Filing Instructions. The Chanda Plan Foundation. Exempt Organization Tax Return. Taxable Year Ended December 31, 2016

Transcription

1 Filing Instructions The Chanda Plan Foundation Exempt Organization Tax Return Taxale Year Ended Decemer 1, 016 Date Due: vemer 15, 017 Remittance: Signature: ne is required. Your Form 990 for the tax year ended 1/1/16 shows no alance due. You are using a Personal Identification Numer (PIN) for signing your return electronically. Sign the IRS e-file Authorization and mail it as soon as possile to: Bivins & Bunyak, CPAs PLLC 70 Harlan St Ste 0 Denver, CO Other: Your return is eing filed electronically with the IRS and is not required to e mailed. Mailing a paper copy of your return to the IRS will delay the processing of your return.

2 Form Department of the Treasury Internal Revenue Service Name of exempt organization Name and title of officer Part I 8879-EO For calendar year 016, or fiscal year eginning , 016, and ending , check the ox on line 1a, a, a, a, or 5a, elow, and the amount on that line for the return eing filed with this form was lank, then leave line 1,,,, or 5, whichever is applicale, lank (do not enter -0-). But, if you entered -0- on the return, then enter -0- on the applicale line elow. Do not complete more than 1 line in Part I. 1a Form 990 check here Total revenue, if any (Form 990, Part VIII, column (A), line 1) a Form 990-EZ check here Total revenue, if any (Form 990-EZ, line 9) a Form 110-POL check here Total tax (Form 110-POL, line ) a Form 990-PF check here Tax ased on investment income (Form 990-PF, Part VI, line 5) a Form 8868 check here Balance Due (Form 8868, line c) Part II Declaration and Signature Authorization of Officer Under penalties of perjury, I declare that I am an officer of the aove organization and that I have examined a copy of the organization s 016 electronic return and accompanying schedules and statements and to the est of my knowledge and elief, they are true, correct, and complete. I further declare that the amount in Part I aove is the amount shown on the copy of the organization s electronic return. I consent to allow my intermediate service provider, transmitter, or electronic return originator (ERO) to send the organization s return to the IRS and to receive from the IRS (a) an acknowledgement of receipt or reason for rejection of the transmission, () the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicale, I authorize the U.S. Treasury and its designated Financial Agent to initiate an electronic funds withdrawal (direct deit) entry to the financial institution account indicated in the tax preparation software for payment of the organization s federal taxes owed on this return, and the financial institution to deit the entry to this account. To revoke a payment, I must contact the U.S. Treasury Financial Agent at no later than usiness days prior to the payment (settlement) date. I also authorize the financial institutions involved in the processing of the electronic payment of taxes to receive confidential information necessary to answer inquiries and resolve issues related to the payment. I have selected a personal identification numer (PIN) as my signature for the organization s electronic return and, if applicale, the organization s consent to electronic funds withdrawal. I authorize to enter my PIN as my signature ERO firm name Enter five numers, ut do not enter all zeros on the organization s tax year 016 electronically filed return. If I have indicated within this return that a copy of the return is eing filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I also authorize the aforementioned ERO to enter my PIN on the return s disclosure consent screen. As an officer of the organization, I will enter my PIN as my signature on the organization s tax year 016 electronically filed return. If I have indicated within this return that a copy of the return is eing filed with a state agency(ies) regulating charities as part of the IRS Fed/State program, I will enter my PIN on the return s disclosure consent screen. Officer's signature Part III Certification and Authentication ERO's EFIN/PIN. Enter your six-digit electronic filing identification numer (EFIN) followed y your five-digit self-selected PIN. IRS e-file Signature Authorization for an Exempt Organization Do not send to the IRS. Keep for your records. Information aout Form 8879-EO and its instructions is at Type of Return and Return Information (Whole Dollars Only) Officer's PIN: check one ox only Date Employer identification numer Chanda Hinton Executive Director Check the ox for the return for which you are using this Form 8879-EO and enter the applicale amount, if any, from the return. If you OMB ,501,19 Bivins & Bunyak, CPAs PLLC // do not enter all zeros I certify that the aove numeric entry is my PIN, which is my signature on the 016 electronically filed return for the organization indicated aove. I confirm that I am sumitting this return in accordance with the requirements of Pu. 16, Modernized e-file (MeF) Information for Authorized IRS e-file Providers for Business Returns. ERO's signature Jonathan Bunyak, CPA 06//17 Date For Paperwork Reduction Act tice, see ack of form. ERO Must Retain This Form See Instructions Do t Sumit This Form To the IRS Unless Requested To Do So Form 8879-EO (016)

