Short Form OMB No. 11-54,5115099Q-EZ Return of Organizations Exempt From Income Tax

©15Undersec ion 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

► Do riot enter social security numbers on this form as it may be made public.• • - • •

I nue ► Information about Form 990-EZ and its instructions is at www.fssgov/Ibnn990.• - •

A For the 2015 calendar year, or tax year beginning 4-1 , 2015, and ending 3-31 , 20 16

B Cheek N a C Name of organization D Employer

q ^ 1360 BENEVOLENT & PROTECTIVE ORDER OF ELKS 34-0074396q Name change Number and street (or P.O. box, if mail is not delivered to sheet address) suite E Telephone number

qwmmtwn

402 CENTER STq 419-289-3553q

Anwxx%ed returnCity or town, side or province. country. and ZIP or foreign postal code F Group Exemption

Appikationp-ding IASHLAND. OHIO 5 Number ►

G Accounting Method: 0 Cash R1 Accrual Other (specify) ► H Check ► 0 If the organization is notI Website: ► I required to attach Schedule BJ Tax-exempt status (check only one) - (] 501 (c)(3) q 501 c 4 insert no. q 4947(a)(1 ) or 0527 (Form 990, 990-EZ or 990-PF).

K Form of organization: q Corporation q Trust q Association q OtherL Add lines 5b, 6c, and 7b to line 9 to determine gross receipts. If gross receipts are $200,000 or more, or if total assets(Part II, column (B) below) are $500,000 or more, file Form 990 instead of Form 990-EZ . . . . . . . . . . ► $ 188993

Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part 1)Check if the organization used Schedule 0 to respond to any question in this Part I . III

1 Contributions, gifts, grants, and similar amounts received . . . . . . . . . . . . . 12 Program service revenue including government fees and contracts . . . . . . . . . 23 Membership dues and assessments . . . . . ! 3 212204 Investment income . . . . . . . . . 4 77435a Gross amount from sale of assets other than inventory I . . . . 5a = -b Less: cost or other basis and sales expenses . . . . . . 5bc Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) . . . . 5c

6 Gaming and fundraising eventsa Gross income from gaming (attach Schedule G if greater thanl

$15,000) . . . . . . . . . . . . . . . . . 6a

b Gross income from fundraising events (not including $ of contributions

cc from fundraising events reported on line 1) (attach Schedule G if thesum of such gross income and contributions exceeds $15,000) . . Sb

c Less: direct expenses from gaming and fundraising even,is . . . 6cd Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract

line 6c) . . . . . . . . . . . . . . . . . . . . . . . . . . 6d7a Gross sales of inventory, less returns and allowances . . . . . 7a 153842b Less: cost of goods sold . . . . . . . . . . . 7b 50736

.c Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) . . . . . . . 7c 1031068 Other revenue (describe In Schedule 0) . . . I 8 61889 Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 . . . ► 9 13825710 Grants and similar amounts paid (list in Schedule 0) 1011 Benefits paid to or for members . . . . . . . . . 1112 Salaries other com ensation and em lo ee benefits 12, p , p y 5832213 Professional fees and other a ments to Inde endent contr ctor3? 13p y p a . .14 Occupancy rent utilities and maintenance 14 61872,, , . . .

ul 15 Printing, publications, postage, and shipping . . . '! 15 347616 Other expenses (describe in Schedule 0) . . . . 1617 Total expenses. Add lines 10 through 16 ► 17 12367018 Excess or (deficit) for the year (Subtract line 17 from line 9) . . . . . . . . . . . . 1S 1458719 Net assets or fund balances at beginning of year (from (line 27, column (A)) (must agree with

end-of-year figure reported on prior year's return)_

19 432038Z 20 Other changes in net assets or fund balances (explain in chedule 0) . . . . . . . . . 20

21 Net assets or fund balances at end of year. Combine lines 18 through 20 . ► 21 446625For Paperwork Reduction Act Notice, see the separate Instructions . Cat. No. 106421 Form 990-EZ (2015)

`fi)

Form 990-EZ (2015) Page 2

• Balance Sheets (see the instructions for Part II)Check if the organization used Schedule 0 to r nd to any question in this Part 11 . . q

