TY 2022 Form 990

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	1,313,368	498,276	1,430,511	1,339,015	2,373,869	6,955,039
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3	1,313,368	498,276	1,430,511	1,339,015	2,373,869	6,955,039
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) ..						76,870
6	Public support. Subtract line 5 from line 4.						6,878,169

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..	1,313,368	498,276	1,430,511	1,339,015	2,373,869	6,955,039
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	1,219,461	1,275,424	1,130,315	1,559,960	1,410,089	6,595,249
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.)..	-392,738	577,199	60,985	620,077	15,684	881,207
11	Total support. Add lines 7 through 10						14,431,495

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

45,478

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 2022 (line 6, column (f) divided by line 11, column (f)) .........

47.660 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

42.000 %

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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.)..

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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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 on 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 on 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) 2022

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

11a

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

11b

A 35% controlled entity of a person described on 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.

Yes

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 on 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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART II, LINE 10	JOINT VENTURE GAIN/LOSS & MISC. 245,446 GRANTS RETURNED 614,871 OTHER INCOME-RESTITUTION 20,890

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2022

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization COPPER SHORES COMMUNITY HEALTH FOUNDATION

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization COPPER SHORES COMMUNITY HEALTH FOUNDATION		Employer identification number 38-3022945

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization COPPER SHORES COMMUNITY HEALTH FOUNDATION			Employer identification number 38-3022945
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2022)

Additional Data

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	165,418	97,048	58,981
b	Contributions ...		90,000	25,000	50,000
c	Net investment earnings, gains, and losses	-23,387	14,369	13,068	8,981
d	Grants or scholarships ...		36,000
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	142,031	165,418	97,048	58,981

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

Board designated or quasi-endowment SchDMd Bullet

64.330 %

Permanent endowment SchDMd Bullet

35.670 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements	46,837	13,057	33,780
d	Equipment ....	116,457	41,181	75,276
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				109,056

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)EQUITY INVESTMENTS				7,952,027
(2)RIGHT OF USE ASSET-OFFICE LEASE				169,634
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				8,121,661

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	169,634
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	-8,259,968
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-14,619,423
b	Donated services and use of facilities .........	2b	7,226
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	367,006
e	Add lines 2a through 2d .....................			2e	-14,245,191
3	Subtract line 2e from line 1..................			3	5,985,223
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	30,000
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	30,000
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	6,015,223

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	4,484,550
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	7,226
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	650,550
e	Add lines 2a through 2d....................			2e	657,776
3	Subtract line 2e from line 1...................			3	3,826,774
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	30,000
b	Other (Describe in Part XIII.) ............	4b	224,918
c	Add lines 4a and 4b.....................			4c	254,918
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	4,081,692

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PAGE 2, PART V, LINE 4	THE ONTONAGON COUNTY CANCER BOARD DESIGNATED ENDOWMENT IS INTENDED TO SUPPORT CANCER RELATED SERVICES, SCREENINGS, WELLNESS AND HEALTH RELATED SUPPORT SERVICES WITHIN ONTONAGON COUNTY. THE PERMANENT SCHOLARSHIP ENDOWMENT IS INTENDED TO SUPPORT ONTONAGON AREA SCHOOLS GRADUATES WITH SCHOLARSHIPS
SCHEDULE D, PAGE 4, PART XI, LINE 2D	SUBSIDIARY INCOME 1/1-9/30 367,006
SCHEDULE D, PAGE 4, PART XII, LINE 2D	SUBSIDIARY EXPENSES 1/1-9/30 650,550
SCHEDULE D, PAGE 4, PART XII, LINE 4B	GRANT TO SUBSIDIARY ELIMINATED ON FS 224,918

