Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 10-01-2022 , and ending 09-30-2023
BCheck if applicable:
CName of organization
VEBA Trust for Public Employees
in the Northwest
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
221 N Wall Street 201
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Spokane, WA99201
D Employer identification number

94-3131623
E Telephone number

G Gross receipts $ 378,434,723
F Name and address of principal officer:
Douglas G Detling
221 N Wall Street 201
Spokane,WA99201
I
Tax-exempt status: ( 9 ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.hraveba.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1990
M State of legal domicile: WA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: To provide qualified health and welfare benefits.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 7
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 7
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 0
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 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 136,883,841 151,943,983
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 25,058,162 21,116,097
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 16,515
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 161,942,003 173,076,595
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 86,717,327 99,277,002
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 7,696,594 7,745,532
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 94,413,921 107,022,534
19 Revenue less expenses. Subtract line 18 from line 12....... 67,528,082 66,054,061
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 742,000,780 864,858,216
21 Total liabilities (Part X, line 26)............. 2,591,822 3,236,183
22 Net assets or fund balances. Subtract line 21 from line 20..... 739,408,958 861,622,033
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: The Trust provides public employees a tax-free health reimbursement arrangement (HRA), compliant with regulatory requirements, efficient administration, prudent investments and superb service.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
This trust holds the assets of the Voluntary Employees' Beneficiary Association Health Care Reimbursement Plan for Public Employees in the Northwest (the Plan) for employees of county, city, town, special purpose district or similar entity in Washington, Oregon or Idaho, whose purpose is to provide public services to its citizens and is authorized to do so by state statute. The Plan provides a method of funding qualified health and welfare benefits to its participants and their dependents.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet  
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A.....................
1
 
No
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment
List of Attached Documents:
// Content
......................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J.......................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
 
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
 
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
286
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
7
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletArthur J Gallagher & Co221 N Wall Street Suite 201   Spokane,WA99201 (509) 838-5571
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Doug Detling......................................................................
Chair
 3.00
.................
  		X   X       0 0 0
(2) Teresa Benner......................................................................
Vice Chair - Thru May 2023
 2.00
.................
  		X   X       0 0 0
(3) Kristy Wolf......................................................................
Treasurer
 3.00
.................
  		X   X       0 0 0
(4) Sylvia Hubbard......................................................................
Secretary
 2.00
.................
  		X   X       0 0 0
(5) Debbie Lund......................................................................
Trustee - Beginning May 2023
 2.00
.................
  		X           0 0 0
(6) Heather Buchanan......................................................................
Trustee
 2.00
.................
  		X           0 0 0
(7) Joy Ramsdell......................................................................
Trustee
 2.00
.................
  		X           0 0 0
(8) Brad Nelson......................................................................
Trustee
 2.00
.................
  		X           0 0 0


















Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 0 0
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Arthur J Gallagher & Co

221 N Wall Street Suite 201
Spokane,WA99201 		Consulting, marketing and client svc,cus 4,816,207
One Bridge Benefits Inc

410 Main Street Suite 5
Buffalo,NY14202 		Software administrator, eligibility and 2,036,935
Goldman Sachs Asset Management

100 Bank St
Burlington,VT05401 		Investment consulting services 211,798
Washington Trust Bank

PO Box 2127
Spokane,WA99210 		Investment and custodial fees 197,540
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a Plan contributions 525100 151,943,983 151,943,983    
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 151,943,983
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 20,398,945     20,398,945
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(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).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   206,075,280 7a
b Less: cost or other basis and sales expenses   205,358,128 7b
c Gain or (loss)   717,152 7c
d Net gain or (loss).........MediumBullet 717,152     717,152
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..MediumBullet      
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a Settlement proceeds 525100 16,515 16,515    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 16,515
12 Total revenue. See instructions.....MediumBullet 173,076,595 151,960,498 0 21,116,097
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members ....... 99,277,002  
5 Compensation of current officers, directors, trustees, and key employees ...........        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........        
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits .......        
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ...... 2,036,935      
b Legal ......... 78,597      
c Accounting ........... 33,800      
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 434,704      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 4,633,846      
12 Advertising and promotion ....        
13 Office expenses ....... 187,920      
14 Information technology ......        
15 Royalties ..        
16 Occupancy ...........        
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 17,040      
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..        
23 Insurance ... 57,200      
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 PCORI fees 258,856      
b Bank charges 6,634      
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 107,022,534      
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 3,456,044 1 3,804,515
2 Savings and temporary cash investments ......... 5,687,990 2 5,914,526
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net .............   4  
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ......   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a  
b Less: accumulated depreciation 10b     10c  
11 Investments—publicly traded securities . 582,823,640 11 695,223,551
12 Investments—other securities. See Part IV, line 11 ..... 147,539,167 12 156,526,217
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 2,493,939 15 3,389,407
16 Total assets. Add lines 1 through 15 (must equal line 33)... 742,000,780 16 864,858,216
Liabilities 17 Accounts payable and accrued expenses ..... 848,854 17 894,845
18 Grants payable ...   18  
19 Deferred revenue ......... 1,742,968 19 2,037,161
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 0 25 304,177
26 Total liabilities. Add lines 17 through 25.. 2,591,822 26 3,236,183
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ........... 739,408,958 28 861,622,033
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 739,408,958 32 861,622,033
33 Total liabilities and net assets/fund balances ........ 742,000,780 33 864,858,216
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
173,076,595
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
107,022,534
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
66,054,061
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
739,408,958
5
Net unrealized gains (losses) on investments ...............
5
56,159,014
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
861,622,033
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
VEBA Trust for Public Employees
in the Northwest
Employer identification number

94-3131623
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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        
d Equipment ....        
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 0
Schedule D (Form 990) 2021

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) Synthetic guaranteed investment contracts		 156,526,217 C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 156,526,217
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.)Small Bullet  
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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
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.)Small Bullet 304,177
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

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 ....... 1 229,235,609
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 56,159,014
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e 56,159,014
3 Subtract line 2e from line 1.................. 3 173,076,595
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c 0
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 173,076,595
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 ........... 1 107,022,534
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e 0
3 Subtract line 2e from line 1................... 3 107,022,534
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 107,022,534
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 (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




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
VEBA Trust for Public Employees
in the Northwest
Employer identification number