(M BesinNng of year (B) End of Year

22 Cash, savings, and investments . . . . . . . . 315930 22 33289123 Land and buildings . . . . . . . . . . . . . . . . . 148744 23 14150024 Other assets (describe in Schedule 0) . . . . . . . . . . . . 2425 Total assets . . . . . . . . . . . . . . . .. . . . . . . . . 464674 25 47439126 Total liabilities (describe in Schedule 0) . . . . 32636 26 2776627 Net assets or fund balances Pine 27 of column (B) must ,a ree with line 21 432038 27 446625• Statement of Program Service Accomplishments (see the instructions for Part III)

Check if the organization used Schedule 0 to respond to any question in this Part III . qWhat is the organization's primary exempt purpose? PROVIDE PUBLIC SERVICE (Required for section

501(c)3) and 501(cx4)

Describe the organization's program service accomplishments for each of its three largest program services, OfWftaftw, optional for

as measured by expenses. In a clear and concise manner, describe the services provided, the number of GH0 )persons benefited, and other relevant information for each program title.

28

29

30

If this amount includes

If this amount includes

check here . . . . ► q 128a

check here . . . . ► q 129a

(Grants $ If this amount includes foreign grants, check here . ► q 30a31 Other program services (describe in Schedule 0) . . . I . . . . . . . . . . . . . .

(Grants $ If this amount includes foreign grants, check here . ► q 31a32 Total program service expenses (add lines 28a through 31 a) . . ► 32

List of Officers, Directors, Trustees, and Key Employees (list each one even if not compensated-see the instructions for Part IV)Check if the organization used Schedule 0 to resound to any auestion in this Part IV . f

to)N M

(b) AveyI

devoted to position

(c) Reportablecompensation

(orms W-211099-MISC)Of not paid, enter -0)

(d) Health benefits,contributions to employee

banerd pis, anddeferred compensation

(e) Estimated amount ofother compensation

CHAD DICKINSON TRUSTEE

ASHLAND, OHIO 10 0 0 0

LORI GIBBEN

ASHLAND OHIO TRUSTEE 101 0 0 0

JIM DOYLE SECRETARY

ASHLAND, OHIO 10 4000 0 0

LARRY MCCONNELL

ASHLAND, OHIO 10 2400 0 0

-------------

Form 9WQ (2015)

fc•ozm 990-EZ C2O15)

• Other Information (Note the Schinstructions for Part No Check if the

33

34

35a

b

c

36

37a

b38a

b

39

a

b40a

b

c

d

e

41

42a

b

c

43

44a

b

c

d

45a

b

)nal benefit contract statementSchedule 0 to respond to any a

Page 3

ments in thein this Part V q

Yes NoDid the organization engage in any significant activity not previously reported to the IRS? If "Yes," provide adetailed description of each activity in Schedule 0 . . . . . . . . . . .

Were any significant changes made to the organ izing or governing documents? If "Yes," attach a conformedcopy of the amended documents if they reflect a changelto the organization's name. Otherwise, explain thechange on Schedule 0 (see instructions) . . . . . . . . . . . . . . . .

Did the organization have unrelated business gross income of $1,000 or more during the year from businessactivities (such as those reported on lines 2 , 6a, and 7a, among others)? . . . . . . . . . . . .

If "Yes," to line 35a, has the organization filed a Form 990-T for the year? If "No," provide an explanation in Schedule 0Was the organization a section 501 (cx4), 501(c)(5), or 501 (c)(6) organization subject to section 6033(e) notice,reporting , and proxy tax requirements during the year? If "Yes," complete Schedule C , Part III . . . . .

Did the organization undergo a liquidation , dissolution, termination , or significant disposition of net assetsduring the year? If "Yes," complete applicable parts of Schedule N . . . . . . . . . . . . .

Enter amount of political expenditures, direct or indirect , as described in the instructions ► 137a

Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . . .Did the organization borrow from , or make any loans to, any officer, director, trustee, or key employee or wereany such loans made in a prior year and still outstanding at the end of the tax year covered by this return?

If "Yes," complete Schedule L, Part II and enter the total amount involved . . . . 38bSection 501 (c)(7) organizations . Enter.

