| Identifier | Return Reference | Explanation |
|---|---|---|
| GRANT APPLICATION PROCESS | FORM 990-PF, PAGE 10, PART XV, LINE 2B | THE FOLLOWING INFORMATION IS REQUIRED OF ALL GRANT APPLICANTS:1. COVER SUMMARY PAGE:O NAME OF ORGANIZATION, INDIVIDUAL, OR PROJECTO CONTACT INFORMATION: NAME, ADDRESS, PHONE, FAX, E-MAILO TOTAL AMOUNT OF GRANT REQUESTO BRIEF DESCRIPTION OF THE REQUESTO QUALIFICATIONS UNDER WHICH APPLICATION IS BEING MADE (SEE ITEM 8)2. GRANT PROPOSAL:O MAXIMUM LENGTH, TWO PAGES DOUBLE-SPACED, 12-POINT TYPE.O IF MORE SPACE IS NEEDED, INCLUDE SUCCINCT ADDITIONAL MATERIAL IN AN APPENDIX.O IF REQUEST IS FOR MORE THAN ONE PROJECT OR PROGRAM - PRIORITIZE NEEDS.3. BACKGROUND INFORMATION:A BRIEF CHARACTERIZATION OF THE PROPOSED INITIATIVE OR ORGANIZATION, ALONG WITH A DESCRIPTION OF THE MISSION STATEMENT, ACTIVITIES, AND SCHEDULES. ALSO MUST PROVIDE CLEAR PRESENTATION OF OVERALL FUNDING NEEDS.4. RELEVANCY:DESCRIBE HOW THE PROPOSED INITIATIVE RELATES TO ADDRESSING ISSUES OF CONCERN TO THE GENERAL PUBLIC. 5. BUDGET (THE FOLLOWING INFORMATION IS REQUESTED WHERE APPLICABLE):O A BUDGET FOR THE PROJECT(S), PROGRAM(S), OR WORK FOR WHICH INTENDED BY THIS PROPOSALO CURRENT YEAR'S AND NEXT YEAR'S OPERATING BUDGET WHERE APPROPRIATEO DESCRIBE INCOME SOURCES, GIVING CONSTITUENCY, AND ANY FUNDS RECEIVED OR PROMISED FOR THIS ENDEAVOR6. PERFORMANCE REPORT:APPLICANTS ARE REQUESTED TO SUBMIT A REPORT ON THE GRANT ACTIVITIES TO THE FOUNDATION WITHIN A YEAR OF RECEIPT OF THE AWARD. IF A PREVIOUS GRANT(S) HAS BEEN RECEIVED, A GRANT REPORT MUST ACCOMPANY THIS PROPOSAL. REPORT MUST BE CLEARLY IDENTIFIED AS SUCH AND BE ON A SEPARATE PAGE OR PAGES. THE REPORT HELPS US NOT ONLY UNDERSTAND WHAT WAS ACCOMPLISHED, BUT ALSO TO HELP US LEARN FROM THE GRANTEE PERSPECTIVE ABOUT THE EFFECTIVENESS OF OUR GRANTING PROCESS. ATTACH EXTRA PAGES OR OTHER MATERIALS THAT ARE RELEVANT TO REPORTING ON THE GRANT.PROJECT NAME:ORGANIZATION OR INDIVIDUAL NAME:1. REPORT ON HOW YOU EXPENDED THE GRANT MONEY TO ACCOMPLISH YOUR PROPOSED PROJECT OR IMPLEMENT YOUR PROGRAM.2. HOW DID RECEIVING THE GRANT CHANGE OR IMPROVE YOUR ORGANIZATION OR PROJECT? PLEASE INCLUDE IN THIS RESPONSE ANY INSIGHTS, INSPIRATIONS OR HINDRANCES YOU ENCOUNTERED.3. IN FULFILLING YOUR GRANT ACTIVITY, WHAT KINDS OF MUTUAL SUPPORT WERE FOSTERED AMONG YOUR PEERS OR PEER ORGANIZATIONS, AND HOW WERE YOU ABLE TO WORK WITH OTHER KINDS OF INITIATIVES OR CORPORATIONS?4. PLEASE INCLUDE WITH YOUR REPORT VISUAL DOCUMENTATION (SUCH AS PHOTOGRAPHS, ARTWORK, OR CHARTS, ETC.) OF YOUR PROJECT OR PROGRAM THAT WILL SHOW US WHAT YOU DID AND THAT MAY ALSO BE USED FOR PURPOSES OF PUBLICITY.SUBMITTED BY:SIGNED:DATE:7. FUTURE DEVELOPMENT:INDICATE PLAN FOR