94-3131623
Return Reference Explanation
Form 990, Part VI, Section A, line 7a There are seven Trustees from two Public Service Agency Categories (PSAC): counties, cities and towns; and special purpose districts. Within each PSAC, one Trustee is elected by the employers from the respective PSAC participating in the Trust, and one Trustee is elected by participants from the respective PSAC. The third Trustee within each PSAC is elected by all remaining Trustees, regardless of their PSAC affiliation. The seventh Trustee is elected by all other Trustees.
Form 990, Part VI, Section B, line 11b The Form 990 was prepared by the independent accounting firm of SCHOEDEL & SCHOEDEL, Certified Public Accountants, PLLC based on information provided by the third-party administrators. Draft copies of the Trust's financial statements and Form 990 were first provided to the Trust's legal counsel and plan consultant for review. Any questions, concerns, or issues raised by the legal counsel and plan consultant were addressed and any necessary revisions were made to the Form 990. A draft of the revised Form 990 was then provided to the Trustees for review. Any additional questions, concerns, or issues raised by the Trustees were addressed at a meeting of the Board of Trustees where the Trust's auditor presents audited financials and a draft of the Form 990. Any necessary revisions were made to the Form 990. Upon final review and approval of the Form 990 by the Board of Trustees, the Trust's auditor filed the Form 990 in accordance with IRS instructions.
Form 990, Part VI, Section B, line 12c Trustees, service providers, third-party administrators, or any other person having responsibility for the management or administration of the Trust's finances, investments, or other proprietary information concerning the Trust are considered interested persons. An interested person is under a continuing obligation to disclose any potential conflict of interest to the Board of Trustees as soon as it is known or reasonably should be known. The interested person is given the opportunity to disclose all material facts to the Trustees when considering the proposed transaction or arrangement. After disclosure of the financial, professional, or personal interest and all material facts, and after any discussion with the interested person, he/she leaves the Trustees meeting while the determination of a conflict of interest is considered. If the disinterested Trustees determine a conflict of interest exists, the Chair of the Board, if appropriate, appoints a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the Trustees determine whether the Trust can obtain with reasonable efforts a more advantageous transaction or arrangement with a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the Board or committee determines by majority vote of the disinterested Trustees whether the transaction agreement or arrangement is in the Trust's best interest, for its own benefit, and whether it is fair and reasonable. In conformity with the above determination the Trustees decide whether to enter into the transaction agreement or arrangement. The minutes of the meeting reflect that the conflict disclosure was made to the Board, the vote taken and, where applicable, the abstention from voting and participation by the interested party. Whenever possible, the minutes frame the decision of the Board in such a way to provide guidance for consideration of future conflict of interest situations. To ensure the Trust operates in a manner consistent with its tax-exempt purposes and does not engage in activities that could jeopardize its tax-exempt status, the Board of Trustees conducts periodic reviews. The periodic reviews include, at a minimum, the following subjects: Whether the contractual arrangements with service providers and the services provided are reasonable, based on competent market and survey information, and the result of arm's length negotiation; Whether contractual arrangements with service providers and arrangements with other organizations conform to written policies, are properly recorded, reflect reasonable investment or payments for goods and services, further tax-exempt purposes, and do not result in inurement, impermissible private benefit or in an excess benefit transaction, and; Whether any transaction conducted by the Trust during the review period involves or could possibly give rise to a conflict of interest.
Form 990, Part VI, Section B, line 15 There are no compensated management officials, officers or key employees of the Trust. If the Trust had such compensated individuals, policies and procedures would be developed to determine compensation.
Form 990, Part VI, Section C, line 19 The Trust makes its governing documents, conflict of interest policy, financial statements, and Form 990 available to the public upon written request by contacting the Trust at 221 N Wall Street, Suite 201, Spokane, WA 99201.
Form 990, Part VII, Section A, Line 1A The Trust does not compensate the members of the Board of Trustees for their duties as Trustees. The Board of Trustees is made up of seven individuals, six of whom are employees of counties, cities, towns or special purpose districts in Washington, Oregon or Idaho. The remaining Trustee is a former employee in a county, city or town. The Trust does not readily have access to information related to the compensation paid by other entities to the Trustees. The Trustees serve on a voluntary basis, and receive no known compensation adjustment from their employers, or any other party, for their services on the Board.
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:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
VEBA Trust for Public Employees
in the Northwest
Employer identification number

94-3131623
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?
Yes No
(1)City of Aberdeen
 
 
         
 
 
(2)City of Airway Heights
 
 
         
 
 
(3)City of Arlington
 
 
         
 
 
(4)City of Black Diamond
 
 
         
 
 
(5)City of Blaine
 
 
         
 
 
(6)City of Bonney Lake
 
 
         
 
 
(7)City of Bremerton
 
 
         
 
 
(8)City of Brewster
 
 
         
 
 
(9)City of Burien
 
 
         
 
 
(10)City of Cashmere
 
 
         
 
 
(11)City of Centralia
 
 
         
 
 
(12)City of Chehalis
 
 
         
 
 
(13)City of Chelan
 
 
         
 
 
(14)City of Cheney
 
 
         
 
 
(15)City of Clarkston
 
 
         
 
 
(16)City of Cle Elum
 
 
         
 
 
(17)City of Colville
 
 
         
 
 
(18)City of Covington
 
 
         
 
 
(19)City of Deer Park
 
 
         
 
 
(20)City of Des Moines
 
 
         
 
 
(21)City of Dupont
 
 
         
 
 
(22)City of East Wenatchee
 
 
         
 
 
(23)City of Ellensburg
 
 
         
 
 
(24)City of Elma
 
 
         
 
 
(25)City of Enumclaw
 
 
         
 
 
(26)City of Ephrata
 
 
         
 
 
(27)City of Federal Way
 
 
         
 
 
(28)City of Ferndale
 
 
         
 
 
(29)City of Fife
 
 
         
 
 
(30)City of Forks
 
 
         
 
 
(31)City of Gig Harbor
 
 
         
 
 
(32)City of Grandview
 
 
         
 
 
(33)City of Kalama
 
 
         
 
 
(34)City of Kelso
 
 
         
 
 
(35)City of Kenmore
 
 
         
 
 
(36)City of La Center
 
 
         
 
 
(37)City of Lacey
 
 
         
 
 
(38)City of Lake Stevens
 
 
         
 
 
(39)City of Langley
 
 
         
 
 
(40)City of Leavenworth
 
 
         
 
 
(41)City of Liberty Lake
 
 
         
 
 