3 Form Under section 501(c), 57, or 97(a)(1) of the Internal Revenue Code (except private foundations) Department of the Treasury Do not enter social security numers on this form as it may e made pulic. Internal Revenue Service Information aout Form 990 and its instructions is at A For the 016 calendar year, or tax year eginning, and ending B I J K Activities & Governance Revenue Expenses Net Assets or Fund Balances Check if applicale: Address change Name change Initial return Final return/ terminated 990 Amended return Application pending Tax-exempt status: Wesite: Form of organization: Part I 1 C Name of organization F Doing usiness as Return of Organization Exempt From Income Tax Numer and street (or P.O. ox if mail is not delivered to street address) City or town, state or province, country, and ZIP or foreign postal code Name and address of principal officer: Summary The Chanda Plan Foundation 160 Carr Street Ste A1/A Lakewood CO 801 Chanda Hinton 6 Raritan Street Denver CO Grants and similar amounts paid (Part I, column (A), lines 1 ) Benefits paid to or for memers (Part I, column (A), line ) Salaries, other compensation, employee enefits (Part I, column (A), lines 5 10) a Professional fundraising fees (Part I, column (A), line 11e) Total fundraising expenses (Part I, column (D), line 5) , Other expenses (Part I, column (A), lines 11a 11d, 11f e) Total expenses. Add lines 1 17 (must equal Part I, column (A), line 5) Revenue less expenses. Sutract line 18 from line Room/suite E Telephone numer G Gross receipts OMB Open to Pulic Inspection D Employer identification numer H(a) Is this a group return for suordinates? Yes H() Are all suordinates included? Yes If "," attach a list. (see instructions) Briefly descrie the organization's mission or most significant activities: through direct services and systemic change to access integrative.. therapies.. Check this ox if the organization discontinued its operations or disposed of more than 5% of its net assets. 5 6 Numer of voting memers of the governing ody (Part VI, line 1a) Numer of independent voting memers of the governing ody (Part VI, line 1) Total numer of individuals employed in calendar year 016 (Part V, line a) Total numer of volunteers (estimate if necessary) a Total unrelated usiness revenue from Part VIII, column (C), line Net unrelated usiness taxale income from Form 990-T, line a 7 Prior Year 8 Contriutions and grants (Part VIII, line 1h) Program service revenue (Part VIII, line g) Investment income (Part VIII, column (A), lines,, and 7d) Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) Total revenue add lines 8 through 11 (must equal Part VIII, column (A), line 1) Total assets (Part, line 16) Total liailities (Part, line 6) Net assets or fund alances. Sutract line 1 from line Part II Signature Block Beginning of Current Year ,60, (c)() 501(c) ( ) (insert no.) 97(a)(1) or 57 H(c) Group exemption numer Corporation Trust Association Other L Year of formation: 006 M State of legal domicile: CO Improving the quality of life for persons with physical disailities Current Year End of Year Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the est of my knowledge and elief, it is true, correct, and complete. Declaration of preparer (other than officer) is ased on all information of which preparer has any knowledge , , 1,69,88 0-5,667 5,86 11,11 5,905 81,967 1,501,19 09,7 1,1 0 97,705 17, ,66 0,99 86, ,9 6,89 799,790 1,09,71,, , ,158 6,561 1,,51 Sign Here Signature of officer Chanda Hinton Type or print name and title Print/Type preparer's name Preparer's signature Date Check if PTIN self-employed Firm's name Bivins & Bunyak, CPAs PLLC Firm's EIN Denver, CO Phone no Firm's address May the IRS discuss this return with the preparer shown aove? (see instructions) For Paperwork Reduction Act tice, see the separate instructions. Date Executive Director Paid Jonathan Bunyak, CPA Jonathan Bunyak, CPA 06//17 P Preparer Use Only 70 Harlan St Ste 0 Yes Form 990 (016)

