Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 71,590 | 1,026,804 | 420,000 | 49,551 | 22,553 | 1,590,498 |
| 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 | 71,590 | 1,026,804 | 420,000 | 49,551 | 22,553 | 1,590,498 |
| 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) .. | 369,730 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,220,768 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 71,590 | 1,026,804 | 420,000 | 49,551 | 22,553 | 1,590,498 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 89,758 | 91,972 | 47,568 | 785 | 0 | 230,083 |
| 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 | 1,820,581 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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 2021 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-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | GRASSROOTS BUSINESS FUND (GBF), A BRAND OF ENTITIES, DELIVERS A DISTINCTIVE BLEND OF INVESTMENT CAPITAL AND BUSINESS ADVISORY SERVICES THROUGH TWO MAIN VEHICLES WORKING TOGETHER: A PRIVATE INVESTMENT FUND AND A NON-PROFIT ORGANIZATION. THROUGH THE FUND, GRASSROOTS BUSINESS INVESTORS I, LP (GBI-I), GBF MAKES EQUITY, MEZZANINE EQUITY, MEZZANINE DEBT, AND STRAIGHT DEBT INVESTMENTS. THESE CUSTOMIZED INVESTMENT STRUCTURES ENSURE THAT GBF'S INVESTMENT PERFORMANCE ALIGNS WITH THE BUSINESSES' PERFORMANCE. THE FUND DELIVERS A FORM OF CAPITAL SUITABLE FOR LONG-TERM INVESTMENT IN BUSINESSES SERVICING LOW INCOME COMMUNITIES. IN TANDEM, THE NON-PROFIT ORGANIZATION, GRASSROOTS BUSINESS PARTNERS, INC. (GBP), PROVIDES BUSINESS ADVISORY SERVICES TO CLIENTS IN THE FUND. GBF'S STAFF, EXPERT CONSULTANTS, AND LOCAL SERVICE PROVIDERS FOCUS ON ENHANCING FINANCIAL AND STRATEGIC PLANNING, CORPORATE GOVERNANCE, HUMAN RESOURCE MANAGEMENT, MARKETING, SUPPLY CHAIN MANAGEMENT, AND MANAGEMENT INFORMATION SYSTEMS. ADDITIONALLY, GBP MANAGES THE INVESTMENT FUND, AND THE DEVELOPING ADDITIONAL TOOLS AND ACTIVITIES TO BOTH ASSIST THE FIELD WITH KNOWLEDGE AND ALSO PROVIDE POSSIBLE FUTURE ACTIVITIES FOR GBP |
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING DIRECTORS OF THE ORGANIZATION ARE ALSO INVESTORS IN A RELATED PARTNERSHIP, GRASSROOTS BUSINESS INVESTORS I, LP: ANDREW ADELSON AND HAROLD ROSEN. EACH OF THESE DIRECTORS CONTRIBUTED CAPITAL TO THE PARTNERSHIP AND RECEIVED A CORRESPONDING INVESTMENT INTEREST IN THE PARTNERSHIP. NONE OF THE INVESTORS HAVE A VOTING INTEREST IN NOR DO THEY RECEIVE COMPENSATION FROM GRASSROOTS BUSINESS INVESTORS I, LP. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 IS SUBMITTED TO THE MEMBERS OF THE GOVERNING BODY FOR REVIEW AND APPROVAL BEFORE THE RETURN IS FILED WITH THE IRS. AT THE REQUEST OF THE GOVERNING BODY, A REPRESENTATIVE OF THE INDEPENDENT ACCOUNTING FIRM MAY ATTEND A MEETING OF THE GOVERNING BODY TO ANSWER QUESTIONS RELATED TO THE FINANCIAL CONDITION OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION CURRENTLY HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL EMPLOYEES AND THE MEMBERS OF THE GOVERNING BODY. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY WAS REVIEWED AND APPROVED BY THE MEMBERS OF THE GOVERNING BODY. THE ORGANIZATION REQUIRES EACH MEMBER OF THE GOVERNING BODY TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM ON AN ANNUAL BASIS. THE FORM REQUIRES THAT ANY CURRENT OR POTENTIAL CONFLICTS OF INTEREST BE DISCLOSED. SHOULD A POTENTIAL NEW CONFLICT BE DISCLOSED, IT IS REVIEWED AT EITHER THE GOVERNING BODY OR SENIOR MANAGEMENT LEVEL TO DETERMINE WHETHER IT IS AN ACTUAL CONFLICT. IF IT IS DEEMED A CONFLICT OF INTEREST, THE EMPLOYEE OR DIRECTOR IS EXCLUDED FROM ANY DECISION-MAKING MEETINGS AND DECISIONS RELATING TO THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE MEMBERS OF THE GOVERNING BODY REVIEW AND APPROVE THE GENERAL STRUCTURE OF THE ORGANIZATION'S COMPENSATION AS WELL AS THE SPECIFIC COMPENSATION OF THE MANAGEMENT TEAM. THE GOVERNING BODY GOVERNS COMPENSATION AND BONUS ADMINISTRATION. THE GOVERNING BODY DECIDES THE GENERAL LEVEL OF COMPENSATION FOR ALL STAFF. STAFF IS COMPENSATED BASED ON INDUSTRY AVERAGES AND THEN COMPENSATION IS APPROVED BY MANAGEMENT. MANAGEMENT'S COMPENSATION IS EVALUATED ANNUALLY AND APPROVED BY THE GOVERNING BODY. THE MOST RECENT REVIEW OF MANAGEMENT COMPENSATION TOOK PLACE IN JUNE 2017, UTILIZING PERFORMANCE AS WELL AS COMPARABLE DATA TO DETERMINE THE FINAL LEVEL OF COMPENSATION FOR MANAGERS. ALL FULL TIME EMPLOYEES ARE ELIGIBLE FOR A BONUS EQUAL TO A MAXIMUM PERCENTAGE OF THEIR GROSS ANNUAL BASE SALARY AS DETERMINED IN THEIR WRITTEN EMPLOYMENT CONTRACT. THE MEMBERS OF THE GOVERNING BODY REVIEW THE OVERALL ALLOCATION OF BONUSES AND IN DETAIL DETERMINE AND APPROVE THE BONUSES FOR MANAGEMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MADE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, FINANCIAL STATEMENTS WERE PUBLISHED IN THE ANNUAL REPORT. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 311,628. MANAGEMENT AND GENERAL EXPENSES 38,035. FUNDRAISING EXPENSES 6,264. TOTAL EXPENSES 355,927. |
| FORM 990, PART XI, LINE 9: | FOREIGN CURRENCY TRANSLATION LOSS -201,909. |
| Software ID: | |
| Software Version: |