Schedule D (Form 990) 2021

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number
38-3022945

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(h) Purpose of grant or assistance
(1) 31 BACKPACKS 1100 CENTURY WAY STE C HOUGHTON,MI49931	45-4916842	3	62,263	BOOK	FOOD, GENERAL
(2) AHMEEK VILLAGE VOLUNTEER FIRE DEPT 111 VIVIAN STREET AHMEEK,MI49901	85-1254853	3	11,252	BOOK	GENERAL SUPPORT
(3) BARAGA AREA SCHOOLS 210 LYONS STREET BARAGA,MI49908	38-6000433	GOV	22,500	BOOK	TRAUMA
(4) BARAGA COUNTY SHELTER HOME 11 S FOURTH ST LANSE,MI49946	38-2512571	3	17,794	BOOK	GENERAL SUPPORT
(5) BARBARA KETTLE GUNDLACH SHELTER 620 CONGLOMERATE ST ONTONAGON,MI49953	38-2321126	3	43,994	BOOK	FAMILY SUPPORT
(6) BIG BROTHERBIG SISTERS PO BOX 428 HOUGHTON,MI49931	38-1368336	3	31,181	BOOK	GENERAL SUPPORT
(7) BOOTJACK FIRE AND RESCUE DEPARTMENT 4715 BOOTJACK RD LAKE LINDEN,MI49945	38-3541429	GOV	20,030	BOOK	GENERAL SUPPORT
(8) CAMP JOSH 34239 QUARTERLINE RD ONTONAGON,MI49953	38-3541669	3	29,744	BOOK	GENERAL SUPPORT
(9) CHASSELL TOWNSHIP PUBLIC SCHOOLS 41585 US HIGHWAY 41 CHASSELL,MI49916	38-6001478	GOV	22,500	BOOK	TRAUMA
(10) CITY OF HOUGHTON 616 SHELDEN AVE HOUGHTON,MI49931	38-6007225	GOV	139,463	BOOK	TASK FORCE SUPPORT
(11) COPPER COUNTRY ANGEL MISSION 119 FIFTH STREET CALUMET,MI49913	84-4106746	3	51,759	BOOK	GENERAL SUPPORT
(12) COPPER COUNTRY HABITAT FOR HUMANITY PO BOX 231 HOUGHTON,MI49931	38-3113603	3	21,966	BOOK	GENERAL SUPPORT
(13) COPPER COUNTRY INTERMEDIATE SCHOOL 809 HECLA ST HANCOCK,MI49930	69-0351635	GOV	45,800	BOOK	COVID FUNDING
(14) COPPER COUNTRY JR HOCKEY ASSOCIAT PO BOX 502 HANCOCK,MI49930	23-7065498	3	12,297	BOOK	SPORT SUPPORT
(15) COPPER COUNTRY SENIOR MEALS 821 W WATER ST HANCOCK,MI49930	38-3041729	3	224,918	BOOK	GENERAL SUPPORT
(16) COPPER HARBOR TRAILS CLUB 230 GRATIOT ST COPPER HARBOR,MI49918	26-2959858	3	132,907	BOOK	RECREATIONAL SUPPORT
(17) COPPER ISLAND ACADEMY 52125 INDUSTRIAL DR CALUMET,MI49913	86-3641151	GOV	11,542	BOOK	EDUCATIONAL SUPPORT
(18) CORO MEDICAL 416 MARY L POLK DR SUITE 505 FRANKLIN,TN37067	82-2669986	3	49,750	BOOK	HEALTH SUPPORT
(19) DAN SCHMIDTT GIFT OF MUSIC 2239 N FARMERS BLOCK RD ALLOUEZ,MI49805	45-5214071	3	8,533	BOOK	GENERAL SUPPORT
(20) DIAL HELP 609 SHELDEN AVENUE HOUGHTON,MI49931	38-2026918	3	530,107	BOOK	CRISIS UNIT FUNDING
(21) DOLLAR BAY TAMARACK SCHOOLS 48475 MAPLE DRIVE DOLLAR BAY,MI49922	38-6001485	GOV	18,000	BOOK	TRAUMA, FOOD
(22) FEEDING AMERICA 161 NORTH CLARK STREET CHICAGO,IL60601	36-3673599	3	13,200	BOOK	FOOD PROGRAM
(23) FRIENDS OF THE PORKIES PO BOX 221 ONTONAGON,MI49953	38-3388836	3	9,258	BOOK	GENERAL SUPPORT