4 Form 990 (016) Page Part III Statement of Program Service Accomplishments 1 Briefly descrie the organization's mission: 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," descrie these new services on Schedule O. Did the organization cease conducting, or make significant changes in how it conducts, any program services? If "Yes," descrie these changes on Schedule O. Descrie the organization's program service accomplishments for each of its three largest program services, as measured y expenses. Section 501(c)() and 501(c)() 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. a (Code: ) (Expenses including grants of ) (Revenue ) ) (Revenue ) including grants of ) (Expenses (Code: c (Code: including grants of ) ) (Expenses ) (Revenue. d Other program services (Descrie in Schedule O.) (Revenue ) (Expenses ) including grants of e Total program service expenses Form 990 (016) Yes Yes Check if Schedule O contains a response or note to any line in this Part III Improving the quality of life for persons with physical disailities through direct services and systemic change to access integrative therapies. 5,6 1,1 Integrative therapy treatments for persons with physical disailities including adaptive exercise/physical therapy, massage, acupuncture, chiropractic, and adaptive yoga. 5,6

5 Form 990 (016) Part IV Checklist of Required Schedules 1 Is the organization descried in section 501(c)() or 97(a)(1) (other than a private foundation)? If Yes, complete Schedule A Is the organization required to complete Schedule B, Schedule of Contriutors (see instructions)? Did the organization engage in direct or indirect political campaign activities on ehalf of or in opposition to candidates for pulic office? If Yes, complete Schedule C, Part I Section 501(c)() organizations. Did the organization engage in loying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II Is the organization a section 501(c)(), 501(c)(5), or 501(c)(6) organization that receives memership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III 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 distriution or investment of amounts in such funds or accounts? If Yes, complete Schedule D, Part I 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 II Did the organization maintain collections of works of art, historical treasures, or other similar assets? If Yes, complete Schedule D, Part III Did the organization report an amount in Part, line 1, for escrow or custodial account liaility, serve as a custodian for amounts not listed in Part ; or provide credit counseling, det management, credit repair, or det negotiation services? If Yes, complete Schedule D, Part IV. 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 If the organization's answer to any of the following questions is Yes, then complete Schedule D, Parts VI, VII, VIII, I, or as applicale. a Did the organization report an amount for land, uildings, and equipment in Part, line 10? If "Yes," complete Schedule D, Part VI Did the organization report an amount for investments other securities in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "Yes," complete Schedule D, Part VII c Did the organization report an amount for investments program related in Part, line 1 that is 5% or more of its total assets reported in Part, line 16? If "Yes," complete Schedule D, Part VIII d Did the organization report an amount for other assets in Part, line 15 that is 5% or more of its total assets reported in Part, line 16? If "Yes," complete Schedule D, Part I e Did the organization report an amount for other liailities in Part, line 5? If "Yes," complete Schedule D, Part f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses 1a 1 1a the organization's liaility for uncertain tax positions under FIN 8 (ASC 70)? If "Yes," complete Schedule D, Part Did the organization otain separate, independent audited financial statements for the tax year? If Yes, complete Schedule D, Parts I and II Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "" to line 1a, then completing Schedule D, Parts I and II is optional Is the organization a school descried in section 170()(1)(A)(ii)? If Yes, complete Schedule E Did the organization maintain an office, employees, or agents outside of the United States? Did the organization have aggregate revenues or expenses of more than 10,000 from grantmaking, fundraising, usiness, 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 Did the organization report on Part I, column (A), line, more than 5,000 of grants or other assistance to or for any foreign organization? If Yes, complete Schedule F, Parts II and IV Did the organization report on Part I, column (A), line, more than 5,000 of aggregate grants or other assistance to or for foreign individuals? If Yes, complete Schedule F, Parts III and IV Did the organization report a total of more than 15,000 of expenses for professional fundraising services on Part I, column (A), lines 6 and 11e? If Yes, complete Schedule G, Part I (see instructions) Did the organization report more than 15,000 total of fundraising event gross income and contriutions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II. 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 a 11 11c 11d 11e 11f 1a 1 1 1a Yes Page Form 990 (016)

