Form990-PF
Click to see attachment
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Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 01-01-2021 , and ending 12-31-2021
Name of foundation
HMSA FOUNDATION
 
Number and street (or P.O. box number if mail is not delivered to street address)POBOX 860
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HONOLULU, HI96808
A Employer identification number

99-0250429
B Telephone number (see instructions)

(808) 948-5145
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$27,796,148J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments 53 53  
4 Dividends and interest from securities... 516,744 516,744  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 4,129,539
b Gross sales price for all assets on line 6a 8,325,424
7 Capital gain net income (from Part IV, line 2)... 4,129,539
8 Net short-term capital gain.........  
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule)....... Click to see attachment 502 502 0
12 Total. Add lines 1 through 11........ 4,646,838 4,646,838 0
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 0 0 0 0
14 Other employee salaries and wages...... 166,482 0 0 0
15 Pension plans, employee benefits....... 11,867 0 0 0
16a Legal fees (attach schedule).........        
b Accounting fees (attach schedule)....... Click to see attachment 25,445 0 0 0
c Other professional fees (attach schedule).... Click to see attachment 44,340 0 0 0
17 Interest...............        
18 Taxes (attach schedule) (see instructions)... Click to see attachment 55,336 0 0 0
19 Depreciation (attach schedule) and depletion...      
20 Occupancy.............. 169 0 0 0
21 Travel, conferences, and meetings....... 105 0 0 0
22 Printing and publications..........        
23 Other expenses (attach schedule)....... Click to see attachment -36,961 0 0 0
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 266,783 0 0 0
25 Contributions, gifts, grants paid....... 350,176 2,405,000
26 Total expenses and disbursements. Add lines 24 and 25 616,959 0 0 2,405,000
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 4,029,879
b Net investment income (if negative, enter -0-) 4,646,838
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing............. 126,944 4,610,574 4,610,574
2 Savings and temporary cash investments.........      
3 Accounts receivable bullet18,205
Less: allowance for doubtful accounts bullet   15,595 18,205 18,205
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet        
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges.......... 169,965 213,745 213,745
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 18,175,821 Click to see attachment15,588,149 22,953,624
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 18,488,325 20,430,673 27,796,148
Liabilities 17 Accounts payable and accrued expenses.......... 68,628 60,914
18 Grants payable................. 8,736,417 6,681,593
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet) Click to see attachment107,373 Click to see attachment82,380
23 Total liabilities (add lines 17 through 22)......... 8,912,418 6,824,887
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions........... 9,575,907 13,605,786
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........    
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 9,575,907 13,605,786
30 Total liabilities and net assets/fund balances (see instructions). 18,488,325 20,430,673
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
9,575,907
2
Enter amount from Part I, line 27a .....................
2
4,029,879
3
Other increases not included in line 2 (itemize) bullet
3
0
4
Add lines 1, 2, and 3 ..........................
4
13,605,786
5
Decreases not included in line 2 (itemize) bullet
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
13,605,786
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a VANGUARTD EMERG MKT 64,301.55 SHARES P 2007-12-31 2021-01-21
b VANGUARTD EMERG MKT 5,458.91 SHARES P 2007-12-31 2021-01-29
c VANGUARD MID CAP 14,749.26 SHARES P 2007-12-31 2021-08-27
d VANGUARD SMALL CAP 9,187.80 SHARES P 2007-12-31 2021-08-27
e VANGUARD INST INDEX 7,600.32 SAHRES P 2007-12-31 2021-08-27
LONG TERM CAPITAL GAIN DISTRIBUTION P    
SHORT TERM CAPITAL GAIN DISTRIBUTION P    
(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 2,900,000   2,449,552 450,448
b 234,186   207,956 26,230
c 1,000,000   336,224 663,776
d 1,000,000   332,648 667,352
e 3,000,000   869,505 2,130,495
183,644     183,644
7,594     7,594
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       450,448
b       26,230
c       663,776
d       667,352
e       2,130,495
      183,644
      7,594
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 4,129,539
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3 7,594
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 64,591
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 64,591
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 80,710
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d 0
7 Total credits and payments. Add lines 6a through 6d.............. 7 80,710
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. Click to see attachment 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9  
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10 16,119
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet16,119 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$ 0(2) On foundation managers.bullet$ 0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$ 0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletHI
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletWWW.HMSAFOUNDATION.ORG
    14
    The books are in care ofbulletMARCUS CHUN Telephone no.bullet (808) 948-5145

    Located atbullet818 KEEAUMOKU STREETHONOLULUHI ZIP+4bullet96814
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
     
    No
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
     
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    MARK MUGIISHI PRESIDENT
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KATHRYN MATAYOSHI VICE PRESIDENT
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    GINA L MARTING TREASURER
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    MICHAEL BRODERICK DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    HELEN COX DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    KENNETH NAKAMURA DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    RICHARD TAAFEE DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    LINDA EZUKA DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    BRANDEE MENINO DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    LESILE WIKLINS DIRECTOR
    1.00     		0 0 0
    PO BOX 860
    HONOLULU,HI96808
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    KAIPO KAUKAHIKO PROGRAM OFFICE
    40.00     		95,476 3,792 0
    PO BOX 860
    HONOLULU,HI96808
    MERYAM LEONG ADMINISTRATOR
    40.00     		74,994 4,361 0
    PO BOX 860
    HONOLULU,HI96808
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    24,695,032
    b
    Average of monthly cash balances.......................
