Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 106,800 | 103,400 | 101,600 | 100,500 | 100,000 | 512,300 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 106,800 | 103,400 | 101,600 | 100,500 | 100,000 | 512,300 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 512,300 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 106,800 | 103,400 | 101,600 | 100,500 | 100,000 | 512,300 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,825 | 2,876 | 2,175 | 2,986 | 3,396 | 13,258 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | 525,558 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| Form 990-EZ, Part I, Line 4 - Other Investment Income | Description: Interest/dividends. Amount: 3,396. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: 40 West Arts, Inc. Grantee Address: 6501 W Colfax Ave Lakewood, CO 80214. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 2,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Jeffco Action Center. Grantee Address: 8755 W 14th St Lakewood, CO 80215. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 7,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Boys & Girls Clubs of Denver. Grantee Address: 2017 W 9th Ave Denver, CO 80204. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Brothers Redevelopment. Grantee Address: 2250 Eaton St, B Denver, CO 80214. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: CrossPurpose. Grantee Address: 8330 W 80th Ave, #9 Arvada, CO 80005. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 7,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Family Tree. Grantee Address: 3805 Marshall St Wheat Ridge, CO 80033. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Catholic Charities. Grantee Address: 6240 Smith Road Denver, CO 80216. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 7,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Hands of the Carpenter. Grantee Address: 16097 S Golden Rd Golden, CO 80401. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 7,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Just Living Recovery. Grantee Address: PO Box 150565 Lakewood, CO 80215. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 4,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Ralston House. Grantee Address: 10795 W 58th Ave Arvada, CO 80002. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Outdoor Lab Foundation. Grantee Address: 3000 Youngfield St, #167 Wheat Ridge, CO 80215. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Friends of Dinosaur Ridge. Grantee Address: 16831 W Alameda Pkwy Morrison, CO 80465. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 2,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Harvest Mtn Ministries (Jeffco Eats). Grantee Address: 1390 Brentwood St Lakewood, CO 80214. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 7,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Lakewood Symphony Orchestra. Grantee Address: 470 S Allison Pkwy Lakewood, CO 80226. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 3,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Gold Crown Foundation. Grantee Address: 150 S Harlan St Lakewood, CO 80226. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Benefits in Action. Grantee Address: 12157 W Cedar Dr Lakewood, CO 80228. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 2,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Jefferson County Library Foundation. Grantee Address: 10790 W 50th Ave, #200 Wheat Ridge, CO 80033. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 9,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Gigi's Playhouse. Grantee Address: 610 Garrison St, Unit F Lakewood, CO 80215. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 2,500. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Jovial Concepts. Grantee Address: 4541 S Braun Ct Morrison, CO 80465. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Charitable. Grantee Name: Lakewood School of Music Foundation. Grantee Address: 730 Simms St, Ste A Lakewood, CO 80401. Grantee Relationship: None. Date of Gift: 06/04/24. Amount Given: 5,000. Total included on Form 990-EZ, line 10: 100,000. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: Bank charges. Amount: 300. Description: Investment fees. Amount: 1,283. Total to Form 990-EZ, line 16: 1,583. |
| Form 990-EZ, Part I, Line 20 - Other Changes in Net Assets | Description: Unrealized gain(loss) in Endowment Fund. Amount: 4,165. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: Endowment Fund. Beg. of Year Amount: 116,253. End of Year Amount: 120,754. |
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