TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JIM PHILLIPS...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(2) BRIDGET FLORY...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(3) WANDA RILEY...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(4) BOB LOLCAMA...................................................................... BOARD CHAIR	1.00 .................	X	X	0	0
(5) VIRGIL CLARKSON...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(6) GREG JASPERSON...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(7) JIM JONES...................................................................... BOARD SECRET	1.00 .................	X	X	0	0
(8) LYNN FLAISIG...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(9) BRENDA JONES...................................................................... BOARD CHAIR	1.00 .................	X	X	0	0
(10) CHRIS WEINREICH...................................................................... BOARD TREASU	1.00 .................	X	X	0	0
(11) GARY STAMPER...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(12) TERRI JEFFREYS...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(13) DEBBIE SULLIVAN...................................................................... BOARD VICE C	1.00 .................	X		0	0
(14) MICHAEL STEADMAN...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(15) CAYLA RAVANCHO...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(16) LINDA ALLEN...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(17) JOHN WALSH...................................................................... CHIEF EXECUT	40.00 .................		X	109,698	21,732

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....	10,030,290	10,093,190	9,708,141	9,672,152	9,796,458	49,300,231
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	10,030,290	10,093,190	9,708,141	9,672,152	9,796,458	49,300,231
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)..
6	Public support. Subtract line 5 from line 4.						49,300,231

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..	10,030,290	10,093,190	9,708,141	9,672,152	9,796,458	49,300,231
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	44,406	31,463	30,701	23,412	22,606	152,588
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 VI.)..
11	Total support. Add lines 7 through 10.						49,452,819

Gross receipts from related activities, etc. (see instructions) ..................

1,106,092

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

99.690 %

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

99.660 %

16a

33 1/3% support test—2015. 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 ....................... right arrow

33 1/3% support test—2014. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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 ....... right arrow

33 1/3% support tests—2014. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization COMMUNITY ACTION COUNCIL OF LEWIS MASON AND THURSTON COUNTIES

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization COMMUNITY ACTION COUNCIL OF LEWIS MASON AND THURSTON COUNTIES		Employer identification number 91-0818368

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization COMMUNITY ACTION COUNCIL OF LEWIS MASON AND THURSTON COUNTIES			Employer identification number 91-0818368
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	1,526,457		1,526,457
b	Buildings	10,956,581	4,016,209	6,940,372
c	Leasehold improvements
d	Equipment ...	951,731	515,730	436,001
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				8,902,830

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ACCRUED INTEREST PAYABLE	207,208
ACCRUED WAGES PAYABLE	83,572
RENTAL DEPOSITS	71,312
PREPAID RENTS	86
LINE OF CREDIT
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	362,178
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1	10,938,040
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3	10,938,040
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	10,938,040

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	11,089,365
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3	11,089,365
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	11,089,365

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PAGE 3, PART X	NO UNCERTAIN TAX POSITIONS WERE ADDRESSED IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENT FOOTNOTES.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number
91-0818368

