2011-04-14T16:14:20-05:00 2010-09-30 Clark Nuber PS 10900 NE 4th Street Suite 1700 Bellevue WA 98004 990 2009-10-01 061701305 HENRY M JACKSON ENDOWMENT HENR 2066828565 1501 4TH AVENUE No 1580 SEATTLE WA 98101 LARA IGLITZIN 2066828565 2011-04-14 1 Jane M Searing 4254544919 2009 2016-02-24 21:20:13Z LARA IGLITZIN 1501 4TH AVENUE No 1580 SEATTLE WA 98101 12671697 0 X WWW.HMJACKSON.ORG X 2002 WA THE HENRY M. JACKSON ENDOWMENT IS A SUPPORTING ORGANIZATION OF THE HENRY M. JACKSON FOUNDATION. 12 12 0 12 0 0 0 0 165237 -60696 0 165237 -60696 474586 119200 0 0 0 5939 206303 237621 680889 356821 -515652 -417517 12003221 13251981 517281 1754950 11485940 11497031 Supporting organization under I.R.C. 509(a)(3) to the Henry M. Jackson Foundation. 0 0 260229 119200 THE HENRY M. JACKSON ENDOWMENT AWARDS GRANTS TO NONPROFIT ORGANIZATIONS ALONG WITH PUBLIC AND PRIVATE EDUCATIONAL INSTITUTIONS IN THE UNITED STATES AND ABROAD. THESE GRANTS CARRY FORWARD THE LIFELONG INTEREST OF SENATOR HENRY M. JACKSON IN EDUCATIONAL PROGRAMS RELATING TO INTERNATIONAL AFFAIRS, PUBLIC SERVICES, AND THE ENVIRONMENT. THE ENDOWMENT SUPPORTS THE GOALS AND OBJECTIVES OF THE HENRY M. JACKSON FOUNDATION. 260229 1 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 12 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X JELENA JURKOVIC 2066828565 1501 - 4TH AVENUE STE 1580 SEATTLE WA 98101 X JOHN HEMPELMANN 4.00 X X 0 0 0 CRAIG GANNETT 2.00 X X 0 0 0 LINDA MASON WILGIS 2.00 X X 0 0 0 DAVID ROSTOV 1.00 X X 0 0 0 JOEL MERKEL 1.00 X X 0 0 0 HELEN H JACKSON 1.00 X 0 0 0 SUSAN GOLUB 1.00 X 0 0 0 EILEEN GREVEY HILLSON 1.00 X 0 0 0 TOM LUCE 1.00 X 0 0 0 JOHN MANGELS 1.00 X 0 0 0 ANNE MARIE LAURENCE 1.00 X 0 0 0 SUSAN WICKWIRE 1.00 X 0 0 0 LARA IGLITZIN 40.00 X 0 144583 6318 0 144583 6318 0 0 1 0 0 307413 307413 12364284 12732393 -368109 -368109 -368109 -60696 0 0 -60696 75200 75200 44000 44000 39045 27332 9761 1952 61952 61952 36280 28784 6247 1249 4455 3118 1114 223 42300 29610 10575 2115 PUBLICATIONS 30370 30370 0 0 HUMAN RIGHTS PROGRAM 8276 8276 0 0 PUBLIC SERVICE PROGRAMS 7418 7418 0 0 INT'L EDUCATION PROGRAM 3000 3000 0 0 ENVIRONMENTAL PROGRAMS 2500 2500 0 0 2025 621 1004 400 356821 260229 90653 5939 21013 102278 426568 51907 3805 8305 11551835 13077733 0 11758 12003221 13251981 1920 5050 515361 107068 0 1642832 517281 1754950 X 1485940 1497031 10000000 10000000 11485940 11497031 12003221 13251981 X 0 1 1 X 0 X X X 0 0 0 HENRY M JACKSON FOUNDATION 521313011 7 1 1 1 260229 1 260229 Schedule A, Part IV, Supplemental Information: SCHEDULE A, PART I, LINE H, COLUMN (VII): AMOUNT OF SUPPORT PROVIDED - AMOUNTS PAID ON BEHALF OF HENRY M. JACKSON FOUNDATION: $260,229 10530314 955625 367913 170764 89465 96592 11497031 12965994 156458 1430212 1011899 150027 10530314 0.13000 0.87000 0.00000 0 1 1 0 DUE TO RELATED ORG 1642832 1642832 Part V, Line 4: Description of Intended Use of Endowment Funds: The endowment funds are permanently restricted by the donor and are held for investment. Earnings from the $10,000,000 are unrestricted and may be used by the Henry M. Jackson Endowment to support operations. 1 Russia & the Newly Independent States 0 0 GRANTS MADE TO CHARITABLE ORGANIZATIONS LOCATED IN RUSSIA NOT APPLICABLE 44000 0 0 44000 Russia & the Newly Independent States HUMAN RIGHTS, BALANCE OF SOCIAL & ECONOMIC INTERESTS IN RUSSIA 10000 WIRE TRANSFER Russia & the Newly Independent States SUPPORTING ACCESS TO SOCIALLY SIGNIFICANT INFORMATION & ARCHIVES IN RUSSIA 19000 WIRE TRANSFER Russia & the Newly Independent States SUPPORTING YOUTH LED EXHIBITION ON POLITICAL REPRESSION IN RUSSIA 15000 WIRE TRANSFER 3 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: GRANT AGREEMENTS INCLUDE A REQUIREMENT TO REPORT BACK TO THE HENRY M. JACKSON ENDOWMENT ON THE USE OF GRANT FUNDS. REPORTING IS DONE ON AN ANNUAL BASIS UNLESS OTHERWISE STIPULATED, GRANT REPORTS (FROM GRANTEES) ARE REVIEWED, MONITORED AND DISCUSSED WITH GRANTEES IF DEEMED NECESSARY. REVIEW IS DONE BY A STAFF PROGRAM OFFICER AND, UPON OCCASION, THE EXECUTIVE DIRECTOR. 