(24) GREAT LAKES RECOVERY CENTER 97 SOUTH FOURTH ST ISHPEMING,MI49849	38-2453316	3	14,602	BOOK	GENERAL SUPPORT
(25) HANCOCK PUBLIC SCHOOLS 501 CAMPUS DRIVE HANCOCK,MI49930	38-6001483	GOV	24,750	BOOK	RECREATIONAL FACILIT
(26) HOUGHTON COUNTY SHERIFF 403 E HOUGHTON AVE HOUGHTON,MI49931	38-6004855	GOV	8,800	BOOK	LIFESAVER PROJECT
(27) KBIC 16429 BEAR RD BARAGA,MI49908	38-1743340	GOV	78,124	BOOK	MEDICAL SUPPORT
(28) KEWEENAW FAMILY RESOURCE CENTER 850 W SHARON AVE STE 6 HOUGHTON,MI49931	38-3138462	3	19,747	BOOK	GENERAL SUPPORT
(29) KEWEENAW NORDIC SKI CLUB PO BOX 564 HANCOCK,MI49930	38-3439782	3	37,193	BOOK	RECREATIONAL SUPPORT
(30) KEWEENAW RANDOM ACTS OF KINDNESS PO BOX 343 AHMEEK,MI49901	47-1446118	3	6,464	BOOK	GENERAL SUPPORT
(31) L'ANSE AREA SCHOOL DISTRICT 201 N FRONT STREET LANSE,MI49946	38-6000435	GOV	45,854	BOOK	TRAUMA
(32) L'ANSE TOWNSHIP 126 N MAIN LANSE,MI49946	38-6007812	GOV	20,000	BOOK	GENERAL SUPPORT
(33) LITTLE BROTHERS FRIENDS OF THE ELDE 527 HANCOCK STREET HANCOCK,MI49930	38-2411631	3	124,922	BOOK	FOOD SUPPORT
(34) MAIN STREET CALUMET PO BOX 188 CALUMET,MI49913	01-0791312	3	25,000	BOOK	FOOD SUPPORT
(35) MOUNTAIN LIONS 35781 US HWY 45 ONTONAGON,MI49953	38-2486533	3	14,000	BOOK	ANIMAL PROTECTION
(36) OMEGA HOUSE 2211 MAUREEN LANE HOUGHTON,MI49931	38-3511814	3	134,260	BOOK	GENERAL SUPPORT
(37) ONTONAGON COUNTY CANCER ASSOC PO BOX 282 ONTONAGON,MI49953	38-2865670	3	16,439	BOOK	GENERAL SUPPORT
(38) PUBLIC SCHOOLS OF CLK 57070 MINE ST CALUMET,MI49913	38-3320033	GOV	66,969	BOOK	COVID
(39) SIMPLE KINDNESS TO YOUTH 809 HECLA ST HANCOCK,MI49930	80-0551359	3	18,309	BOOK	EDUCATIONAL SUPPORT
(40) STANTON TOWNSHIP PUBLIC SCHOOLS 50870 HOLMAN ROAD HOUGHTON,MI49931	38-2005834	GOV	16,500	BOOK	COVID & TRAUMA
(41) SUPERIOR SEARCH & RESCUE PO BOX 682 HOUGHTON,MI49931	38-2971413	3	13,337	BOOK	GENERAL SUPPORT
(42) SWEDETOWN TRAILS CLUB PO BOX 214 CALUMET,MI49913	38-2628847	3	35,049	BOOK	GENERAL SUPPORT
(43) UNITE UP 1014 COLLEGE AVE HOUGHTON,MI49931	86-2144844	3	6,777	BOOK	GENERAL SUPPORT
(44) UP HUMAN TRAFFICKING TASK FORCE PO BOX 232 MARQUETTE,MI49855	83-1831010	GOV	5,535	BOOK	SAFETY SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) SCHOLARSHIPS	43	223,400	CASH
(2) SAFE COMMUNITY SUPPLIES	3	4,049	CASH
(3) POVERTY EDUC. SUPPLIES	2	3,322	CASH
(4) FOOD SUPPLIES	3	11,546	CASH
(5) INCOME STAB/SUPPLIES&GAS	27	10,514	CASH
(6) HEALTHY IND/SUPPLIES&TRAI	2	2,659	CASH
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
SCHEDULE I, PAGE 1, PART I, LINE 2	THE ORGANIZATION REQUESTS A PROGRAM OVERVIEW AND BUDGET, A SIX-MONTH PROGRESS REPORT, AND A FINAL STATUS REPORT COMPLETED WITHIN 60 DAYS FROM THE FINAL EXPENDITURES.