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) BREMERTON FOODLINE PO BOX 824 BREMERTON,WA98337	91-1111086	501(C)	83,685	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(2) BREMERTON SALVATION ARMY PO BOX 886 BREMERTON,WA98337	94-1155347	501(C)	77,499	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(3) CENTRAL KITSAP FOOD BANK PO BOX 784 SILVERDALE,WA98383	91-1425561	501(C)	57,781	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(4) CHURCH OF LIVING WATER 1615 CHAMBERS ST SE OLYMPIA,WA98501	91-1074612	501(C)	13,877	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(5) COVE CITY OUTREACH 5126 E BROCKDALE RD SHELTON,WA98584	55-0885495	501(C)	16,874	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(6) HOOD CANAL FOOD BANK PO BOX 995 HOODSPORT,WA98548	91-1449048	501(C)	25,067	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(7) LEWIS COUNTY FOOD COALITION 2901 SAWALL AVE CENTRALIA,WA98531	91-1391826	501(C)	68,930	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(8) MATLOCK FOOD BANK PO BOX 122 MATLOCK,WA98560	91-1229585	501(C)	16,238	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(9) MORTON FOOD BANK (SACRED HEART/PASTOR'S PANTRY) PO BOX 880 MORTON,WA98356	94-2712386	501(C)	16,501	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(10) NEW MANNA PENTECOSTAL SOUP KITCHEN 2535 PERRY AVE BREMERTON,WA98311	02-0617889	501(C)	24,293	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(11) NORTH MASON FOOD BANK PO BOX 491 BELFAIR,WA98528	94-3197896	501(C)	45,272	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(12) OLYMPIA SALVATION ARMY PO BOX 173 OLYMPIA,WA98507	94-1156347	501(C)	33,427	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(13) PIONEER FOOD BANK 611 E AGATE RD SHELTON,WA98584	91-1740647	501(C)	5,696	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(14) SHARENET PO BOX 250 KINGSTON,WA98346	91-1229210	501(C)	8,364	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(15) SOMMA FOOD BANK PO BOX 103 SILVER CREEK,WA98585	91-1302453	501(C)	11,998	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(16) SOUTH KITSAP FAMILY KITCHEN 2483 MITCHELL RD SE PORT ORCHARD,WA98366	91-0840233	501(C)	5,701	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(17) SOUTH KITSAP HELPLINE 1351 BAY ST PORT ORCHARD,WA98366	91-1117868	501(C)	65,685	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(18) ST VINCENT'S BREMERTON 1137 N CALLOW BREMERTON,WA98312	91-0635027	501(C)	39,662	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(19) THURSTON COUNTY FOOD BANK 220 THURSTON AVE NE OLYMPIA,WA98501	23-7297837	501(C)	350,928	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(20) WHITE PASS FOOD BANK PO BOX 733 RANDLE,WA98377	23-7331514	501(C)	17,594	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE
(21) YELM COMMUNITY SERVICES (UBCO) PO BOX 5320 YELM,WA98597	23-7226534	501(C)	69,414	FMV	USDA TEFAP FOOD	TO SUPPORT LOCAL ARE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) EMERGENCY SERVICE PROGRAM	10255	2,233,531	N/A	N/A
(2) FAMILY SERVICE PROGRAMS	7400	1,674,317	N/A	N/A
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
SCHEDULE I, PAGE 1, PART I, LINE 2	PROCEDURES HAVE BEEN IMPLEMENTED TO DETERMINE THE ELIGIBILITY OF PROGRAM PARTICIPANTS FOR ALL GRANT FUNDED PROGRAMS OPERATED BY THE ORGANIZATION. INTAKE AND CERTIFICATION OF PARTICIPANT ELIGIBILITY IS DONE BASED UPON THE REQUIREMENTS SET FORTH BY EACH INDIVIDUAL GRANT FUNDED PROGRAM. EXPENDITURES ARE MONITORED TO ENSURE COMPLIANCE WITH PROGRAM REQUIREMENTS.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	74	1,082,786	USDA PRICING SCHEDULE
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2015)

