lefile GRAPHIC print - DO NOT PROCESS I As Filed Data - DLN: 93492220001347 Short Form OMB No 1545-1150 Return of Organization Exempt From Income Tax 2016 Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) Do not enter social security numbers on this form as it may be made public. Departmeniofzhe Treasun Information about Form 990-EZ and Its instructions is at Internal Rm cnuc Sen Ice Inspection A For the 2016 calendar year, or tax year beginning 01-01-2016 and ending 12-31-2016 Check if applicabie (3 Name of organization Employer Identification number Address change THE TRIXIE FOUNDATION INC 614268775 Name change Number and street (or 0 box, if mail is not delivered to street address} Room/sunte Telephone number Initial return 0 BOX 1 Final return/terminated City or town, state or provmce, country, and ZIP or foreign postal code Amended return KY 41180 r- Group Exemption Application pending Number Accounting Method Cash DAccrual Other (specn?y) Check 'f the organization ?5 "0t reqwred to attach Schedule (Form 990, or 990-PF) I Website: ORG Tax-exempt status{check only one) - 501(c)( 1(insert no El 4947(a)(1) or Cl 527 Form of organization Corporation El Trust El AssoCIetIon Other Add lines 5b, 6c, and 7b to fine 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 990-123,210 Revenue, Expenses, and Changes in Net Assets or Fund Balances (see the instructions for Part I) Check if the organization used Scheduie to respond to any question in this Part Contributions, gifts, grants, and Similar amounts received . . . . . . . . . . . . . . . . . . . . 1 102,351 2 Program serVIce revenue including government fees and contracts . . . . . . . . . . . . . . 2 3 3 4 4 5a Gross amount from sale of assets other than inventory . . . . . 53 20,855 Less cost or other ba5is and sales expenses . . . . . . . 5b Gain or (loss) from saie of assets other than inventory (Subtract line 5b from line Se20,855 6 Gaming and fundraismg events ?5 a Gross Income from gaming (attach Schedule if greater than $15,000) I 6a I :3 Gross income from fundraismg events (not including of contributions from Eff fundraismg events reported on line 1) (attach Schedule if the sum of such gross Income and contributions exceeds $15,000) . . 6b Less direct expenses from gaming and fundraisrng events . . . 6c Net income or (loss) from gaming and fundraismg events (add lines 6a and 6b and subtract line 6c) 6d 7a Gross sales of inventory, less returns and aliowances . . . . . . 7a Less cost of goods sold . . . . . . . . . . . . . 7b Gross pro?t or (loss) from sales of Inventory (Subtract line 7b from line 7aOther revenue (describe In ScheduEe Total revenue. Add lines 123,210 10 Grants and Similar amounts paid (list in Schedule Benefits paid to or for members . . . . . . . . . . . . . . . . 11 .4 12 Salaries, other compensation, and employee benefits . . . . . . . . . . . . . . . . 12 23,019 13 Professmnal fees and other payments to independent contractors . . . . . . . . . . . .. 13 550 14 Occupancy, rent, Utilities, and maintenance . . . . . . . . . . . . . . . . . . . 14 14,684 15 Printing, publications, postage, and shipping . . . . . . . . . . . . . . 15 1,004 16 Other expenses (describe in Schedule 32,248 17 Total expenses. Add lines 10 through 71,505 18 Excess or (defICIt) for the year (Subtract line 17 from igne 51,705 2: 19 Net assets or fund balances at beginning of year (from line 27, column (must agree With .2 end-of-year figure reported on prior year's return333,593 20 Other changes in net assets or fund balances (explain in Scheduie Net assets or fund balances at end of year Combine lines 18 through 385,298 For Paperwork Reduction Act Notice, see the separate instructions. Cat No 106421 Form 990-EZ (2016) Form 990-EZ (2016) Balance Sheets (see the Instructions for Part II) Check if the organization used Schedute to respond to any question in Part II Page 2 (A) Beginning of year (B) End of year 22 Cash, savmgs, and investments . . . . . . . . . . . . . . 46,314 22 21,117 23 Land and . . . . . . . . . . . . . . . . . . 180,040 23 281,040 24 Other assets (describe Schedute 119,301 24 119,301 25 Total assets . . . . . . . . . . . . . . . . . . . . . . 345,655 25 421,458 26 Total liabilities (describe in Schedule 012,062 26 36,160 27 Net assets or fund balances (fine 27 of coturnn (B) must agree With line 21) 333,593 27 385,298 Statement of Program Service Accomplishments (see the instructions for Part Expenses Check if the organization used Schedule 0 to respond to any guestron in this Part . . Cl (Reqmred for section 501(5) What is the organization's primary exempt purpose? (3) and 501(c)(4) KILL ANIMAL SHELTER o:gamz)ations, optional for ers Describe the organization' 5 program sewice accomplishments for each of Its three iargest program serVIces, as measured by expenses In a clear and contise manner, describe the serVIces prowded, the number of persons benefited, and other relevant :nformation for each program titte 28 (Grants If this amount Includes foreign grants, check here . . . 283 29 293 (Grants If this amount includes foreign grants, check here . . . 