Initiation fees and capital contributions included on line 9 . . . . . . . 39a

Gross receipts , included on line 9, for public use of club facilities . . . . . . . 39b

Section 501 (c)(3) organizations. Enter amount of tax imposed on the organization during the year under.section 4911 ► ; section 4912 ► I ; section 4955 ►Section 501 (c)(3), 501 (cx4), and 501(c)(29) organizations . Did the organization engage in any section 4958excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior yearthat has not been reported on any of its prior Forms 990 or1990-Q? If "Yes," complete Schedule L, Part

Section 501 (cX3), 501 (cX4), and 501 (c)(29) organizations . Enter amount of tax imposed

I

on organization managers or disqualified persons during the year under sections 4912,4955 , and 4958 . . . . . . . . . . . . . . .. . . . . . . . . ►Section 501 (c)(3), 501 (cx4), and 501 (c)(29) organizations. Enter amount of tax on line40c reimbursed by the organization . . . . . . . ., . . . . . . ►All organizations . At any time during the tax year, was thi organization a party to a prohibited tax sheltertransaction? If "Yes," complete Form 8886-T . . . . . . . . . . . . . . . . .

List the states with which a copy of this return is filed ► OHIO

The organization 's books are in care of ► LARRY MCCONNELL --^__ `--- ` Telephone no. ►Located at ► 402 CENTER ST, ASHLAND, OHIO 1 ZIP + 4 ►At any time during the calendar year, did the organization have an interest In or a signature or other authority overa financial account in a foreign country (such as a bank account, securities account , or other financial account)?

If "Yes," enter the name of the foreign country: ► `

See the instructions for exceptions and filing requirements for FinCEN Form 114, Report of Foreign Bank andFinancial Accounts (FBAR).

At any time during the calendar year, did the organization maintain an office outside the U.S.? . . . . .If "Yes," enter the name of the foreign country: No- ,

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-EZ in lieu of Form 1041 -Check here

and enter the amount of tax-exempt interest received or accIrued during the tax year . . . . . ► u

Did the organization maintain any donor advised funds 'during the year? If "Yes," Form 990 must becompleted instead of Form 990-EZ . . . . . . . . . . . . . . . . . . .

Did the organization operate one or more hospital facilities during the year? If "Yes," Form 990 must becompleted instead of Form 990-Q . . . . . . . . . . . . . .

Did the organization receive any payments for indoor tanning services during the year? . . . . . . .If "Yes' to line 44c, has the organization filed a Form 720 to report these payments? if 'No, 0 provide anexplanation in Schedule 0 . . . . . . . . . . . . . . . . . . . . . . . . . . .

Did the organization have a controlled entity within the meaning of section 512(b)(13)' . . . . . . .

Did the organization receive any payment from or engage in any transaction with a controlled entity within themeaning of section 512(bx13)? If 'Yes," Form 990 and Schedule R may need to be completed instead ofForm 990-EZ (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . .

419-289-3553

____ 44_805

Yes No

42b 3

42c 3

► q

Yes No

M -

44c 3

44d

45a 3

33 3

34 3

35a` 33.`b 3

3`c 3

36

S7b V

3U

40b 3

Form 990-EZ (2ot5)

Form 990-U (2015) page 4

Yes No

46 Did the organization engage, directly or indirectly, in political campaign activities on behalf of or in oppositionto candidates for public office? If "Yes," complete Schedule C. Part I . . . . . . . . . . F46 3

IgUM Section 501(c)(3) organizations onlyAll section 501 (c)(3) organizations must answerl questions 47-49b and 52, and complete the tables for lines50 and 51.Check if the organization used Schedule 0 to resound to any auestion in this Part VI

Yes No47 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 . . . . .. . . . . . . . . . . . . . . . . 47 3

48 Is the organization a school as described in section 170(bx1)(A)(i)? If "Yes," complete Schedule E . . . . 48 349a Did the organization make any transfers to an exempt non writable related organization? . . . . . . 49a 3

b If "Yes," was the related organization a section 527 organization? . . . . . . . . . . . . . . 49b 350 Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key

employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and title of each employee(b) Average

hours per weekdevoted to position

(c) Reportablecompensation

(Forms W-2M 099-MISC)

(d) Health benefits.contributions to employee

^ deferred(a) Estimated amount ofother compensation

--------- - ----------------------------

f Total number of other employees paid over $100,000 . .^ . ►51 Complete this table for the organization's five highest compensated independent contractors who each received more than

$100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and business address of each independent contractor

V I vial I lull lUQ1 vI vu1G7 II lU JC1 IU iIL wllu a'.Lu, QaVn IdliVw

52 Did the organization complete Schedule A? Note: All

under penalties of perjury, Itrue, correct, and compJet .