6 Form 990 (016) Page Part IV Checklist of Required Schedules (continued) Yes 0a a c a 6 7 a c d 5a Did the organization operate one or more hospital facilities? If Yes, complete Schedule H If Yes to line 0a, did the organization attach a copy of its audited financial statements to this return? Did the organization report more than 5,000 of grants or other assistance to any domestic organization or domestic government on Part I, column (A), line 1? If Yes, complete Schedule I, Parts I and II Did the organization report more than 5,000 of grants or other assistance to or for domestic individuals on Part I, column (A), line? If Yes, complete Schedule I, Parts I and III Did the organization answer Yes to Part VII, Section A, line,, or 5 aout compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J Did the organization have a tax-exempt ond issue with an outstanding principal amount of more than 100,000 as of the last day of the year, that was issued after Decemer 1, 00? If Yes, answer lines through d and complete Schedule K. If, go to line 5a..... Did the organization invest any proceeds of tax-exempt onds eyond a temporary period exception? Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt onds? Did the organization act as an on ehalf of issuer for onds outstanding at any time during the year? Section 501(c)(), 501(c)(), and 501(c)(9) organizations. Did the organization engage in an excess enefit transaction with a disqualified person during the year? If Yes, complete Schedule L, Part I Is the organization aware that it engaged in an excess enefit transaction with a disqualified person in a prior year, and that the transaction has not een reported on any of the organization's prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I Did the organization report any amount on Part, line 5, 6, or for receivales from or payales to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, sustantial contriutor or employee thereof, a grant selection committee memer, or to a 5% controlled entity or family memer of any of these persons? If Yes, complete Schedule L, Part III Was the organization a party to a usiness transaction with one of the following parties (see Schedule L, Part IV instructions for applicale filing thresholds, conditions, and exceptions): A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV A family memer of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV An entity of which a current or former officer, director, trustee, or key employee (or a family memer thereof) was an officer, director, trustee, or direct or indirect owner? If Yes, complete Schedule L, Part IV Did the organization receive more than 5,000 in non-cash contriutions? If Yes, complete Schedule M Did the organization receive contriutions of art, historical treasures, or other similar assets, or qualified conservation contriutions? If Yes, complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? If Yes, complete Schedule N, Part I Did the organization sell, exchange, dispose of, or transfer more than 5% of its net assets? If "Yes," complete Schedule N, Part II Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections and ? If Yes, complete Schedule R, Part I Was the organization related to any tax-exempt or taxale entity? If Yes, complete Schedule R, Parts II, III, or IV, and Part V, line Did the organization have a controlled entity within the meaning of section 51()(1)? If "Yes" to line 5a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 51()(1)? If Yes, complete Schedule R, Part V, line Section 501(c)() organizations. Did the organization make any transfers to an exempt non-charitale related organization? If Yes, complete Schedule R, Part V, line 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 VI Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? te. All Form 990 filers are required to complete Schedule O. 0a 0 1 a c d 5a a 8 8c a Form 990 (016)

7 Form 990 (016) Page 5 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 a c a a a 5a c 6a 7 a c d e f g h 8 9 a 10 a 11 a Enter the numer reported in Box of Form Enter -0- if not applicale Enter the numer of Forms W-G included in line 1a. Enter -0- if not applicale Did the organization comply with ackup withholding rules for reportale payments to vendors and reportale gaming (gamling) winnings to prize winners?. Enter the numer of employees reported on Form W-, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered y this return a If at least one is reported on line a, did the organization file all required federal employment tax returns? te. If the sum of lines 1a and a is greater than 50, you may e required to e-file (see instructions) Did the organization have unrelated usiness gross income of 1,000 or more during the year? If Yes, has it filed a Form 990-T for this year? If to line, provide an explanation in Schedule O 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 ank account, securities account, or other financial account)? If Yes, enter the name of the foreign country: See instructions for filing requirements for FinCEN Form 11, Report of Foreign Bank and Financial Accounts (FBAR). Was the organization a party to a prohiited tax shelter transaction at any time during the tax year? Did any taxale party notify the organization that it was or is a party to a prohiited tax shelter transaction? If Yes to line 5a or 5, did the organization file Form 8886-T?... Does the organization have annual gross receipts that are normally greater than 100,000, and did the organization solicit any contriutions that were not tax deductile as charitale contriutions? If Yes, did the organization include with every solicitation an express statement that such contriutions or gifts were not tax deductile? Organizations that may receive deductile contriutions under section 170(c). Did the organization receive a payment in excess of 75 made partly as a contriution and partly for goods If Yes, did the organization notify the donor of the value of the goods or services provided? Did the organization sell, exchange, or otherwise dispose of tangile personal property for which it was required to file Form 88? If Yes, indicate the numer of Forms 88 filed during the year d Did the organization receive any funds, directly or indirectly, to pay premiums on a personal enefit contract? Did the organization, during the year, pay premiums, directly or indirectly, on a personal enefit contract? If the organization received a contriution of qualified intellectual property, did the organization file Form 8899 as required? If the organization received a contriution of cars, oats, airplanes, or other vehicles, did the organization file a Form 1098-C? Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained y the sponsoring organization have excess usiness holdings at any time during the year? Sponsoring organizations maintaining donor advised funds. Did the sponsoring organization make any taxale distriutions under section 966? Did the sponsoring organization make a distriution to a donor, donor advisor, or related person? Section 501(c)(7) organizations. Enter: Initiation fees and capital contriutions included on Part VIII, line a Gross receipts, included on Form 990, Part VIII, line 1, for pulic use of clu facilities Section 501(c)(1) organizations. Enter: Gross income from memers or shareholders Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) a Section 97(a)(1) non-exempt charitale trusts. Is the organization filing Form 990 in lieu of Form 101? If Yes, enter the amount of tax-exempt interest received or accrued during the year Section 501(c)(9) qualified nonprofit health insurance issuers. a c and services provided to the payor? Is the organization licensed to issue qualified health plans in more than one state? te. See the instructions for additional information the organization must report on Schedule O. Enter the amount of reserves the organization is required to maintain y the states in which the organization is licensed to issue qualified health plans Enter the amount of reserves on hand c 1a Did the organization receive any payments for indoor tanning services during the tax year? If "Yes," has it filed a Form 70 to report these payments? If "," provide an explanation in Schedule O Form 990 (016) 1a a c a a 5a 5 5c 6a 6 7a 7 7c 7e 7f 7g 7h 8 9a 9 1a 1a 1a 1 Yes