ENABLING THE CONTINUED VIABILITY OF PROPOSED WORK. THIS COULD INCLUDE PLANS FOR EXPANDING FUNDING BASE SUPPORT AND OTHER SOURCES OF CURRENT AND FUTURE FUNDING8. QUALIFICATIONS:PROVIDE DOCUMENTATION AS APPROPRIATE TO INDIVIDUAL OR ORGANIZATIONAL STATUS. PLEASE SEND A LIST OF OFFICERS AND DIRECTORS, YOUR FEDERAL EMPLOYER IDENTIFICATION NUMBER FEIN), A CURRENT BROCHURE, AND IF TAX EXEMPT, INCLUDE IRS SECTION 501(C)(3) LETTER OF DETERMINATION. IF THERE IS AN IRS DETERMINATION OTHER THAN SECTION 501(C)(3), PLEASE INDICATE THIS ON COVER SUMMARY.8. QUALIFICATIONS:PROVIDE DOCUMENTATION AS APPROPRIATE TO INDIVIDUAL OR ORGANIZATIONAL STATUS. PLEASE SEND A LIST OF OFFICERS AND DIRECTORS, YOUR FEDERAL EMPLOYER IDENTIFICATION NUMBER FEIN), A CURRENT BROCHURE, AND IF TAX EXEMPT, INCLUDE IRS SECTION 501(C)(3) LETTER OF DETERMINATION. IF THERE IS AN IRS DETERMINATION OTHER THAN SECTION 501(C)(3), PLEASE INDICATE THIS ON COVER SUMMARY. |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| DIVIDENDS DECLARED | AT COST | 84 | 84 |
| CHARLES SCHWAB US MC ETF | AT COST | 22,623 | 27,836 |
| CHARLES SCHWAB US REIT ETF | AT COST | 23,062 | 19,622 |
| ISHARES SELECT DIVIDEND ETF | AT COST | 79,814 | 78,594 |
| SCHWAB EMERGING MARKETS EQUITY ETF | AT COST | 17,541 | 21,623 |
| SCHWAB INTERNATIONAL EQUITY ETF | AT COST | 20,346 | 23,438 |
| SCHWAB SHORT TERM US TREASURY ETF | AT COST | 43,382 | 43,372 |
| SCHWAB US AGGREGATE BOND ETF | AT COST | 43,886 | 47,264 |
| SCHWAB US DIVIDEND EQUITY ETF | AT COST | 79,920 | 98,278 |
| SCHWAB US LARGE CAP GROWTH ETF | AT COST | 22,314 | 35,403 |
| SCHWAB US SMALL CAP ETF | AT COST | 28,157 | 35,712 |
| AAA/HIMCO SHORT DURATION FUND | AT COST | 42,733 | 43,136 |
| LORD ABBETT SHORT DURATION INCOME FUND | AT COST | 43,586 | 43,592 |
| AMERICAN FUNDS EUROPACIFIC GROWTH FUND | AT COST | 19,985 | 27,275 |
| AMERICAN FUNDS WASHINGTON MUTUAL FUND | AT COST | 30,478 | 33,422 |
| BAIRD MIDCAP FUND | AT COST | 19,587 | 24,928 |
| LOOMIS SAYLES GROWTH FUND | AT COST | 24,001 | 32,197 |
| MFS VALUE FUND | AT COST | 29,200 | 32,392 |
| RUSSELL INVESTMENTS GLOBAL REAL ESTATE SECURITIES FUND | AT COST | 23,823 | 21,997 |
| SCHWAB S&P 500 INDEX FUND | AT COST | 46,021 | 59,563 |
| WELLS FARGO SPECIAL MID CAP VALUE FUND | AT COST | 17,383 | 19,426 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL FEES | 1,289 | 0 | 0 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| REGISTRATION FEES | 10 | 0 | 0 |
| Name | Address |
|---|---|
|
PRIME ELECTRIC INC |
3460 161ST AVE SE BELLEVUE,WA98008 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXCISE TAX ON INVESTMENT INCOME | 877 | 0 | 0 | |
| FOREIGN INCOME TAX | 94 | 94 | 0 | |
| EXCISE TAX | 1,500 | 0 | 0 |