SignHere

PaidPreparerUse Only

0MB No.' ^SCHEDULE A Public Charity Status and Public Support(Form 990 or 990-EZ)

conplete d the arga Z i is a section 5o1(c)( tlon or a sedlon 4947(axt) nonexempt dale bust 2016

Deparbrient of the ITay ► Attach to Form 990 or Fonn 990-EL • - • •

internal Revenue Service ► hdorrnation about Sc tiefide A (Form 990 or 990-EZ) and its etstiuctioas is at www.lr .gov/torm990i. • •

Name of tfie orgar^atlon Employer identification number

1360 BENEVOLENT & PROTECTIVE ORDER OF ELKS 34-0074396• Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)1 q A church, convention of churches, or association of chuiches described in section 170(b)(1)(A)(i).2 q A school described in section 170(b)(1)(A)(a). (Attach Schedule E (Form 990 or 990-E4)3 q A hospital or a cooperative hospital service organiizationI described in section 170(b)(1)(A)('p).4 q A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(ifi). Enter the

hospital's name, city, and state:

5 q An organization operated for the benefit of a college or university owned or operated by a governmental unit described insection 170(b)(1)(A)(iv). (Complete Part 11.)

6 q A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).7 q An organization that normally receives a substantial part of its support from a governmental unit or from the general public

described in section 170(b)(1)(A)(vi). (Complete Part II.)

8 q A community trust described in section 170(b)(1)(A)(vi11.(Complete Part II.)9 q An agricultural research organization described in section 170(b)(1)(A)(ix) operated in conjunction with a land-grant college

or university or a non-land-grant college of agriculture (see instructions). Enter the name, city, and state of the college oruniversity:

10 q An organization that normaify receives: (1) more than 331/3% of its support from contributions, membership fees, and grossreceipts from activities related to its exempt functions-subject to certain exceptions, and (2) no more than 331/3% of itssupport from gross investment income and unrelated business taxable income (less section 511 tax) from businessesacquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part 111.)

11 q An organization organized and operated exclusively to test for public safety. See section 509(a)(4).12 q An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes

of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3).Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

a q Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by givingthe supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of thesupporting organization. You must complete Part R , Sections A and B.

b q Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by havingcontrol or management of the supporting organization vested in the same persons that control or manage the supportedorganization(s). You must complete Part IV, Sections A and C.

c q Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with,its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E

d q Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s)that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentivenessrequirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

e q Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type IIIfunctionally integrated, or Type III non-functionally integrated supporting organization.

f Enter the number of supported organizations . . . . 1 . . . . . . . . . . . . . . . . . .g Provide the following information about the supported organization(s).

() Name of supported organization Q EIN (8^ Type of arganteariOn(described on Imes 1-10above (see Instructions))

QN Is theawnRated n Yow 9--*g

doc+wit?

(W) Amount of monetarySupport (seeUistructions)

(vi) Amount ofother support (see

Instructions)

Yes No

(B)

(C)

(D)

Total

For Paperwork Rec .action Act Notice, an the dr tuetlons for Form 990 or 990;EL Cat No. 11285F Schedule A (Form 990 or 9904M 2016

Schedule A (Form 990 or 98¢EZ) 2016 Page 2

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify underPart III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Sucoort

Calendar year (or fiscal year beginning in) ► 2012 (b) 2013 c 2014 2015 a 2016 TotalI Gifts, grants, contributions, and

membership fees received. (Do notinclude any "unusual grants.") . . .

2 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

3 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

4 Total. Add lines 1 through 3 . . . .

5 The portion of total contributions byeach person (other than a =governmental unit or publiclysupported organization) included online 1 that exceeds 2% of the amountshown on line 11, column (t) = _

6 Public support. Subtract line 5 from line 4aecaon 0. 10131 ou pore

Calendar year (or fiscal year beginning In) ► (a) 2012 (b 2013 (c) 2014 d) 2015 (e) 2016 Total7 Amounts from line 4 . . . . . .

