PROVAIL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
PROVAIL (EIN 91-0593488)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-03-14
IRS object ID
201110739349300861
Schema version
2009v1.7
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)
Timestamp2011-03-14T17:41:09-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PETERSON SULLIVAN LLP CPA'SBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1601 UNION ST STE 2300AddressLine1
CitySEATTLECity
StateWAState
ZIP Code981012345ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN910593488EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PROVAILBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPROVNameControl
Phone2063637303Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line112550 Aurora Ave NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98133ZIPCode

Officer Officer

FieldValueIRS element (for citing)
Namemichael j hatzenbelerName
TitleCEOTitle
Phone2063637303Phone
Date Signed2011-03-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRaymon G HolmdahlName
Phone2063827777Phone
Date Prepared2011-03-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichael J HatzenbelerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line112550 Aurora Ave NAddressLine1
CitySEATTLECity
StateWAState
ZIP Code98133ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11445827GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.PROVAIL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1942YearFormation
State Legal DomicileWAStateLegalDomicile
Activity Or Mission DescriptionPROVAIL'S MISSION IS TO SUPPORT PEOPLE WITH DISABILITIES TO FULFILL THEIR LIFE CHOICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees379TotalNbrEmployees
Total Nbr Volunteers360TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8005524ContributionsGrantsPriorYear
Contributions Grants Current Year7862553ContributionsGrantsCurrentYear
Program Service Revenue Prior Year651476ProgramServiceRevenuePriorYear
Program Service Revenue CY807375ProgramServiceRevenueCY
Investment Income Prior Year6919InvestmentIncomePriorYear
Investment Income Current Year11025InvestmentIncomeCurrentYear
Other Revenue Prior Year507038OtherRevenuePriorYear
Other Revenue Current Year888486OtherRevenueCurrentYear
Total Revenue Prior Year9170957TotalRevenuePriorYear
Total Revenue Current Year9569439TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7765223SalariesEtcPriorYear
Salaries Etc Current Year7398184SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year239951TotalFundrsngExpCurrentYear
Other Expense Prior Year1444339OtherExpensePriorYear
Other Expenses Current Year1561332OtherExpensesCurrentYear
Total Expenses Prior Year9209562TotalExpensesPriorYear
Total Expenses Current Year8959516TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-38605RevenuesLessExpensesPriorYear
Revenues Less Expenses CY609923RevenuesLessExpensesCY
Total Assets BOY2896455TotalAssetsBOY
Total Assets EOY3440380TotalAssetsEOY
Total Liabilities BOY2215599TotalLiabilitiesBOY
Total Liabilities EOY2315068TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY680856NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1125312NetAssetsOrFundBalancesEOY
Mission DescriptionPROVAIL'S MISSION IS TO SUPPORT PEOPLE WITH DISABILITIES TO FULFILL THEIR LIFE CHOICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1146493Expense
Revenue807375Revenue
DescriptionTHERAPEUTIC and Assistive Technology Services - Our services include Speech Therapy, Occupational Therapy and Assistive Technology. These services enable children and adults with disabilities or injuries to maximize their performance and productivity at home, work, school, and in leisure activities. Approximately 380 clients are served each year. In addition, the Dental Clinic provides professional dental services to people with disabilities, serving approximately 225 clients each year.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense957502Expense
Revenue912973Revenue
DescriptionSupported Employment and Vocational Services - We work with individuals with disabilities to secure and retain competitive employment by helping with the process of identifying career goals, matching candidates to positions, training and orientation and ongoing support where needed. Approximate caseload is 140 clients. We operate a light manufacturing facility that provides employment and vocational services for approximately 30 persons with disabilities in an integrated, competitive workplace.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense5598928Expense
DescriptionCOMMUNITY LIVING services - provides supported living services to adults with severe development disabilities. We provide 24-hour support, instruction, personal care and nursing services in accessible, community-based homes throughout the Greater Seattle Area. Approximately 65 clients are served.Description
FieldValueIRS element (for citing)
Total Program Service Expense7702923TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10968NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees379NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Kelly RondouBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2063637303TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112550 Aurora Ave NAddressLine1
CitySeattleCity
StateWAState
ZIP Code98133ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Doug McFarland
Chair1.00XX000
Katie Cissell
Secretary1.00XX000
Carly List
1st Vice Chair1.00XX000
Ken Toole
Treasurer1.00XX000
Jared Hager
2nd Vice Chair1.00XX000
Jenny Cochrane
Member1.00X000
Derek Crump
Member1.00X000
Bob Frey
Member1.00X000
Jeana Jorgensen
Member1.00X000
Chris King
Member1.00X000
Nolan Newman CPA
Member1.00X000
Skylar Sherwood
Member1.00X000
Zoe Vinson
Member1.00X000
Randy Willett
Member1.00X000
Michael Hatzenbeler
