TY 2020 Form 990

(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

(1) CHUCK PETRUSHA......................................................................
PRESIDENT

3.00
.................

(2) BETTY CHINN......................................................................
VICE PRESIDE

40.00
.................

(3) DAVID TYSON......................................................................
TREASURER

1.00
.................

(4) KURT KRAMER......................................................................
SECRETARY

1.00
.................

(5) PAUL GALLEGOS......................................................................
BOARD MEMBER

1.00
.................

(6) THERESA HESSIAN......................................................................
BOARD MEMBER

1.00
.................

(7) DAN PRICE......................................................................
BOARD MEMBER

1.00
.................

(8) ROLLIN RICHMOND......................................................................
BOARD MEMBER

1.00
.................

(9) JUSTIN ZABEL......................................................................
BOARD MEMBER

1.00
.................

(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 business address

(B)
Description of services

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

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

BETTY KWAN CHINN HOMELESS
FOUNDATION

Employer identification number

46-1413135

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) 2020

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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	465,430	417,661	895,203	966,737	1,147,970	3,893,001
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	465,430	417,661	895,203	966,737	1,147,970	3,893,001
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.						3,893,001

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
7	Amounts from line 4..	465,430	417,661	895,203	966,737	1,147,970	3,893,001
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
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						3,893,001

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

279

First 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

100.000 %

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

100.000 %

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 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 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

Additional Data

Software ID:
Software Version:

	(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 ........


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


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

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.)
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

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	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
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

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	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
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

