TY 2019 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) MARCELLA B SCHANKWEILER...................................................................... PRESIDENT	40.00 .................	X	X	118,070	0	18,490
(2) BRAD MINOR...................................................................... CHAIRMAN	1.00 .................	X	X	0	0	0
(3) CHRISTOPHER SELGRATH DO...................................................................... VICE CHAIRMA	1.00 .................	X	X	0	0	0
(4) CHARLES GREENBERG...................................................................... SECRETARY	1.00 .................	X	X	0	0	0
(5) JOSEPH MANION...................................................................... TREASURER	1.00 .................	X	X	0	0	0
(6) KEVIN NORRIS...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(7) CATHERINE SHIELDS...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(8) DEB RINALDI...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(9) CHRISTOPHER SOLECKI...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(10) SUSAN SCHULTZ...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(11) JOSEPH NICOLAS...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(12) TRISH SINNOTT...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(13) DALE MOSS...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(14) BRIAN HAVRILLA...................................................................... DIRECTOR	1.00 .................	X		0	0	0
(15) MEG GARRETT...................................................................... DIRECTOR	1.00 .................	X		0	0	0

- 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	1,570,060	993,265	1,323,393	2,328,167	1,649,647	7,864,532
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	1,570,060	993,265	1,323,393	2,328,167	1,649,647	7,864,532
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)..						1,273,084
6	Public support. Subtract line 5 from line 4.						6,591,448

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..	1,570,060	993,265	1,323,393	2,328,167	1,649,647	7,864,532
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	5,012	8,245	51,676	75,506	80,713	221,152
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.)..	681,226	820,118	463,706	410,189	162,594	2,537,833
11	Total support. Add lines 7 through 10						10,623,517

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

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 2019 (line 6, column (f) divided by line 11, column (f)) .........

62.050 %

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

55.860 %

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

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) 2019

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 (explain in Part VI). 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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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
PART II, LINE 10	SPECIAL EVENTS 2,537,833

Schedule A (Form 990 or 990-EZ) 2019

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization FOR PETE'S SAKE CANCER RESPITE FOUNDATION

Part I Contributors	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization FOR PETE'S SAKE CANCER RESPITE FOUNDATION		Employer identification number 23-3013896

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization FOR PETE'S SAKE CANCER RESPITE FOUNDATION			Employer identification number 23-3013896
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) (2019)

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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 ....	1,809,919	1,130,320	1,102,332	1,013,978	256,538
b	Contributions ...	250,000	652,000		77,431	740,326
c	Net investment earnings, gains, and losses	87,477	53,599	64,963	10,923	17,114
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	11,000	26,000	36,975
f	Administrative expenses ....
g	End of year balance ......	2,136,396	1,809,919	1,130,320	1,102,332	1,013,978

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

Board designated or quasi-endowment SchDMd Bullet

49.890 %

Permanent endowment SchDMd Bullet

50.110 %

Term 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 .....	14,402		14,402
b	Buildings ....	280,640	127,538	153,102
c	Leasehold improvements	21,305	18,343	2,962
d	Equipment ....	34,385	30,107	4,278
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				174,744

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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)BENEFICIAL INTEREST IN REMAINDER TRU				228,116
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				228,116

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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	158,700
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) 2019

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	2,128,245
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-3,303
b	Donated services and use of facilities .........	2b	492,804
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-46,604
e	Add lines 2a through 2d .....................			2e	442,897
3	Subtract line 2e from line 1..................			3	1,685,348
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	-22,311
c	Add lines 4a and 4b....................			4c	-22,311
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	1,663,037

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	2,111,499
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	492,804
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	-26,889
e	Add lines 2a through 2d....................			2e	465,915
3	Subtract line 2e from line 1...................			3	1,645,584
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	1,645,584

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 2, PART V, LINE 4	FPS HAS ESTABLISHED A RESTRICTED ENDOWMENT FUND ACCOUNT. IN ACCORDANCE WITH THE DONORS' INTENT, THE PRINCIPAL OF THIS FUND IS INVESTED IN PERPETUITY AND EARNINGS GENERATED ARE RESTRICTED AND USED FOR PROGRAM EXPENSES EXCLUSIVELY. MONIES HELD IN THIS ENDOWMENT ARE SEGREGATED INTO A SEPARATE ACCOUNT.
SCHEDULE D, PAGE 4, PART XI, LINE 2D	PV ADJUSTMENT 2,596 SPECIAL EVENT DONATED SERVICES -49,200
SCHEDULE D, PAGE 4, PART XI, LINE 4B	SPECIAL EVENT EXPENSES -22,311
SCHEDULE D, PAGE 4, PART XII, LINE 2D	SPECIAL EVENT EXPENSES 22,311 SPECIAL EVENT DONATED SERVICES -49,200