(42)City of Longview
 
 
         
 
 
(43)City of Lynnwood
 
 
         
 
 
(44)City of Mabton
 
 
         
 
 
(45)City of Marysville
 
 
         
 
 
(46)City of McCleary
 
 
         
 
 
(47)City of Medina
 
 
         
 
 
(48)City of Mercer Island
 
 
         
 
 
(49)City of Millwood
 
 
         
 
 
(50)City of Milton
 
 
         
 
 
(51)City of Monroe
 
 
         
 
 
(52)City of Mountlake Terrace
 
 
         
 
 
(53)City of Normandy Park
 
 
         
 
 
(54)City of North Bonneville
 
 
         
 
 
(55)City of Oak Harbor
 
 
         
 
 
(56)City of Okanogan
 
 
         
 
 
(57)City of Olympia
 
 
         
 
 
(58)City of Omak
 
 
         
 
 
(59)City of Palouse
 
 
         
 
 
(60)City of Pasco
 
 
         
 
 
(61)City of Port Orchard
 
 
         
 
 
(62)City of Poulsbo
 
 
         
 
 
(63)City of Pullman
 
 
         
 
 
(64)City of Puyallup
 
 
         
 
 
(65)City of Redmond (WA)
 
 
         
 
 
(66)City of Renton
 
 
         
 
 
(67)City of Richland
 
 
         
 
 
(68)City of Ridgefield
 
 
         
 
 
(69)City of Roy
 
 
         
 
 
(70)City of SeaTac
 
 
         
 
 
(71)City of Seattle
 
 
         
 
 
(72)City of Sedro Woolley
 
 
         
 
 
(73)City of Selah
 
 
         
 
 
(74)City of Shelton
 
 
         
 
 
(75)City of Spokane
 
 
         
 
 
(76)City of Stevenson
 
 
         
 
 
(77)City of Sunnyside
 
 
         
 
 
(78)City of Tacoma
 
 
         
 
 
(79)City of Tonasket
 
 
         
 
 
(80)City of Tukwila
 
 
         
 
 
(81)City of Tumwater
 
 
         
 
 
(82)City of Union Gap
 
 
         
 
 
(83)City of University Place
 
 
         
 
 
(84)City of Vancouver
 
 
         
 
 
(85)City of Washougal
 
 
         
 
 
(86)City of West Richland
 
 
         
 
 
(87)City of Yakima
 
 
         
 
 
(88)Town of Coulee Dam
 
 
         
 
 
(89)Town of Garfield
 
 
         
 
 
(90)Adams County
 
 
         
 
 
(91)Asotin County
 
 
         
 
 
(92)Benton County WA
 
 
         
 
 
(93)Chelan County
 
 
         
 
 
(94)Clallam County
 
 
         
 
 
(95)Columbia County
 
 
         
 
 
(96)Cowlitz County
 
 
         
 
 
(97)Douglas County
 
 
         
 
 
(98)Franklin County
 
 
         
 
 
(99)Garfield County
 
 
         
 
 
(100)Grant County
 
 
         
 
 
(101)Island County
 
 
         
 
 
(102)King County
 
 
         
 
 
(103)Kitsap County
 
 
         
 
 
(104)Kittitas County
 
 
         
 
 
(105)Lewis County
 
 
         
 
 
(106)Lincoln County
 
 
         
 
 
(107)Mason County
 
 
         
 
 
(108)Okanogan County
 
 
         
 
 
(109)Pacific County
 
 
         
 
 
(110)Pend Oreille County
 
 
         
 
 
(111)Pierce County
 
 
         
 
 
(112)San Juan County
 
 
         
 
 
(113)Skagit County
 
 
         
 
 
(114)Skamania County
 
 
         
 
 
(115)Snohomish County
 
 
         
 
 
(116)Spokane County
 
 
         
 
 
(117)Stevens County
 
 
         
 
 
(118)Thurston County
 
 
         
 
 
(119)Wahkiakum County
 
 
         
 
 
(120)Walla Walla County
 
 
         
 
 
(121)Whitman County
 
 
         
 
 
(122)Yakima County
 
 
         
 
 
(123)Adams County Fire Protection Dist No 5
 
 
         
 
 
(124)Alderwood Water & Wastewater District
 
 
         
 
 
(125)Area Agency on Aging & Disabilities in SW WA
 
 
         
 
 
(126)Asotin County Health District
 
 
         
 
 
(127)Bainbridge Island Fire Dept
 
 
         
 
 
(128)Bainbridge Island Metro Parks
 
 
         
 
 
(129)Beacon Hill Sewer District
 
 
         
 
 
(130)Belfair Water District No 1
 
 
         
 
 
(131)Bellingham Housing Authority
 
 
         
 
 
(132)Ben Franklin Transit
 
 
         
 
 
(133)Benton County Fire District No 1
 
 
         
 
 
(134)Benton County Fire Protection Dist No 2
 
 
         
 
 
(135)Benton County PUD
 
 
         
 
 
(136)Benton Franklin Health District
 
 
         
 
 
(137)Birch Bay Water & Sewer District
 
 
         
 
 
(138)Cascade Irrigation District
 
 
         
 
 
(139)Cascade Valley Hospital
 
 
         
 
 
(140)Cascade Water Alliance
 
 
         
 
 
(141)Cascadia Conservation District
 
 
         
 
 
(142)Cedar River Water & Sewer
 
 
         
 
 
(143)Central Kitsap Fire & Rescue
 
 
         
 
 
(144)Central Pierce Fire & Rescue
 
 
         
 
 
(145)Chelan County Fire No 3
 
 
         
 
 
(146)Chelan County Fire No 9
 
 
         
 
 
(147)Chelan County PUD
 
 
         
 
 
(148)Chelan Douglas Regional Port Authority
 
 
         
 
 
(149)Clallam County Fire Dist No 3
 
 
         
 
 
(150)Clallam County PUD No 1
 
 
         
 
 
(151)Clallam Transit System
 
 
         
 
 
(152)Clark County Fire District No 3
 
 
         
 
 
(153)Clark County Fire District No 6
 
 
         
 
 
(154)Clark County Fire & Rescue
 
 
         
 
 
(155)Clark County PUD
 
 
         
 
 
(156)Clark County Public Transportation
 
 
         
 
 
(157)Coal Creek Utility District
 
 
         
 
 
(158)Columbia County Fire No 3
 
 
         
 
 