- 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

2020

Open to Public
Inspection

Name of the organization

BETTY KWAN CHINN HOMELESS
FOUNDATION

Employer identification number

46-1413135

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4A	THE BETTY KWAN CHINN DAY CENTER OPENED IN NOVEMBER 2013 AT 133 7TH STREET IN EUREKA. THE DAY CENTER PROVIDES SUPPORTIVE SERVICES TO INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS OR LIVING IN VULNERABLE HOUSING SITUATIONS. DAY CENTER SERVICES INCLUDE: PHONE USE, MAIL SERVICE, COMPUTER ACCESS, JOB SEARCH ASSISTANCE, HOUSING SEARCH ASSISTANCE, PROFESSIONAL CLOTHING, EMPLOYMENT READINESS INFORMATION, REFERRALS TO OTHER RESOURCES, AND AN AFTER SCHOOL PROGRAM. THE AFTER SCHOOL PROGRAM AT THE DAY CENTER IS FREE AND OPEN TO CHILDREN EXPERIENCING HOMELESSNESS, VULNERABLY HOUSED CHILDREN, AND FOSTER CHILDREN IN KINDERGARTEN THROUGH 5TH GRADE. THROUGH A PARTNERSHIP WITH EUREKA CITY SCHOOLS, THE DAY CENTER IS A BUS STOP FOR STUDENTS AFTER SCHOOL. THE FOCUS OF THE AFTER SCHOOL PROGRAM IS PROMOTING ACADEMIC SUCCESS BY ENSURING HOMEWORK IS COMPLETED, ACCURATE, AND UNDERSTOOD. THE AFTER SCHOOL PROGRAM SERVES AN AVERAGE OF 15 CHILDREN PER YEAR.
FORM 990, PAGE 2, PART III, LINE 4B	BETTY'S HOUSE FAMILY SHELTER OPENED IN JANUARY 2017, AND HAS 32 BEDS AVAILABLE. REFERRALS FOR THE FAMILY SHELTER ARE ACCEPTED FROM CALWORKS AND CHILD WELFARE SERVICES. FAMILY SHELTER RESIDENTS MAY STAY IN THE PROGRAM FOR UP TO 6 MONTHS WITH THE POSSIBILITY FOR AN EXTENSION ON A CASE-BY-CASE BASIS. FAMILIES WORK WITH THE CASE MANAGEMENT TEAM TO SET GOALS AND ASSESS THEIR PROGRESS. THE FAMILY SHELTER REQUIRES RESIDENTS TO: BE EMPLOYED OR ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAGEMENT TEAM AND OTHER AGENCIES. ALL SCHOOL-AGED CHILDREN AT THE FAMILY SHELTER MUST BE ATTEND SCHOOL. THE FAMILY SHELTER PRIORITIZES SINGLE FATHERS, TWO PARENT FAMILIES AND FAMILIES WITH TEENAGES BECAUSE THEY HAVE LIMITED SHELTER OPTIONS. ON AVERAGE, THE FAMILY SHELTER CAN HOUSE UP TO 7 FAMILIES AT A TIME. BETTY'S HOUSE MEDICAL RESPITE IS A PROGRAM FOR SINGLE ADULTS EXPERIENCING HOMELESSNESS THAT HAVE BEEN IN THE HOSPITAL FOR TREATMENT OF AN ILLNESS OR INJURY. THE MEDICAL RESPITE PROGRAM HAS 10 BEDS AVAILABLE. RESIDENTS ENTER THE MEDICAL RESPITE PROGRAM AFTER BEING SCREENED AT ST. JOSEPH HOSPITAL TO ASSESS FITNESS FOR THE PROGRAM AT BETTY'S HOUSE. ONCE APPROVED, THE RESIDENT IS MOVED FROM THE HOSPITAL TO BETTY'S HOUSE IMMEDIATELY UPON DISCHARGE. RESIDENTS ARE APPROVED FOR A 21 DAY STAY IN ORDER TO RECOVER FROM THE ILLNESS OR INJURY THEY WERE BEING TREATED FOR AT THE HOSPITAL. THE ST. JOSEPH HEALTH CARE TRANSITIONS TEAM IS RESPONSIBLE FOR THE MEDICAL CARE AND CASE MANAGEMENT OF THE RESPITE RESIDENTS.
FORM 990, PAGE 2, PART III, LINE 4C	BETTY'S BLUE ANGEL VILLAGE IS A HOMELESS SHELTER PROGRAM ESTABLISHED ON MAY 1, 2016. THIS 90-DAY PROGRAM PROVIDES TRANSITIONAL HOUSING AND CASE MANAGEMENT FOR UP TO 40 OF THE MOST CHRONICALLY HOMELESS INDIVIDUALS OVER THE AGE OF 18 IN EUREKA, CALIFORNIA. RESIDENTS ARE PROVIDED UP TO 3 MEALS PER DAY AND ARE TREATED FOR MEDICAL ISSUES BY THE MOBILE OPEN DOOR HEALTH SERVICE. WHILE AT THE VILLAGE, RESIDENTS ARE REQUIRED TO: BE EMPLOYED OR BE ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSEING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAGEMENT TEAM AND OTHER AGENCIES. RESIDENTS ARE ALLOWED TO BRING THEIR PETS WITH THEM INTO THE INDIVIDUAL ROOMS AND ARE PROVIDED FREE FOOD, SUPPLIES, AND VET CARE FOR THEIR PETS WHILE THEY ARE AT THE VILLAGE.
FORM 990, PAGE 2, PART III, LINE 4D	BETTY'S BLUE ANGEL OUTREACH, USING THE CAL FRESH GRANT, SERVES 475 MEALS PER DAY, OVER 11,000 EMERGENCY FOOD BAGS PER YEAR, ALONG WITH MONTHLY FOOD DELIVERY TO FAMILIES. THE OUTREACH PROGRAM ALSO TRANSPORTS HOMELESS CHILDREN TO SCHOOL, PAYS FOR MEDICAL PRESCRIPTIONS, PROVIDES CLEAN CLOTHES AND BLANKETS, AND PROVIDES FREE SHOWERS FROM 8-NOON ON MONDAY, WEDNESDAY, AND FRIDAYS. BETTY'S ANNEX OPENED IN AUGUST 2020 AND HAS 15 BEDS AVAILABLE FOR SINGLE WOMEN AND WOMEN WITH CHILDREN. REFERRALS FOR THE ANNEX ARE ACCEPTED FROM CALWORKS AND CHILD WELFARE SERVICES. ANNEX RESIDENTS MAY STAY IN THE PROGRAM FOR UP TO 6 MONTHS WITH THE POSSIBILITY FOR AN EXTENSION ON A CASE-BY-CASE BASIS. RESIDENTS WORK WITH THE CASE MANAGEMENT TEAM TO SET GOALS AND ASSESS THEIR PROGRESS. THE ANNEX REQUIRES RESIDENTS TO: BE EMPLOYED OR ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAAGMENET TEAM AND OTHER AGENCIES. ALL SCHOOL-AGE CHILDREN AT THE ANNEX MUST ATTEND SCHOOL. THE ANNEX HAS 4 ROOMS FOR SINGLE WOMEN AND 4 ROOMS FOR WOMEN WITH CHILDREN.
FORM 990, PAGE 6, PART VI, LINE 11B	NO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PAGE 6, PART VI, LINE 19	UPON 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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO HONOR ALL OF HUMANITY BY PROVIDING DIRECT RESPONSES TO IMMEDIATE NEEDS AND HELPING THE HOMELESS ACHIEVE THE DIGNITY NEEDED TO RETURN TO SOCIETY AS CONTRIBUTING MEMBERS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	25
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) .........	966,737	1,147,970
9	Program service revenue (Part VIII, line 2g) .........		0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	97	129
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)		0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	966,834	1,148,099
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
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)	517,413	595,839
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	424,805	313,636
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	942,218	909,475
19	Revenue less expenses. Subtract line 18 from line 12.......	24,616	238,624
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	943,484	1,182,108
21	Total liabilities (Part X, line 26).............		0
22	Net assets or fund balances. Subtract line 21 from line 20.....	943,484	1,182,108