    1b
    2,571,466
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    27,266,498
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    27,266,498
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    408,997
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    26,857,501
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    1,342,875
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    1,342,875
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    64,591
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    64,591
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    1,278,284
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    1,278,284
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    1,278,284
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 1,278,284
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 1,087,068
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016......  
    b From 2017......  
    c From 2018......  
    d From 2019......  
    e From 2020......  
    f Total of lines 3a through e ........ 0
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 2,405,000
    a Applied to 2020, but not more than line 2a 1,087,068
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 1,278,284
    e Remaining amount distributed out of corpus 39,648
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 39,648
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		39,648
    10 Analysis of line 9:
    a Excess from 2017....  
    b Excess from 2018....  
    c Excess from 2019....  
    d Excess from 2020....  
    e Excess from 2021.... 39,648
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or e-mail address of the person to whom applications should be addressed:
    HMSA FOUNDATION
    PO BOX 860
    HONOLULU,HI96808
    (808) 948-5145
    bThe form in which applications should be submitted and information and materials they should include:
    SEE STATEMENT 12
    cAny submission deadlines:
    NONE
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    SEE STATEMENT 13
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    FAMILY VIOLENCE AND SEXUAL ASSAULT INSTITUTE
    10065 OLD GROVE RD STE 101
    SAN DIEGO,CA92131     		  PC KAHAUIKI VILLAGE (KV) IS A UNIQUE PERMANENT HOUSING PROJECT THAT ADDRESSES GENERATIONAL HOMELESSNESS, WITH A GOAL TO MITIGATE ADVERSE CHILDHOOD EXPERIENCES AND TRAUMA THAT MANY HOMELESS CHILDREN AND FAMILIES FACE. THEY SEEK TO BUILD RESILIENCE BY FOSTERING A NEIGHBORHOOD CULTURE THAT AFFORDS OPPORTUNITIES FOR PRO-SOCIAL EXPERIENCES. THEY HOPE THAT THEIR EFFORTS SUPPORT THE GOAL THAT THEIR FAMILIES CAN LEAD PRODUCTIVE AND FULFILLING LIVES TO BREAK THE CYCLE OF INTERGENERATIONAL TRAUMA. DESIGN AND IMPLEMENT PROGRAM EVALUATION TO TRACK OUTCOMES FOR KV FAMILIES AND CHILDREN SERVED THROUGH THEPROJECT AND ESTABLISH FEEDBACK LOOPS TO CONTINUOUSLY IMPROVE CLIENT SERVICES, CONTENT, AND DELIVERY. EVALUATION WILL UTILIZE A MIXED METHODS APPROACH, COLLECTING BOTH QUANTITATIVE AND QUALITATIVE DATA TO CAPTURE THE DIVERSE PERSPECTIVES OF CLIENT FAMILIES, PROGRAM STAFF, AND ALLIED PROVIDERS. 15,000
    FIVE MOUNTAINS HAWAII
    64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIES THAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIR FAMILY. 100,000
    HAWAII APPLESEED CENTER FOR LAW AND ECONOMIC JUSTICE
    733 BISHOP ST STE 180
    HONOLULU,HI96813     		  PC PREVENT PANDEMIC-RELATED EVICTIONS. CRAFT AND IMPLEMENT MEDIATION AND RELIEF PROGRAMS THAT WILL HELP SUSTAIN THE HOUSING ECOSYSTEM BY FACILITATING AND ENCOURAGING THE PAYMENT OF RENT USING FEDERAL FUNDS WHILE PREVENTING HOMELESSNESS 10,000
    HAWAII HOTEL INDUSTRY FOUNDATION
    2270 KALAKAUA AVE