(159)Columbia County Public Transportation
 
 
         
 
 
(160)Columbia County Rural Library District
 
 
         
 
 
(161)Consolidated Diking Improvement District
 
 
         
 
 
(162)Covington Water District
 
 
         
 
 
(163)Cowlitz County Fire District No 5
 
 
         
 
 
(164)Cowlitz County Fire District No 6
 
 
         
 
 
(165)Cowlitz County PUD
 
 
         
 
 
(166)Cowlitz 911
 
 
         
 
 
(167)Cowlitz Wahkiakum Council of Govt
 
 
         
 
 
(168)Cross Valley Water District
 
 
         
 
 
(169)Douglas County PUD No 1
 
 
         
 
 
(170)Douglas County Sewer District No 1
 
 
         
 
 
(171)Duvall Fire
 
 
         
 
 
(172)East Jefferson Fire & Rescue
 
 
         
 
 
(173)East Pierce Fire & Rescue
 
 
         
 
 
(174)East Wenatchee Water District
 
 
         
 
 
(175)Eastmont Metro Park District
 
 
         
 
 
(176)Enduris Washington
 
 
         
 
 
(177)Energy Northwest
 
 
         
 
 
(178)Fall City Water District
 
 
         
 
 
(179)Ferry County PUD
 
 
         
 
 
(180)Franklin County Emergency Mgmt
 
 
         
 
 
(181)Franklin County Fire No 3
 
 
         
 
 
(182)Franklin County PUD
 
 
         
 
 
(183)Grand Coulee Project Hydroelectric
 
 
         
 
 
(184)Grant County PUD No 2
 
 
         
 
 
(185)Grays Harbor County PUD
 
 
         
 
 
(186)Greater Columbia Behavioral Health
 
 
         
 
 
(187)Great Rivers Behavioral Health Admin Svcs Org
 
 
         
 
 
(188)Great Rivers Behavioral Health Org
 
 
         
 
 
(189)Hartstene Pointe Water & Sewer
 
 
         
 
 
(190)Highline Water District
 
 
         
 
 
(191)Housing Authority of Thurston County
 
 
         
 
 
(192)Inland Power & Light Company
 
 
         
 
 
(193)Island County Emerg Svcs Comm Center
 
 
         
 
 
(194)Jefferson Communications 911
 
 
         
 
 
(195)Jefferson County PUD
 
 
         
 
 
(196)Jefferson Transit Authority
 
 
         
 
 
(197)King County Fire Protection Dist No 27
 
 
         
 
 
(198)King County Water Dist No 20
 
 
         
 
 
(199)King County Water Dist No 49
 
 
         
 
 
(200)King County Water Dist No 90
 
 
         
 
 
(201)King County Water Dist No 125
 
 
         
 
 
(202)Kitsap County PUD No 1
 
 
         
 
 
(203)Kitsap Public Health District
 
 
         
 
 
(204)Kitsap Regional Library District
 
 
         
 
 
(205)Kittitas County Fire No 2
 
 
         
 
 
(206)Kittitas County PUD No 1
 
 
         
 
 
(207)Klickitat County EMS District No 1
 
 
         
 
 
(208)Klickitat County PUD No 1
 
 
         
 
 
(209)Lacey Fire District No 3
 
 
         
 
 
(210)Lake Chelan Reclamation District
 
 
         
 
 
(211)Lake Meridian Water District
 
 
         
 
 
(212)Lake Stevens Sewer District
 
 
         
 
 
(213)Lake Whatcom Water & Sewer
 
 
         
 
 
(214)Lakehaven Water & Sewer District
 
 
         
 
 
(215)Lewis County PUD
 
 
         
 
 
(216)Link Transit
 
 
         
 
 
(217)LOTT Clean Water Services
 
 
         
 
 
(218)Lynnwood Public Facilities District
 
 
         
 
 
(219)Malaga Water District
 
 
         
 
 
(220)Manchester Water District
 
 
         
 
 
(221)Marysville Fire District
 
 
         
 
 
(222)Mason County Fire District No 5
 
 
         
 
 
(223)Mason County PUD No 1
 
 
         
 
 
(224)Mason County PUD No 3
 
 
         
 
 
(225)Metro Parks Tacoma
 
 
         
 
 
(226)Midway Sewer District
 
 
         
 
 
(227)Moab Irrigation District 20
 
 
         
 
 
(228)Mountain View Fire & Rescue
 
 
         
 
 
(229)Mukilteo Water District
 
 
         
 
 
(230)North Beach Water District
 
 
         
 
 
(231)North City Water District
 
 
         
 
 
(232)North County Regional Fire & EMS
 
 
         
 
 
(233)North Kitsap Fire & Rescue
 
 
         
 
 
(234)North Mason Regional Fire Authority
 
 
         
 
 
(235)North Perry Avenue Water District
 
 
         
 
 
(236)NE Sammamish Sewer & Water
 
 
         
 
 
(237)NE Tri County Health District
 
 
         
 
 
(238)Northwest Seaport Alliance
 
 
         
 
 
(239)North Whidbey Fire & Rescue
 
 
         
 
 
(240)Okanogan County Fire No 15
 
 
         
 
 
(241)Okanogan County Public Health
 
 
         
 
 
(242)Okanogan County PUD No1
 
 
         
 
 
(243)Olympic View Water & Sewer District
 
 
         
 
 
(244)Pacific County Fire Protection District
 
 
         
 
 
(245)Pangborn Memorial Airport
 
 
         
 
 
(246)Pend Oreille County Library District
 
 
         
 
 
(247)Pend Oreille County PUD
 
 
         
 
 
(248)Peninsula Development District
 
 
         
 
 
(249)Peninsula Light Company
 
 
         
 
 
(250)Pierce County Library System
 
 
         
 
 
(251)Pierce County Noxious Weed Control Bd
 
 
         
 
 
(252)Port Ludlow Fire & Rescue
 
 
         
 
 
(253)Port of Bremerton
 
 
         
 
 
(254)Port of Camas - Washougal
 
 
         
 
 
(255)Port of Chehalis
 
 
         
 
 
(256)Port of Chelan County
 
 
         
 
 
(257)Port of Clarkston
 
 
         
 
 
(258)Port of Everett
 
 
         
 
 
(259)Port of Kalama
 
 
         
 
 
(260)Port of Kennewick
 
 
         
 
 
(261)Port of Longview
 
 
         
 
 