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	THE COMMUNITY ACTION COUNCIL IS A NON-PROFIT AGENCY COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THOSE IN OUR COMMUNITY BY HELPING MEET THE BASIC NEEDS OF HOUSING, HEATING, SAFETY, MENTAL HEALTH, FOOD AND NUTRITION FOR FAMILIES AND INDIVIDUALS AND TO LESSEN THE IMPACT OF POVERTY. WHILE PROVIDING SERVICES DIRECTLY, AND THROUGH PARTNERSHIPS, WE STRIVE TO EMPOWER AND STRENGTHEN FAMILIES AND PROMOTE SELF-SUFFICIENCY.
FORM 990, PAGE 2, PART III, LINE 4A	PUGET SOUND ENERGY HELP PROVIDES ASSISTANCE WITH THE COST OF NATURAL GAS AND ELECTRICITY CONSUMPTION TO QUALIFIED PSE CUSTOMERS WITH AN ACCOUNT IN THEIR NAME OR IN THE NAME OF A MEMBER OF THEIR HOUSEHOLD. IN ADDITION TO PSE, WE PARTNERED UP WITH COUNTY PUD'S AND CASCADE NATURAL GAS TO DISTRIBUTE 2,285,783 IN PRIVATE FUEL FUNDS TO 12,269 INDIVIDUALS IN 5,460 HOUSEHOLDS, ENSURING WARMTH AND LIGHT DURING THE WINTER MONTHS. THE NEED FOR FOOD ASSISTANCE IS STEADILY INCREASING. WE SERVED OVER 11,476 INDIVIDUALS IN LEWIS, MASON, THURSTON AND KITSAP COUNTIES AT TEFAP FOOD BANKS DISTRIBUTING 1,342,989 POUNDS OF FOOD. MORE AND MORE PEOPLE ARE SEEKING FOOD BANKS AND OTHER RESOURCES IN ORDER TO SURVIVE, AND COMMUNITY ACTION COUNCIL IS HERE TO HELP. TEFAP FEEDING SITES SERVED 230,505 MEALS TO HUNGRY INDIVIDUALS AND FAMILIES.
FORM 990, PAGE 2, PART III, LINE 4B	MULTIDISCIPLINARY RESPONSE TO VICTIMS OF CHILD ABUSE AND THEIR FAMILIES. THIS RESPONSE INCLUDES PREVENTION, INVESTIGATION, PROSECUTION, AND TREATMENT AND INCLUDES COMMUNITY PARTNERS WHO ARE EXPERTS IN THOSE AREAS. THE DATA REVEALS THAT 38% OF THE VICTIMS WERE 12 YEARS OLD OR YOUNGER; 83% WERE WOMEN AND 70% HAVE BEEN SEXUALLY ABUSED. THE FAMILY ADVOCATE ASSISTED OVER 500 PEOPLE WITH SERVICES. MONARCH ADDED THE LEWIS AND MASON COUNTY CRIME VICTIM ADVOCACY SERVICES AND PROVIDED ASSISTANCE TO OVER 2,133 CRIME VICTIMS. OUR WIC PROGRAM PROVIDES NUTRITIOUS FOODS AND NUTRITION EDUCATION TO HELP LOW-INCOME HOUSEHOLDS SELECT HEALTHY FOODS FOR PREGNANT, BREASTFEEDING, AND POST-PARTUM WOMEN, BABIES AND SMALL CHILDREN. CHILDREN START SCHOOL WITH AN IMPROVED ABILITY TO LEARN. OUR CLIENTS LEARN HOW TO PROVIDE HEALTHY FOODS FOR THEIR FAMILIES AND AS A RESULT, KIDS START SCHOOL WITH AN IMPROVED ENERGY TO LEARN AND PLAY 2,876 ENROLLED WIC FAMILIES BECAME MORE SELF-SUFFICIENT AND EMPOWERED BY OUR VARIOUS PROGRAMS AT THIS CRUCIAL TIME IN THEIR LIVES. KIDS NEED HEALTHY FOOD TO FUEL THEIR BODIES AND BRAINS OUR WIC PROGRAM DISTRIBUTED 1,499,475 TO HOUSEHOLDS WITH YOUNG CHILDREN IN THURSTON AND MASON COUNTIES. THIS HAS ENABLED THEM TO STOCK HEALTHY AND NUTRITIOUS FOOD OPTIONS IN THEIR KITCHENS
FORM 990, PAGE 2, PART III, LINE 4C	HOUSED 692 PEOPLE.