    HONOLULU,HI96815     		  PC FOOD DISTRIBUTION PROGRAM FOR PEOPLE IN THE TOURISM INDUSTRY THAT LOST JOBS AND WERE IMPACTED BY COVID-19. 10,000
    HAWAII VA FOUNDATION
    111 HEKILI ST 102
    KAILUA,HI96734     		  PC PAIRS SENIORS WITH A VOLUNTEER SPONSOR. THE VOLUNTEER PROVIDES TELEPHONE SAFETY CHECK-IN, WHICH INVOLVES SOCIALIZATION, COMPASSIONATE LISTENING, AND TELEPHONE REASSURANCE. THE VOLUNTEER WILL ALSO SHOP FOR AND DELIVERS THE CLIENT'S BASIC NEEDS (FOOD, SUPPLIES, OR MEDICATION) IF NEEDED. 10,000
    HAWAIIAN COMMUNITY ASSETS INC
    2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC STRATEGIC PLANNING SESSION COSTS 20,000
    HAWAIIAN COMMUNITY ASSETS INC
    2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOMECOMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCYWITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGHMORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIPASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FORTRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONSEDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 65,000
    HAWAIIAN ISLANDS LAND TRUST
    126 QUEEN ST STE 306
    HONOLULU,HI96813     		  PC MAUNAWILA HEIAU COMPLEX ECOLOGICAL AND EDUCATIONAL PROGRAM. TO ADVANCE THE CULTURAL AND ECOLOGICAL RESTORATION OF THE MANUAWILA HEIAU COMPLEX A NINE ACRE PUBLIC PRESERVE. THE PROGRAM WILL PROVIDE EDUCATIONAL OPPORTUNITIES, INTERNSHIPS TO LOW-INCOME YOUTHS, AND PROVIDE ECOLOGICAL STEWARDSHIP TO MAINTAIN THE PARCEL FOR SAFE PUBLIC ACCESS. 15,000
    HEALTHY MOTHERS HEALTHY BABIES COALITION OF HAWAII
    245 N KUKUI ST STE 102A
    HONOLULU,HI96817     		  PC MANA MAMA PROGRAM CREATES A STRONG FOUNDATION FOR BIRTHING PEOPLE AND THEIR BABIES THROUGH A NURSE AND MIDWIFERY-LED COMMUNITY CARE PROGRAM, DELIVERING QUALITY MATERNAL AND REPRODUCTIVE HEALTHCARE, WHILE WRAPPING FAMILIES IN SOCIAL SERVICES. 15,000
    HOIWAI FUND
    59-005 HOALUA ST
    HALEIWA,HI96712     		  PC SUPPORT THE PHILANTHROPY-SERVING ORGANIZATION UNITING AND COORDINATING HAWAII'S FUNDERS TO STRENGTHEN THE COLLECTIVE WELL-BEING AND RESILIENCE OF THE COMMUNITIES BY CREATING OPPORTUNITIES FOR CONNECTION, CO-LEARNING AND GROWTH TO HEAL AND TRANSFORM HAWAII. 10,000
    HUI MALAMA O KE KAI FOUNDATION
    41-477 HIHIMANU ST
    WAIANAE,HI96795     		  PC WELLNESS INITIATIVES FOR THE CHILDREN AND FAMILIES OF WAIMANALO 1) FARM-TO-TABLE HEALTHY SNACK PROGRAM, 2) BOARD AND STONE CARVING CLASSES, AND 3) INDIGENOUS ARE WELLNESS PROGRAM. 10,000
    KAALA FARM INC
    86-120 FARRINGTON HWY
    WAIANAE,HI96792     		  PC LAND BASED CULTURAL AND ENVIRONMENTAL EDUCATIONAL PROGRAMS TO SERVE NATIVE HAWAIIANS OF ALL AGES. MAINTAIN HEALTHY WATERSHEDS WHERE HAWAIIAN TRADITIONS ARE CARRIED FORTH AND THE RELATIONSHIP BETWEEN THE LAND AND PEOPLE ARE FORTIFIED TO STRENGTHEN THE COMMUNITY. 15,000
    KE KULA NUI 0 WAIMANALO
    P0 BOX 723
    WAIMANALO,HI96795     		  PC "KUKULU KAIAULU" PROGRAM TO PROVIDE AND SUPPORTCULTURALLY GROUNDED, COMMUNITY DRIVEN AND HANDS-ON PROGRAMMING AND RESEARCH THAT PROMOTE WHOLISTIC WELLNESS, MULTI-GENERATIONAL KNOWLEDGE, AND COMMUNITY CONNECTEDNESS. 15,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
    2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGH STRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH AND HARMONY THROUGH PROGRAMS THAT PROVIDE WRAPAROUND SUPPORT, SUPPLIES, FRESH PRODUCE, MEALS AND MEDICINE TO PATIENTS DURING THE COVID PANDEMIC. 100,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT
    47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL,ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEINGOF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVICPROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OFTHE DIVERSE MULTI-CULTURAL COMMUNITY. 75,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT
