Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
HALEAKALA INC DBA THE KITCHEN
Employer identification number
13-2829756
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
1,592,428
2,012,587
1,401,499
1,443,632
1,750,221
8,200,367
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
1,592,428
2,012,587
1,401,499
1,443,632
1,750,221
8,200,367
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
702,688
6
Public support. Subtract line 5 from line 4.
7,497,679
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
1,592,428
2,012,587
1,401,499
1,443,632
1,750,221
8,200,367
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
69,170
61,070
73,105
88,204
70,408
361,957
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
3,393
2,431
9,963
294,799
47,293
357,879
11
Total support (Add lines 7 through 10).
8,920,203
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,281,075
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
84.050 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
89.660 %
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
HALEAKALA INC DBA THE KITCHEN
Employer identification number
13-2829756
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 2
MELISSA SCHIFF SOROS IS MARRIED TO ROBERT SOROS AND BOTH ARE KITCHEN BOARD MEMBERS. MARLA MAYER IS MARRIED TO CHRIS AHEARN AND BOTH ARE KITCHEN BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11
PRIOR TO FILING, THE BOARD OFFICERS SIGNING THE DOCUMENT ARE GIVEN THE 990 TO REVIEW AND APPROVE. THE 990 IS DISTRIBUTED TO THE AUDIT COMMITTEE, ALONG WITH THE FINANCIAL STATEMENTS FOR REVIEW AND APPROVAL. ADDITIONALLY, THE AUDIT COMMITTEE MEETS WITH THE CPAS WHO CONDUCTED THE AUDIT AND PREPARED THE 990.
FORM 990, PART VI, SECTION B, LINE 12C
1. DUTY TO DISCLOSE: IN CONNECTION WITH ANY PRESENT OR PROPOSED TRANSACTION OR ARRANGEMENT, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE PERSONS IN THE ORGANIZATION WITH RESPONSIBILITY FOR, OR WHO ARE CONSIDERING, THE TRANSACTION OR ARRANGEMENT. THESE PERSONS MAY INCLUDE STAFF, OFFICERS, DIRECTORS OR A MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS: A. AFTER THE INTERESTED PERSON DISCLOSES THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE RESPONSIBLE PERSONS SHALL EVALUATE WHETHER THE FINANCIAL INTEREST PRESENTS A CONFLICT OF INTEREST. IF THE FINANCIAL INTEREST WAS DISCLOSED TO AN INDIVIDUAL MEMBER OF THE STAFF, OFFICER OR DIRECTOR, SUCH PERSON SHALL PRESENT THE MATTER TO THE BOARD OR RESPONSIBLE COMMITTEE OF THE ORGANIZATION. B. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, WHETHER THE TRANSACTION OR ARRANGEMENT PRESENTS A POSSIBLE CONFLICT OF INTEREST. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: A. IF THE FINANCIAL INTEREST HAS BEEN DISCLOSED TO THE BOARD OR A COMMITTEE, AND IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE CHAIRPERSON THEREOF SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE OPTIONS, INCLUDING, IF APPROPRIATE, ALTERNATIVES TO THE EXISTING OR PROPOSED TRANSACTION OR ARRANGEMENT. B. AFTER EXERCISING DUE DILIGENCE (TAKING INTO ACCOUNT, WITHOUT LIMITATION, THE UNIQUE QUALIFICATIONS OF THE PERSON OR ENTITY PROVIDING THE GOODS OR SERVICES INVOLVED IN THE TRANSACTION OR ARRANGEMENT, AND THE AMOUNT OF CONSIDERATION, MONETARY OR OTHERWISE, INVOLVED IN THE TRANSACTION OR ARRANGEMENT), THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN, WITH REASONABLE EFFORTS, A DEMONSTRABLY MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT PRESENT A CONFLICT OF INTEREST. C. IF A DEMONSTRABLY MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE EXISTING OR PROPOSED TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, WHETHER IT IS FAIR AND REASONABLE AND WHETHER TO MAINTAIN OR ENTER INTO THE TRANSACTION OR ARRANGEMENT. 4. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: A. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A PERSON HAS FAILED TO DISCLOSE A FINANCIAL INTEREST IN VIOLATION OF THIS POLICY, IT SHALL INFORM THE PERSON OF THE BASIS FOR SUCH BELIEF, AND AFFORD SUCH PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. B. IF, AFTER HEARING THE PERSON'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THE PERSON HAS FAILED TO DISCLOSE A FINANCIAL INTEREST AS REQUIRED BY THIS POLICY, IT SHALL TAKE APPROPRIATE ACTION.
FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S BOARD OF DIRECTORS RECEIVE NO COMPENSATION. THE EXECUTIVE DIRECTOR'S SALARY IS APPROVED BY THE BOARD OF DIRECTORS. IN DETERMINING THE SALARY, THE BOARD CONSIDERS OVERALL PERFORMANCE, THE POSITION AND HEALTH OF THE ORGANIZATION IN RELATION TO OTHER SIMILAR ORGANIZATIONS. A WRITTEN EMPLOYMENT CONTRACT, APPROVED BY THE BOARD OF DIRECTORS, IS ISSUED TO THE EXECUTIVE DIRECTOR, WHICH DETAILS COMPENSATION. A COMPENSATION SURVEY IS MADE AVAILABLE TO THE BOARD TO HELP DETERMINE APPROPRIATE SALARIES FOR THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19
THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OTHER WRITTEN POLICIES ARE AVAILABLE UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.