Schedule I (Form 990) 2022

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KEVIN STORE EXECUTIVE DIRECTOR	(i) (ii)	143,164 -------------	4,000 -------------	200 -------------	13,317 -------------	22,247 -------------	182,928 -------------	-------------

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	1	30,646
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( SUPPLIES )	X	1	194
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2022)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Return Reference	Explanation
FORM 990, PAGE 1, PART I, LINE 6	COMMUNITY MEMBERS WHO ASSISTED ON VARIOUS COMMITTEES THROUGHOUT THE YEAR.
FORM 990, PAGE 2, PART III, LINE 4A	ACCESS TO CARE- GRANTS TO ORGANIZATIONS AND INDIVIDUALS TO MEET THE FINANCIALS RESOURCES NEEDED TO DEVELOP NEW AND/OR EXPANDED HEALTH SERVICES WITH MEET A COMMUNITY'S NEEDS, AS WELL AS PROVIDING GAS CARDS TO INDIVIDUALS TO BE USED FOR MEDICAL TRAVEL. GIVING TUESDAY-CAMPAIGN AIMED INVOLVING THE LOCAL COMMUNITY TO JOIN IN ON THE GLOBAL GENEROSITY MOVEMENT WHICH CREATES A DAY THAT ENCOURAGES PEOPLE TO DONATE TO A LIST OF QUALIFIED NON-PROFIT CHARITIES. THE FOUNDATION MATCHES THE COMMUNITY DONATIONS UP TO A SPECIFIED DOLLAR AMOUNT EACH YEAR. THE FOUNDATION HAS AIDED IN MORE THAN 2.7 MILLION DOLLARS IN DONATIONS TO NON-PROFIT ORGANIZATIONS IN BARAGA, HOUGHTON, KEWEENAW AND ONTONAGON COUNTIES.
FORM 990, PAGE 2, PART III, LINE 4B	FOOD STABILITY THE FOUNDATION HAS RESEARCHED THE WAYS IN WHICH FOOD INSECURITIES AND NUTRITION AFFECT AN INDIVIDUAL'S OVERALL HEALTH. IN AN EFFORT TO REDUCE THE NEGATIVE EFFECTS OF FOOD INSECURITIES, HUNGER, AND POOR NUTRITION, THE FOUNDATION HAS BEGUN IDENTIFYING FUNDING STRATEGIES TO ADDRESS THE COMMUNITY'S AWARENESS TO FOOD AND THE CRITICAL IMPACT IT HAS ON INDIVIDUAL AND POPULATION HEALTH. THE FOUNDATION'S GRANTING AND HANDS-ON WORK WITHIN THE COMMUNITY IS INTENDED TO CURB THE HEALTH RISKS ASSOCIATED WITH FOOD INSECURITY AND NUTRITIONAL INSTABILITY. ON 10/1/22 THE FOUNDATION'S WHOLLY OWNED SUBSIDIARY COPPER COUNTRY SENIOR MEALS MERGED WITH AND INTO THE FOUNDATION. ACTIVITY FROM COPPER COUNTRY SENIOR MEALS PROGRAM AFTER 9/30/22 IS INCLUDED WITHIN THE FOOD STABILITY PROGRAM, AND INCLUDES PROVIDING NUTRITIOUS MEALS TO SENIOR CITIZENS IN THEIR HOMES OR AT CONGREGATE SITES AS WELL AS PROVIDING MEALS TO THE LOCAL HEAD START PROGRAM.
FORM 990, PAGE 2, PART III, LINE 4D	HEALTHY INDIVIDUALS PROVIDES GRANTS, INCLUDING SUBSTANCE USE DISORDER, SPECIFICALLY ADDERSSING THE NEEDS OF OUR POPULATION. -EARLY INTERVENTION AND PREVENTION PROGRAMS INCLUDING SUBSTANCE USE DISORDER. -EMERGENCY AND MOBILE CRISIS RESPONSE. -MENTAL AND BEHAVORIAL HEALTH SERVICE ACCESS, COORDINATION, AND NAVIGATION. -SUICIDE PREVENTION AND AWARENESS. -YOUTH LEADERSHIP AND RESILIENCY DEVELOPMENT. -PARENT