CEO40.00X113987010531
Jerry Hynes
COO40.00X11162606389
FieldValueIRS element (for citing)
Total Reportable Comp From Org225613TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation16920TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns137693FederatedCampaigns
Fundraising Events135560FundraisingEvents
Government Grants7456761GovernmentGrants
All Other Contributions132539AllOtherContributions
Total Contributions7862553TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
REHABILITATION & DENTA900099704139704139
traumatic brain injury900099103236103236
FieldValueIRS element (for citing)
Total Program Service Revenue807375TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6925TotalRevenueColumn
Exclusion$6,925ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4100Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4100Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4100TotalRevenueColumn
Exclusion$4,100ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events57945GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events135560CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses86402FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-28457TotalRevenueColumn
Exclusion-$28,457ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory2702959GrossSalesOfInventory
Cost Of Goods Sold1789986CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column912973TotalRevenueColumn
Related Or Exempt Function Income912973RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
cobra & misc receipts9000991779$1,779
Miscellaneous9000991447$1,447
laundry income900099744$744
FieldValueIRS element (for citing)
Total Other Revenue3970TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column9569439TotalRevenueColumn
Related Or Exempt Function Income1720348RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$13,462ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total242533Total
Program Services213295ProgramServices
Management And General23082ManagementAndGeneral
Fundraising6156Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6112209Total
Program Services5390899ProgramServices
Management And General574504ManagementAndGeneral
Fundraising146806Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total390578Total
Program Services330256ProgramServices
Management And General43312ManagementAndGeneral
Fundraising17010Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total652864Total
Program Services578317ProgramServices
Management And General62743ManagementAndGeneral
Fundraising11804Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total50253Total
Program Services31861ProgramServices
Management And General18088ManagementAndGeneral
Fundraising304Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total119872Total
Program Services75996ProgramServices
Management And General43147ManagementAndGeneral
Fundraising729Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total18706Total
Program Services4669ProgramServices
Management And General1762ManagementAndGeneral
Fundraising12275Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total135301Total
Program Services113593ProgramServices
Management And General16650ManagementAndGeneral
Fundraising5058Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total406376Total
Program Services273804ProgramServices
Management And General118778ManagementAndGeneral
Fundraising13794Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total100473Total
Program Services99569ProgramServices
Management And General761ManagementAndGeneral
Fundraising143Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total30202Total
Program Services21108ProgramServices
Management And General6108ManagementAndGeneral
Fundraising2986Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total67660Total
Program Services63400ProgramServices
Management And General3544ManagementAndGeneral
Fundraising716Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total98404Total
Program Services59074ProgramServices
Management And General38018ManagementAndGeneral
Fundraising1312Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total67272Total
Program Services47142ProgramServices
Management And General19363ManagementAndGeneral
Fundraising767Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
GENERAL AND ADMINISTRAT414088379789294864813
DUES & SUBSCRIPTIONS18365680611559
TAXES, LICENSES AND FEE16841109685737136
fundraising expenses1514215142
MISCELLANEOUS23772377

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8959516Total
Program Services7702923ProgramServices
Management And General1016642ManagementAndGeneral
Fundraising239951Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY136536BOY
EOY201269EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY171626BOY
EOY743718EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1635457BOY
EOY1545797EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY58577BOY
EOY38527EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY53157BOY
EOY68304EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2273382LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1569434LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY672687BOY
EOY703948EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY87663BOY
EOY87663EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY80752BOY
EOY51154EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2896455BOY
EOY3440380EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY823197BOY
EOY935816EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1233860BOY
EOY1196845EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY158542BOY
EOY182407EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2215599BOY
EOY2315068EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY680856BOY
EOY1125312EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY680856BOY