    47-200 WAIHEE RD
    KAHULUI,HI96744     		  PC COMMUNITY NEEDS ASSESSMENT AND CURRICULUM DEVELOPMENT FOR YOUTH PROGRAMS. 20,000
    KUMANO I KE ALA
    P0 BOX 181
    WAIMEA,HI97696     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OFSTEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVEHAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROWSELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI.KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING,FOOD SECURITY, AND YOUTH EMPOWERMENT 60,000
    LANAI COMMUNITY HEALTH CENTER
    P0 BOX 630142
    LANAI CITY,HI96763     		  PC LANAI HIGH AND ELEMENTARY SCHOOL EDUCATION ANDPHYSICAL EDUCATION SCHOOL PROGRAM. DEVELOP A TRUSTINGRELATIONSHIP WITH THE YOUTH; PROVIDING EDUCATION ON HEALTHAND WELLNESS; AND DEVELOPMENT OF FUTURE WORKFORCE. ACTIVITIESINCLUDE HEALTH EDUCATION, SCREENING PROGRAMS, PARTICIPATIONIN COLLEGE AND CAREER FAIRS AND OUTREACH AT SCHOOLEVENTS/CARNIVALS. 10,000
    MA KA HANA KA IKE
    P0 BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITHA WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDSTHEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWERTO CHANGE THEIR FUTURE 75,000
    MAUI SWIM CLUB INC
    POBOX 330506
    KAHULUI,HI96733     		  PC REPLACE OLD EQUIPMENT AND SUPPORT LEARN TO SWIM PROGRAM THAT PRIMARILY SERVES LOW TO MODERATE INCOME FAMILIES. 5,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS
    30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC TO ASSESS, MAINTAIN AND ENHANCE FINANCIAL SYSTEMS. 20,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS
    30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGHPRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLSON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACYAND EVALUATION, AND IMPACT. 50,000
    PARTNERS IN DEVELOPMENT FOUNDATION
    2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 20,000
    PARTNERS IN DEVELOPMENT FOUNDATION
    2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THEOVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII.PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATIONTRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS,PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIALSERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 12,500
    SURFRIDER SPIRIT SESSION
    POBOX 1677
    KAILUA,HI96734     		  PC SURFRIDER SPIRIT SESSIONS PROVIDE ADULT MENTORING SERVICES AND EVIDENCE-BASED, GENDER RESPONSIVE AND TRAUMA INFORMED PROGRAMING FOR AT-RISK, ADJUDICATED AND VULNERABLE YOUTH ON OAHU. 15,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOODFOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL ASTHROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS,FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTEDAGRICULTURE BOXES, BUS MOBILE MARKET AND FARMERS MARKET 75,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC "DA BUX SNAP" PROJECT TO ENLIST NEW SNAP(SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) OUTLETS TO PROVIDE SNAP RECIPIENTS ACCESS TO AFFORDABLE HAWAIIGROWN PRODUCE. 15,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96721     		  PC DEVELOP A PROJECT PLAN FOR HAWAII ISLAND'S COMMUNITY FOOD CENTER 20,000
    THE MONKEY POD
    9856 APE PI
    WAIMEA,HI96796     		  PC KEIKI IN MOTION - NUTRITION EDUCATION, PHYSICAL AND MENTAL ACTIVITY PROGRAM DESIGNED FOR ELEMENTARY AND MIDDLE SCHOOL-AGED CHILDREN IN AN AFTER-SCHOOL OR SUMMER SETTING. THE PROGRAM IS COMPOSED OF NUTRITION EDUCATION, PHYSICAL ACTIVITIES AND A LEARNING ENVIRONMENT TO ENCOURAGE ACTIVE LIVING, HEALTHY EATING AND MENTAL WELLNESS. 15,000
    UNIVERSITY OF HAWAII FOUNDATION
    1314 S KING ST STE B