EDUCATION AND ENGAGEMENT. -ADDICTION SERVICES. -PROGRAMMING ADDRESSING OTHER FORMS OF MENTAL ILLNESS, STRESS REDUCTION, ANDZIETY, AND DEPRESSION THAT MAY INCLUDE PHYSICAL AND MINDFULNESS ACTIVITIES. ACCESS TO EDUCATION EDUCATION IS AN IMPORTANT COMPONENT TO A HEALTHIER COMMUNITY. HEALTH RISK STUDIES HAVE SHOWN POPULATIONS AND INDIVIDUALS WITH HIGHER LEVELS OF EDUCATION COMPLETION GENERALLY HAVE NOTICEABLY REDUCED HEALTH RISK FACTORS. IN ADDITION, ACCESS TO EDUCATIONAL TRAINING AND THE RETENTION OF THOSE STUDENTS WITHIN THE LOCAL COMMUNITY CONTRIBUTE TO A MORE VIBRANT AND PROSPEROUS ECONOMY, FURTHER REDUCING HEALTH RISK FACTORS THAT ARE MORE COMMONLY ASSOCIATED AND PRONOUNCED WITH LOWER INCOME EARNING HOUSEHOLDS. IN ADDITION TO ACCESS TO EDUCATION, MEDICAL INNOVATION AND RESEARCH IS A CRITICALLY IMPORTANT ASPECT OF THE FOUNDATION'S INVESTMENT IN THE LOCAL COMMUNITY. THROUGH PARTNERSHIP WITH EDUCATIONAL INSTITUTIONS, THE FOUNDATION IS ABLE TO SUPPORT RESEARCH AND OTHER ACADEMIC OFFERINGS THAT WILL HELP INFORM, ADDRESS, OR BE APPLIED TO HEALTH RISK FACTORS WITHIN THE LOCAL COMMUNITIES. INCOME STABILITY POVERTY INTERSECTS NEARLY ALL OTHER AREAS OF SOCIAL DETERMINANTS OF HEALTH AND THE HEALTH RISK FACTORS ASSOCIATED WITH THEM. THE FOUNDATION HAS UNDERTAKEN THE STEPS NECESSARY TO LAUNCH A FORMAL POVERTY LITERACY AND MITIGATION PROGRAM THAT INCLUDES COMMUNITY ENGAGEMENT, ECONOMIC DEVELOPMENT, FINANCIAL EDUCATION AND LITERACY TRAINING, AND OTHER STEPS TO BUILD COMMMUNITY PARTNERSHIPS IN ADDRESSING POVERTY AND THE INHERENT AFFECTS.
FORM 990, PAGE 6, PART VI, LINE 10B	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PAGE 6, PART VI, LINE 11B	THE EXECUTIVE DIRECTOR OF THE FOUNDATION REVIEWS THE FORM 990 IN DETAIL PRIOR TO FILING. THE 990 IS THEN REVIEWED WITH FOUNDATION BOARD MEMBERS AT A REGULARLY SCHEDULED BOARD MEETING. EACH BOARD MEMBER IS PROVIDED A COPY OF THE FORM 990 FOR REVIEW BEFORE THE RETURN IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12C	AN ANNUAL CONFLICT OF INTEREST POLICY STATEMENT IS COMPLETED AND SIGNED BY EACH BOARD MEMBER. THE EXECUTIVE DIRECTOR REVIEWS THE COMPLETED CONFLICT OF INTEREST FORMS. IF A CONFLICT IS IDENTIFIED, THAT BOARD MEMBER IS EXCUSED FROM ANY DISCUSSION OR VOT RELATING TO THE IDENTIFIED CONFLICT.
FORM 990, PAGE 6, PART VI, LINE 15A	THE ORGANIZATION UTILIZES WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY OR STUDIES, AND APPROVAL BY THE BOARD TO ESTABLISH COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 15B	THE ORGANIZATION UTILIZES WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY OR STUDIES, AND APPROVAL BY THE BOARD TO ESTABLISH COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9	ASSETS RECEIVED FROM MERGER 7,500 OFFSET INVESTMENT IN SUBSIDIARY -33,859 TOTAL -26,359