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2019

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GALA (event type)	(b) Event #2 GOLF (event type)	(c) Other events 5 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	369,373	116,876	230,633	716,882
2	Less: Contributions . . . .	248,010	75,670	198,017	521,697
3	Gross income (line 1 minus line 2) . . . . . .	121,363	41,206	32,616	195,185

4	Cash prizes . . . . .
5	Noncash prizes . . . .	16,057	6,430	7,828	30,315
6	Rent/facility costs . . . .		1,000	18,560	19,560
7	Food and beverages . . .	94,635	26,587	11,889	133,111
8	Entertainment . . . .	17,822	415	11,037	29,274
9	Other direct expenses . . .	11,592	9,018	21,697	42,307
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				254,567
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-59,382

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities: PA

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2019

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation
SCHEDULE G, PART IV	IN 2020 THE COVID-19 SHUT DOWN PROHIBITED FPS FROM HAVING THREE OF THE ORGANIZATIONS MAJOR EVENTS: PA WALK, NEW YORK HAPPY HOUR, AND THE FASHION SHOW. THE PROJECTED LOSS OF REVENUES FOR THE THREE EVENTS TOTAL OVER 410,000.

Schedule G (Form 990 or 990-EZ) 2019

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number
23-3013896

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 noncash assistance	(h) Purpose of grant or assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

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) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) PATIENT STIPEND	124	103,119	FMV
(2) STAYCATION STIPEND	24	4,200	FMV
(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

AS PART OF ITS RESPITE EXCURSION PROGRAM, FPS WANTS TO ENSURE THAT EACH TRAVELING FAMILY HAS AMPLE FINANCIAL RESOURCES TO MAKE THE RESPITE MEANINGFUL AND MEMORABLE. THUS, IN ADDITION TO ATTRACTION TICKETS, GIFT CERTIFICATES, TOILETRIES, INSPIRATIONAL WRITINGS, JOURNALS, ROBES, ETC. AS PART OF THE RESPITE, FPS ALSO PROVIDES EACH PATIENT AND HIS/HER TRAVELING PARTNERS WITH A GENEROUS CASH STIPEND FOR INCIDENTAL EXPENSES. AT A MINIMUM, THIS STIPEND IS 1,000 PER WEEK PER FAMILY. THIS INCREASES BASED UPON THE PATIENT/CAREGIVER/FAMILY'S OUTSTANDING NEEDS, FAMILY SIZE AND FINAL RESPITE DESTINATION.

Schedule I (Form 990) 2019

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

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 ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( RAFFLE/AUCTION )	X	8	26,899	FAIR MARKET VALUE
26 Other ( SPECIAL EVENT )	X	5	34,334	FAIR MARKET VALUE
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 isn't 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 nonstandard 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 didn't 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) (2019)

Page 2

Part IISupplemental 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, PAGE 2, PART II	PART I, COLUMN (B): NUMBER OF CONTRIBUTIONS

Schedule M (Form 990) (2019)