(262)Port of Moses Lake
 
 
         
 
 
(263)Port of Olympia
 
 
         
 
 
(264)Port of Pasco
 
 
         
 
 
(265)Port of Peninsula
 
 
         
 
 
(266)Port of Port Angeles
 
 
         
 
 
(267)Port of Port Townsend
 
 
         
 
 
(268)Port of Ridgefield
 
 
         
 
 
(269)Port of Skagit
 
 
         
 
 
(270)Port of Skamania County
 
 
         
 
 
(271)Port of Tacoma
 
 
         
 
 
(272)Port of Vancouver
 
 
         
 
 
(273)Port of Walla Walla
 
 
         
 
 
(274)Port of Willapa Harbor
 
 
         
 
 
(275)Port of Woodland
 
 
         
 
 
(276)Poulsbo Fire
 
 
         
 
 
(277)Public Utility District 2 Pacific
 
 
         
 
 
(278)Puget Sound Regional Council
 
 
         
 
 
(279)Puget Sound Regional Fire Authority
 
 
         
 
 
(280)Quilcene Fire
 
 
         
 
 
(281)Riverside Fire Authority
 
 
         
 
 
(282)Ronald Wastewater District
 
 
         
 
 
(283)San Juan County Fire Protection District
 
 
         
 
 
(284)Silver Lake Water District
 
 
         
 
 
(285)Silverdale Water District
 
 
         
 
 
(286)Si View Metropolitan Park District
 
 
         
 
 
(287)Skagit 911
 
 
         
 
 
(288)Skagit Transit
 
 
         
 
 
(289)Skamania County PUD No 1
 
 
         
 
 
(290)Skamania EMS
 
 
         
 
 
(291)Skyway Water & Sewer District
 
 
         
 
 
(292)Snohomish Conservation District
 
 
         
 
 
(293)Snohomish County Fire Dist No 5
 
 
         
 
 
(294)Snohomish County Fire Dist No 26
 
 
         
 
 
(295)Snohomish Regional Fire & Rescue
 
 
         
 
 
(296)Soos Creek Water & Sewer District
 
 
         
 
 
(297)South Bay Fire District
 
 
         
 
 
(298)South Beach Fire and EMS
 
 
         
 
 
(299)South King Fire & Rescue
 
 
         
 
 
(300)South King County Water District
 
 
         
 
 
(301)South Kitsap Fire & Rescue
 
 
         
 
 
(302)Southeast Thurston Fire
 
 
         
 
 
(303)Southeast WA Aging & LTC Council of Gov'ts
 
 
         
 
 
(304)Southwest Suburban Sewer District
 
 
         
 
 
(305)Spokane County Fire District No 4
 
 
         
 
 
(306)Spokane County Fire District No 9
 
 
         
 
 
(307)Spokane County Fire District No 10
 
 
         
 
 
(308)Spokane Housing Authority
 
 
         
 
 
(309)Spokane Noxious Weed Board
 
 
         
 
 
(310)Spokane Transit Authority
 
 
         
 
 
(311)Spokane Valley Fire Dept
 
 
         
 
 
(312)Stevens County Conservation District
 
 
         
 
 
(313)Stevens County Fire Protection Dist No 1
 
 
         
 
 
(314)Stevens County PUD
 
 
         
 
 
(315)Three Rivers Regional Wastewater Authority
 
 
         
 
 
(316)Thurston County Fire Dist No 13
 
 
         
 
 
(317)Thurston County PUD No 1
 
 
         
 
 
(318)Timberlands Regional Support Network
 
 
         
 
 
(319)Tri-County Economic Development Dist
 
 
         
 
 
(320)Valley Transit
 
 
         
 
 
(321)Valley View Sewer District
 
 
         
 
 
(322)Valley Water District
 
 
         
 
 
(323)Vashon Island Fire
 
 
         
 
 
(324)Vera Water & Power
 
 
         
 
 
(325)Wahkiakum PUD
 
 
         
 
 
(326)Walla Walla County Fire District No 4
 
 
         
 
 
(327)Walla Walla Fire Protection District No 5
 
 
         
 
 
(328)Washington Assoc of County Officials
 
 
         
 
 
(329)Washington Assoc of Prosecuting Attorneys
 
 
         
 
 
(330)Washington Cities Insurance Authority
 
 
         
 
 
(331)Washington State Association of Counties
 
 
         
 
 
(332)Washington PUD Association
 
 
         
 
 
(333)Water & Sewer Risk Mgmt Pool
 
 
         
 
 
(334)Wenatchee Valley Transportation
 
 
         
 
 
(335)West Pierce Fire & Rescue
 
 
         
 
 
(336)West Sound Utility District
 
 
         
 
 
(337)West Thurston Regional Fire Authority
 
 
         
 
 
(338)Whatcom County Fire District 1
 
 
         
 
 
(339)Woodinville Water District
 
 
         
 
 
(340)Yakima County Fire District 4
 
 
         
 
 
(341)Yakima County Fire District 5
 
 
         
 
 
(342)Yakima County Fire District 6
 
 
         
 
 
(343)Yakima Fire District 12
 
 
         
 
 
(344)Yakima Health District
 
 
         
 
 
(345)City of Albany
 
 
         
 
 
(346)City of Ashland
 
 
         
 
 
(347)City of Astoria
 
 
         
 
 
(348)City of Baker City
 
 
         
 
 
(349)City of Bay City
 
 
         
 
 
(350)City of Beaverton
 
 
         
 
 
(351)City of Bend
 
 
         
 
 
(352)City of Boardman
 
 
         
 
 
(353)City of Brookings
 
 
         
 
 
(354)City of Canby
 
 
         
 
 
(355)City of Central Point
 
 
         
 
 
(356)City of Clatskanie
 
 
         
 
 
(357)City of Coburg
 
 
         
 
 
(358)City of Columbia City
 
 
         
 
 
(359)City of Coos Bay
 
 
         
 
 
(360)City of Cornelius
 
 
         
 
 
(361)City of Cottage Grove
 
 
         
 
 
(362)City of Dallas
 
 
         
 
 
(363)City of Dayton
 
 
         
 
 
(364)City of Dundee
 
 
         
 
 
(365)City of Estacada
 
 
         
 
 
(366)City of Forest Grove
 
 
         
 
 
(367)City of Garibaldi
 
 
         
 
 
(368)City of Gervais
 
 
         
 
 
(369)City of Gladstone
 
 
         