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

COPPER SHORES COMMUNITY
HEALTH FOUNDATION

Employer identification number

38-3022945

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COPPER COUNTRY SENIOR MEALS 821 WATER STREET HANCOCK,MI49930 38-3041729	MEALS	MI	3	7	N/A	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) COPPER COUNTRY SENIOR MEALS	B	224,918	CASH

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO SUPPORT THE CHARITABLE HEALTH NEEDS OF THE COMMUNITY THROUGH ENHANCED PHILANTHROPY AND COMMUNITY COLLABORATION
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 2021 (Part V, line 2a) ......	5	42
6	Total number of volunteers (estimate if necessary) .............	6	9
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,339,015	2,373,869
9	Program service revenue (Part VIII, line 2g) .........		36,032
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,189,424	3,589,638
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	620,076	15,684
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	8,148,515	6,015,223
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,300,471	2,590,310
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)	667,938	1,044,060
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)....	367,508	447,322
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,335,917	4,081,692
19	Revenue less expenses. Subtract line 18 from line 12.......	4,812,598	1,933,531
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	85,620,667	73,990,365
21	Total liabilities (Part X, line 26).............	153,143	1,235,092
22	Net assets or fund balances. Subtract line 21 from line 20.....	85,467,524	72,755,273

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,353,304 including grants of $ 1,344,627 ) (Revenue $ )
	ACCESS TO CARE- GRANTS TO ORGANIZATIONS AND INDIVIDUALS TO MEET THE FINANCIALS RESOURCES NEEDED TO DEVELOP NEW AND/OR EXPANDED HEALTH SERVICES WITH MEET A COMMUNITY'S NEEDS, AS WELL AS PROVIDING GAS CARDS TO INDIVIDUALS TO BE USED FOR MEDICAL TRAVEL. GIVING TUESDAY-CAMPAIGN AIMED INVOLVING THE LOCAL COMMUNITY TO JOIN IN ON THE GLOBAL GENEROSITY MOVEMENT WHICH CREATES A DAY THAT ENCOURAGES PEOPLE TO DONATE TO A LIST OF QUALIFIED NON-PROFIT CHARITIES. THE FOUNDATION MATCHES THE COMMUNITY DONATIONS UP TO A SPECIFIED DOLLAR AMOUNT EACH YEAR. THE FOUNDATION HAS AIDED IN MORE THAN 2.7 MILLION DOLLARS IN DONATIONS TO NON-PROFIT ORGANIZATIONS IN BARAGA, HOUGHTON, KEWEENAW AND ONTONAGON COUNTIES.

4b	(Code: ) (Expenses $ 900,438 including grants of $ 369,288 ) (Revenue $ 36,032 )
	FOOD STABILITY THE FOUNDATION HAS RESEARCHED THE WAYS IN WHICH FOOD INSECURITIES AND NUTRITION AFFECT AN INDIVIDUAL'S OVERALL HEALTH. IN AN EFFORT TO REDUCE THE NEGATIVE EFFECTS OF FOOD INSECURITIES, HUNGER, AND POOR NUTRITION, THE FOUNDATION HAS BEGUN IDENTIFYING FUNDING STRATEGIES TO ADDRESS THE COMMUNITY'S AWARENESS TO FOOD AND THE CRITICAL IMPACT IT HAS ON INDIVIDUAL AND POPULATION HEALTH. THE FOUNDATION'S GRANTING AND HANDS-ON WORK WITHIN THE COMMUNITY IS INTENDED TO CURB THE HEALTH RISKS ASSOCIATED WITH FOOD INSECURITY AND NUTRITIONAL INSTABILITY. ON 10/1/22 THE FOUNDATION'S WHOLLY OWNED SUBSIDIARY COPPER COUNTRY SENIOR MEALS MERGED WITH AND INTO THE FOUNDATION. ACTIVITY FROM COPPER COUNTRY SENIOR MEALS PROGRAM AFTER 9/30/22 IS INCLUDED WITHIN THE FOOD STABILITY PROGRAM, AND INCLUDES PROVIDING NUTRITIOUS MEALS TO SENIOR CITIZENS IN THEIR HOMES OR AT CONGREGATE SITES AS WELL AS PROVIDING MEALS TO THE LOCAL HEAD START PROGRAM.