8 Gross income from interest, dividends,payments received on securities loans,rents, royalties and income from similar ^sources . . . . . . . . . .

9 Net income from unrelated businessactivities , whether or not the businessis regularly carried on

10 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part VI .) . . . . . . .

11 Total support. Add lines 7 through 1012 Gross receipts from related activities, etc. (see instructions) . . . . . . . . . . 1213 First five years. If the Form 990 is for the organization 's first, second , third, fourth , or fifth tax year as a section 501(c)(3)

organization, check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . ► n

14 Public support percentage for 2016 pine 6, column (f) divided by line 11, column (f)) . . . . 14 %15 Public support percentage from 2015 Schedule A, Part 11, Tine 14 . . . . . . . . 15 %16a 331rs% support test-2016. If the organization did not check the box on line 13, and line 14 is 33'j% or more, check this

box and stop here. The organization qualifies as a pubiiclylsupported organization . . . . . . . . . . . . ► q

b 33'ra% support test-2015. If the organization did not check a box on line 13 or 16a, and line 15 is 331/3% or more, checkthis box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . ► q

17a 10%-facts-and-circumstances test-2016. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain inPart VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supportedorganization . . . . . . . . . . . . . . . .I . . . . . . . . . . . . . . . . . . . . ► q

b 10%-facts-and-circumstances test-2015. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publiclysupported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► q

18 Private foundation . If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and seeinstructions . . . . . . . . . . . . . . . .I . . . . . . . -. - . . . . . . . . . . ► q

Schedule A (Form 980 or 990-FA 2018

Schedule A (Form 990 or 990-E4 2016 Page 3

(Complete only if you checked the box on line 1^0 of Part I or if the organization failed to qualify under Part II.If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public SuooortCalendar year (or fiscal year beginning In) ► (2)2012 { (b) 2013 (d) 2014 2015 (e) 2016 Total

I Gifts, grants, contributions, and membership feesreceived. (Do not include an 'Musual gets.1 23610 22830 22459 22800 21220 112919

2 Gross receipts from admissions, merchandisesold or services performed, or facilitiesfurnished in any activity that is mated to theorganization's tax-exempt purpose . . . 135707 141901 157940 134797 153842 724187

3 Gross receipts from activities that are not anunrelated trade or business under section 513

4 Tax revenues levied for theorganization's benefit and either paidto or expended on its behalf . . .

5 The value of services or facilitiesfurnished by a governmental unit to theorganization without charge . . . .

6 Total. Add lines 1 through 5 . . . . 159317 164731 180399 157597 175062 8371067a Amounts included on lines 1, 2, and 3

received from disqualified persons .

b Amounts included on fines 2 and 3received from other than disqualifiedpersons that exceed the greater of $5,000or 1 % of the amount on line 13 for the year

c Add lines 7a and 7b . . . . . .8 Public support (Subtract line 7c from f"

line 6.) . . . . . . . . 837106secuon rb. rota; supportCalendar year (or fiscal year beginning in) ►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 pesssection 511 taxes) from businessesacquired after June 30, 1975 . . . .

c Add lines 10a and 10b . . . . .

11 Net income from unrelated businessactivities not included in line 10b, whetheror not the business is regularly carried on

12 Other income. Do not include gain orloss from the sale of capital assets(Explain in Part VI.) . . . . . . .

13 Total support (Add lines 9, 1Oc, 11,and 12.) . . . . . . . . . .

(a) 2012 (b) 2013 (c) 2014 2015 (e) 2016 Total

159317 164731 180399 157597 175062 837106

4820 4311 6096 10590 7743 33560

4820 { 4311 6096 10590 7743 33560

22017 10832 6745 6108 6188 51890

186154 { 179874 193240 174295 1, 188993 92255614 First five years. If the Form 990 is for the organization's

organization, check this box and stop here . . . .