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

FOR PETE'S SAKE CANCER RESPITE
FOUNDATION

Employer identification number

23-3013896

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	FPS ENABLES CANCER PATIENTS AND THEIR LOVED ONES THE OPPORTUNITY TO STRENGTHEN, DEEPEN AND UNIFY THEIR RELATIONSHIPS BY CREATING UNFORGETTABLE AND LASTING RESPITE EXPERIENCES. IN FY20, FPS PROVIDED SERVICES TO 190 PATIENTS AND THEIR FAMILIES, RESULTING IN 124 RESPITE EXPERIENCES WITH 438 TRAVELERS. ADDITIONALLY, 158 PEOPLE WERE SERVED THROUGH ANCILLARY SERVICES. FPS SERVED A TOTAL OF 596 PEOPLE. THESE NUMBERS REFLECT THE CHANGES MADE TO OUR PROGRAM BECAUSE OF THE COVID-19 PANDEMIC AND OUR NEED TO SUSPEND ANY NEW NOMINATIONS FROM MARCH 2020 THROUGH JUNE 2020. THE TWO MAIN CHANGES TO OUR PROGRAM INCLUDE OUR FOCUSED APPROACH TO COMMUNITY RESPITES WITH OUR TRAVEL PARTNER WOODLOCH AND THE FORMALIZATION OF OUR STAYCATION RESPITE PROGRAM. WHEN THE PANDEMIC OCCURRED, WE HAD NEARLY 50 FAMILIES IN QUE FOR OUR TRAVEL RESPITE PROGRAM. BECAUSE OF OUR SWIFT REACTION, WE WERE ABLE TO SEND 21 FAMILIES ON COMMUNITY RESPITES IN JUNE AND THE REMAINING FAMILIES WERE PART OF THE NEWLY FORMED STAYCATION RESPITE PROGRAM.
FORM 990, PAGE 2, PART III, LINE 4A	FAMILIES IN THE FPS RESPITE PROGRAM ARE SUPPORTED IN SEVERAL WAYS. BASED UPON THE HEALTH OF THE PATIENT, THEY EITHER RECEIVED A TRAVEL RESPITE OR A STAYCATION RESPITE. BOTH ARE TAILORED TO THE FAMILY AND THE RELEVANT NEEDS AS DETERMINED BY THE NOMINATOR AND THE FPS PROGRAM COORDINATOR VIA CONVERSATIONS WITH THE PATIENT AND CAREGIVER. FOLLOWING THE RESPITE OR STAYCATION, FPS CONTINUES TO PROVIDE ANCILLARY SUPPORT TO THE PATIENT, CAREGIVER, AND FAMILY. ON THEIR RESPITE EXPERIENCE, PATIENTS TRAVELED TO THE TWO FPS HOMES NEAR ORLANDO, FLORIDA, AND TO OTHER DONATED RESPITE DESTINATIONS ALONG THE NEW JERSEY, NORTH CAROLINA, AND FLORIDA COASTS, AS WELL AS IN THE POCONOS, MAINE AND CARIBBEAN. WE ARE ABLE TO SUPPLEMENT ADDITIONAL STAYS THANKS TO THE GENEROSITY OF 5 TRAVEL PARTNERS AND 15 HOME DONORS. BECAUSE OF THE PANDEMIC, FPS RESTRICTED ITS RESPITES IN THE FINAL FOUR MONTHS TO COMMUNITY RESPITES WITH TRAVEL PARTNER WOODLOCH. AFTER SHUTDOWN IN MARCH AND WITH 50 FAMILIES IN THE PROGRAM AT THIS JUNCTURE, FPS WAS ABLE TO SEND 21 FAMILIES ON COMMUNITY RESPITE TO WOODLOCH IN JUNE, 2020 AND FOR THE REMAINING 29 FAMILIES, WAS ABLE TO PROVIDE A MEANINGFUL STAYCATION RESPITE. TO BE ELIGIBLE FOR THE PROGRAM, A PATIENT MUST BE NOMINATED BY A MEMBER OF HIS/HER ONCOLOGY TEAM. FPS NOMINATORS USE CLINICAL ASSESSMENT FACTORS TO BEST IDENTIFY PATIENTS IN NEED OF RESPITE. NEW NOMINATORS PARTICIPATE IN A SHORT EDUCATIONAL PROGRAM ABOUT THE MISSION OF FPS. SOME NOMINATORS SERVE AS MEMBERS OF THE FPS PROGRAM ADVISORY COMMITTEE, CHARGED WITH OVERSEEING THE ENTIRE PATIENT PROGRAM, PROGRAM GUIDELINES, AND CLINICAL ASSESSMENT FACTORS. OUR TOP THREE NOMINATING MEDICAL INSTITUTIONS INCLUDE CROZER CHESTER MEDICAL CENTER, PENN ABRAMSON CANCER CENTER AND MD ANDERSON CANCER CENTER.