 
 
(370)City of Gresham
 
 
         
 
 
(371)City of Happy Valley
 
 
         
 
 
(372)City of Harrisburg
 
 
         
 
 
(373)City of Hermiston
 
 
         
 
 
(374)City of Hillsboro
 
 
         
 
 
(375)City of Hood River
 
 
         
 
 
(376)City of Independence
 
 
         
 
 
(377)City of John Day
 
 
         
 
 
(378)City of Joseph
 
 
         
 
 
(379)City of Junction City
 
 
         
 
 
(380)City of King City
 
 
         
 
 
(381)City of Klamath Falls
 
 
         
 
 
(382)City of La Grande
 
 
         
 
 
(383)City of Lake Oswego
 
 
         
 
 
(384)City of La Pine
 
 
         
 
 
(385)City of Lebanon
 
 
         
 
 
(386)City of Madras
 
 
         
 
 
(387)City of McMinnville
 
 
         
 
 
(388)City of Medford
 
 
         
 
 
(389)City of Milwaukie
 
 
         
 
 
(390)City of Molalla
 
 
         
 
 
(391)City of Monmouth
 
 
         
 
 
(392)City of Myrtle Creek
 
 
         
 
 
(393)City of Nehalem
 
 
         
 
 
(394)City of Newberg
 
 
         
 
 
(395)City of Newport
 
 
         
 
 
(396)City of Oakridge
 
 
         
 
 
(397)City of Oregon City
 
 
         
 
 
(398)City of Pendleton
 
 
         
 
 
(399)City of Philomath
 
 
         
 
 
(400)City of Phoenix
 
 
         
 
 
(401)City of Pilot Rock
 
 
         
 
 
(402)City of Portland
 
 
         
 
 
(403)City of Rainier
 
 
         
 
 
(404)City of Redmond
 
 
         
 
 
(405)City of Reedsport
 
 
         
 
 
(406)City of Rockaway Beach
 
 
         
 
 
(407)City of Roseburg
 
 
         
 
 
(408)City of Salem
 
 
         
 
 
(409)City of Sheridan
 
 
         
 
 
(410)City of Sherwood
 
 
         
 
 
(411)City of Silverton
 
 
         
 
 
(412)City of Springfield
 
 
         
 
 
(413)City of Stanfield
 
 
         
 
 
(414)City of St Helens
 
 
         
 
 
(415)City of Stayton
 
 
         
 
 
(416)City of Sublimity
 
 
         
 
 
(417)City of Sweet Home
 
 
         
 
 
(418)City of Talent
 
 
         
 
 
(419)City of The Dalles
 
 
         
 
 
(420)City of Tigard
 
 
         
 
 
(421)City of Tillamook
 
 
         
 
 
(422)City of Troutdale
 
 
         
 
 
(423)City of Tualatin
 
 
         
 
 
(424)City of Umatilla
 
 
         
 
 
(425)City of Union
 
 
         
 
 
(426)City of Vernonia
 
 
         
 
 
(427)City of Waldport
 
 
         
 
 
(428)City of Warrenton
 
 
         
 
 
(429)City of West Linn
 
 
         
 
 
(430)City of Willamina
 
 
         
 
 
(431)City of Woodburn
 
 
         
 
 
(432)Baker County
 
 
         
 
 
(433)Benton County OR
 
 
         
 
 
(434)Clackamas County
 
 
         
 
 
(435)Clatsop County
 
 
         
 
 
(436)Columbia County
 
 
         
 
 
(437)Coos County
 
 
         
 
 
(438)Curry County
 
 
         
 
 
(439)Douglas County
 
 
         
 
 
(440)Gilliam County
 
 
         
 
 
(441)Hood River County
 
 
         
 
 
(442)Jackson County
 
 
         
 
 
(443)Jefferson County
 
 
         
 
 
(444)Josephine County
 
 
         
 
 
(445)Klamath County
 
 
         
 
 
(446)Lane County
 
 
         
 
 
(447)Lincoln County
 
 
         
 
 
(448)Linn County
 
 
         
 
 
(449)Morrow County
 
 
         
 
 
(450)Multnomah County
 
 
         
 
 
(451)Tillamook County
 
 
         
 
 
(452)Umatilla County
 
 
         
 
 
(453)Wallowa County
 
 
         
 
 
(454)Washington County
 
 
         
 
 
(455)Yamhill County
 
 
         
 
 
(456)Alsea School District
 
 
         
 
 
(457)Applegate Valley RFPD
 
 
         
 
 
(458)Arlington School District
 
 
         
 
 
(459)Ashland Parks & Recreation Comm
 
 
         
 
 
(460)Association of Oregon Counties
 
 
         
 
 
(461)Astoria School District
 
 
         
 
 
(462)Athena-Weston School District
 
 
         
 
 
(463)Aumsville Rural Fire District
 
 
         
 
 
(464)Aurora Rural Fire Protection
 
 
         
 
 
(465)Baker Charter Schools
 
 
         
 
 
(466)Banks Fire District No 13
 
 
         
 
 
(467)Banks School District No 13
 
 
         
 
 
(468)Black Butte Ranch Police
 
 
         
 
 
(469)Black Butte Ranch Rural Fire District
 
 
         
 
 
(470)Blue Mountain Hospital District
 
 
         
 
 
(471)Boring Fire District
 
 
         
 
 
(472)Camas Valley School District
 
 
         
 
 
(473)Canby Fire District No 62
 
 
         
 
 
(474)Canby Utility Board
 
 
         
 
 
(475)Central Lincoln PUD
 
 
         
 
 
(476)Central School District
 
 
         
 
 
(477)City County Insurance
 
 
         
 
 
(478)City of Salem Firefighters
 
 
         
 
 
(479)Clackamas River Water District
 
 
         
 
 
(480)Clatskanie PUD
 
 
         
 
 
(481)Clatskanie School District
 
 
         
 
 
(482)Clean Water Services
 
 
         
 
 
(483)Cloverdale Rural Fire District
 
 
         
 
 
(484)Coburg Fire Board
 
 
         
 
 
(485)Colton Rural Fire District
 
 
         
 
 
(486)Columbia 911 Communications
 
 
         
 
 
(487)Columbia River Fire & Rescue
 
 
         
 
 
(488)Columbia River PUD
 
 
         
 
 
(489)Condon School District
 
 
         
 
 
(490)Corbett School District
 
 
         
