRS element (for citing)
Distributable Amount As Adjusted	0	DistributableAmountAsAdjusted

Qualifying Distributions QualifyingDistributions

Field	Value	IRS element (for citing)
Expenses And Contributions	86825	ExpensesAndContributions
Qualifying Distributions	86825	QualifyingDistributions
Adj Qualifying Distributions	86825	AdjQualifyingDistributions

Undistributed Income UndistributedIncome

Field	Value	IRS element (for citing)
Distributable Amount As Adjusted	0	DistributableAmountAsAdjusted
Excess Distri Carryover Year4	32550	ExcessDistriCarryoverYear4
Excess Distri Carryover Year3	68361	ExcessDistriCarryoverYear3
Excess Distri Carryover Year2	116890	ExcessDistriCarryoverYear2
Excess Distri Carryover Year1	153795	ExcessDistriCarryoverYear1
Total Excess Distri Carryover	371596	TotalExcessDistriCarryover
Qualifying Distributions	86825	QualifyingDistributions
Remaining Distri From Corpus	86825	RemainingDistriFromCorpus
Total Corpus	458421	TotalCorpus
Undistributed Income CY	0	UndistributedIncomeCY
Excess Distri Cyov To Next Year	458421	ExcessDistriCyovToNextYear
Excess From Year4	32550	ExcessFromYear4
Excess From Year3	68361	ExcessFromYear3
Excess From Year2	116890	ExcessFromYear2
Excess From Year1	153795	ExcessFromYear1
Excess From Current Year	86825	ExcessFromCurrentYear

Supplementary Information SupplementaryInformation

Field	Value	IRS element (for citing)
Contributing Manager	CANDACE C HOLZGRAFE	ContributingManager

Appication Submission Info AppicationSubmissionInfo

Field	Value	IRS element (for citing)
Recipient Name	CANDACE HOLZGRAFE	RecipientName

Recipient US Address RecipientUSAddress

Field	Value	IRS element (for citing)
Address Line1	300 SE SPOKANE APT 7	AddressLine1
City	PORTLAND	City
State	OR	State
ZIP Code	97202	ZIPCode

Field	Value	IRS element (for citing)
Recipient Phone Number	5032353685	RecipientPhoneNumber
Form And Info And Materials	NO PRESCRIBED FORM	FormAndInfoAndMaterials
Submission Deadlines	NONE	SubmissionDeadlines
Restrictions On Awards	NONE	RestrictionsOnAwards

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (18 entries)

Address Line1RecipientUSAddress/AddressLine1	CityRecipientUSAddress/City	StateRecipientUSAddress/State	ZIP CodeRecipientUSAddress/ZIPCode	Recipient RelationshipRecipientRelationship	Purpose Of Grant Or ContributionPurposeOfGrantOrContribution	AmountAmount
BIG BROTHERSSISTERS
42-600 COOK STREET 110	PALM DESERT	CA	92211	NONE	PROGRAM SUPPORT	$310
OREGON ZOO FOUNDATION
4001 SW CANYON ROAD	PORTLAND	OR	97221	NONE	PROGRAM SPONSORSHIP	$1,000
WESTSIDE METROS SOCCER
4840 SW WESTERN AVE	BEAVERTON	OR	97005	NONE	SUPPORT CHILDRENS SOCCER TEAMS	$14,000
THE LIVING DESERT
47-900 PORTSIDE AVE	PALM DESERT	CA	92263	NONE	PROGRAM SUPPORT	$1,615
COASTER THEATRE FOUND
9770 SW SUNSHINE CT	BEAVERTON	OR	97005	NONE	PROGRAM SPONSOR	$10,000
PORTLAND WOMEN'S FOUND
PO BOX 1032	PORTLAND	OR	97207	NONE	PROGRAM SUPPORT	$20,000
ST MARY'S ACADEMY
1615 SW 5TH AVENUE	PORTLAND	OR	97201	NONE	TUITION ASSISTANCE FUND	$10,000
VARIETY
74-040 HWY 111	PALM DESERT	CA	92260	NONE	PROVIDING BIKES/HELMETS TO CHILDREN	$5,000
MY SISTER'S HOUSE
PO BOX 305	TROUTDALE	OR	97060	NONE	PROGRAM SUPPORT	$5,000
GOOD SAMARITAN HOME
2130 HARRISON	QUINCY	IL	62301	NONE	PROGRAM SUPPORT	$5,000
QUINCY PUBLIC SCHOOL FOUN
1416 MAINE STREET	QUINCY	IL	62301	NONE	PROGRAM SUPPORT	$1,000
ST JAMES MISSION CIRCLE
PO BOX 1376	SOLANA BEACH	CA	92075	NONE	PROGRAM SUPPORT	$5,000
AMERICAN CANCER SOCIETY
330 SW CURRY STREET	PORTLAND	OR	97239	NONE	PROGRAM SUPPORT	$500
ESTACADA SKATE PARK
475 SE MAIN STREET	ESTACADA	OR	97023	NONE	PROGRAM SUPPORT	$5,000
SUNSHINE PANTRY
7795 SW CIRRUS DRIVE	BEAVERTON	OR	97008	NONE	PROGRAM SUPPORT	$2,000
PORTLAND GARDEN CLUB
1132 SW VISTA AVENUE	PORTLAND	OR	97205	NONE	PROGRAM SUPPORT	$100
SUNSET HOMEQUINCY
418 WASHINGTON STREET	QUINCY	IL	62301	NONE	PROGRAM SUPPORT	$300
CULVER STOCKTON COLLEGE
1 COLLEGE HILL	CANTON	MO	63435	NONE	PROGRAM SUPPORT	$1,000