FORM 990, PAGE 2, PART III, LINE 4B	FPS HAS BEEN COLLECTING OUTCOME DATA ON RESPITE FOR ITS COMMUNITY RESPITE MODEL IN A DETAILED WAY, WHICH INCLUDES BOTH PRE- AND POST-RESPITE SURVEYS. THE DATA COLLECTED FROM THESE COMMUNITY RESPITES FORMED THE BASIS FOR A AN ABSTRACT SUBMITTED TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGISTS (ASCO) ANNUAL MEETING FOR PRESENTATION. FPS IS PROUD TO REPORT ITS ABSTRACT WAS CHOSEN FROM THOUSANDS TO BE PUBLISHED AS PART OF ASCOS VIRTUAL ANNUAL MEETING IN MAY 2020. THE FORMAL ABSTRACT NAME IS INDIVIDUAL AND COMMUNITY RESPITE AS SUPPORTIVE CARE FOR ADULT CANCER PATIENTS, THEIR CAREGIVERS AND THEIR FAMILIES. HTTPS://ASCOPUBS.ORG/DOI/ABS/10.1200/JCO.2020.38.15_SUPPL.E24183 EVALUATION OF THE PROGRAM IS ASSESSED FROM STATISTICS DERIVED FROM BOTH PATIENTS- AND ONCOLOGY EVALUATIONS. SINCE DATA COLLECTION STARTED SINCE 2005, THE OVERALL RATING OF THE IMPROVED ABILITY TO COPE WITH CANCER IS 3.89 ON A SCALE OF ONE TO FOUR. ONE HUNDRED PERCENT OF ALL NOMINATING PROFESSIONALS RECOGNIZE POST-RESPITE IMPROVEMENT IN THE PATIENTS AND PATIENT'S FAMILY/CAREGIVER'S ABILITY TO COPE WITH CANCER. AS PART OF THE FPS COMMITMENT TO TRANSPARENCY, FPS POSTS ITS PATIENT AND NOMINATOR OUTCOME MEASURES ON ITS WEBSITE. FPS ALSO BEGAN A RESEARCH STUDY TO CORRELATE THE SIGNIFICANCE OF RESPITE WITH IMPROVED OUTCOMES RELATED TO COMMUNICATION, TREATMENT, MENTAL HEALTH, RELATIONSHIPS (BOTH WITHIN FAMILY AND TREATMENT TEAM) AND OTHER GENERALIZED DAILY ACTIVITIES. THIS STUDY WAS COMPLETED DURING THE FISCAL YEAR AND THE DATA IS CURRENTLY BEING SCORED AND WILL BE AVAILABLE UPON COMPLETION.
FORM 990, PAGE 2, PART III, LINE 4D	FPS ALSO PROVIDES EMOTIONAL SUPPORT TO OUR TRAVELERS AND THEIR CAREGIVERS. IN FY20, FPS PROVIDED 3,869 ANCILLARY SUPPORT CONTACTS AND RESPONDED TO 496 PROGRAM INQUIRIES. FURTHERMORE, SOCIAL MEDIA AND THE INTERNET HAS ALLOWED FPS TO REACH OVER 17,700 PEOPLE. THESE TOUCHPOINTS INCLUDE FACEBOOK, PATIENT SELF-CARE NEWSLETTER, AND CANCER CARE BOOKS. WITH THE ADDITION OF A STAFF PERSON, THE FAMILY ENGAGEMENT OFFICER, DEDICATED TO BEING THE POINT OF CONTACT AFTER THE RESPITE EXPERIENCE OR TAKE A BREAK STAYCATION, FPS HAS SEEN A SIGNIFICANT INCREASE IN THE ANCILLARY SUPPORT CONTACTS. IN ADDITION TO CONTINUING THE STAYCATION PROGRAM AIMED AT PROVIDING AN "IN HOME" RESPITE EXPERIENCE FOR PATIENTS TOO SICK TO TRAVEL, FPS WAS ABLE TO PROVIDE AN INCREASED LEVEL OF ANCILLARY SERVICES TO ITS PATIENTS THROUGH THE PROCUREMENT OF SEVERAL GRANTS AND IN-KIND GIFTS. THE SERVICES INCLUDED, BUT NOT LIMITED TO, ADDITIONAL SUPPORT FOR OUR PATIENTS THROUGH COMPLIMENTARY TICKETS TO AMUSEMENT PARKS AND ATHLETIC EVENTS, MONTHLY LUNCH BUNCH, ASSISTANCE DURING THE HOLIDAY SEASON, AND CONTINUED WEEKLY OUTREACH RUN BY VOLUNTEERS. PANO ACCREDITATION: FPS IS A PROUD RECIPIENT OF THE PENNSYLVANIA ASSOCIATION OF NONPROFIT ORGANIZATIONS (PANO) STANDARDS FOR EXCELLENCE ACCREDITATION. THIS AWARD RECOGNIZES FPS AS AN ETHICAL AND ACCOUNTABLE ORGANIZATION DEDICATED TO THE HIGHEST LEVEL OF EXCELLENCE WITHIN THE NONPROFIT SECTOR. THIS AWARD IS BESTOWED ONLY TO THE MOST WELL-MANAGED AND RESPONSIBLY GOVERNED NONPROFIT ORGANIZATIONS THAT HAVE DEMONSTRATED COMPLIANCE WITH THE 56 SPECIFIC STANDARDS FOR EXCELLENCE BASED ON HONESTY. FPS IS ONE OF 50 NONPROFITS STATEWIDE AND THE FIRST NONPROFIT IN MONTGOMERY COUNTY TO HOLD THIS HONOR FROM OVER 11,000 REGISTERED PA CHARITIES. FPS HAS MET, COMPLIED WITH, AND INTEGRATED THE ACCREDITATION PROGRAM AND THUS, ALL GOVERNANCE QUESTIONS ASKED IN THE FORM 990 HAVE BEEN ADDRESSED BY THE ORGANIZATION IN ITS NORMAL COURSE OF BUSINESS.