30 303 (Grants If this amount includes forEIgn grants, check here . . . El 31 Other program serVIces (describe in Schedute (Grants If this amount inciudes foreign grants, check here . . . El 313 32 Total program service expenses (add lines 28a through 31a55,944 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 respond to any question In this Part IV. . . . . Average hours per week devoted to posmon Reportable compensation (Forms MISC) (if not paid, Name and title (6) Health bene?ts, contributions to employee benefit pians, and deferred compensation I Estimated amount of other compensation enter RANDY SKAGGS 80 00 193 0 0 PRESIDENT DEBORAH SALLEE 2 00 0 0 0 VICE PRESIDENT ANNA KARAKEN 0 00 0 0 0 SECRETARY Form 990-EZ (2016) Form 990-EZ (2016) Other Information (Note the Schedule A and personal benefit contract statement requirements in the instructions for Part Check if the organization used Schedule 0 to respond to any question in this Part . . El Page 42a Did the organizatton engage in any Significant actIVIty not prewously reported to the If "Yes,? prowde a detailed description of each actiVIty in Schedule Were any Significant changes made to the organizing or governing documents? If "Yes,? attach a conformed copy of the amended documents if they re?ect a change to the organization's name OtherWIse, explain the change on Scheduie 0 (see instructionsDid the organization have unrelated busmess gross income of $1,000 or more during the year from busmess aCthEtles (such as those reported on lines 2, 6a, and 7a, among others"Yes," to line 35a, has the organization filed a Form 990-T for the year? If prowde an explanation in Scheduie 0 Was the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization subject to section 6033(e) notice, reporting, and proxy tax reqwrements during the year? If "Yes," complete Scheduie C, Part 111 Did the organization undergo a liqwdation, dissolution, termination, or Significant disposition of net assets during the year? If?Yes," complete applicable parts of Schedule . . . . . . . . . . . . . . . Enter amount of political expenditures, direct or indirect, as described in the instructions 37a Did the organization fife Form for this yearDid the organization borrow from, or make any toans to, any officer, director, trustee, or key employee or were any such loans made in a prior year and still outstanding at the end of the tax year covered by this return? . . If ?Yes," complete Scheduie L, Part II and enter the total amount invoived . 38b 37b No 38a No Section 501(c)(7) organizations Enter Initiation fees and capital contributions included on fine 39a Gross receipts, included on line 9, for public use of club faCiIities . . . . . 39b Section 501(c)(3) organizations Enter amount of tax imposed on the organization during the year under section 4911 section 4912 section 4955 5 Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ7 If?Yes," complete Schedu?e L, Part I Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations Enter amount of tax imposed on organization managers or disquaEiFied persons during the year under sections4912, 4955, and 4958 5 40b Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations Enter amount of tax on line 40c reimbursed by the organization All organizations At any time during the tax year, was the organization a party to a prohibited tax shelter transaction? If "Yes,? complete Form 8886List the states which a copy of this return is filed 5 KY The organization?s books are in care of RANDY SKAGGS 40e No Telephone no (606) 738-4276 Located at 1167 BRUSHY ROAD WEBBVILLE, KY ZIP 4 41180 At any time during the calendar year, did the organization have an interest in or a signature or other authority over a Yes No finanCIal account in a foreign country (such as a bank account, securmes account, or other finanCIal account)? 42b If ?Yes," enter the name of the foreign country See the instructions for exceptions and filing reqmrements for Form 114, Report of Foreign Bank and Financial Accounts (FBAR) At any time during the calendar year, did the organization maintain an office outSIde the 7 42c No If ?Yes," enter the name of the foreign country 43 Section 4947(a)(1) nonexempt charitable trusts fillhg Form 990-EZ in lieu of Form 1041 Check here . . . . . El and enter the amount of tax-exempt interest received or accrued during the tax year . . . . 43 I Yes No 44a Did the organization maintain any donor adVIsed funds during the year? If "Yes," Form 990 must be completed instead of Form ggo'Did the organization operate one or more hospital faCilities during the year? If "Yes," Form 990 must be compteted No Did the organization receive any payments for indoor tanning serwces during the year44c: No If "Yes," to line 44c, has the organization filed a Form 720 to report these payments? If prowde an 44d 45a Did the organization have a controlled entity Within the meaning of section 512(b)(1345b Did the organization receive any payment from or engage in any transaction With a controlled Within the meaning of section 512(b)(13)? If ?Yes," Form 990 and Schedule may need to be completed instead of Form (See Form 990-EZ (2016) Form 990-EZ (2016) Page 4 Yes No a 46 Did the organization engage, direc?y or indirectiy, In political campaign actiwties on behalf of or in oppoSItion to candidates for public office? If ?Yes," complete Schedule C, Part Section 501(c)(3) organizations only Ali section 501(c)(3) organizations must answer questions 47?49b and 52, and complete the tables for lines 50 and 51. Check if the organization used Schedule 0 to respond to any question in this Part Did the organization engage in lobbying actiwties or have a section 501(h) election in effect during the tax year? If "Yes," complete Scheduie C, Part the organization a school as described in section If "Yes," complete Schedule . . 