    HONOLULU,HI96814     		  PC SUPPORT THE UNIVERSITY OF HAWAII AT MANOA SCHOOL OF NURSING & DENTAL HYGIENE 1) INTERPROFESSIONAL HEALTH SCIENCES EDUCATION AND SIMULATION PROGRAM ("HIPE PROGRAM") AND 2) ENDOWED PROFESSORSHIP TO RECRUIT AND RETAIN FACULTY OF THE HIGHEST CALIBER IN THE AREA OF INTERPROFESSIONAL EDUCATION AND TECHNOLOGY SUPPORTED LEARNING. 200,000
    UNIVERSITY OF HAWAII FOUNDATION
    1314 S KING ST STE B
    HONOLULU,HI96814     		  PC ESTABLISH THE LEARNING INNOVATIONS ENDOWMENT TO SUPPORT THE UNIVERSITY OF HAWAII AT MANOA JOHN A. BURNS SCHOOL OF MEDICINE IN IT ITS EFFORTS TO DEVELOP AND IMPLEMENT INNOVATIVE CURRICULUM INITIATIVES, WITH THE ULTIMATE GOAL OF ENHANCED RECRUITMENT, TRAINING, AND RETENTION OF THE MOST CAPABLE AND COMMITTED FUTURE PHYSICIANS FOR HAWAII. 1,000,000
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATION
    P O BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWER COMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS, SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLY RESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVEL PLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT AND UNDERSTAND HEALTH RELEVANT DATA FROM PARTICIPANTS OF THEIR COMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIALNETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILTENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BYACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THECOMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLECOMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS INHEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZEDROLE IN PREVENTION 150,000
    WAIMANALO HEALTH CENTER
    41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY ANDPREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TOTHE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLYUNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE ANDPROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALINGGARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERSWITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINALGARDENS AND ALSO PROVIDES REMEDIES THROUGHTHE PROVISION OF HEALING SERVICES AND CLASSES 100,000
    WAIMANALO HEALTH CENTER
    41-1347 KALANIANAOLE HWY
    WAIANAE,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TO THE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLY UNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE AND PROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALING GARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERS WITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINAL GARDENS AND ALSO PROVIDES REMEDIES THROUGH THE PROVISION OF HEALING SERVICES AND CLASSES 20,000
    WE ARE OCEANIA
    720 N KING ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THE OVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII. PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATION TRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS, PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIAL SERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 37,500
    Total .................................bullet 3a 2,405,000
    bApproved for future payment
    FIVE MOUNTAINS HAWAII
    64-1035 MAMALAHOA HWY STE F
    KAMUELA,HI96743     		  PC PROVIDE BIO-PSYCHO-SOCIAL SERVICES TO ADDRESS THE DISPARITIES THAT EXIST AMONG NORTH HAWAII NATIVE HAWAIIANS AND THEIR FAMILY. 200,000
    KUALOA HEEIA ECUMENICAL YOUTH PROJECT
    47-200 WAIHEE RD
    KANEOHE,HI96744     		  PC "KEY PROJECT". NURTURE AND PROMOTE THE CULTURAL, ENVIRONMENTAL, SOCIAL, ECONOMIC AND RECREATIONAL WELL-BEING OF THE KUALOA-HEEIA AREA BY PROVIDING VITAL GRASSROOTS CIVIC PROGRAMS AND RESOURCES THAT EFFECTIVELY SERVE THE NEEDS OF THE DIVERSE MULTI-CULTURAL COMMUNITY. 150,000
    KUMANO I KE ALA
    P O BOX 181