FORM 990, PAGE 6, PART VI, LINE 11B	REVIEW OF THE 990 HAS BEEN EXTENSIVE, BEGINNING WITH STAFF AND ACCOUNTING REVIEW TO FORMULATING A DRAFT PRODUCT. THE DRAFTS OF BOTH THE 990 AND AUDITED FINANCIAL STATEMENTS WERE THEN REVIEWED BY THE FPS FINANCE COMMITTEE WITH COMMENTS AND SUGGESTIONS DIRECTED TO THE FPS TREASURER. AFTER REVIEW AND APPROVAL BY THE FINANCE COMMITTEE AND TREASURER, THE DRAFTS ARE FORWARDED TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENTS. THE AUDIT AND FORM 990 ARE CONSIDERED FINAL AFTER THE REVIEW PERIOD HAS PASSED.
FORM 990, PAGE 6, PART VI, LINE 12C	AS PART OF ITS STANDARDS FOR EXCELLENCE ACCREDITATION, FPS HAS DEVELOPED STRATEGIES FOR MONITORING AND ENFORCING POTENTIAL CONFLICTS OF INTEREST. ANNUALLY, INDIVIDUAL BOARD MEMBER PERFORMANCE EVALUATIONS ARE DISTRIBUTED WITH THE CONFLICT OF INTEREST FORMS. THE SECRETARY IS THEN CHARGED WITH COLLECTION OF THESE FORMS AND REPORTING OF RESULTS TO THE CHAIR OF THE GOVERNANCE COMMITTEE.
FORM 990, PAGE 6, PART VI, LINE 15A	AS PART OF ITS STANDARDS FOR EXCELLENCE ACCREDITATION, FPS HAS DEVELOPED STRATEGIES FOR DETERMINING REVIEW OF ITS CURRENT COMPENSATION STRUCTURE WHICH BEGINS WITH THE PRESENTATION OF THE PRELIMINARY BUDGET TO THE FINANCE COMMITTEE AND THE BOARD. THIS COMPENSATION REVIEW TAKES INTO ACCOUNT COMPARATIVE SALARIES IN SIMILARLY BUDGETED ORGANIZATIONS. ALL SALARIES ARE INDIVIDUALLY LISTED IN THE PRELIMINARY BUDGET BASED UPON SAID COMPARISONS. FINAL BUDGET APPROVAL IS THEN GRANTED AFTER THE FINAL BUDGET PRESENTATION IN JUNE OF EACH FISCAL YEAR.
FORM 990, PAGE 6, PART VI, LINE 15B	AS PART OF ITS STANDARDS FOR EXCELLENCE ACCREDITATION, FPS HAS DEVELOPED STRATEGIES FOR DETERMINING REVIEW OF ITS CURRENT COMPENSATION STRUCTURE WHICH BEGINS WITH THE PRESENTATION OF THE PRELIMINARY BUDGET TO THE FINANCE COMMITTEE AND THE BOARD. THIS COMPENSATION REVIEW TAKES INTO ACCOUNT COMPARATIVE SALARIES IN SIMILARLY BUDGETED ORGANIZATIONS. ALL SALARIES ARE INDIVIDUALLY LISTED IN THE PRELIMINARY BUDGET BASED UPON SAID COMPARISONS. FINAL BUDGET APPROVAL IS THEN GRANTED AFTER THE FINAL BUDGET PRESENTATION IN JUNE OF EACH FISCAL YEAR.
FORM 990, PAGE 6, PART VI, LINE 19	FPS IS PROUD OF ITS FINANCIAL INTEGRITY AND ITS COMMITMENT TO STEWARDSHIP USING THE FINANCIAL RESOURCES ENTRUSTED TO US BY OUR COMMUNITY OF FAMILY AND FRIENDS. AS PART OF THE COMMITMENT, FPS BELIEVES IN TRANSPARENCY AND POSTS ITS AUDIT AND FORM 990 ON WWW.TAKEABREAKFROMCANCER.ORG AND CONTINUALLY EDUCATES ITS STAKEHOLDERS ABOUT ITS STRATEGIC INITIATIVES, VIA OUR WEBSITE. WE ALSO INVITE PROSPECTIVE DONORS TO VISIT OUR FINANCIAL AND PROGRAM INFORMATION AVAILABLE ON WWW.GUIDESTAR.ORG AND READ OVER REVIEWS ON WWW.GREATNONPROFITS.ORG. FPS IS A PLATINUM-LEVEL GUIDESTAR EXCHANGE PARTICIPANT, DEMONSTRATING ITS COMMITMENT TO TRANSPARENCY. ANY ADDITIONAL DOCUMENTATION IS AVAILABLE UPON REQUEST.
FORM 990, PART VIII	THE REDUCTION IN REVENUE WAS THE RESULT OF FPS NOT MAKING A STRATEGIC EFFORT TO ACQUIRE MAJOR GIFTS TO SUPPORT THE ONGOING ENDOWMENT EFFORTS. IN THE PRIOR FISCAL YEAR TWO LARGE GIFTS WERE RECEIVED TOTALING 850,000 WHILE, THIS FISCAL YEAR ONE LARGE GIFT OF 300,000 WAS RECEIVED.
FORM 990, PART XI, LINE 9	PV ADJUSTMENT 2,596 SPECIAL EVENT DONATED SERVICES -49,200 SPECIAL EVENT EXPENSES 22,311 SPECIAL EVENT EXPENSES -22,311 SPECIAL EVENT DONATED SERVICES 49,200 TOTAL 2,596