Field	Value	IRS element (for citing)
Tot Grant Or Contri Paid During Year	86825	TotGrantOrContriPaidDuringYear

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

Field	Value	IRS element (for citing)
Trnsfr Of Cash To Noncharitable EO	false	TrnsfrOfCashToNoncharitableEO
Trnsfr Oth Assets Noncharitable EO	false	TrnsfrOthAssetsNoncharitableEO
Sales Or Exchanges Of Assets	false	SalesOrExchangesOfAssets
Purchase Assets Noncharitable EO	false	PurchaseAssetsNoncharitableEO
Rental Of Facilities Etc	false	RentalOfFacilitiesEtc
Reimbursement Arrangements	false	ReimbursementArrangements
Loans Or Loan Guarantees	false	LoansOrLoanGuarantees
Performance Of Services Etc	false	PerformanceOfServicesEtc
Sharing Of Facilities Etc	false	SharingOfFacilitiesEtc
Relationships Noncharitable E Os	false	RelationshipsNoncharitableEOs

Schedule B IRS990ScheduleB

Field	Value	IRS element (for citing)
Organization501c3 Exempt PF	X	Organization501c3ExemptPF
General Rule	X	GeneralRule

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	1	ContributorNumber
Contributor Name Individual	CANDACE HOLZGRAFE	ContributorNameIndividual

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	300 SE SPOKANE STREET	AddressLine1
City	PORTLAND	City
State	OR	State
ZIP Code	97202	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	60000	AggregateContributions
Person Contribution Type	X	PersonContributionType

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

Field	Value	IRS element (for citing)
Category	INDIRECT ACCOUNTING FEES	Category
Amount	$840	Amount

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

Field	Value	IRS element (for citing)
Category	INDIRECT LEGAL FEES	Category
Amount	$289	Amount

Taxes Schedule TaxesSchedule

Taxes Taxes

Field	Value	IRS element (for citing)
Category	INDIRECT TAXES/LICENSES	Category
Amount	$45	Amount

CLARK LEWIS FAMILY FOUNDATION: Form 990PF, tax year 2010

Return header ReturnHeader

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Preparer Firm US Address PreparerFirmUSAddress

Filer Filer

Name Name

US Address USAddress

Officer Officer

Preparer Preparer

Form 990-PF IRS990PF

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

Balance Sheets BalanceSheets

Changes In Net Assets Fund Balances ChangesInNetAssetsFundBalances

Qlfy Und Sect4940e For Reduced Tax QlfyUndSect4940eForReducedTax

Excise Tax Based On Investment Incm ExciseTaxBasedOnInvestmentIncm

Statements Regarding Activities StatementsRegardingActivities

Books In Care Of US Address BooksInCareOfUSAddress

Statements Regarding Acty4720 StatementsRegardingActy4720

Ofcr Dir Trustees Key Employee Info OfcrDirTrusteesKeyEmployeeInfo

Ofcr Dir Trustees Or Key Employee OfcrDirTrusteesOrKeyEmployee (5 entries)

Sum Of Program Related Investments SumOfProgramRelatedInvestments

Minimum Investment Return MinimumInvestmentReturn

Distributable DistributableAmount

Qualifying Distributions QualifyingDistributions

Undistributed Income UndistributedIncome

Supplementary Information SupplementaryInformation

Appication Submission Info AppicationSubmissionInfo

Recipient US Address RecipientUSAddress

Grant Or Contri Paid During Year GrantOrContriPaidDuringYear (18 entries)

Trnsfr Tr Rln With Noncharitable EO TrnsfrTrRlnWithNoncharitableEO

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Contributor Address US ContributorAddressUS

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees AccountingFees

Compensation Explanation CompensationExplanation

Compensation Compensation (5 entries)

Legal Fees Schedule LegalFeesSchedule

Legal Fees LegalFees

Taxes Schedule TaxesSchedule

Taxes Taxes

Comments