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 198,851 including grants of $ ) (Revenue $ )
	THE BETTY KWAN CHINN DAY CENTER OPENED IN NOVEMBER 2013 AT 133 7TH STREET IN EUREKA. THE DAY CENTER PROVIDES SUPPORTIVE SERVICES TO INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS OR LIVING IN VULNERABLE HOUSING SITUATIONS. DAY CENTER SERVICES INCLUDE: PHONE USE, MAIL SERVICE, COMPUTER ACCESS, JOB SEARCH ASSISTANCE, HOUSING SEARCH ASSISTANCE, PROFESSIONAL CLOTHING, EMPLOYMENT READINESS INFORMATION, REFERRALS TO OTHER RESOURCES, AND AN AFTER SCHOOL PROGRAM. THE AFTER SCHOOL PROGRAM AT THE DAY CENTER IS FREE AND OPEN TO CHILDREN EXPERIENCING HOMELESSNESS, VULNERABLY HOUSED CHILDREN, AND FOSTER CHILDREN IN KINDERGARTEN THROUGH 5TH GRADE. THROUGH A PARTNERSHIP WITH EUREKA CITY SCHOOLS, THE DAY CENTER IS A BUS STOP FOR STUDENTS AFTER SCHOOL. THE FOCUS OF THE AFTER SCHOOL PROGRAM IS PROMOTING ACADEMIC SUCCESS BY ENSURING HOMEWORK IS COMPLETED, ACCURATE, AND UNDERSTOOD. THE AFTER SCHOOL PROGRAM SERVES AN AVERAGE OF 15 CHILDREN PER YEAR.

4b	(Code: ) (Expenses $ 293,525 including grants of $ ) (Revenue $ )
	BETTY'S HOUSE FAMILY SHELTER OPENED IN JANUARY 2017, AND HAS 32 BEDS AVAILABLE. REFERRALS FOR THE FAMILY SHELTER ARE ACCEPTED FROM CALWORKS AND CHILD WELFARE SERVICES. FAMILY SHELTER RESIDENTS MAY STAY IN THE PROGRAM FOR UP TO 6 MONTHS WITH THE POSSIBILITY FOR AN EXTENSION ON A CASE-BY-CASE BASIS. FAMILIES WORK WITH THE CASE MANAGEMENT TEAM TO SET GOALS AND ASSESS THEIR PROGRESS. THE FAMILY SHELTER REQUIRES RESIDENTS TO: BE EMPLOYED OR ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAGEMENT TEAM AND OTHER AGENCIES. ALL SCHOOL-AGED CHILDREN AT THE FAMILY SHELTER MUST BE ATTEND SCHOOL. THE FAMILY SHELTER PRIORITIZES SINGLE FATHERS, TWO PARENT FAMILIES AND FAMILIES WITH TEENAGES BECAUSE THEY HAVE LIMITED SHELTER OPTIONS. ON AVERAGE, THE FAMILY SHELTER CAN HOUSE UP TO 7 FAMILIES AT A TIME. BETTY'S HOUSE MEDICAL RESPITE IS A PROGRAM FOR SINGLE ADULTS EXPERIENCING HOMELESSNESS THAT HAVE BEEN IN THE HOSPITAL FOR TREATMENT OF AN ILLNESS OR INJURY. THE MEDICAL RESPITE PROGRAM HAS 10 BEDS AVAILABLE. RESIDENTS ENTER THE MEDICAL RESPITE PROGRAM AFTER BEING SCREENED AT ST. JOSEPH HOSPITAL TO ASSESS FITNESS FOR THE PROGRAM AT BETTY'S HOUSE. ONCE APPROVED, THE RESIDENT IS MOVED FROM THE HOSPITAL TO BETTY'S HOUSE IMMEDIATELY UPON DISCHARGE. RESIDENTS ARE APPROVED FOR A 21 DAY STAY IN ORDER TO RECOVER FROM THE ILLNESS OR INJURY THEY WERE BEING TREATED FOR AT THE HOSPITAL. THE ST. JOSEPH HEALTH CARE TRANSITIONS TEAM IS RESPONSIBLE FOR THE MEDICAL CARE AND CASE MANAGEMENT OF THE RESPITE RESIDENTS.