FORM 990, PAGE 2, PART III, LINE 4D	HOUSING & OTHER SERVICES - THESE PROGRAMS INCLUDE WEATHERIZATION AND MINOR HOME REPAIR, UTILITY ASSISTANCE, OUR WEATHERIZATION TRAINING CENTER, AND COMMUNITY RESOURCE REFERRAL ACTIVITIES. THE GOAL OF OUR WEATHERIZATION PROGRAM IS TO IMPROVE THE QUALITY OF LIFE OF OUR CLIENTS BY REDUCING THEIR ENERGY AND BUDGET BURDENS, ALLOWING THEM TO BECOME MORE SELF-SUFFICIENT. LAST YEAR WE IMPROVED THE HEALTH AND SAFETY OF 102 HOMES AND PROVIDED BASIC SERVICES TO AN ADDITIONAL 9 HOMES. UTILITY ASSISTANCE FUNDS ARE DONATED TO THE UTILITIES BY CUSTOMERS TO HELP PEOPLE PAY THEIR UTILITY BILL AND AVOID DISCONNECTION. COMMUNITY ACTION COUNCIL DISTRIBUTED 9,494 IN FUNDS TO HELP 368 INDIVIDUALS IN 103 HOMES WITH UTILITY PAYMENTS. THE WEATHERIZATION TRAINING CENTER PROVIDES TRAINING IN LEAD SAFE PRACTICES, OSHA, THERMAL IMAGING AND MORE. THE FACILITY ALLOWS FOR VIDEO CONFERENCING, MAKING IT TRULY MULTIFUNCTIONAL TO THE AGENCY AND COMMUNITY AS A WHOLE. WE ACTIVELY PARTNER WITH 70 PUBLIC AND PRIVATE ORGANIZATIONS TO EXPAND RESOURCES AND OPPORTUNITIES IN ORDER TO ACHIEVE POSITIVE FAMILY AND COMMUNITY OUTCOMES. PARTNERSHIPS INCLUDE NONPROFITS, FAITH BASED ORGANIZATIONS, LOCAL GOVERNMENTS, AND PRIVATE ORGANIZATIONS. 26,999 PEOPLE RECEIVED APPROPRIATE RESOURCE REFERRAL TO COMMUNITY ACTION COUNCIL SERVICES AS WELL AS OTHER SERVICE PROVIDERS IN THE COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 3	THE ORGANIZATION HAS DELEGATED THE DAY TO DAY MANAGEMENT DUTIES OVER ITS 88 LOW-INCOME HOUSING UNITS AND ITS 14 SENIOR CITIZEN HOUSING UNITS TO ADWEST REALTY SERVICES INC, 545 RAINIER BLVD N, SUITE 9, ISSAQUAH, WA 98027.
FORM 990, PAGE 6, PART VI, LINE 11B	THE FORM 990 IS DISTRIBUTED TO ALL MEMBERS OF THE GOVERNING BODY BY E-MAIL OR BY HARD COPY. THE FORM 990 IS THEN PRESENTED, DISCUSSED, AND APPROVED AT A REGULAR OR SPECIAL MEETING OF THE ORGANIZATION'S GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 12C	THE ORGANIZATION HAS AN APPROVED CONFLICT OF INTEREST POLICY AND CONDUCTS AN ANNUAL TRAINING FOR ALL STAFF. EACH YEAR BOARD MEMBERS SIGN A STATEMENT REGARDING CONFLICT OF INTEREST. CONTRACTS ARE REVIEWED AS APPROPRIATE TO DETERMINE IF A CONFLICT OF INTEREST MAY EXIST.
FORM 990, PAGE 6, PART VI, LINE 15A	ALL SALARY RANGES WERE DETERMINED BY A REVIEW OF INDEPENDENT DATA. SALARY SURVEYS ARE REVIEWED, AS AVAILABLE, TO DETERMINE IF RANGES ARE APPROPRIATE. NEW RANGES ARE DETERMINED AFTER A REVIEW OF APPROPRIATE JOBS IN THE COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 15B	ALL SALARY RANGES WERE DETERMINED BY A REVIEW OF INDEPENDENT DATA. SALARY SURVEYS ARE REVIEWED, AS AVAILABLE, TO DETERMINE IF RANGES ARE APPROPRIATE. NEW RANGES ARE DETERMINED AFTER A REVIEW OF APPROPRIATE JOBS IN THE COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 18	THE ORGANIZATION MAKES ITS FORMS 1023, 990, AND 990-T AVAILABLE FOR PUBLIC INSPECTION UPON VERBAL OR WRITTEN REQUEST.
FORM 990, PAGE 6, PART VI, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO MEMBERS OF THE PUBLIC UPON VERBAL OR WRITTEN REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