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: FPS ENABLES CANCER PATIENTS AND THEIR LOVED ONES THE OPPORTUNITY TO STRENGTHEN, DEEPEN AND UNIFY THEIR RELATIONSHIPS BY CREATING UNFORGETTABLE AND LASTING RESPITE EXPERIENCES THROUGH ITS TRAVEL RESPITES AND STAYCATION RESPITES PROGRAMS.
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	14
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	18
6	Total number of volunteers (estimate if necessary) .............	6	625
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 39 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,328,167	1,649,647
9	Program service revenue (Part VIII, line 2g) .........		0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	75,506	80,713
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	22,762	-67,323
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,426,435	1,663,037
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	156,763	107,319
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)	823,055	981,809
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 348,243
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	563,817	556,456
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,543,635	1,645,584
19	Revenue less expenses. Subtract line 18 from line 12.......	882,800	17,453
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,929,136	3,072,271
21	Total liabilities (Part X, line 26).............	39,453	165,842
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,889,683	2,906,429

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,194,280 including grants of $ 107,319 ) (Revenue $ )
	FAMILIES IN THE FPS RESPITE PROGRAM ARE SUPPORTED IN SEVERAL WAYS. BASED UPON THE HEALTH OF THE PATIENT, THEY EITHER RECEIVED A TRAVEL RESPITE OR A STAYCATION RESPITE. BOTH ARE TAILORED TO THE FAMILY AND THE RELEVANT NEEDS AS DETERMINED BY THE NOMINATOR AND THE FPS PROGRAM COORDINATOR VIA CONVERSATIONS WITH THE PATIENT AND CAREGIVER. FOLLOWING THE RESPITE OR STAYCATION, FPS CONTINUES TO PROVIDE ANCILLARY SUPPORT TO THE PATIENT, CAREGIVER, AND FAMILY. ON THEIR RESPITE EXPERIENCE, PATIENTS TRAVELED TO THE TWO FPS HOMES NEAR ORLANDO, FLORIDA, AND TO OTHER DONATED RESPITE DESTINATIONS ALONG THE NEW JERSEY, NORTH CAROLINA, AND FLORIDA COASTS, AS WELL AS IN THE POCONOS, MAINE AND CARIBBEAN. WE ARE ABLE TO SUPPLEMENT ADDITIONAL STAYS THANKS TO THE GENEROSITY OF 5 TRAVEL PARTNERS AND 15 HOME DONORS. BECAUSE OF THE PANDEMIC, FPS RESTRICTED ITS RESPITES IN THE FINAL FOUR MONTHS TO COMMUNITY RESPITES WITH TRAVEL PARTNER WOODLOCH. AFTER SHUTDOWN IN MARCH AND WITH 50 FAMILIES IN THE PROGRAM AT THIS JUNCTURE, FPS WAS ABLE TO SEND 21 FAMILIES ON COMMUNITY RESPITE TO WOODLOCH IN JUNE, 2020 AND FOR THE REMAINING 29 FAMILIES, WAS ABLE TO PROVIDE A MEANINGFUL STAYCATION RESPITE. TO BE ELIGIBLE FOR THE PROGRAM, A PATIENT MUST BE NOMINATED BY A MEMBER OF HIS/HER ONCOLOGY TEAM. FPS NOMINATORS USE CLINICAL ASSESSMENT FACTORS TO BEST IDENTIFY PATIENTS IN NEED OF RESPITE. NEW NOMINATORS PARTICIPATE IN A SHORT EDUCATIONAL PROGRAM ABOUT THE MISSION OF FPS. SOME NOMINATORS SERVE AS MEMBERS OF THE FPS PROGRAM ADVISORY COMMITTEE, CHARGED WITH OVERSEEING THE ENTIRE PATIENT PROGRAM, PROGRAM GUIDELINES, AND CLINICAL ASSESSMENT FACTORS. OUR TOP THREE NOMINATING MEDICAL INSTITUTIONS INCLUDE CROZER CHESTER MEDICAL CENTER, PENN ABRAMSON CANCER CENTER AND MD ANDERSON CANCER CENTER.