8 Form 990 (016) Page 6 Part VI Governance, Management, and Disclosure For each "Yes" response to lines through 7 elow, and for a "" response to line 8a, 8, or 10 elow, descrie 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 1a Enter the numer of voting memers of the governing ody at the end of the tax year a 10 If there are material differences in voting rights among memers of the governing ody, or if the governing ody delegated road authority to an executive committee or similar committee, explain in Schedule O. Enter the numer of voting memers included in line 1a, aove, who are independent Did any officer, director, trustee, or key employee have a family relationship or a usiness relationship with any other officer, director, trustee, or key employee? Did the organization delegate control over management duties customarily performed y or under the direct supervision of officers, directors, or trustees, or key employees to a management company or other person? Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? Did the organization ecome aware during the year of a significant diversion of the organization s assets? Did the organization have memers or stockholders? a Did the organization have memers, stockholders, or other persons who had the power to elect or appoint one or more memers of the governing ody? a Are any governance decisions of the organization reserved to (or suject to approval y) memers, stockholders, or persons other than the governing ody? Did the organization contemporaneously document the meetings held or written actions undertaken during the year y the following: a The governing ody? a Each committee with authority to act on ehalf of the governing ody? Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot e reached at the organization s mailing address? If Yes, provide the names and addresses in Schedule O Section B. Policies (This Section B requests information aout policies not required y the Internal Revenue Code.) Yes 10a affiliates, and ranches to ensure their operations are consistent with the organization's exempt purposes? a Has the organization provided a complete copy of this Form 990 to all memers of its governing ody efore filing the form? Descrie in Schedule O the process, if any, used y the organization to review this Form a c a 16a Did the organization have local chapters, ranches, or affiliates?. If Yes, did the organization have written policies and procedures governing the activities of such chapters, Did the organization have a written conflict of interest policy? If, go to line Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?.... Did the organization regularly and consistently monitor and enforce compliance with the policy? If Yes, descrie in Schedule O how this was done Did the organization have a written whistlelower policy?.. Did the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval y independent persons, comparaility data, and contemporaneous sustantiation of the delieration and decision? The organization s CEO, Executive Director, or top management official Other officers or key employees of the organization If Yes to line 15a or 15, descrie the process in Schedule O (see instructions). Did the organization invest in, contriute assets to, or participate in a joint venture or similar arrangement with a taxale entity during the year? If Yes, did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicale federal tax law, and take steps to safeguard the organization s exempt status with respect to such arrangements? 16 Section C. Disclosure 17 List the states with which a copy of this Form 990 is required to e filed ne Section 610 requires an organization to make its Forms 10 (or 10 if applicale), 990, and 990-T (Section 501(c)()s only) availale for pulic inspection. Indicate how you made these availale. Check all that apply. Own wesite Another's wesite Upon request Other (explain in Schedule O) 19 Descrie in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements availale to the pulic during the tax year. 0 State the name, address, and telephone numer of the person who possesses the organization's ooks and records: Chanda Hinton 160 Carr Street, Ste A1/A Lakewood CO a 10 11a 1a 1 1c a 15 16a Form 990 (016)