1 UNIVERSITY OF WASHINGTON FOUNDATION UNIV OF WA PO BOX 353650 SEATTLE WA 98105 943079432 501(C)(3) 12700 N/A N/A STERLING MUNRO SCHOLARSHIP AT THE UNIVERSITY OF WASHINGTON UNIVERSITY OF WASHINGTON FOUNDATION UNIV OF WA PO BOX 353650 SEATTLE WA 98105 943079432 501(C)(3) 7500 N/A N/A GSPA ENVIRONMENTAL FELLOWS/SCHOLARSHIP AT THE UNIVERSITY OF WASHINGTON NATIONAL BUREAU OF ASIAN RESEARCH 1414 NE 42ND ST STE 300 SEATTLE WA 98105 911444105 501(C)(3) 25000 N/A N/A SUPPORT OF U.S. - CHINA LEADERSHIP FORUM INTERNATIONAL COALITION OF SITES OF CONSCIENCE 333 - 7TH AVENUE 14TH FLOOR NEW YORK NY 10001 204874389 501(C)(3) 15000 N/A N/A SUPPORT HISTORIC SITES DEDICATED TO HUMAN RIGHTS IN RUSSIA SEATTLE INDIAN HEALTH BOARD 611 - 12TH AVE S STE 200 SEATTLE WA 98144 910869056 501(C)(3) 10000 N/A N/A SUPPORT OF PUBLICATION ON INDIAN AFFAIRS AND HEALTHCARE ENVIRONMENTAL LAW INSTITUTE 2000 L STREET NW STE 620 WASHINGTON DC 20036 520901863 501(C)(3) 5000 N/A N/A EVENT SUPPORT - TRANSPARENCY AND OPEN GOVERNMENT 5 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grant agreements include a requirement to report back to the Henry M. Jackson Endowment on the use of grant funds. Reporting is done on an annual basis unless otherwise stipulated. Grant reports (from grantees) are reviewed, monitored and discussed with grantees if deemed necessary. Review is done by a staff program officer and, upon occasion, by the Executive Director. X 0 0 0 0 0 0 0 0 0 LARA IGLITZIN 0 144583 0 0 0 0 0 0 0 6318 0 150901 0 0 Form 990, Part VI, Section A, line 2 HELEN H. JACKSON AND ANNE MARIE LAURENCE HAVE A FAMILY RELATIONSHIP. Form 990, Part VI, Section B, line 11 Board members are provided with a copy of Form 990, first in draft form and again once the Executive Committee and the Finance Committee members have performed their review and the return is finalized for filing. Form 990, Part VI, Section B, line 12c Annually, at the Board of Directors meeting, all officers are required to sign a new conflict of interest policy. The Endowment maintains, on file, the signed copies from the board members. Guidelines are discussed at that meeting and all board members are made aware of the importance of this policy. If a conflict arises, the conflicted board member recuses themselves from voting on the matter. Form 990, Part VI, Section B, line 15 The Executive Director's salary is paid and determined by the Henry M. Jackson Foundation. Compensation is reviewed annually by the executive committee. Any adjustments to salaries must be voted on and approved by the executive committee. Salaries are compared to budget during the year to ensure correctness of pay. This is done at the beginning of each fiscal year as part of the budgeting process. Last salary review was performed in fall 2010 for the upcoming fiscal year 2011. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART I, LINE 6 THE BOARD OF GOVERNORS IS COMPRISED OF VOLUNTEERS, 12 INDIVIDUALS SERVED THROUGHOUT THE YEAR. HENRY M JACKSON FOUNDATION 1501- 4TH AVE SUITE 1580 SEATTLE WA 98101 521313011 SUPPORT EDUCATIONAL PROGRAMS DC 501(C)(3) Line 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0