4c	(Code: ) (Expenses $ 386,519 including grants of $ 386,504 ) (Revenue $ )
	SAFE & HEALTHFUL COMMUNITIES SAFE COMMUNITIES & RECREATION ARE AN IMPORTANT FACET OF A HEALTHY COMMUNITY. ACCESS TO RESOURCES THROUGH THE BUILT ENVIRONMENT AND RECREATIONAL ASSETS PROVIDE AND CONTRIBUTE TO AN INDIVIDUALS' CHOICE TO LIVE A HEALTHIER LIFESTYLE. IN ADDITION, SUPPORT OF RECREATION FOCUSED ON COMMUNITY GROUPS, LOCAL EMERGENCY SERVICES, AND LAW ENFORCEMENT EFFORTS, ALONG WITH SUPPORT FOR MOBILIZATION RECREATION PLANNING THROUGH THE MANY MUNICIPAL PARTNERS IN THE REGION ALL CONTRIBUTE TO MAKING A HEALTHIER, SAFER, AND MORE VIBRANT COMMUNITY.

	(Code: ) (Expenses $ 494,600 including grants of $ 489,891 ) (Revenue $ )
	HEALTHY INDIVIDUALS PROVIDES GRANTS, INCLUDING SUBSTANCE USE DISORDER, SPECIFICALLY ADDERSSING THE NEEDS OF OUR POPULATION. -EARLY INTERVENTION AND PREVENTION PROGRAMS INCLUDING SUBSTANCE USE DISORDER. -EMERGENCY AND MOBILE CRISIS RESPONSE. -MENTAL AND BEHAVORIAL HEALTH SERVICE ACCESS, COORDINATION, AND NAVIGATION. -SUICIDE PREVENTION AND AWARENESS. -YOUTH LEADERSHIP AND RESILIENCY DEVELOPMENT. -PARENT EDUCATION AND ENGAGEMENT. -ADDICTION SERVICES. -PROGRAMMING ADDRESSING OTHER FORMS OF MENTAL ILLNESS, STRESS REDUCTION, ANDZIETY, AND DEPRESSION THAT MAY INCLUDE PHYSICAL AND MINDFULNESS ACTIVITIES. ACCESS TO EDUCATION EDUCATION IS AN IMPORTANT COMPONENT TO A HEALTHIER COMMUNITY. HEALTH RISK STUDIES HAVE SHOWN POPULATIONS AND INDIVIDUALS WITH HIGHER LEVELS OF EDUCATION COMPLETION GENERALLY HAVE NOTICEABLY REDUCED HEALTH RISK FACTORS. IN ADDITION, ACCESS TO EDUCATIONAL TRAINING AND THE RETENTION OF THOSE STUDENTS WITHIN THE LOCAL COMMUNITY CONTRIBUTE TO A MORE VIBRANT AND PROSPEROUS ECONOMY, FURTHER REDUCING HEALTH RISK FACTORS THAT ARE MORE COMMONLY ASSOCIATED AND PRONOUNCED WITH LOWER INCOME EARNING HOUSEHOLDS. IN ADDITION TO ACCESS TO EDUCATION, MEDICAL INNOVATION AND RESEARCH IS A CRITICALLY IMPORTANT ASPECT OF THE FOUNDATION'S INVESTMENT IN THE LOCAL COMMUNITY. THROUGH PARTNERSHIP WITH EDUCATIONAL INSTITUTIONS, THE FOUNDATION IS ABLE TO SUPPORT RESEARCH AND OTHER ACADEMIC OFFERINGS THAT WILL HELP INFORM, ADDRESS, OR BE APPLIED TO HEALTH RISK FACTORS WITHIN THE LOCAL COMMUNITIES. INCOME STABILITY POVERTY INTERSECTS NEARLY ALL OTHER AREAS OF SOCIAL DETERMINANTS OF HEALTH AND THE HEALTH RISK FACTORS ASSOCIATED WITH THEM. THE FOUNDATION HAS UNDERTAKEN THE STEPS NECESSARY TO LAUNCH A FORMAL POVERTY LITERACY AND MITIGATION PROGRAM THAT INCLUDES COMMUNITY ENGAGEMENT, ECONOMIC DEVELOPMENT, FINANCIAL EDUCATION AND LITERACY TRAINING, AND OTHER STEPS TO BUILD COMMMUNITY PARTNERSHIPS IN ADDRESSING POVERTY AND THE INHERENT AFFECTS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 494,600 including grants of $ 489,891 ) (Revenue $ )
4e	Total program service expenses3,134,861