 
 
(491)Corbett Water District
 
 
         
 
 
(492)Crescent Rural Fire Protection
 
 
         
 
 
(493)Creswell School District
 
 
         
 
 
(494)Crook County Fire & Rescue
 
 
         
 
 
(495)Crooked River Ranch Fire & Rescue
 
 
         
 
 
(496)Dayton Fire District
 
 
         
 
 
(497)Dayton School District
 
 
         
 
 
(498)Dayville School District
 
 
         
 
 
(499)Depoe Bay Fire District
 
 
         
 
 
(500)Douglas County Fire District No 2
 
 
         
 
 
(501)East Umatilla Fire & Rescue
 
 
         
 
 
(502)East Umatilla Health District
 
 
         
 
 
(503)Echo School District
 
 
         
 
 
(504)Emergency Comm of So Oregon
 
 
         
 
 
(505)Estacada Rural Fire District No 69
 
 
         
 
 
(506)Eugene Water & Electric Board
 
 
         
 
 
(507)Evans Valley Fire District #6
 
 
         
 
 
(508)Four Rivers Community School
 
 
         
 
 
(509)Gervais School District
 
 
         
 
 
(510)Goshen Fire District
 
 
         
 
 
(511)Grant County ESD
 
 
         
 
 
(512)Grant School District No 3
 
 
         
 
 
(513)Greater Albany Public School District
 
 
         
 
 
(514)Green Area Water Sanitary Authority
 
 
         
 
 
(515)Halsey-Shedd Rural Fire Protection
 
 
         
 
 
(516)Hermiston Fire & Emergency
 
 
         
 
 
(517)Hermiston School District
 
 
         
 
 
(518)Hood River Library District
 
 
         
 
 
(519)Hood River School District
 
 
         
 
 
(520)Housing Authority of Clackamas Co
 
 
         
 
 
(521)Illinois Valley Fire District
 
 
         
 
 
(522)InterMountain ESD
 
 
         
 
 
(523)Jackson County Fire District No 3
 
 
         
 
 
(524)Jackson County Fire District No 4
 
 
         
 
 
(525)Jackson County Fire District No 5
 
 
         
 
 
(526)Jefferson County Fire District No 1
 
 
         
 
 
(527)Jewell School District
 
 
         
 
 
(528)Keizer Rural Fire Protection
 
 
         
 
 
(529)Klamath 911 Communications
 
 
         
 
 
(530)Knappa School District
 
 
         
 
 
(531)La Pine Rural Fire Protection District
 
 
         
 
 
(532)Lake County ESD
 
 
         
 
 
(533)Lake Oswego School District
 
 
         
 
 
(534)Lane Fire Authority
 
 
         
 
 
(535)Lane Library District
 
 
         
 
 
(536)(OREGON CONTINUED)
 
 
         
 
 
(537)League of Oregon Cities
 
 
         
 
 
(538)Lebanon Community School District
 
 
         
 
 
(539)Lebanon Fire District
 
 
         
 
 
(540)Lewis & Clark Rural Fire Protection District
 
 
         
 
 
(541)Lincoln County School District
 
 
         
 
 
(542)Lyons Rural Fire District
 
 
         
 
 
(543)Marion County Fire District No 1
 
 
         
 
 
(544)Marion County Housing Authority of Oregon
 
 
         
 
 
(545)McKenzie Fire & Rescue
 
 
         
 
 
(546)McMinnville School District
 
 
         
 
 
(547)McMinnville Water & Light
 
 
         
 
 
(548)Medford Water Commission
 
 
         
 
 
(549)METCOM
 
 
         
 
 
(550)Mid Columbia Center for Living
 
 
         
 
 
(551)Mid Columbia Council of Govt
 
 
         
 
 
(552)Mid Columbia Fire & Rescue
 
 
         
 
 
(553)Mid-Willamette Valley Council of Govt
 
 
         
 
 
(554)Milton-Freewater Unified School District
 
 
         
 
 
(555)MINET
 
 
         
 
 
(556)Mohawk Valley Rural Fire District
 
 
         
 
 
(557)Molalla Rural Fire District No 73
 
 
         
 
 
(558)Monroe Rural Fire Protection District
 
 
         
 
 
(559)Monument School District
 
 
         
 
 
(560)Morrow County School District
 
 
         
 
 
(561)Mt Angel Fire District
 
 
         
 
 
(562)Multnomah ESD
 
 
         
 
 
(563)Neah-Kah-Nie School District
 
 
         
 
 
(564)Neahkahnie Water District
 
 
         
 
 
(565)Nestucca Valley School District
 
 
         
 
 
(566)North Central ESD
 
 
         
 
 
(567)North Lincoln Fire & Rescue District
 
 
         
 
 
(568)North Marion School District
 
 
         
 
 
(569)North Santiam School District
 
 
         
 
 
(570)Northern Wasco School District
 
 
         
 
 
(571)Northern Wasco County PUD
 
 
         
 
 
(572)Northwest Oregon Housing Authority
 
 
         
 
 
(573)Northwest Regional ESD
 
 
         
 
 
(574)Oakland School District
 
 
         
 
 
(575)Orbis Cascade Alliance
 
 
         
 
 
(576)Oregon City School District
 
 
         
 
 
(577)Pendleton School District
 
 
         
 
 
(578)Perrydale School District
 
 
         
 
 
(579)Philomath Fire & Rescue
 
 
         
 
 
(580)Philomath School District
 
 
         
 
 
(581)Pilot Rock School District
 
 
         
 
 
(582)Pleasant Home Water District
 
 
         
 
 
(583)Polk County Fire
 
 
         
 
 
(584)Polk Soil & Water Conservation District
 
 
         
 
 
(585)Port of Morrow
 
 
         
 
 
(586)Port of Portland
 
 
         
 
 
(587)Port of St Helens
 
 
         
 
 
(588)Port Orford Langlois School District
 
 
         
 
 
(589)Prairie City School District
 
 
         
 
 
(590)Prosper Portland
 
 
         
 
 
(591)Redmond Fire & Rescue
 
 
         
 
 
(592)Riverdale School District
 
 
         
 
 
(593)Rockwood Water PUD
 
 
         
 
 
(594)Rogue River Fire District
 
 
         
 
 
(595)Rogue Valley Council of Governments
 
 
         
 
 
(596)Rogue Valley Transportation
 
 
         
 
 
(597)Roseburg Urban Sanitary Authority
 
 
         