15 Public support percentage for 2016 (line 8, column (f) d

16 Public support percentage from 2015 Schedule A. Part

t, second, third, fourth , or fifth tax year as a section 501 (c)(3). . . . . . . . . . . . . . . . . . . . ► C

by line 13, column (f)) . . . 15 90%15 . . . . . . . . . 16 90 %

17 Investment income percentage for 2016 (line 1 Oc, column (f) divided by line 13, column (f)) . . . 17 3%18 Investment income percentage from 2016 Schedule A, Part III, line 17 . . . . . . . . 18 3 %19a 331,3% support tests-2016. If the organization did not check the box on line 14, and line 15 Is more than 33'x3%, and line

17 is not more than 331/3%, check this box and stop here. The organization qualifies as a publicly supported organization . ► q

b 3310% support tests-2015. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 331/s%, andline 18 Is not more than 331,3%, check this box and stop here.. The organization qualifies as a publicly supported organization ► 0

20 Private foundation. If the organization did not check a boxion line 14 19a, or 19b, check this box and see instructions ► q

Schedule A (Form 990 or 9904SQ 2D16

Schedule A (Form 990 or 990-EZ) 2016 page 4

Supporting Organizations(Complete only if you checked a box in line 12 on Part I. If you checked 12a of Part I, complete Sections Aand B. If you checked 12b of Part 1, complete Sections A and C. If you checked 12c of Part I, completeSections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting OrganizationsYes No

1 Are all of the organization's supported organizations listed by name in the organization's governingdocuments? If "No, ° describe in Part VI how the supported organizations are designated. If designated byclass or purpose, describe the designation. If historic and continuing relationship, explain. 1

2 Did the organization have any supported organization tliat does not have an IRS determination of status ; . _under section 509(a)(1) or (2)? If "Yes," explain In Part VI how the organization determined that the supported -S _yorganization was described in section 509(a)(1) or (2). 2

3a Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes,' answer - -_(b) and (c) below. 38

b Did the organization confirm that each supported or9an' ion qualified under section 501(c)(4), (5), or (6) and- "satisfied the public support tests under section 509(a)(2)? If "Yes, ° describe in Part VI when and how the

organization made the determination. 3b

c Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B)purposes? If "Yes,' explain in Part VI what controls the organization put in place to ensure such use. J 4^

4a Was any supported organization not organized in the United States ("foreign supported organization')? if"Yes," and ifyou checked 12a or 12b in Part), answer (b) and (c) below. 4a

b Did the organization have ultimate control and discretion din deciding whether to make grants to the foreignsupported organization? If "Yes, ° describe in Part V1 how the organization had such control and discretion _" -despite being controlled or supervised by or in connection (with its supported organizations. 4b

c Did the organization support any foreign supported organization that does not have an IRS determination -under sections 501(cx3) and 509(a)(1) or (2)? If 'Yes," explain in Part VI what controls the organization used • "to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) - _ Jpurposes. 4c

5a Did the organization add, substitute, or remove any supported organizations during the tax year? if 'Yes,'answer (b) and (c) below (if applicable). Also, provide detail in Part Vl, including (7 the names and EINnumbers of the supported organizations added, substituted, or removed; (t) the reasons for each such action;n) the authority under the organization's organizing document authorizing such action; and (iv) how the actionwas accomplished (such as by amendment to the organizing document).

b Type I or Type II only. Was any added or substituted supported organization part of a class alreadydesignated in the organization's organizing document?

c Substitutions only. Was the substitution the result of an event beyond the organization's control? Sc

6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) toanyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefitedby one or more of its supported organizations, or (iii) other supporting organizations that also support orbenefit one or more of the filing organization's supported organizations? If Wes, ° provide detail in Part V1. 6

7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor -(defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity withregard to a substantial contributor? If "Yes," complete Part 1 of Schedule L (Foam 990 or 990-E2).

8 Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?If "ft ° complete Part I of Schedule L (Form 990 or 990-EZ).

9a Was the organization controlled directly or indirectly at` any time during the tax year by one or moredisqualified persons as defined in section 4946 (other than foundation managers and organizations describedin section 509(a)(1) or (2))? If °Yes,"provide detail in Part W. 98

b Did one or more disqualified persons (as defined In line 9a) hold a controlling interest in any entity In whichthe supporting organization had an interest? If Wes," provide detail in Part W. gb

c Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefitfrom, assets in which the supporting organization also had an interest? If °Yes," provide detail in Part VL Be

10a Was the organization subject to the excess business holdings rules of section 4943 because of section4943(t) (regarding certain Type II supporting organizations, and all Type III non-functionally integratedsupporting organizations)? If 'Yes,"answer 10b below. 10s

b Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, todetermine whether the organization had excess business holdings.)