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) KEVIN STORE...................................................................... EXECUTIVE DI	40.00 .................		X	147,364	0	35,564
(2) BERNADETTE YEOMAN-OUELLETTE...................................................................... CHAIR	2.30 .................	X	X	0	0	0
(3) BRENT PETERSON...................................................................... VICE CHAIR	1.00 .................	X	X	0	0	0
(4) BRUCE RUKKILA...................................................................... TREASURER	1.50 .................	X	X	0	0	0
(5) ANN CLANCY-KLEMME...................................................................... SECRETARY	1.30 .................	X	X	0	0	0
(6) MICHELE BLAU...................................................................... DIRECTOR	0.40 .................	X		0	0	0
(7) GUY ST GERMAIN...................................................................... DIRECTOR	0.70 .................	X		0	0	0
(8) JAMES BOBULA...................................................................... DIRECTOR	0.60 .................	X		0	0	0
(9) JAMEY MARKHAM...................................................................... DIRECTOR	0.50 .................	X		0	0	0
(10) PAUL OLLILA...................................................................... DIRECTOR	0.30 .................	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	147,364	35,564

(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	103,057

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,270,812

g	Noncash contributions included in lines 1a - 1f:$		1g	30,840

h Total. Add lines 1a-1f.......		2,373,869

		Business Code
2a	PROGRAM REVENUE	624210	36,032	36,032
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		36,032

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,410,089			1,410,089
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	1,165,063	3,751,178	7a
b	Less: cost or other basis and sales expenses	2,571	2,734,121	7b
c	Gain or (loss)	1,162,492	1,017,057	7c
d	Net gain or (loss).........			2,179,549	2,179,549
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	GRANTS RETURNED			12,500	12,500
b	OTHER INCOME			3,184	3,184
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			15,684
12	Total revenue. See instructions.....			6,015,223	2,231,265		1,410,089

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,334,820	2,334,820
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	255,490	255,490
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 ...........	147,537		147,537
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........	533,984	230,811	303,173
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	53,406	23,472	29,934
9	Other employee benefits .......	250,373	164,507	85,866
10	Payroll taxes ...........	58,760	21,612	37,148
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	43,530		43,530
c	Accounting ...........	37,929	267	37,662
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	30,000		30,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	1,220		1,220
12	Advertising and promotion ....	63,479	2,813	60,666
13	Office expenses .......	36,930	14,803	22,127
14	Information technology ......	18,379	634	17,745
15	Royalties ..
16	Occupancy ...........	52,807	9,998	42,809
17	Travel ............	14,496	1,789	12,707
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	13,957	251	13,706
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	8,872	1,570	7,302
23	Insurance ...	14,778		14,778
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	FOOD	48,660	48,660
b	DUES AND SUBSCRIPTIONS	18,862	142	18,720
c	SUPPLIES AND SMALL EQUIPM	13,046	13,046
d	EVENT COORDINATION	9,319		9,319
e	All other expenses	21,058	10,176	10,882
25	Total functional expenses. Add lines 1 through 24e	4,081,692	3,134,861	946,831	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 ........			535,570	1	894,308
2	Savings and temporary cash investments .........			10,253	2	10,264
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			207,000	4	137,772
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	1,357,234
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			10,646	9	24,207
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	163,294
b	Less: accumulated depreciation	10b	54,238	55,181	10c	109,056
11	Investments—publicly traded securities .			76,797,460	11	63,335,863
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 ...........			8,004,557	15	8,121,661
16	Total assets. Add lines 1 through 15 (must equal line 33)...			85,620,667	16	73,990,365

17	Accounts payable and accrued expenses .....	72,175	17	91,531
18	Grants payable ...	80,968	18	973,927
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	169,634
26	Total liabilities. Add lines 17 through 25..	153,143	26	1,235,092

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	85,112,804	27	72,510,563
28	Net assets with donor restrictions ...........	354,720	28	244,710
	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 ...........	85,467,524	32	72,755,273
33	Total liabilities and net assets/fund balances ........	85,620,667	33	73,990,365