COMMUNITY ACTION COUNCIL OF LEWIS
MASON AND THURSTON COUNTIES

Employer identification number

91-0818368

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(f) Direct controlling entity
(1) CAC 515 PRESERVATION LLC 3020 WILLAMETTE DR NE LACEY,WA98516 47-4541505	LOW INCOME	WA	12,003	COMMUNITY ACTION COUNCIL OF LEWIS MASON & THU

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) PRAIRIE RUN ASSOCIATES A WASHINGTO 3020 WILLAMETTE DR NE LACEY,WA98516 91-2033774	LOW-INCOME	WA	NA	RELATED	-8	44,306		No		Yes		0.010 %
(2) VIRGINIA STATION ASSOCIATES LP 3020 WILLAMETTE DR NE LACEY,WA98516 91-2122981	LOW-INCOME	WA	NA	RELATED	-4	214,307		No		Yes		0.010 %
(3) MONTESANO HARBOR LLC 3020 WILLAMETTE DR NE LACEY,WA98516 20-2185910	LOW-INCOME	WA	NA	RELATED	-3	104,995		No		Yes		0.010 %
(4) MONTESANO HARBOR ANNEX LLC 3020 WILLAMETTE DR NE LACEY,WA98516 20-4842302	LOW-INCOME	WA	NA	RELATED	-6	157,345		No		Yes		0.010 %
(5) SALMON RUN YELM ASSOCIATES LLLP 3020 WILLAMETTE DR NE LACEY,WA98516 26-3217266	LOW INCOME	WA	NA	RELATED	17,969	573,123		No		Yes		0.010 %
(6) CAC 515 PRESERVATION PORTFOLIO ASSOCIATES LLLP 3020 WILLAMETTE DR NE LACEY,WA98516 45-5525336	LOW INCOME	WA	NA	RELATED	12,003	482,135		No		Yes		0.010 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MONTESANO HARBOR ANNEX LLC	D	453,079	LOAN BALANCES
(2) SALMON RUN YELM ASSOCIATES LLLP	L	18,000	CASH
(3) CAC 515 PRESERVATION PORTFOLIO ASSOCIATES LLLP	L	12,000	CASH

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	9,672,152	9,796,458
9	Program service revenue (Part VIII, line 2g) .........	1,089,876	1,097,128
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	23,275	35,490
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	434	8,964
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	10,785,737	10,938,040
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,039,753	4,984,418
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	3,196,236	3,381,854
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 6,420
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,470,959	2,723,093
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	10,706,948	11,089,365
19	Revenue less expenses. Subtract line 18 from line 12.......	78,789	-151,325
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	11,633,423	11,259,037
21	Total liabilities (Part X, line 26).............	9,545,339	9,322,278
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,088,084	1,936,759

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 4,139,839 including grants of $ 3,310,101 ) (Revenue $ )
	EMERGENCY SERVICE PROGRAMS - THESE PROGRAMS INCLUDE FEDERALLY AND PRIVATELY FUNDED ENERGY ASSISTANCE, EMERGENCY FOOD ASSISTANCE, AND TEMPORARY FOOD ASSISTANCE. THROUGH THE FEDERALLY FUNDED LIHEAP PROGRAM WE PROVIDED ENERGY ASSISTANCE TO 12,147 INDIVIDUALS IN 4,795 HOUSEHOLDS. WE DISTRIBUTED 2,068,356 TO HELP RESIDENTS COVER THEIR GAS, ELECTRICITY, OIL, WOOD OR PROPANE BILLS. OUR ENERGY ASSISTANCE PROGRAM BELIEVES IN PROVIDING EQUITABLE, CONFIDENTIAL AND RELIABLE ENERGY ASSISTANCE SERVICES TO LOW-INCOME FAMILIES AND INDIVIDUALS. PUGET SOUND ENERGY HELP PROVIDES ASSISTANCE WITH THE COST OF NATURAL GAS AND ELECTRICITY CONSUMPTION TO QUALIFIED PSE CUSTOMERS WITH AN ACCOUNT IN THEIR NAME OR IN THE NAME OF A MEMBER OF THEIR HOUSEHOLD. IN ADDITION TO PSE, WE PARTNERED UP WITH COUNTY PUD'S AND CASCADE NATURAL GAS TO DISTRIBUTE 2,285,783 IN PRIVATE FUEL FUNDS TO 12,269 INDIVIDUALS IN 5,460 HOUSEHOLDS, ENSURING WARMTH AND LIGHT DURING THE WINTER MONTHS. THE NEED FOR FOOD ASSISTANCE IS STEADILY INCREASING. WE SERVED OVER 11,476 INDIVIDUALS IN LEWIS, MASON, THURSTON AND KITSAP COUNTIES AT TEFAP FOOD BANKS DISTRIBUTING 1,342,989 POUNDS OF FOOD. MORE AND MORE PEOPLE ARE SEEKING FOOD BANKS AND OTHER RESOURCES IN ORDER TO SURVIVE, AND COMMUNITY ACTION COUNCIL IS HERE TO HELP. TEFAP FEEDING SITES SERVED 230,505 MEALS TO HUNGRY INDIVIDUALS AND FAMILIES.