    WAIMEA,HI97696     		  PC KUMANO I KE ALA (KIKA) WILL BUILD A FOUNDATION OF STEWARDSHIP OF THE LAND AND PLACE THROUGH NATIVE HAWAIIAN CULTURAL EDUCATION PROGRAMS TO GROW SELF-DIRECTED, CRITICAL THINKERS FOR A SUSTAINABLE WEST KAUAI. KIKA'S PROGRAM FOCUS IS LAND RESTORATION, TARO FARMING, FOOD SECURITY, AND YOUTH EMPOWERMENT 120,000
    MA KA HANA KA IKE
    P O BOX 968
    HANA,HI96713     		  PC MA KA HANA KA IKE (MKH) WILL PROVIDE HANA YOUTH WITH A WAY TO LEARN THAT MAKES SENSE TO THEM, THAT BUILDS THEIR SELF-ESTEEM AND SHOWS THEM THEY HAVE THE POWER TO CHANGE THEIR FUTURE 150,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC SUPPORT DISTRIBUTION OF THE SAFEST AND HIGHEST FOOD FOR HAWAII COUNTY THROUGH THEIR FOOD BANK SITES AS WELL AS THROUGH OUTREACH PROGRAMS AND PANTRY FOR SENIOR CITIZENS, FOOD BACK PACKS FOR CHILDREN, COMMUNITY SUPPORTED AGRICULTURE BOXES, BUS MOBILE MARKET. AND FARMERS MARKET 150,000
    WAIMANALO HEALTH CENTER
    41-1347 KALANIANAOLE HWY
    WAIMANALO,HI96795     		  PC WAIMANALO HEALTH CENTER (WHC) PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES, WITH SPECIAL ATTENTION TO THE NEEDS OF NATIVE HAWAIIANS AND THE MEDICALLY UNDERSERVED. A NATIVE HAWAIIAN HEALING PRACTICE AND PROGRAM HAS BEEN INTEGRATED, INCLUDING A CULTURAL HEALING GARDEN TO PROVIDE PATIENTS AND COMMUNITY MEMBERS WITH HEALING PLANTS TO BEGIN THEIR OWN FOOD AND MEDICINAL GARDENS AND ALSO PROVIDES REMEDIES THROUGH THE PROVISION OF HEALING SERVICES AND CLASSES 200,000
    HAWAIIAN COMMUNITY ASSETS INC
    2000 N VINEYARD BLVD B140
    HONOLULU,HI96817     		  PC BUILD THE CAPACITY OF LOW- AND MODERATE-INCOME COMMUNITIES TO ACHIEVE AND SUSTAIN ECONOMIC SELF-SUFFICIENCY WITH A PARTICULAR FOCUS ON NATIVE HAWAIIANS THROUGH MORTGAGE LENDING PROGRAMS; MICRO-LOANS, HOMEOWNERSHIP ASSET BUILDING, AND FINANCIAL EDUCATION; AND TRAINING FOR TRANSITIONAL HOUSING AND COMMUNITY BASED ORGANIZATIONS EDUCATION AND FINANCIAL INSTITUTIONS AND GOVERNMENT ENTITIES. 130,000
    KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
    2239 N SCHOOL ST
    HONOLULU,HI96819     		  PC SERVE COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGH STRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH AND HARMONY THROUGH TWO PROGRAMS, HO'OULU 'AINA AND ROOT'S CAFE 200,000
    MOLOKAI CHILD ABUSE PREVENTION PATHWAYS
    30 OKI PL STE 204
    KAUNAKAKAI,HI96748     		  PC KEEP CHILDREN SAFE AND SUPPORTS FAMILY WELL-BEING THROUGH PRIMARY PREVENTION EDUCATION. WORK IN MOLOKAI SCHOOLS ON THREE AREAS: PRIMARY PREVENTION EDUCATION, ADVOCACY AND EVALUATION, AND IMPACT. 100,000
    PARTNERS IN DEVELOPMENT FOUNDATION
    2040 BACHELOT ST
    HONOLULU,HI96817     		  PC WE ARE OCEANIA (WAO) PROGRAM TO RESPOND TO THE OVERWHELMING NEED FOR SUPPORT OF MICRONESIANS IN HAWAII. PROVIDES DIRECT SERVICES IN LANGUAGE ACCESS, ACCULTURATION TRAINING, CULTURAL EXPERTISE, HEALTH CONNECTION DAYS, PRE-EMPLOYMENT TRAINING, CENSUS ENUMERATION, SOCIAL SERVICE REFERRALS, AND COMMUNITY NEWSLETTERS. 100,000
    WAIANAE COMMUNITY RE-DEVELOPMENT CORPORATION
    P O BOX 441
    WAIANAE,HI96792     		  PC DEVELOP COMMUNITY HEALTH HUBS (CHHS) TO EMPOWER COMMUNITY-BASED ORGANIZATIONS (CBOS) WITH RIGOROUS, SCIENTIFICALLY-INFORMED METHODOLOGIES AND DATA TYPICALLY RESERVED FOR ACADEMIC RESEARCH. CHHS WILL SERVE AS A NOVEL PLATFORM THAT OFFERS CBOS THE CAPACITY TO COLLECT AND UNDERSTAND HEALTH-RELEVANT DATA FROM PARTICIPANTS OF THEIR COMMUNITY-INITIATED PROGRAMS ALONG WITH THAT OF THEIR SOCIAL NETWORK. DATA WILL BE EVALUATED IN THE CONTEXT OF THE BUILT ENVIRONMENT FOR HEALTH/SOCIAL/ECONOMICS/POLICY IMPACTS BY ACADEMIC CONSULTANTS, WHICH WILL BE ROUTED BACK TO THE COMMUNITY AND STAKEHOLDERS. THE INFORMATION CAN ENABLE COMMUNITY ORGANIZATIONS TO ENGAGE STAKEHOLDERS IN HEALTH/WELLBEING AND POTENTIALLY PLAY A PREVIOUSLY UNRECOGNIZED ROLE IN PREVENTION 450,000