9 Form 990 (016) 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 tale for all persons required to e listed. Report compensation for the calendar year ending with or within the organization's tax year. 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. List all of the organization's current key employees, if any. See instructions for definition of "key employee." List the organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportale compensation (Box 5 of Form W- and/or Box 7 of Form 1099-MISC) of more than 100,000 from the organization and any related organizations. List all of the organization's former officers, key employees, and highest compensated employees who received more than 100,000 of reportale compensation from the organization and any related organizations. 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 reportale compensation from the organization and any related organizations. List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons. Check this ox if neither the organization nor any related organization compensated any current officer, director, or trustee. (1) () () () (5) (6) (7) (8) (9) (10) (11) (A) (B) (C) (D) (E) (F) Name and Title Average Position Reportale Reportale Estimated hours per (do not check more than one compensation compensation from amount of week ox, unless person is oth an from related other (list any hours for officer and a director/trustee) the organization organizations (W-/1099-MISC) compensation from the related (W-/1099-MISC) organization organizations and related elow dotted organizations line) Chanda Hinton Executive Director Ben Stockman Chairperson Megan Mahncke Vice Chair Amy Dickinson Secretary Jeff Hutcheson Treasurer Ryan Zeiger Board Memer Melissa Winthers Board Memer Lisa Blandford Board Memer Ryan Martorano Board Memer Len rten Board Memer John Reid Board Memer Individual trustee or director Institutional trustee Officer Key employee Highest compensated employee Former , Form 990 (016)

10 Form 990 (016) 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 elow dotted line) Individual trustee or director Institutional trustee Officer (C) Position (do not check more than one ox, unless person is oth an officer and a director/trustee) Key employee Highest compensated employee Former (D) Reportale compensation from the organization (W-/1099-MISC) (E) Reportale compensation from related organizations (W-/1099-MISC) (F) Estimated amount of other compensation from the organization and related organizations Su-total c Total from continuation sheets to Part VII, Section A d Total (add lines 1 and 1c) ,500 Total numer of individuals (including ut not limited to those listed aove) who received more than 100,000 of reportale compensation from the organization 5 0 5,500 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 For any individual listed on line 1a, is the sum of reportale compensation and other compensation from the organization and related organizations greater than 150,000? If Yes, complete Schedule J for such individual 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 Section B. Independent Contractors 1 Complete this tale 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) (B) Name and usiness address Description of services 5 Yes (C) Compensation Total numer of independent contractors (including ut not limited to those listed aove) who received more than 100,000 of compensation from the organization 0 Form 990 (016)

11 Form 990 (016) Page 9 Part VIII Statement of Revenue Check if Schedule O contains a response or note to any line in this Part VIII Contriutions, Gifts, Grants and Other Similar Amounts Program Service Revenue Other Revenue 1a Federated campaigns a Memership dues c Fundraising events c 61,9 d e f Related organizations Government grants (contriutions)... All other contriutions, gifts, grants, 1d 1e and similar amounts not included aove 1f 1,07,896 g ncash contriutions included in lines 1a-1f: 10, h Total. Add lines 1a 1f Busn. Code a c d e f All other program service revenue g Total. Add lines a f Investment income (including dividends, interest, and other similar amounts) Income from investment of tax-exempt ond proceeds Royalties (i) Real (ii) Personal 6a Gross rents Less: rental exps. c Rental inc. or (loss) d Net rental income or (loss) a Gross amount from (i) Securities (ii) Other sales of assets other than inventory Less: cost or other asis & sales exps. c Gain or (loss) d Net gain or (loss) a Gross income from fundraising events c (not including of contriutions reported on line 1c). See Part IV, line Less: direct expenses Net income or (loss) from fundraising events Gross income from gaming activities. 11a c d All other revenue e Total. Add lines 11a 11d Total revenue. See instructions a 67,05 7,759 9a See Part IV, line Less: direct expenses a c 10a Net income or (loss) from gaming activities Gross sales of inventory, less returns and allowances Less: cost of goods sold a c Net income or (loss) from sales of inventory Miscellaneous Revenue 76,765 91,197-1, 61,9 1 Busn. Code (A) (B) (C) (D) Total revenue Related or Unrelated Revenue exempt function revenue usiness revenue excluded from tax under sections ,69,88 5,86 5,86-1, -1, 9,66 9, Unrelated-Massage&Acupunctu ,501,19 0-1,71 5,8 Form 990 (016)