4b	(Code: ) (Expenses $ 2,943,765 including grants of $ 1,674,317 ) (Revenue $ )
	FAMILY SERVICE PROGRAMS - THESE PROGRAMS INCLUDE THE MONARCH CHILDREN'S JUSTICE AND ADVOCACY CENTER, THE CRIME VICTIMS CENTER, ESSENTIAL NEEDS, AND WOMEN, INFANTS, AND CHILDREN (WIC). FUNDING FOR THESE PROGRAMS COMES FROM VARIOUS SOURCES INCLUDING USDA WOMEN, INFANTS, AND CHILDREN (WIC), COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG), THE COMMUNITY SERVICES BLOCK GRANT (CSBG), AND THE US DEPARTMENT OF JUSTICE OFFICE OF CRIME VICTIMS ASSISTANCE (OCVA). IN CONJUNCTION WITH OUR PARTNER AGENCIES, MONARCH PROVIDED A WIDE RANGE OF SERVICES AT NO COST TO 1,591 CHILD VICTIMS AND THEIR FAMILIES. WE WORK TO REDUCE THE INCIDENCE AND IMPACT OF CHILD ABUSE BY PROVIDING A COORDINATED, MULTIDISCIPLINARY RESPONSE TO VICTIMS OF CHILD ABUSE AND THEIR FAMILIES. THIS RESPONSE INCLUDES PREVENTION, INVESTIGATION, PROSECUTION, AND TREATMENT AND INCLUDES COMMUNITY PARTNERS WHO ARE EXPERTS IN THOSE AREAS. THE DATA REVEALS THAT 38% OF THE VICTIMS WERE 12 YEARS OLD OR YOUNGER; 83% WERE WOMEN AND 70% HAVE BEEN SEXUALLY ABUSED. THE FAMILY ADVOCATE ASSISTED OVER 500 PEOPLE WITH SERVICES. MONARCH ADDED THE LEWIS AND MASON COUNTY CRIME VICTIM ADVOCACY SERVICES AND PROVIDED ASSISTANCE TO OVER 2,133 CRIME VICTIMS. OUR WIC PROGRAM PROVIDES NUTRITIOUS FOODS AND NUTRITION EDUCATION TO HELP LOW-INCOME HOUSEHOLDS SELECT HEALTHY FOODS FOR PREGNANT, BREASTFEEDING, AND POST-PARTUM WOMEN, BABIES AND SMALL CHILDREN. CHILDREN START SCHOOL WITH AN IMPROVED ABILITY TO LEARN. OUR CLIENTS LEARN HOW TO PROVIDE HEALTHY FOODS FOR THEIR FAMILIES AND AS A RESULT, KIDS START SCHOOL WITH AN IMPROVED ENERGY TO LEARN AND PLAY 2,876 ENROLLED WIC FAMILIES BECAME MORE SELF-SUFFICIENT AND EMPOWERED BY OUR VARIOUS PROGRAMS AT THIS CRUCIAL TIME IN THEIR LIVES. KIDS NEED HEALTHY FOOD TO FUEL THEIR BODIES AND BRAINS OUR WIC PROGRAM DISTRIBUTED 1,499,475 TO HOUSEHOLDS WITH YOUNG CHILDREN IN THURSTON AND MASON COUNTIES. THIS HAS ENABLED THEM TO STOCK HEALTHY AND NUTRITIOUS FOOD OPTIONS IN THEIR KITCHENS