EOY1125312EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2896455BOY
EOY3440380EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7902594CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7792920CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8104453CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8005524CurrentTaxYearMinus1Year
Current Tax Year7862553CurrentTaxYear
Total39668044Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7902594CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7792920CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8104453CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8005524CurrentTaxYearMinus1Year
Current Tax Year7862553CurrentTaxYear
Total39668044Total
FieldValueIRS element (for citing)
Public Support Total17039668044PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3454CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11930CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years19730CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6919CurrentTaxYearMinus1Year
Current Tax Year6925CurrentTaxYear
Total48958Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years104671CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10562CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12751CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5515CurrentTaxYearMinus1Year
Current Tax Year3970CurrentTaxYear
Total137469Total
FieldValueIRS element (for citing)
Total Support39854471TotalSupport
Gross Receipts From Admissions Etc9565975GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99530PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99220PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSchedule A, Part II, Line 10, Explanation of Other Income: MISCELLANEOUSGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis70500OtherCostOrOtherBasis
Book Value70500BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis614566OtherCostOrOtherBasis
Depreciation377407Depreciation
Book Value237159BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis604431OtherCostOrOtherBasis
Depreciation359513Depreciation
Book Value244918BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis983885OtherCostOrOtherBasis
Depreciation832514Depreciation
Book Value151371BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings703948TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
FUNDS HELD IN TRUST FOR OTHERS$1,709
Deferred Rent$180,698
FieldValueIRS element (for citing)
Total Of Amounts182407TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationPart X: No uncertain tax positions were addressed in the organizations financial statement footnotes.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1LuncheonNameOfEvent1
Gross Receipts Event134658GrossReceiptsEvent1
Charitable Contributions Event126201CharitableContributionsEvent1
Gross Revenue Event18457GrossRevenueEvent1
Rent Facility Costs Event1500RentFacilityCostsEvent1
Other Direct Expenses Event114229OtherDirectExpensesEvent1
Name Of Event2Golf TournamentNameOfEvent2
Gross Receipts Event2153046GrossReceiptsEvent2
Charitable Contributions Event2103558CharitableContributionsEvent2
Gross Revenue Event249488GrossRevenueEvent2
Other Direct Expenses Event271372OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events5801GrossReceiptsOtherEvents
Charitable Contrib Other Events5801CharitableContribOtherEvents
Other Direct Expenses Other Events301OtherDirectExpensesOtherEvents
Gross Receipts Total193505GrossReceiptsTotal
Charitable Contributions Total135560CharitableContributionsTotal
Gross Revenue Total Events57945GrossRevenueTotalEvents
Rent Facility Costs Total Events500RentFacilityCostsTotalEvents
Other Direct Expenses Total Events85902OtherDirectExpensesTotalEvents
Direct Expense Summary Events86402DirectExpenseSummaryEvents
Net Income Summary-28457NetIncomeSummary

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name Persontrish tooleNamePerson
FieldValueIRS element (for citing)
Relationshipspouse of a board memberRelationship
Amount Of Transaction27165AmountOfTransaction
Description Of TransactionTrish is employed by Provail as an occupational therapist.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The organization will provide a draft copy of the form 990 to the governing board and management approximately two weeks prior to it being filed and request any questions or comments be directed to the cfo.
Form 990, Part VI, Section B, line 12cEach Board member is asked to review and sign the conflict of interest policy on an annual basis and also filled out a questionnaire as part of the preparation for the 990 dealing with independence. We have had no conflicts to deal with.
Form 990, Part VI, Section B, line 15aThe Executive Committee of the Board undertakes the evaluation and compensation setting for the CEO. They completed the evaluation portion getting input from the Board of directors and employees supervised by the CEO. They also reviewed salaries at comparable agencies by pulling 990's for them. Minutes of these meetings were kept. Using both the evaluation and the comparable salary information they set the salary for the CEO. We have no other employees who meet the definition of key employee
Form 990, Part VI, Section C, line 19These documents are available upon request.
form 990, part xi, line 2cthis process has not changed from the prior year.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Provail - Affiliates
12550 aurora ave nseattleWA98133912146011Community HousingWA501(c)(3)7N/A
auburn community living
12550 aurora ave nseattleWA98133911814582Community HousingWA501(c)(3)7N/A
eastside community living
12550 aurora ave nseattleWA98133943206977Community HousingWA501(c)(3)7N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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