Schedule A (Form 990 or 990-EZ) 2D16

SIBA (Form 990 or 990-EZ) 2016 5

Yes No

11 Has the organization accepted a gift or contribution from any of the following persons?

a A person who directly or indirectly controls, either alone or together with persons described in (b) and (C)below, the governing body of a supported organization? 11a

b A family member of a person described in (a) above? 11bc A 35% controlled entity of a person described in a or above? If °Yes° to a, b, or c, provide detail in Part W. MC I I

Section B. Type I Supporting OrganizationsYes No

I Did the directors , trustees, or membership of one or morelsupported organizations have the power toregularly appoint or elect at least a majority of the organization 's directors or trustees at all times during thetax year? If "No," describe in Part V/ how the supported organization(s) effectively operated, supervised, orcontrolled the organization 's activities. If the organization had more than one supported organization,describe how the powers to appoint and/or remove dinctors or trustees were allocated among the supported `= Yorganizations and what conditions or restrictions, if any, applied to such powers during the tax year.

2 Did the organization operate for the benefit of any supported organization other than the supportedorganization (s) that operated , supervised, or controlled the supporting organization? If "Yes," explain in PartVI how providing such benefit carried out the purposes of the supported organization (s) that operated, . _supervised, or controlled the supporting organization . 2

_ _^..

Section C. Type 11 Supporting OrganizationsYes No

I Were a majority of the organization's directors or trustees during the tax year also a majority of the directors - = aor trustees of each of the organization's supported organization(s)? If "No, ° describe in Part VI how controlor management of the supporting organization was vested 'in the same persons that controlled or managedthe supported organization(s). i

Section D. All Type III Supporting Organkations

Yes NoI Did the organization provide to each of its supported organizations, by the last day of the fifth month of the

organization's tax year, (i) a written notice describing the typeland amount of support provided during the prior taxyear, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of theorganization's governing documents in effect on the date of nitification, to the extent not previously provided?

2 Were any of the organization's officers, directors, or trustees either ( appointed or elected by the supportedorganization(s) or (ii) serving on the governing body of a supported organization? if "No," explain in Part VI howthe organization maintained a close and continuous working lrelationship with the supported organization(s). 2

3 By reason of the relationship described in (2), did the organization's supported organizations have asignificant voice in the organization's investment policies and in directing the use of the organization'sincome or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization'ssupported organizations played in this regard. 3

1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions).

a q The organization satisfied the Activities Test. Complete dine 2 below.

b q The organization is the parent of each of its supported organizations. Complete line 3 below.

c El The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions).

2 Activities Test. Answer (a) and (b) below. Yes No

a Did substantially all of the organization's activities during the tax year directly further the exempt purposes ofthe supported organization(s) to which the organization was responsive? If "Yes, ° then in Part Vl identifythose supported organizations and explain how these activities directly furthered their exempt purposes,how the organization was responsive to those supported organizations, and how the organization determinedthat these activities constituted substantially all of its activities. 2a -

b Did the activities described in (a) constitute activities that, but for the organization's involvement, one or moreof the organization's supported organization(s) would have been engaged in? If "Yes," explain in Part W thereasons for the organization's position that its supported organization(s) would have engaged in theseactivities but for the organization's involvement. - 2b

3 Parent of Supported Organizations. Answer (a) and (b) be%wa Did the organization have the power to regularly appoint or ielect a majority of the officers, directors, or

trustees of each of the supported organizations? Provide details in Part W. 3a

b Did the organization exercise a substantial degree of direction over the policies, programs, and activities of eachof its supported organizations? If 'Yes," describe In Part VI the role played by the ori- nizatlon in this rooani. 3b

Schedule A (Form 990 or 990-EZ) 2a16

Schedule A (Form 990 or 990-Q) 2016

1 q Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). Seeinstruc ions. All other Tvoe III non-functionally intearated suonortina organizations must complete Sections A through E.