4c	(Code: ) (Expenses $ 1,294,327 including grants of $ ) (Revenue $ )
	AFFORDABLE HOUSING PROGRAMS - THESE PROGRAMS PROVIDED 88 UNITS OF AFFORDABLE (LOW-INCOME) FAMILY HOUSING, 14 UNITS OF SENIOR UNASSISTED HOUSING, AND 2 SINGLE FAMILY AFFORDABLE HOMES. IN PARTNERSHIP WITH OTHER ENTITIES AN ADDITIONAL 271 UNITS OF AFFORDABLE FAMILY HOUSING WERE PROVIDED. IN ORDER TO IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITY, WE WILL CONTINUE TO PLAY A KEY ROLE AS A PROVIDER OF AFFORDABLE HOUSING IN OUR SERVICE AREA. WORKING WITH MULTIPLE JURISDICTIONS WE STRIVE TO INCREASE THE NUMBER OF AFFORDABLE HOUSING OPPORTUNITIES IN OUR COMMUNITY. IN THE PAST YEAR WE HOUSED 692 PEOPLE.

	(Code: ) (Expenses $ 1,220,302 including grants of $ ) (Revenue $ )
	HOUSING & OTHER SERVICES - THESE PROGRAMS INCLUDE WEATHERIZATION AND MINOR HOME REPAIR, UTILITY ASSISTANCE, OUR WEATHERIZATION TRAINING CENTER, AND COMMUNITY RESOURCE REFERRAL ACTIVITIES. THE GOAL OF OUR WEATHERIZATION PROGRAM IS TO IMPROVE THE QUALITY OF LIFE OF OUR CLIENTS BY REDUCING THEIR ENERGY AND BUDGET BURDENS, ALLOWING THEM TO BECOME MORE SELF-SUFFICIENT. LAST YEAR WE IMPROVED THE HEALTH AND SAFETY OF 102 HOMES AND PROVIDED BASIC SERVICES TO AN ADDITIONAL 9 HOMES. UTILITY ASSISTANCE FUNDS ARE DONATED TO THE UTILITIES BY CUSTOMERS TO HELP PEOPLE PAY THEIR UTILITY BILL AND AVOID DISCONNECTION. COMMUNITY ACTION COUNCIL DISTRIBUTED 9,494 IN FUNDS TO HELP 368 INDIVIDUALS IN 103 HOMES WITH UTILITY PAYMENTS. THE WEATHERIZATION TRAINING CENTER PROVIDES TRAINING IN LEAD SAFE PRACTICES, OSHA, THERMAL IMAGING AND MORE. THE FACILITY ALLOWS FOR VIDEO CONFERENCING, MAKING IT TRULY MULTIFUNCTIONAL TO THE AGENCY AND COMMUNITY AS A WHOLE. WE ACTIVELY PARTNER WITH 70 PUBLIC AND PRIVATE ORGANIZATIONS TO EXPAND RESOURCES AND OPPORTUNITIES IN ORDER TO ACHIEVE POSITIVE FAMILY AND COMMUNITY OUTCOMES. PARTNERSHIPS INCLUDE NONPROFITS, FAITH BASED ORGANIZATIONS, LOCAL GOVERNMENTS, AND PRIVATE ORGANIZATIONS. 26,999 PEOPLE RECEIVED APPROPRIATE RESOURCE REFERRAL TO COMMUNITY ACTION COUNCIL SERVICES AS WELL AS OTHER SERVICE PROVIDERS IN THE COMMUNITY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 1,220,302 including grants of $ ) (Revenue $ )
4e	Total program service expenses9,598,233