    UNIVERSITY OF HAWAII FOUNDATION
    1314 S KING ST STE B
    HONOLULU,HI96814     		  PC ESTABLISH THE LEARNING INNOVATIONS ENDOWMENT TO SUPPORT THE UNIVERSITY OF HAWAII AT MANOA JOHN A. BURNS SCHOOL OF MEDICINE IT ITS EFFORTS TO DEVELOP AND IMPLEMENT INNOVATIVE CURRICULUM INITIATIVES, WITH THE ULTIMATE GOAL OF ENHANCED RECRUITMENT, TRAINING, AND RETENTION OF THE MOST CAPABLE AND COMMITTED FUTURE PHYSICIANS FOR HAWAII. 4,000,000
    UNIVERSITY OF HAWAII FOUNDATION
    1314 S KING ST STE B
    HONOLULU,HI96814     		  PC SUPPORT THE UNIVERSITY OF HAWAII AT MANOA SCHOOL OF NURSING & DENTAL HYGIENE 1) INTERPROFESSIONAL HEALTH SCIENCES EDUCATION AND SIMULATION PROGRAM ("HIPE PROGRAM") AND 2) ENDOWED PROFESSORSHIP TO RECRUIT AND RETAIN FACULTY OF THE HIGHEST CALIBER IN THE AREA OF INTERPROFESSIONAL EDUCATION AND TECHNOLOGY SUPPORTED LEARNING. 800,000
    THE FOOD BASKET INC
    80 HOLOMUA ST
    HILO,HI96720     		  PC "DA BUX SNAP" PROJECT TO ENLIST NEW SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) OUTLETS TO PROVIDE SNAP RECIPIENTS ACCESS TO AFFORDABLE HAWAII GROWN PRODUCE. 15,000
    Total .................................bullet 3b 6,765,000
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		    14 53  
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 4,129,539  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) .. 0 4,646,838 0
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    4,646,838
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    HAWAII MEDICAL SERVICE ASSOCIATION (HMSA) 501(C)(4) THE FOUNDATION IS ORGANIZED AND OPERATED FOR THE PRIMARY PURPOSE OF ENGAGING IN HEALTH PROMOTION, EDUCATION AND RESEARCH ACTIVITIES WITHIN THE MEANING OF IRC SECTION 170(C)(2).
    HAWAII MEDICAL SERVICE ASSOCIATION RETIREE HEALTH BENEFITS TRUST 501(C)(9) THE TRUST WAS ESTABLISHED BY HMSA ("EMPLOYER") TO FUND THE COST OF POST-RETIREMENT MEDICAL BENEFITS FOR ELIGIBLE EMPLOYEES AND DEPENDENTS.
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 AccountingFeesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    ACCOUNTING FEES 25,445 0 0 0

    TY 2021 GeneralExplanationAttachment
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Identifier Return Reference Explanation
      PART XV, LINE 2B THE FORM IN WHICH APPLICATIONS SHOULD BE SUBMITTED AND INFORMATION AND MATERIALS THEY SHOULD INCLUDE: 1. REGISTRATION INFORMATION * ORGANIZATION INFORMATION * CONTACT INFORMATION 2. PROPOSAL ON ORGANIZATION'S LETTERHEAD (NO MORE THAN EIGHT PAGES). INCLUDE THE FOLLOWING: * STATEMENT OF NEED. WHAT IS THE DESIRED LONG-TERM EFFECT OF THE PROJECT AND WHY IS IT SO IMPORTANT THAT IT HAVE THIS EFFECT? * ACTIVITIES. WHAT WOULD BE THE KEY ACTIONS OR EVENTS DURING THE GRANT PERIOD? * OUTPUTS. WHAT ARE THE PRODUCTS OF THOSE ACTIONS OR EVENTS? * OUTCOMES. WHAT KEY CHANGES IN SKILLS, KNOWLEDGE, VALUES, ATTITUDES, BEHAVIORS, CONDITIONS, ETC. WILL RESULT FROM THE ACTIVITIES? * INDICATORS. INDICATORS, SOMETIMES CALLED EVALUATION, ARE OBSERVABLE AND MEASURABLE DATA THAT CAN BE COLLECTED TO TRACK THE SUCCESS IN ACHIEVING THE OUTCOMES. * DESCRIPTION OF THE ORGANIZATION AND ITS QUALIFICATIONS. * BUDGET. INDICATE THE AMOUNT REQUESTED, THE PROPOSED USE OF FUNDS AND OTHER SOURCES OF FUNDING CURRENTLY BEING SOUGHT. 3. COPY OF THE ORGANIZATION'S CURRENT IRS DETERMINATION LETTER INDICATING 501(C)(3) TAX-EXEMPT STATUS OR LETTER STATING STATUS AS A UNIT OF GOVERNMENT. 4. LIST OF THE ORGANIZATION'S OFFICERS AND DIRECTORS AND THEIR AFFILIATIONS. 5. MOST RECENT IRS FORM 990 AND ANNUAL FINANCIAL STATEMENTS OF THE ORGANIZATION. 6. RELEVANT LETTERS OF SUPPORT. 7. OTHER RELEVANT APPENDICES (QUALIFICATIONS OF KEY STAFF, SAMPLE PROGRAM MATERIALS, ETC.)