Section A - Adjusted Net Income (A) Prior Year (B) Current Year(optional)

1 Net short-term capital gain 1

2 Recoveries of prior-yew distributions 23 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 orcollection of gross income or for management, conservation, ormaintenance of property held for production of income (see instructions) 6

7 Other a ses (see instructions 7

8 Ad' ed Net Income (subtract lines 5, 6, and 7 from line 4)j 8

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year(optional)

I Aggregate fair market value of all non-exempt-use assets (seeinstructions for short tax year or assets held for part of 3 ^

a Averse monthly value of securities is

b Averse monthly cash balances I 1b

c Fair market value of other non-exempt-use assets ! 1c

d Total (add lines 1 a, 1 b, and 1c 1d-

e Discount claimed for blockage or otherfactors (explain in detail in Part

7 7'" $

=

2 Acquisition indebtedness applicable to non-exempt-use assets 23 Subtract line 2 from line 1d. 3

4 Cash deemed held for exempt use. Enter 1-1/2% 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 .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

2 Enter 85% of line 1 . 2 .'

3 Minimum asset amount for prior year (from Section B, line 8, Column 34 Enter greater of line 2 or line 3. 4

5 Income tax imposed in prior year 5 1,

6 Distributable Amount. Subtract line 5 from line 4, unless subject toemergency tempomy reduction (see instructions) . 6T q Check here if the current year is the organization 's first as a non-functionally intearated Tvoe III suooordna organization (see

instructions).

Schedule A (Form 990 or 990-EZ) 2016

Schedule A (Form 990 or 990-EZ) 2016

Tvroe IIISection D - Distributions Current Year

1 Amounts paid to supported organizations to accomplish 6xempt purposes

2 Amounts paid to perform activity that directly furthers exempt purposes of supportedorganizations, in excess of income from activity 1

3 Administrative expenses paid to accomplish exempt u ses of supported organizations4 Amounts paid to acquire exempt-use assets

5 Qualified set-aside amounts (prior IRS approval required)6 Other distributions (describe in Part . See instructions. 17 Total annual distributions . Add lines 1 through 6.

8 Distributions to attentive supported organizations to which the organization is responsive(provide details in Part VI). See instructions.

9 Distributable amount for 2016 from Section C, line 610 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions) 01 (IQUnderdistributions

Pre-2016

(iii)Distributable

Amount for 2016

I Distributable amount for 2016 from Section C, line 6 - -

Underdistributions, if any, for years prior to 20162 (reasonable cause required-explain in Part VI). See

instructions.

3 Excess distributions carryover, if an , to 2016a 77b

c From 2013

d From 2014

e From 2015f Total of lines 3a through eg Applied to underdistributions of prior yearsh Applied to 2016 distributable amounti Carryover from 2011 not applied (see instructions)j Remainder. Subtract lines , 3h, and 3i from 3f. I r4 Distributions for 2016 from

Section D, fine 7: $

a Applied to underdistributions of prior yearsb Applied to 2016 distributable amount _ - - - 'c Remainder. Subtract lines 4a and 4b from 4.

5 Remaining underdistributions for years prior to 2016, ifany. Subtract lines 3g and 4a from line 2. For resultgreater than zero, explain in Part VI. See instructions. - -

6 Remaining underdistributions for 2016. Subtract lines 3hand 4b from line 1. For result greater than zero, explain iPart VI. See instructions.

V'

-

7 Excess distributions carryover to 2017. Add lines 3jand 4c.

I s

8 Breakdown of line 7: V

b Excess from 2013 . . .

c Excess from 2014 .

d Excess from 2015 .

e Excess from 2016 .

Schedule A (Form 990 or 990-E7,) 2018

SCHEDULE 0(Form 990 or!

De wtn nt of the ThostrybvbwW Remus Savioe

Name of the ;Ton

Supplemental Information to Form 990 or 990-EZ 0MB No. 1545-0047

Complete to provide information for responses to specific questions on O 6Form 890 or 990-EZ or to provide any additional information.

► Attach to Form 990 or 990-EZ 11111283M . •► intonnation about Schedule 0 (Form 990 or 990-Q) and its Ins1 uctions is at www.hs gov/fonm99Q. • •

Wen non number

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EL Cat No. 51056K Schedule 0 (Form 990 or 990-EZ) (2D16)