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	214,806	40,512

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1	Briefly describe the organization’s mission or most significant activities: THE COMMUNITY ACTION COUNCIL IS A NON-PROFIT AGENCY COMMITTED TO IMPROVING THE QUALITY OF LIFE FOR THOSE IN OUR COMMUNITY BY HELPING MEET THE BASIC NEEDS OF HOUSING, HEATING, SAFETY, MENTAL HEALTH, FOOD AND NUTRITION FOR FAMILIES AND INDIVIDUALS AND TO LESSEN THE IMPACT OF POVERTY. WHILE PROVIDING SERVICES DIRECTLY, AND THROUGH PARTNERSHIPS, WE STRIVE TO EMPOWER AND STRENGTHEN FAMILIES AND PROMOTE SELF-SUFFICIENCY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	52
6	Total number of volunteers (estimate if necessary) .............	6	27
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) BRIAN SANDA........................................................................ CHIEF FINANC	40.00 .......................	X	105,108	0	18,780

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	8,686,018

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,110,440

g	Noncash contributions included in lines 1a-1f:$ 1,082,786
h Total.Add lines 1a-1f.......		9,796,458

		Business Code
2a	RENTAL INCOME FROM LOW INCOME		877,354	877,354
b	RENTAL INCOME FROM SENIOR HOU		103,122	103,122
c	RENTAL INCOME RELATED TO CHIL		46,604	46,604
d	SERVICE FEES RELATED TO WEATH		42,131	42,131
e	OTHER PROGRAM REVENUES		18,517	18,517
f	All other program service revenue.			9,400	9,400
g Total.Add lines 2a–2f.....			1,097,128

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			22,606			22,606
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	23,813
b	Less: cost or other basis and sales expenses	10,929
c	Gain or (loss)	12,884
d	Net gain or (loss).....			12,884			12,884
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		8,964
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			8,964
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			10,938,040	1,097,128		35,490

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,076,570	1,076,570
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	3,907,848	3,907,848
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	2,632,879	2,020,645	612,234
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	99,241	73,949	25,292
9	Other employee benefits .......	420,558	336,048	84,510
10	Payroll taxes ...........	229,176	175,885	53,291
11	Fees for services (non-employees):
a	Management ......	170,262	89,795	80,467
b	Legal .........	2,212	1,167	1,045
c	Accounting ...........	48,645	25,655	22,990
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	6,420			6,420
12	Advertising and promotion ....
13	Office expenses .......	43,543	24,960	18,583
14	Information technology ......	90,469	61,970	28,499
15	Royalties ..
16	Occupancy ...........	485,773	341,365	144,408
17	Travel ............	78,049	59,538	18,511
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	458,463	366,307	92,156
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	500,783	355,563	145,220
23	Insurance ...	97,319	57,102	40,217
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DIRECT CLIENT SERVICES	446,771	428,871	17,900
b	SUPPLIES	131,555	98,694	32,861
c	SMALL EQUIPMENT	96,504	51,536	44,968
d	OTHER EXPENSES	66,325	44,765	21,560
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	11,089,365	9,598,233	1,484,712	6,420
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			587,552	1	555,614
2	Savings and temporary cash investments .........			7,948	2	7,956
3	Pledges and grants receivable, net ......			796,037	3	630,018
4	Accounts receivable, net .............				4
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....			493,079	7	493,079
8	Inventories for sale or use ........			79,909	8	79,240
9	Prepaid expenses and deferred charges ......			66,759	9	94,978
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	13,434,769
b	Less: accumulated depreciation	10b	4,531,939	9,150,690	10c	8,902,830
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			125,584	12	125,555
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			325,865	15	369,767
16	Total assets. Add lines 1 through 15 (must equal line 34)...			11,633,423	16	11,259,037

17	Accounts payable and accrued expenses .....	279,318	17	197,985
18	Grants payable ...		18
19	Deferred revenue .........	124,274	19	442,445
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	8,374,770	23	8,319,670
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	766,977	25	362,178
26	Total liabilities. Add lines 17 through 25..	9,545,339	26	9,322,278

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,044,751	27	1,936,759
28	Temporarily restricted net assets ...........	43,333	28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,088,084	33	1,936,759
34	Total liabilities and net assets/fund balances ........	11,633,423	34	11,259,037