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	FPS HAS BEEN COLLECTING OUTCOME DATA ON RESPITE FOR ITS COMMUNITY RESPITE MODEL IN A DETAILED WAY, WHICH INCLUDES BOTH PRE- AND POST-RESPITE SURVEYS. THE DATA COLLECTED FROM THESE COMMUNITY RESPITES FORMED THE BASIS FOR A AN ABSTRACT SUBMITTED TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGISTS (ASCO) ANNUAL MEETING FOR PRESENTATION. FPS IS PROUD TO REPORT ITS ABSTRACT WAS CHOSEN FROM THOUSANDS TO BE PUBLISHED AS PART OF ASCOS VIRTUAL ANNUAL MEETING IN MAY 2020. THE FORMAL ABSTRACT NAME IS INDIVIDUAL AND COMMUNITY RESPITE AS SUPPORTIVE CARE FOR ADULT CANCER PATIENTS, THEIR CAREGIVERS AND THEIR FAMILIES. HTTPS://ASCOPUBS.ORG/DOI/ABS/10.1200/JCO.2020.38.15_SUPPL.E24183 EVALUATION OF THE PROGRAM IS ASSESSED FROM STATISTICS DERIVED FROM BOTH PATIENTS- AND ONCOLOGY EVALUATIONS. SINCE DATA COLLECTION STARTED SINCE 2005, THE OVERALL RATING OF THE IMPROVED ABILITY TO COPE WITH CANCER IS 3.89 ON A SCALE OF ONE TO FOUR. ONE HUNDRED PERCENT OF ALL NOMINATING PROFESSIONALS RECOGNIZE POST-RESPITE IMPROVEMENT IN THE PATIENTS AND PATIENT'S FAMILY/CAREGIVER'S ABILITY TO COPE WITH CANCER. AS PART OF THE FPS COMMITMENT TO TRANSPARENCY, FPS POSTS ITS PATIENT AND NOMINATOR OUTCOME MEASURES ON ITS WEBSITE. FPS ALSO BEGAN A RESEARCH STUDY TO CORRELATE THE SIGNIFICANCE OF RESPITE WITH IMPROVED OUTCOMES RELATED TO COMMUNICATION, TREATMENT, MENTAL HEALTH, RELATIONSHIPS (BOTH WITHIN FAMILY AND TREATMENT TEAM) AND OTHER GENERALIZED DAILY ACTIVITIES. THIS STUDY WAS COMPLETED DURING THE FISCAL YEAR AND THE DATA IS CURRENTLY BEING SCORED AND WILL BE AVAILABLE UPON COMPLETION.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	OUR THIRD ACCOMPLISHMENT IS OUR COMMITMENT TO FISCAL RESPONSIBILITY AND NONPROFIT SUSTAINABILITY. IN LIGHT OF THIS, FPS RECEIVED A LARGE CONTRIBUTION TOTALING 300,000, WHICH THE FPS BOARD DESIGNATED A PORTION FOR ENDOWMENT AND LONG-TERM STRATEGIC USE. THESE FUNDS ARE INVESTED FOR LONG-TERM APPRECIATION AND A RESOURCE TO BE USED FOR SUSTAINABILITY AND GROWTH. IN FY20, FPS RECEIVED ALMOST 554,000 OF IN-KIND SUPPORT FOR THE PROGRAM IN THE FORM OF COMPLIMENTARY OFFICE SPACE, PATIENT ACCOMMODATIONS, PROFESSIONAL AND MARKETING SERVICES, RESPITE SUPPLIES AND SPECIAL EVENT GOODS AND SERVICES. NONCASH CONTRIBUTIONS ARE CRITICAL TO THE ORGANIZATION'S SUCCESS AND ALLOW FPS TO BEST USE ITS CONSTITUENT DOLLARS.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	FPS ALSO PROVIDES EMOTIONAL SUPPORT TO OUR TRAVELERS AND THEIR CAREGIVERS. IN FY20, FPS PROVIDED 3,869 ANCILLARY SUPPORT CONTACTS AND RESPONDED TO 496 PROGRAM INQUIRIES. FURTHERMORE, SOCIAL MEDIA AND THE INTERNET HAS ALLOWED FPS TO REACH OVER 17,700 PEOPLE. THESE TOUCHPOINTS INCLUDE FACEBOOK, PATIENT SELF-CARE NEWSLETTER, AND CANCER CARE BOOKS. WITH THE ADDITION OF A STAFF PERSON, THE FAMILY ENGAGEMENT OFFICER, DEDICATED TO BEING THE POINT OF CONTACT AFTER THE RESPITE EXPERIENCE OR TAKE A BREAK STAYCATION, FPS HAS SEEN A SIGNIFICANT INCREASE IN THE ANCILLARY SUPPORT CONTACTS. IN ADDITION TO CONTINUING THE STAYCATION PROGRAM AIMED AT PROVIDING AN "IN HOME" RESPITE EXPERIENCE FOR PATIENTS TOO SICK TO TRAVEL, FPS WAS ABLE TO PROVIDE AN INCREASED LEVEL OF ANCILLARY SERVICES TO ITS PATIENTS THROUGH THE PROCUREMENT OF SEVERAL GRANTS AND IN-KIND GIFTS. THE SERVICES INCLUDED, BUT NOT LIMITED TO, ADDITIONAL SUPPORT FOR OUR PATIENTS THROUGH COMPLIMENTARY TICKETS TO AMUSEMENT PARKS AND ATHLETIC EVENTS, MONTHLY LUNCH BUNCH, ASSISTANCE DURING THE HOLIDAY SEASON, AND CONTINUED WEEKLY OUTREACH RUN BY VOLUNTEERS. PANO ACCREDITATION: FPS IS A PROUD RECIPIENT OF THE PENNSYLVANIA ASSOCIATION OF NONPROFIT ORGANIZATIONS (PANO) STANDARDS FOR EXCELLENCE ACCREDITATION. THIS AWARD RECOGNIZES FPS AS AN ETHICAL AND ACCOUNTABLE ORGANIZATION DEDICATED TO THE HIGHEST LEVEL OF EXCELLENCE WITHIN THE NONPROFIT SECTOR. THIS AWARD IS BESTOWED ONLY TO THE MOST WELL-MANAGED AND RESPONSIBLY GOVERNED NONPROFIT ORGANIZATIONS THAT HAVE DEMONSTRATED COMPLIANCE WITH THE 56 SPECIFIC STANDARDS FOR EXCELLENCE BASED ON HONESTY. FPS IS ONE OF 50 NONPROFITS STATEWIDE AND THE FIRST NONPROFIT IN MONTGOMERY COUNTY TO HOLD THIS HONOR FROM OVER 11,000 REGISTERED PA CHARITIES. FPS HAS MET, COMPLIED WITH, AND INTEGRATED THE ACCREDITATION PROGRAM AND THUS, ALL GOVERNANCE QUESTIONS ASKED IN THE FORM 990 HAVE BEEN ADDRESSED BY THE ORGANIZATION IN ITS NORMAL COURSE OF BUSINESS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,194,280