12 Form 990 (016) Page 10 Part I Statement of Functional Expenses Section 501(c)() and 501(c)() 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 I Do not include amounts reported on lines 6, 7, 8, 9, and 10 of Part VIII. 1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line Grants and other assistance to domestic individuals. See Part IV, line Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and Benefits paid to or for memers Compensation of current officers, directors, trustees, and key employees Compensation not included aove, to disqualified persons (as defined under section 958(f)(1)) and persons descried in section 958(c)()(B) Other salaries and wages Pension plan accruals and contriutions (include section 01(k) and 0() employer contriutions) 9 Other employee enefits Payroll taxes Fees for services (non-employees): a Management Legal c d e f g Accounting Loying Professional fundraising services. See Part IV, line 17 Investment management fees Other. (If line 11g amount exceeds 10% of line 5, column (A) amount, list line 11g expenses on Schedule O.) Advertising and promotion Office expenses Information technology Royalties Occupancy Travel Payments of travel or entertainment expenses for any federal, state, or local pulic officials Conferences, conventions, and meetings... Interest Payments to affiliates Depreciation, depletion, and amortization... Insurance Other expenses. Itemize expenses not covered aove (List miscellaneous expenses in line e. If line e amount exceeds 10% of line 5, column (A) amount, list line e expenses on Schedule O.) a c d e All other expenses Total functional expenses. Add lines 1 through e Joint costs. Complete this line only if the organization reported in column (B) joint costs from a comined educational campaign and fundraising solicitation. Check here if following SOP 98- (ASC ) (A) (B) (C) (D) Total expenses Program service Management and Fundraising expenses general expenses expenses 1,1 1,1 5,500 9,95 1,700 7,875 8, 6,986,081 1,65 1,550 1,550 10,96 6,0,065 1,61 0,865,865 18,000 7,889 7,889 15,717 15,717 67,11 10,800 0,08 15,91,15 8,90,1 6,60 1,567,69 8,500 8, ,78 1,78 10,65 10,65 SCI Waiver Expense 0,570 0,570 Telephone and Internet 5,50 5,50 Training and Development Allocated Administrative -7,76 105,50-1,66 701,9 5,6 7,180 9,7 Form 990 (016)

13 Form 990 (016) Page 11 Part Balance Sheet Check if Schedule O contains a response or note to any line in this Part (A) (B) Beginning of year End of year 1 Cash non-interest earing ,6 1 68,8 Savings and temporary cash investments ,79 10,855 5 Pledges and grants receivale, net Accounts receivale, net Loans and other receivales from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L Loans and other receivales from other disqualified persons (as defined under section 958(f)(1)), persons descried in section 958(c)()(B), and contriuting employers and sponsoring organizations of section 501(c)(9) voluntary employees' eneficiary organizations (see instructions). Complete Part II of Schedule L tes and loans receivale, net Inventories for sale or use ,5 8 9 Prepaid expenses and deferred charges , ,99 10a Land, uildings, and equipment: cost or other asis. Complete Part VI of Schedule D a 1,0,77 Less: accumulated depreciation ,00 1,06,708 10c 1,0,7 11 Investments pulicly traded securities , ,78 1 Investments other securities. See Part IV, line Investments program-related. See Part IV, line Intangile assets , Other assets. See Part IV, line Total assets. Add lines 1 through 15 (must equal line ) ,09, Accounts payale and accrued expenses Grants payale , ,898,, , Deferred revenue.... Tax-exempt ond liailities Escrow or custodial account liaility. Complete Part IV of Schedule D Loans and other payales to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons. Complete Part II of Schedule L Secured mortgages and notes payale to unrelated third parties ,50 67,58 5 Unsecured notes and loans payale to unrelated third parties Other liailities (including federal income tax, payales to related third Assets Liailities Net Assets or Fund Balances parties, and other liailities not included on lines 17-). Complete Part of Schedule D Total liailities. Add lines 17 through Organizations that follow SFAS 117 (ASC 958), check here and complete lines 7 through 9, and lines and. Unrestricted net assets Temporarily restricted net assets Permanently restricted net assets Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 0 through. Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, uilding, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund alances Total liailities and net assets/fund alances ,85, , , ,561 1,,51 6,561 1,,51 1,09,71,,509 Form 990 (016)