      PART XV, LINE 2D ANY RESTRICTIONS OR LIMITATIONS ON AWARDS, SUCH AS BY GEOGRAPHICAL AREAS, CHARITABLE FIELDS, KINDS OF INSTITUTIONS, OR OTHER FACTORS: IN GENERAL, THE FOUNDATION MAKES GRANTS TO ORGANIZATIONS THAT ARE TAX-EXEMPT BECAUSE 1) THEY ARE A UNIT OF GOVERNMENT OR 2) THEY ARE A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE FOUNDATION DOES NOT MAKE GRANTS TO INDIVIDUALS. ALL APPLICANT ORGANIZATIONS ARE REQUIRED TO SUBMIT PROOF OF THEIR TAX-EXEMPT STATUS BEFORE THEIR PROPOSAL WILL BE CONSIDERED. THE FOUNDATION DOES NOT GENERALLY SUPPORT REQUESTS FOR ENDOWMENTS, CAPITAL CAMPAIGNS, SCHOLARSHIP FUNDS LOBBYING, OR VOTER REGISTRATION FUNDS. A MAXIMUM FLAT RATE OF 5 PERCENT OF TOTAL BUDGET WILL BE ALLOWED FOR INDIRECT COSTS. ALL PROJECTS MUST PRIMARILY BENEFIT PEOPLE WITHIN THE STATE OF HAWAII. FUNDING AMOUNTS AND GRANT PERIODS SHOULD BE COMMENSURATE WITH THE SIZE AND SCOPE OF THE ACTIVITY.

    TY 2021 InvestmentsOtherSchedule2
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    VANGUARD INSTITUTIONAL INDEX FMV 1,486,127 4,875,976
    VANGUARD DEVELOPED MARKETS FMV 5,454,625 6,102,209
    VANGUARD INDEX MID CAP FUND FMV 938,086 2,833,191
    VANGUARD SMALL CAP FUND FMV 884,963 2,610,172
    PIMCO TOTAL RETURN FUND FMV 3,302,598 3,172,699
    DOUBLELINE TOTAL RETURN FUND FMV 3,521,750 3,359,377

    TY 2021 OtherExpensesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    NON DEDUCTIBLE BUSINESS PROMOTION 1,088 0 0 0
    MEALS - NON TRAVEL 101 0 0 0
    POSTAGE AND FREIGHT 40 0 0 0
    DUES AND SUBSCRIPTIONS 226 0 0 0
    DATA PROCESSING 88 0 0 0
    PROFESSIONAL ASSOCIATIONS 4,256 0 0 0
    PROMOTIONS 600 0 0 0
    TELEPHONE 53 0 0 0
    FAS158 ADJUSTMENT -43,413 0 0 0


    TY 2021 OtherIncomeSchedule2
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Revenue And Expenses Per Books Net Investment Income Adjusted Net Income
    REFUND OF INVESTMENT FEES 502 502 0


    TY 2021 OtherLiabilitiesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Description Beginning of Year - Book Value End of Year - Book Value
    DUE TO AFFILIATES 11,691 0
    DEFERRED TAX LIABILITY 95,682 82,380


    TY 2021 OtherProfessionalFeesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    BLACKBAUD 12,340 0 0 0
    ISLANDER INSTITUTE 32,000 0 0 0


    TY 2021 TaxesSchedule
    Name:
    HMSA FOUNDATION
    EIN:
    99-0250429
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    PAYROLL AND OTHER TAXES 55,336 0 0 0