48 No 49:: Did the organization make any transfers to an exempt non-charitable related organization"Yes,? was the related organization a section 527 organizationComplete 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 Name and titie of each employee Average Reportable Health benefits, Estimated amount hours per week compensation contributions to employee of other compensation devoted to posmon (Forms benefit plans, and MISC) deferred compensation NONE Total number of other employees paid over $100,000 . . . . . . . . . . . . . 51 Complete this table for the organazation's fiVe highest compensated independent contractors who each received more than $100,000 of compensation from the organization If there is none, enter "None Name and busmess address of each independent contractor Type of servace Compensation Total number of other independent contractors each receivmg over 52 Did the organization complete Schedule NOTE. All Section 501( Under penalties of perjury, I declare that I have examined this return, inclu knowledge and belief, it IS true, correct, and complete Declaration of prepa has any icnowledge it it Signature of of?cer Sign Here SKAGGS PRESIDENT Type or print name and title Print/Type preparer's name Preparer?s Signature ADRIANNE AUVIL Paid Preparer Firm's name i ADRIANNE AUVIL CPA Use Only Firm's address 1544 WINCHESTER AVENUE Ashland, KY 411017934 May the IRS discuss this return With the preparer shown above? See instru Schedule (Form 990 or 990-EZ) 2016 Part II-B Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)). Page 3 For each "Yes" response on lines 1a through 1: below, prowde in Part Iii/a detailed description of the lobbying actiwty Yes Amount 1 During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of Volunteers? Paid staff or management (include compensation in expenses reported on lines to through 1i)? Media advertisements? Mailings to members, legislators, or the public? Publications, or published or broadcast statements? Grants to other organizations for lobbying purposes? Direct contact With legislators, their staffs, government offiCIals, or a legislative body? Rallies, demonstrations, seminars, conventions, speeches, lectures, or any samilar means? Other actiwties? Total Add lines 1c through in Did the actiwties in line 1 cause the organization to be not described in sectiOn 501(c)(3)? If "Yes," enter the amount of any tax incurred under section 4912 If "Yes," enter the amount of any tax incurred by organization managers under section 4912 If the filing organization incurred a section 4912 tax, did it file Form 4720 for this yearComplete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c) (6). 1 2 3 Were substantially all (90% or more) dues received nondeductible by members? Did the organization make only in?house lobbying expenditures of $2,000 or less? Did the organization agree to carry over lobbying and political expenditures from the prior year? Yes No 1 2 3 art Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either BOTH Part lines 1 and 2, are answered "No" OR (D) Part line 3, is answered ?Yes." 5 Dues, assessments and Similar amounts from members Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid). Current year Carryover from last year Total Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? Taxable amount of lobbying and political expenditures (see Instructions) 1 2a 2b 2c: Part IV Supplemental Information Prowde the descriptions reqmred for Part l-A, line 1, Part le, line 4, Part i-C, line 5, Part II-A (affiliated group list), Part II-A, lines 1 and 2 (see instructions), and Part line 1 Also, complete this part for any additional information Return Reference Explanation Schedule (Form 990 or 2016 le?le GRAPHIC print - DO NOT PROCESS As Filed Data - DLN: 93492220001347l SCHEDULE 0 Supplemental Information to Form 990 or OMB 1545'0047 (Form 990 or 990.. Complete to provide information for responses to specific questions on 20 1 6 El) Form 990 or 990-EZ or to provide any additional information. Attach to Form 990 or 990-EZ. Information about Schedule 0 (Form 990 or 990-EZ) and its instructions is at :Open ?30 1 Inspection Name of the organTiatton Employer identification number THE TRIXIE FOUNDATION INC Department of the Treasun 61-1268775 990 Schedule 0, Supplemental Information Return Explanatlon Reference Description Description AmountANlMAL FOOD AND SUPPLIES AND MEDICAL SUPPLIES of other . LAUNDRY, ETC FEES AND FEES 920VEHICLE MAINT expenses ENANCE 1,458 Part I line 16