(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

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	118,070	18,490

1a	Federated campaigns..		1a	31,888
b	Membership dues..		1b
c	Fundraising events..		1c	523,642
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,094,117

g	Noncash contributions included in lines 1a - 1f:$		1g	61,233

h Total. Add lines 1a-1f.......		1,649,647

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....

3 Investment income (including dividends, interest, and othersimilar amounts) ......			80,713		80,713
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ 523,642of contributions reported on line 1c). See Part IV, line 18 ....
			8a	195,185
b	Less: direct expenses ...		8b	262,207
c	Net income or (loss) from fundraising events..			-67,022		-67,022
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	5,240
b	Less: direct expenses ...		9b	5,541
c	Net income or (loss) from gaming activities..			-301		-301
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
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.....			1,663,037		13,390

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	107,319	107,319
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	136,560	81,936	13,656	40,968
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........	670,017	481,414	26,790	161,813
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	108,492	77,229	5,266	25,997
10	Payroll taxes ...........	66,740	46,718	3,337	16,685
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	9,950		9,950
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)	48,115	14,478	22,355	11,282
12	Advertising and promotion ....	1,744	27	1,252	465
13	Office expenses .......	62,242	21,133	1,159	39,950
14	Information technology ......	51,970	27,805	4,416	19,749
15	Royalties ..
16	Occupancy ...........	41,965	38,443	705	2,817
17	Travel ............	54,691	53,922	341	428
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	3,901	2,452	186	1,263
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	35,614	29,302	1,492	4,820
23	Insurance ...	20,750	11,258	7,799	1,693
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	ACCOMMODATIONS	94,581	94,581
b	PROGRAM ANCILLARY SERV.	69,461	69,461
c	PROGRAM SUPPORT EXPENSES	24,026	24,026
d	BAD DEBTS	12,639			12,639
e	All other expenses	24,807	12,776	4,357	7,674
25	Total functional expenses. Add lines 1 through 24e	1,645,584	1,194,280	103,061	348,243
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 ........			29,859	1	93,323
2	Savings and temporary cash investments .........			1,085,192	2	761,988
3	Pledges and grants receivable, net ......			316,564	3	353,951
4	Accounts receivable, net .............				4
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			37,436	9	9,992
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	350,732
b	Less: accumulated depreciation	10b	175,988	183,632	10c	174,744
11	Investments—publicly traded securities .			907,454	11	1,334,671
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			137,580	14	115,486
15	Other assets. See Part IV, line 11 ...........			231,419	15	228,116
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,929,136	16	3,072,271

17	Accounts payable and accrued expenses .....	39,453	17	7,142
18	Grants payable ...		18
19	Deferred revenue .........		19
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 any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
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		25	158,700
26	Total liabilities. Add lines 17 through 25..	39,453	26	165,842

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,556,452	27	1,594,776
28	Net assets with donor restrictions ...........	1,333,231	28	1,311,653
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	2,889,683	32	2,906,429
33	Total liabilities and net assets/fund balances ........	2,929,136	33	3,072,271