 
 
(598)Salem Area Mass Transit District
 
 
         
 
 
(599)Sandy Rural Fire
 
 
         
 
 
(600)Santa Clara RFPD
 
 
         
 
 
(601)Scappoose Rural Fire District
 
 
         
 
 
(602)Scappoose School District
 
 
         
 
 
(603)Scio School District
 
 
         
 
 
(604)Seaside School District
 
 
         
 
 
(605)Sheridan School District
 
 
         
 
 
(606)Sherwood School District
 
 
         
 
 
(607)Siletz Valley Rural Fire
 
 
         
 
 
(608)Silver Falls School District
 
 
         
 
 
(609)Silverton Fire District
 
 
         
 
 
(610)Sisters Camp Sherman Fire District
 
 
         
 
 
(611)South Coast Education Service District
 
 
         
 
 
(612)Southern Oregon Regional Economic Development Inc
 
 
         
 
 
(613)South Fork Water Board
 
 
         
 
 
(614)South Gilliam County Health District
 
 
         
 
 
(615)South Lane Fire & Rescue
 
 
         
 
 
(616)South Lane School District
 
 
         
 
 
(617)Southwestern Polk Rural Fire
 
 
         
 
 
(618)Springfield Utility Board
 
 
         
 
 
(619)Stanfield School District
 
 
         
 
 
(620)Sublimity Fire District
 
 
         
 
 
(621)Sunriver Service District
 
 
         
 
 
(622)Sunset Empire Parks & Rec District
 
 
         
 
 
(623)Tangent Rural Fire
 
 
         
 
 
(624)Tigard-Tualatin School District
 
 
         
 
 
(625)Tillamook PUD
 
 
         
 
 
(626)Tillamook Cty Emerg Comm District
 
 
         
 
 
(627)Tillamook County Transp District
 
 
         
 
 
(628)Tillamook Fire District
 
 
         
 
 
(629)Tillamook School District
 
 
         
 
 
(630)Treasure Valley Community College
 
 
         
 
 
(631)TRIMET
 
 
         
 
 
(632)Tualatin Valley Water District
 
 
         
 
 
(633)Turner Fire District
 
 
         
 
 
(634)Ukiah School District
 
 
         
 
 
(635)Umatilla County School District 6R
 
 
         
 
 
(636)Umatilla Rural Fire Protection District
 
 
         
 
 
(637)Umpqua Public Transportation District
 
 
         
 
 
(638)Wahtonka (Riverbend) Community School
 
 
         
 
 
(639)Warrenton-Hammond School District
 
 
         
 
 
(640)Washington County Consolidated Communications Agency
 
 
         
 
 
(641)Western Lane Fire & EMS Authority
 
 
         
 
 
(642)West Multnomah Soil & Water Conservation District
 
 
         
 
 
(643)West Valley Housing Authority
 
 
         
 
 
(644)Willamette ESD
 
 
         
 
 
(645)Winston-Dillard Fire No 5
 
 
         
 
 
(646)Woodburn Fire District
 
 
         
 
 
(647)Yamhill Communications Agency
 
 
         
 
 
(648)Yamhill County Housing Authority
 
 
         
 
 
(649)City of Boise
 
 
         
 
 
(650)City of Caldwell
 
 
         
 
 
(651)City of Coeur dAlene
 
 
         
 
 
(652)City of Cottonwood
 
 
         
 
 
(653)City of Donnelly
 
 
         
 
 
(654)City of Garden City
 
 
         
 
 
(655)City of Hailey
 
 
         
 
 
(656)City of Idaho Falls
 
 
         
 
 
(657)City of Lewiston
 
 
         
 
 
(658)City of Moscow
 
 
         
 
 
(659)City of Nampa
 
 
         
 
 
(660)City of New Plymouth
 
 
         
 
 
(661)City of Nezperce
 
 
         
 
 
(662)City of Orofino
 
 
         
 
 
(663)City of Pocatello
 
 
         
 
 
(664)City of Post Falls
 
 
         
 
 
(665)City of Rathdrum
 
 
         
 
 
(666)City of Rexburg
 
 
         
 
 
(667)City of Rigby
 
 
         
 
 
(668)City of Sandpoint
 
 
         
 
 
(669)City of St Maries
 
 
         
 
 
(670)City of Sun Valley
 
 
         
 
 
(671)Bonner County
 
 
         
 
 
(672)Fremont County
 
 
         
 
 
(673)Kootenai County
 
 
         
 
 
(674)Madison County
 
 
         
 
 
(675)Nez Perce County
 
 
         
 
 
(676)Shoshone County
 
 
         
 
 
(677)American Falls School District
 
 
         
 
 
(678)Association of Idaho Cities
 
 
         
 
 
(679)Basin School District No 72
 
 
         
 
 
(680)Blackfoot Charter Community
 
 
         
 
 
(681)Canyon Highway District No 4
 
 
         
 
 
(682)Community Library District
 
 
         
 
 
(683)Eagle Fire Protection District
 
 
         
 
 
(684)Idaho Science & Tech Charter School
 
 
         
 
 
(685)Idaho Stem Academy
 
 
         
 
 
(686)Kootenai County Emerg Medical Svcs
 
 
         
 
 
(687)Lakeland Joint SD No 272
 
 
         
 
 
(688)Lakes Highway District
 
 
         
 
 
(689)Latah County Library District
 
 
         
 
 
(690)Lewiston Orchards Irrigation District
 
 
         
 
 
(691)Local Highway Technical Assistance Council
 
 
         
 
 
(692)Madison Memorial Hospital
 
 
         
 
 
(693)Meridian Library District
 
 
         
 
 
(694)Middleton Rural Fire District
 
 
         
 
 
(695)Nampa Fire Protection District
 
 
         
 
 
(696)North Kootenai Water & Sewer
 
 
         
 
 
(697)Northern Lakes Fire District
 
 
         
 
 
(698)Post Falls Highway District
 
 
         
 
 
(699)Selkirk Fire Rescue & EMS
 
 
         
 
 
(700)Star Fire Protection District
 
 
         
 
 
(701)Valley Regional Transit
 
 
         
 
 
(702)Wood River Fire Protection District
 
 
         
 
 
(703)Worley Highway District
 
 
         
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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
Yes No Yes No












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?
Yes No












Schedule R (Form 990) 2021
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
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





Schedule R (Form 990) 2021
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
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


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