4c	(Code: ) (Expenses $ 177,802 including grants of $ ) (Revenue $ )
	BETTY'S BLUE ANGEL VILLAGE IS A HOMELESS SHELTER PROGRAM ESTABLISHED ON MAY 1, 2016. THIS 90-DAY PROGRAM PROVIDES TRANSITIONAL HOUSING AND CASE MANAGEMENT FOR UP TO 40 OF THE MOST CHRONICALLY HOMELESS INDIVIDUALS OVER THE AGE OF 18 IN EUREKA, CALIFORNIA. RESIDENTS ARE PROVIDED UP TO 3 MEALS PER DAY AND ARE TREATED FOR MEDICAL ISSUES BY THE MOBILE OPEN DOOR HEALTH SERVICE. WHILE AT THE VILLAGE, RESIDENTS ARE REQUIRED TO: BE EMPLOYED OR BE ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSEING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAGEMENT TEAM AND OTHER AGENCIES. RESIDENTS ARE ALLOWED TO BRING THEIR PETS WITH THEM INTO THE INDIVIDUAL ROOMS AND ARE PROVIDED FREE FOOD, SUPPLIES, AND VET CARE FOR THEIR PETS WHILE THEY ARE AT THE VILLAGE.

	(Code: ) (Expenses $ 218,690 including grants of $ ) (Revenue $ )
	BETTY'S BLUE ANGEL OUTREACH, USING THE CAL FRESH GRANT, SERVES 475 MEALS PER DAY, OVER 11,000 EMERGENCY FOOD BAGS PER YEAR, ALONG WITH MONTHLY FOOD DELIVERY TO FAMILIES. THE OUTREACH PROGRAM ALSO TRANSPORTS HOMELESS CHILDREN TO SCHOOL, PAYS FOR MEDICAL PRESCRIPTIONS, PROVIDES CLEAN CLOTHES AND BLANKETS, AND PROVIDES FREE SHOWERS FROM 8-NOON ON MONDAY, WEDNESDAY, AND FRIDAYS. BETTY'S ANNEX OPENED IN AUGUST 2020 AND HAS 15 BEDS AVAILABLE FOR SINGLE WOMEN AND WOMEN WITH CHILDREN. REFERRALS FOR THE ANNEX ARE ACCEPTED FROM CALWORKS AND CHILD WELFARE SERVICES. ANNEX RESIDENTS MAY STAY IN THE PROGRAM FOR UP TO 6 MONTHS WITH THE POSSIBILITY FOR AN EXTENSION ON A CASE-BY-CASE BASIS. RESIDENTS WORK WITH THE CASE MANAGEMENT TEAM TO SET GOALS AND ASSESS THEIR PROGRESS. THE ANNEX REQUIRES RESIDENTS TO: BE EMPLOYED OR ACTIVELY SEEKING EMPLOYMENT; BE ACTIVELY SEEKING HOUSING; TO BE ATTENDING CASE MANAGEMENT MEETINGS; AND TO BE MEETING GOALS SET BY THE CASE MANAAGMENET TEAM AND OTHER AGENCIES. ALL SCHOOL-AGE CHILDREN AT THE ANNEX MUST ATTEND SCHOOL. THE ANNEX HAS 4 ROOMS FOR SINGLE WOMEN AND 4 ROOMS FOR WOMEN WITH CHILDREN.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 218,690 including grants of $ ) (Revenue $ )
4e	Total program service expenses888,868

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

(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

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	653,943

f	All other contributions, gifts, grants, and similar amounts not included above		1f	494,027

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

h Total. Add lines 1a-1f.......		1,147,970

		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) ......			129	129
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 $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
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.....			1,148,099	129

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 ...........
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 ...........
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........	519,825	505,492	14,333
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	76,014	75,882	132
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	2,160		2,160
b	Legal .........
c	Accounting ...........	159		159
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)	6,639	5,860	779
12	Advertising and promotion ....	984		984
13	Office expenses .......	4,083	4,083
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	93,860	93,860
17	Travel ............	3,541	3,541
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	7,883	6,880	1,003
23	Insurance ...	17,124	17,124
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	SUPPLIES-FOOD	109,121	109,121
b	MISCELLANEOUS	29,590	29,013	577
c	SUPPLIES - OTHER	29,278	29,117	161
d	FUEL	3,599	3,599
e	All other expenses	5,615	5,296	319
25	Total functional expenses. Add lines 1 through 24e	909,475	888,868	20,607	0
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 ........			282,338	1	472,484
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............				4
5	Loans and other receivables from 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 ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	722,109
b	Less: accumulated depreciation	10b	12,485	661,146	10c	709,624
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			943,484	16	1,182,108

17	Accounts payable and accrued expenses .....		17
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
26	Total liabilities. Add lines 17 through 25..	0	26	0

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	300,921	27	577,640
28	Net assets with donor restrictions ...........	642,563	28	604,468
	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 ...........	943,484	32	1,182,108
33	Total liabilities and net assets/fund balances ........	943,484	33	1,182,108

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 ......

1a	Land .....	100,000		100,000
b	Buildings ....	490,420		490,420
c	Leasehold improvements
d	Equipment ....
e	Other .....	131,689	12,485	119,204
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				709,624

(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.)